Can infrastructure enable healthcare interoperability?

Last April at HIMSS in Chicago, Intel participated in the IHE showcase , which is essentially a huge "plug fest" for healthcare vendors promoting interoperability in healthcare. Integrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. The IHE process delivers a set of interoperability "profiles", which are comprised of established standards to address specific clinical use cases.

Intel is one of many vendors who deliver products to the healthcare marketplace which provide IHE profile support to address concrete, critical interoperability issues in healthcare. Intel SOA Expressway for Healthcare is software middleware that enables support for IHE profiles at the infrastructure layer, which provides implementers greater flexibility and control in building solutions for information sharing. The two example below can help to clarify what is meant by "infrastructure layer" interoperability.

1) An EHR application can understand HL7v2.5, but is not able to query and retrieve clinical documents from a community HIE that has adopted the IHE profile XDS (Cross Enterprise Document Sharing). Expressway can enable this use case without requiring any changes to the EHR application.

2 ) A hospital wishes to publish and share encounter summaries with a network of affiliated physicians. Expressway can facilitate this by simply redirecting the HL7v2.x message feed from the hospital interface engine. In addition to IHE profile support, Intel has spent several years developing pre-defined maps from all major version of HL7 2.x to HL7v3 based data formats. This reduces the time and cost spent integrating systems.

In both of these examples, there is a need to leverage existing investments in legacy whilst recognizing that more flexible, scalable architectures and standards are required going forward. Expressway fulfills an integration function as part of an infrastructure layer, which permits healthcare providers to approach interoperability in a manner and at a pace that is more consistent with their own strategy, rather than a vendor roadmap or one department's legacy applications.

Moreover, an integration approach to healthcare interoperability is a key enabler towards "intrinsic interoperability", which is the ultimate goal of standards. Renowned SOA expert and author Thomas Erl wrote that "software programs that are not interoperable need to be integrated. Therefore, integration can be seen as a process that enables interoperability. " In Healthcare, organizations such as IHE as well as standards bodies like HL7 and OMG (through HSSP) are making great progress towards realizing this vision. If they are successful, then the need for integration should begin to gradually go away.

For next years Showcase, there is already discussion within IHE about plans for a new showcase category for interoperability "infrastructure" based on middleware solutions like Intel SOA Expressway for Healthcare.

If you are looking for more information on Expressway's support for IHE profiles, I would encourage you to visit Joe Welsh's new blog at: /en-us/blogs/author/joe-welsh/

Intel® SOA Expressway for Healthcare is a specific implementation of a new product category called a SOA "soft appliance", which delivers a breakthrough in simplicity, cost and scalability for enabling high-quality health information exchange.

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