IHE IT Infrastructure

The IHE IT Infrastructure (ITI) domain addresses the implementation of standards-based interoperability solutions to improve information sharing, workflow and patient care.

This domain, begun in 2003, was originally launched by sponsor Health Information Management Systems Society (HIMSS). In 2008, GIP-DMP (Groupement d'Intérêt Public pour le Dossier Médical Personnel) joined HIMSS to help sponsor this domain adding additional user representation in Europe.

Together they are responsible for development and publication of the IHE IT Infrastructure Technical Framework.

IHE IT Infrastructure Profiles

The ITI Technical Framework specifies the following ITI Profiles. Where available, the titles below link to expanded brief descriptions of the profile. Implementers should refer to the Technical Frameworks page for details.

• Consistent Time [CT] ensures system clocks and time stamps of computers in a network are well synchronized (median error less than 1 second).
• Audit Trail and Node Authentication [ATNA] authenticates systems using certificates and sends PHI-related audit events to a repository to help implement confidentiality policies.
• Retrieve Information for Display [RID] provides simple (browser-based) read-only access to clinical information (e.g. allergies or lab results) located outside the user’s current application.
• Enterprise User Authentication [EUA] enables single sign-on by facilitating one name per user for participating devices and software.
• Patient Identifier Cross Referencing [PIX] cross-references patient identifiers between hospitals, sites, health information exchange networks, etc.
• Patient Synchronized Application [PSA] allows selection of a patient in one application to cause other applications on a workstation to tune to that same patient.
• Patient Demographics Query [PDQ] lets applications query a central patient information server and retrieve a patient’s demographic and visit information.
• Patient Administration Management [PAM] establishes the continuity and integrity of patient data in and across acute care settings, as well as among ambulatory caregivers.
• Cross Enterprise Document Sharing [XDS] registers and shares electronic health record documents between healthcare enterprises, ranging from physician offices to clinics to acute care in-patient facilities and personal health records.
• Personnel White Pages [PWP] provides basic directory information on human workforce members to other workforce members and applications.
• Cross-Enterprise Document Media Interchange [XDM] transfers XDS documents and metadata using CDs, USB memory, or email attachments.
• Cross-Enterprise Document Reliable Interchange [XDR] exchanges health documents between health enterprises using a reliable point-to-point network communication.
• Cross-Enterprise Sharing of Scanned Documents [XDS-SD] defines how to couple legacy paper, film, electronic and scanner outputted formats, represented within a structured HL7 CDA R2 header, with a PDF or plaintext formatted document containing clinical information.
• Patient Identifier Cross-Reference and Patient Demographics Query for HL7v3 [PIX/PDQ/v3] extends the Patient Identifier Cross-Reference and Patient Demographics Query profiles leveraging HL7 version 3.
• Registry Stored Query Transaction for Cross-Enterprise Document Sharing Profile adds a single transaction, Stored Query, to the XDS Profile. Stored Query is a large improvement over the existing Query Registry transaction since it removes the use of SQL.
• Retrieve Form for Data Capture [RFD] enables EHR applications to directly request forms from clinical trial sponsors and public health reporting.
• Cross-Comunity Access [XCA] allows to query and retrieve patient relevant health data held by other communities. Such communities may be XDS Affinity Domains which define document sharing using the XDS profile or any other communities, no matter what their internal sharing structure.

Supplemental Documentation
Supplemental documentation for ITI profiles can be found here in the IT Infrastructure Implementation Guide maintained by the IT Infrastructure Technical Committee. This includes examples, schemas, and other supporting information. Note that these documents may be revised and updated more frequently than the profiles themselves.

Educational Materials

The IT Infrastructure (ITI) Planning Committee has published a series of slide presentations for use by all parties interested in interoperability, electronic health records and health information exchange. The goal of the material is to connect the dots between the problem and the solution defined by ITI profiles. It is geared to an audience which is familiar with healthcare interoperability problems in general but is not familiar with the way IHE addresses problems or the specific profiles provided by ITI.

Click here for to see the full list of presentations and for links to the MS PowerPoint^© slide sets.

Committees

The ITI Planning and Technical committees develop and maintain the ITI Technical Framework.

Detailed committee responsibilities include:

• Planning Committee
• • Developing and reviewing Integration Profile proposals
  • Determining scope of development priorities
  • Communication and coordination of development activities with other IHE domain
    
• Technical Committee
• • Assessing the feasibility and scope of development priorities
  • Developing detailed documentation of approved Integration Profile proposals
  • Developing and maintaining the IHE Technical Framework

These committees are composed of representatives of stakeholder organizations who are users or developers of healthcare IT systems and related infrastructure. The committees are international in scope. All qualified stakeholders are invited to join.

Participation is open and voluntary, but in order to remain a voting committee member, participants must take part regularly in committee meetings and teleconferences and perform committee assignments. All IHE committee participants serve as representatives of IHE Member Organizations. Information on becoming an IHE Member Organization is available on the IHE Governance page. You can contact the secretary of the IHE ITI committees via email at ihe@himss.org.

The ITI committees maintain their working documents on dedicated pages on the IHE Wiki. There you can find committee rosters, schedules of committee activities and works in progress.

Email communication among participants in the committees takes place through Google Groups maintained for this purpose. You can request an invitation to join the committee lists below.