IHE Pharmacy

A domain in
development

Jacqueline Surugue
Co-Chair, IHE Pharmacy Planning Committee
Representing users
-----------------------------------------------------------------
Simon Letellier
Secretary, IHE Pharmacy Planning Committee
Representing users
What do users need?

Our needs in our daily professional real life:

Health information systems able to

exchange informations and to use the
informations they have exchanged
Our needs
in the community

Healthcare information systems

allowing seamless care
for the patient
Our needs
at hospital

Healthcare information systems

allowing seamless care for the patient
on national and international level
 Interoperability
Definition:

« The ability of 2 systems (or more) to exchange information

and use the information they have exchanged. »
[From IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]

“The ability of information systems to work together within and across

organizational boundaries in order to advance the effective delivery of
healthcare for individuals and communities”
(From HIMSS Integration and Interoperability Steering Committee, 2005)
IHE
IHE: Integrating the Healthcare Enterprise

Mission:
Removing the interoperability barriers
in the domain of Health

From a user’s point of view, IHE = the solution

European initiatives for e-Health
What about IHE Pharmacy?

The history of IHE Pharmacy is linked to the history of IHE Europe:

• 9th Feb 2007, Berlin (D): Preliminary IHE Europe Committee invites the President of the European
Association of Hospital Pharmacists, (J. Surugue, F), to deliver on the domain “pharmacy”

•1st April 2008, Brussels (B): IHE Europe aisbl is created

Karima Bourquard and Peter Kuenecke

First Co Chair “Users” and Co Chair “Vendors”
of IHE Europe aisbl

• 10th January 2008, Brussels (B): IHE Europe Pharmacy first meeting
In 2009, Pharmacy was recognized as a IHE Domain
11 Years of Steady Evolution 1998 – 2009
Radiology
since 1998
Pharmacy
NEW 2009
Cardiology
Pathology
since 2004
since 2006

Eye Care Laboratory

since 2004
since 2006

(Healthcare)
IT Infrastructure
since 2003
Quality
Research & Public Health Radiation Oncology
since 2004
since 2006

Patient Care Devices Patient Care Coordination

since 2005 since 2004

The IHE Development Domains

9
 IHE Pharmacy
The IHE global approach:

A close co-operation between users and vendors

•Users identify the integration problems
•Vendors provide technical solutions

Users: Vendors
Pharmacists from the Community, Healthcare IT companies
from healthcare structures, in hospitals and community
Orders and pharmacy associations Providers of IT solutions
Public healthcare authorities and IT specialists
 IHE Pharmacy
An international representation with different countries
and connections on global level

Regular meetings in Brussels (B), Paris (F), or during

Connectathon (first time this year, in Bordeaux (F)

A meeting hosted by COCIR, France, Italy, Netherlands and Greece

represented by the EAHP Web Group
Diamant Building, Brussels members for Hospital Pharmacy

from left to right:

Jacqueline Surugue, Simon Letellier (F), Nino
Cozzolino (I), Rob Moss (ND), Leonidas Tzimis (Gr)

Support of sponsors:
Nictiz, Phast, Gmsih, EAHP, IHE Europe
 IHE Pharmacy
This is a hospital use case
Adam Everyman was admitted to Good Health Hospital.
Dr. Hippocrates, after having reviewed current treatment, prescribes Doliprane 1000 mg
tablets, 1 orally three times a day for the duration of the inpatient admission.

Susie Supply, a hospital pharmacist, reviews the medication order, the current treatment,
and local pharmacotherapy guidelines as well as the appropriateness of the medicine,
form, strength, route and dose. She authorizes the dispensing of this medication. The order
is then scheduled for administration.

Florence Nightingale, a nurse, does the drug administration round next morning and
checks the physician's order, electronic signature and the patient's identity. She opens the
appropriate container, visually checks the medication, scans its barcode and administers it
to Adam Everyman.
IHE Pharmacy
This is a sequence diagramme
 Standards Adoption Process
Testing at
Connectathons IHE
Develop technical Demonstrations
specifications

Identify available
Products
standards (e.g. HL7, with IHE
DICOM, IETF, OASIS)

Timely access to
Document Use Case information Easy to integrate
Requirements 14
products
 2006
K. Bourquard
Key past documentation
IHE Medication Management HITSP Medication Management
White Paper - 2003 Interoperability Specification - 2007
What has been done?

An IHE White Paper

•Final version (integration of

comments collected after having been put
for public comments last year)

•70 pages

•Community Pharmacy use cases

•Hospital Pharmacy use cases
•Harmonization of actors
definitions

ftp://ftp.ihe.net/Pharmacy/White%20Paper/IHE_Eur_Pharmacy_White_Paper_Final_Text_1.2.pdf
Use cases

• HMW

• CMPD
 TF documentation

• Organization of the TF
(Technical Framework)
documentation

After a doodle on the meeting paperboard

[ J. Brandstätter (Codewerk – IHE Austria)]
TF documentation
Elaboration of the Technical Framework documents:
Put for public comment 2010 - 2011

TF Supplement
Common parts
from the White Paper
TF Supplement TF Supplement
for hospital Pharmacy for community Pharmacy
[HMW profile] [CMPD profile]
Common actors
Prescription Placer Pharmaceutical Adviser
• Receives prescriptions and
• Creates Prescription Orders checks them to
– Informs the other actors that a
prescription is available / • Requests and Receives
updated Current Treatment from
– Receives updates about the other repositories (inside
actions for the prescription
or outside hospital (Not yet covered))
Medication Dispenser
• Receives prescription orders and advice, to dispense Medication for a
patient
• Also does all the actions and management required to deliver the
medication to the patient’s stock – including stock redistribution if needed
(Not yet detailed).
Dedicated actors

Community Pharmacy Manager (CMPD)

• Receives and send Prescriptions, Dispense documents and
Pharmaceutical Advice
• Manage ID/document links between
placers/dispensers/advisers and repositories/registries.

Med. Administration Informer (HMW)

• Receives Prescriptions, Dispense messages and
Pharmaceutical Advice to administer the medication at the
defined time.
• Sends the report of administration to the other actors.
Hospital Pharmacy : HMW

Hospital medication
workflow showing
actors and
transactions
between them

From the white paper

 HMW :
HL7v2 transaction flow diagram

Hospital medication
workflow will use
HL7v2.5 completed
with v2.6 message
definitions
 HMW :
Hospital Medication Workflow
P
R
E
S
C
R
I
P
T
I
O Supply chain
N
CMPD: Community Pharmacy
Pharmacy/Medication management
HL7v3 Dispense event with full prescription
Resources
• Wiki site :
– http://wiki.ihe.net/index.php?title=Pharmacy

• Ftp site :
– ftp://ftp.ihe.net/Pharmacy
(username :iheyr2; password : interop)

• Google groups (mailing list):

– groups.google.com/group/ihe-pharmacy
Milestones
Sept. 2010 – Internal review of
Technical Framework

Oct. 2010 - Public Review and

Release for Trial Implementation

Pisa, Italy, 11-15 April 2011

Connectathon, a « connectivity marathon »
•Massive yearly event :
•80 vendors
•250-300 engineers
•100-120 systems
•….integrated in 5 days

Results will be published on www.ihe-europe.org

Milestones
Achieving Interoperability of health systems on the global level requires a
considerable lot of work.
Get involved!
If you are a vendor,
come at Connectathons and test your systems!

Next Connectathon: Leopolda Storica in Pisa, Italy, 11 -15 April 2011

For patients’ transnational seamless care

between hospital and ambulatory all over the world.

Results will be published on www.ihe-europe.org