Use of Integrating the Healthcare Enterprise (IHE) standards and profiles generates the necessary technical framework to exchange health care data, while maintaining the syntactic and semantic components needed to accommodate a diverse range of health information consumers, according to a new policy statement by the American College of Cardiology.

Systems developed in accordance with IHE better communicate, are easier to implement, and enable health care providers to use information more effectively, wrote lead author John R. Windle , MD, of the University of Nebraska, Omaha. The policy statement was joined by the American Society of Echocardiography, the American Society of Nuclear Cardiology, the Heart Rhythm Society, and the Society for Cardiovascular Angiography and Interventions, among other medical societies (J Am Coll Cardiol. 2016 Aug 15 doi: 10.1016/j.jacc.2016.04.017 ).

“The ACC believes that meaningful interoperability of data, agnostic of proprietary vendor formatting, is crucial for optimal patient care as well as the many associated activities necessary to support a robust and transparent health care delivery system,” the ACC policy states. “IHE serves a unique role and fills a critical gap in pursuit of this goal.”

IHE is a nonprofit international organization established in 1998 that develops standards-based frameworks for sharing information within care sites and across networks. The organization leverages existing data standards to facilitate communication of information among health care information systems and joins users of health care information technology (HIT) in a recurring four-step process, according to the IHE website. The process includes defining critical-use cases for information sharing, creating detailed specifications for communication among systems to address the critical-use cases, implementing these specifications throughout the industry, and selecting and optimizing established standards. Industry experts then implement these specifications, called “IHE profiles,” into “HIT systems,” and IHE tests the systems at planned and supervised events called “connectathons.”

IHE is divided into 12 clinical domains, each of which includes integration profiles. The profiles identify actors, transactions, and information content necessary to address use cases within certain practice areas. The work is compiled into IHE technical frameworks – detailed documents that serve as implementation guides. All documents and artifacts are freely available on the IHE website . Within the cardiology domain, 14 profiles have completed the development cycle and have been tested and validated at a connectathon testing event.

Through its policy statement, the ACC is promoting adoption of IHE by several means, including:

• Engaging support from health care system executives by encouraging specification of support for IHE integration profiles in all requests for proposals.

• Encouraging end users to request support for IHE integration profiles.

• Lobbying the Department of Health and Human Services Office of the National Coordinator for Health Information Technology to support the IHE technical frameworks in the EHR Incentive Program and beyond.

• Collaborating with other organizations such as the American Heart Association and the Joint Commission.

The ACC policy notes that health providers should not underestimate the complexity of true interoperability, but stresses that IHE is key to a stronger platform for data exchange.

“Developing meaningful interoperability across the diverse and complex field of health care will require leadership from medical societies as well as federal and state organizations in the form of policies and financial incentives that will steer industry to develop and implement the infrastructure and systems that consumers require,” Dr. Windle and his colleagues wrote. “Although we cannot overemphasize the enormity of this process, IHE will allow the rapid dissemination of best practices through efforts in standardization.”

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