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| 400 engineers from all over the world testing their Healthcare Applications |
This is the 19th year for IHE North American
Connectathon, which has been held in Cleveland, Ohio
for the past several years.
This event brings together 60 plus health care imaging and IT vendors for a
week who work collaboratively connecting their systems. There were 115 systems this
year, each one prepared to test interconnectivity. The goal is to reduce
on-site testing and integration and ultimately advance health IT and patient
care.
There were 400 engineers in attendance for the event and in
addition, there were 65 so-called monitors who check the connectivity results.
The general connectathon rule is that a vendor has to show that it can
communicate with at least 3 other systems from different vendors to claim that
they passed a specific test. The systems under test on the IHE NA Connectathon
floor represent most of the top health IT vendors who provide systems such as
EMR’s, patient care devices, imaging
modalities, image archiving systems
(PACS), and review stations. Except for any small devices such as monitoring
systems and infusion pumps which are easy to carry, the engineers take
simulators with them running the same software that would create MR, CT, nuclear
medicine or mammography images and simulate the big archiving and communication
systems that host the images and results.
This big event poses the question; how relevant is the
support of these profiles, which are based on standards such as DICOM, HL7 and
others, and what does it mean to support these? As an example, last year the
emphasis at the connectathon was on testing XDS (Cross Enterprise Document and
Imaging Sharing) profiles that have been very slow to be deployed this past
year. Yes, most systems now support these profiles allowing information to be
shared, identified, and managed between different enterprises, however with the
exception of implementations in the UK, there have been relatively few
implementations in other countries including the USA.
In the US this might be caused by the demise of several
public Health Information Exchanges (HIE) due to a lack of funding and failing
business models to support these, which basically took away the infrastructure
to exchange the information using these profiles. Another barrier is the
widespread implementation of proprietary interfaces to exchange these images
with many cloud providers.
A major trend at the 2017 connectathon has been the
emergence of patient care devices and web services, i.e. FHIR and DICOMWeb. The
adoption of these standards might be much faster than the ones dealing with
image and information sharing as there is a major benefit to be achieved in
patient safety and efficiency using intelligent devices. As an example, anyone
who recently has been hospitalized and watched what a nurse does every time he
or she changes the supply for an infusion pump can attest; all those changes
are always entered into the patient record manually. An intelligent infusion
pump using IHE will be able to update the patient record automatically, producing
major savings in efficiency and a potential reduction of errors, resulting in
better patient safety.
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| 60 or so monitors who evaluate the test results for pass/fail |
Another promising area is the upload of images from mobile
devices into a PACS or electronic record. DICOM has added web services capability
to its standard, allowing a phone app taking a picture, for example for wound
care or from a dermatologist, in order to upload these images securely using
the widely available web services interfaces. This could become a “killer-app”
which will drive widespread implementation.
Overall, the connectathon was well attended, albeit with
lower attendance than last year (I estimate 10 percent to 20 percent lower). It
will be interesting to see next year if this is going to be a trend. This event
is a major investment in time and effort. Preparation for it, including the
creation of tools for simulators and test sets and performing pre-tests are on
an order of magnitude bigger than the actual testing week. It appears that
several companies are skipping one year and attend every other year instead of
attending every year.
For the smaller vendors especially, it is still a major
opportunity to test their applications against many of the big players. It also
provides a good insight into how robust some of the implementations are as
several of them had some major issues when trying to connect. So, overall a
successful event, from my perspective it is worth attending again next year.
