OXFORD, UK — The accent was on electronic health records (EHR) at Europe's annual Connectathon for health information systems, held in mid-April at St. Catherine's College.
For the first time in the eight-year history of the event, the number of tests for interoperability between vendor products and hospital IT infrastructure challenged the traditional dominance of testing for new radiology and picture archiving and communications systems.
This shift in emphasis among the 83 vendors participating in the event is explained by the growing importance of EHRs programs emerging across Europe, according to Eric Poiseau, technical manager for Integrating the Healthcare Enterprise in Europe (IHE-Europe; Brussels), organizer of the Connectathon.
The North America IHE Connectathon took place at the end of January in Chicago, where 70 vendors tested software onboard new medical device systems.
This year's European event also saw the first tests ever conducted for reliability of data from point-of-care (POC) devices using specifications developed through the open development methods of IHE.
The newly developed POC requirements are part of the larger IHE Laboratory domain pioneered by IHE teams in Europe and Japan and responds to what one Connectathon executive said is "a tremendous frustration building among people who are screaming for lab reports, people who want them right now on their office computer."
Laboratory Point of Care Testing (LPOCT) specifications developed by IHE-Europe cover the workflow related to clinical laboratory tests performed during patient medical visits or at bedside by ward staff and move the lab results locked inside proprietary systems to a specific patient's records.
A new and unexpected participant at the Connectathon in Oxford this year was Roche Diagnostics (Basel, Switzerland), whose engineers were there for the LPOCT validation.
Initially driven by the market demand for compatibility among radiology units, IHE has grown by developing technical frameworks, testing tools and integration profiles defining eight distinct areas, or domains, within healthcare including cardiology, patient care coordination and laboratory, for example, as well as the dominant radiology and the growing domain of infrastructure.
Supported by both manufacturers of health systems and IT users, such as regional hospitals, professional medical societies and governmental agencies, IHE uses a collaborative method for integrating different standards for data including Digital Imaging and Communications in Medicine (DICOM), Health Language Seven (HL7).
Compliance with IHE specifications is voluntary, and though validation results for specific company products are posted to the IHE website after each Connectathon, there is no official certification of supplier's products.
Yet the broad-based development of IHE specifications has won the formal endorsement of specifications in certain domains by France, Italy, the Netherlands and Finland. In Austria, a national IHE organization was created this year by the health ministry.
Many vendors in Europe selling medical devices within these national systems will increasingly require a proof of compliance with IHE workflows for their hospital departments to satisfy workflows set forth in requests for proposals (Medical Device Daily; May 2, 2007).
On a larger scale, IHE-Europe will be a partner for the Large-Scale European Pilot for e-health that is to receive funding from the European Union later this year and when developed will see the exchange of shared patient identification, emergency medical summaries and medication histories between eight to 12 nations (MDD; May 3, 2007).
A GE Healthcare (Waukesha, Wisconsin) executive told MDD that the handwriting is on the wall for European medical device manufacturers and indicated the proof can be seen with early adopters at Connectathon testing data exchanges using the upgraded profile for Cross-Enterprise Document Sharing (XDS) that takes advantage of new web service technologies.
Vendors participating in the event ranged from giants like Agfa (Mortsel, Belgium), GE Healthcare and Siemens (Erlangen, Germany) to single-product suppliers of healthcare systems whose sales are exclusive to a single national program.
More informally called a "plug-fest," each supplier at a Connectathon is required to hook up with three competing systems to either push or pull data to demonstrate compatibility. More than 1,850 such tests were conducted over the five days in Oxford.
The cavernous temporary building constructed by St. Catherine's College to house the event looked more like a setting for an Internet gaming tournament than the avant-garde of European healthcare IT.
Only one medical device was physically present, and there were several screens for radiology imaging.
Instead, the testing is virtual with hundreds of laptops loaded with device software hard-wired to the internet pulling data from remote servers that either simulated hospital IT systems or were actual hospital IT systems participating in the event.
Traffic on the IHE-Europe website that hosts testing software and is used for "speed-dating" among the participating vendors to signal interest and availability for compatibility testing jumped four times its usual weekly volume, according to Poiseau, whose day job is with the Institut National de Recherche en Informatique et Automatique (Rennes, France).
Poiseau said Connectathon presents a unique opportunity for medical device manufacturers to identify and solve problems on the fly during the event.
"The cost of fixing a bug during a Connectathon is about 10 times less than the cost of a bug identified on a customer's site," he said.