Integrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industry to improve electronic communication among medical systems. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively. Physicians, medical specialists, nurses, administrators and other care providers envision a day when vital information can be passed seamlessly from system to system within and across departments and made readily available at the point of care. IHE is designed to make their vision a reality by improving the state of systems integration and removing barriers to optimal patient care.

The IHE was conceived by the Healthcare Information and Management Systems Society (HIMSS) and the Radiological Society of North America (RSNA). The IHE brings together a wide range of stakeholders to develop the framework and process for industry to achieve new levels of systems integration. IHE enables vendors to cooperate in implementing standards for communication among information systems – computers, medical devices and other systems - while giving users - clinicians, information technology professionals and engineers - an important advisory role.

The Patient Care Device Domain (PCD) supports the integration of patient data from medical devices to clinical and enterprise systems. In September, 2005, the ACCE was awarded sponsorship of the Patient Care Device (PCD) domain under IHE. In 2006, HIMSS joined with ACCE as a co-sponsor of the PCD.

Medical devices can provide large amounts of data to the medical record, but existing processes for entering that information are time consuming, frustrating and error prone. The PCD domain, through its committees of users and vendors, is addressing these problems and designing a Technical Framework for future medical device interoperability.

Recent Developments
Committee members representing vendors, clinicians, and engineers have developed a Technical Framework documenting the requirements for interoperable communication of a wide variety of physiologic measurements. Participating companies tested their equipment's interoperability with each other in "Connectathons" in 2007, 2008, and February 2009. Collaborating users and developers tested systems from twelve manufacturers in 2009. On display at HIMSS2009 are examples of these efforts:

• Communication of patient physiologic data from patient-connected devices to clinical information systems and to a medical record system (DEC)
• Ability to process patient identity from an HL7 ADT system and associate it with device data flows (PIB)
• Ability to filter the large volumes of data from patient care devices and define a reduced flow to medical record and other systems (SPD)
• Sending infusion parameters electronically to infusion pumps and sending infusion parameters back to the medication administration system (PIV)
• Communication of alarms from alarm source systems to alarm management systems and from alarm management systems to alarm communication systems (e.g. phones, central displays, etc) (ACM)
• Harmonization of nomenclature, units of measure, and enumerated values to facilitate safe and interoperable communication between devices and systems (RTM)

Work in Progress
Among the projects for the coming year, culminating in the 2010 Connectathon and 2010 HIMSS Showcase are:

• Device Point-of-Care Integration (discovery and association, symmetric communication, and data reporting)
• Device information in HL7 v.3/CDA
• Interoperable waveform communications
• Ability to query a medical device or system for retrospective data
• Medical device semantic architecture
• Medical equipment management (operational status and monitoring, location services, risk management, patch management)
• Regulatory considerations deploying PCD profiles
• Extension of existing work

Invitation
The PCD invites you to participate in this exciting process. Here's how:

• Look for more information about the IHE at www.ihe.net, and on the latest PCD activities at www.ihe.net/pcd or the PCD Wiki
• Join the effort – users, developers, manufacturers – the speed of development is directly related to the numbers participating. Just email efurst@ieee.org