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IHE — Integrating the Healthcare Enterprise

Overview

IHE is an international initiative that produces implementation specifications called integration profiles, which define precisely how health IT standards such as HL7 FHIR, DICOM, and SNOMED CT should be applied together to solve specific clinical interoperability problems. Founded in 1998 as a collaboration between HIMSS and the Radiological Society of North America (RSNA) and now governed as an independent international organisation, IHE has expanded from radiology into laboratory, pathology, pharmacy, patient identity, document sharing, and IT infrastructure, with national deployment initiatives active across Europe, North America, Asia, and Australia. Where standards bodies define the vocabulary and syntax, IHE defines the choreography: which transactions occur in which order, which actors send and receive them, and which options are required versus voluntary.

Integration Profiles

IHE profiles are grouped into domain-specific technical frameworks. Key frameworks relevant to this graph include:

  • IHE ITI (IT Infrastructure) covers foundational profiles for patient identity management (PIX/PDQ), cross-enterprise document sharing (XDS, XDR, XDM), audit logging (ATNA), and the FHIR-based Mobile access to Health Documents (MHD) profile used in EHDS implementation contexts.
  • IHE RAD (Radiology) covers DICOM workflow, scheduled imaging, results distribution, and structured reporting.
  • IHE LAB (Laboratory) covers laboratory order and result exchange relevant to LOINC-coded result reporting.
  • IHE PCC (Patient Care Coordination) covers clinical document profiles including the International Patient Summary (IPS), which is mandated under EHDS.
  • IHE QRPH (Quality, Research and Public Health) covers profiles supporting clinical research, registries, and public health reporting relevant to CDISC and OMOP CDM integration contexts.

Relationship to HL7 FHIR and DICOM

IHE does not compete with HL7 FHIR or DICOM but sits on top of them, specifying how implementations must use these standards to achieve confirmed interoperability.

IHE Europe and IHE France

IHE Europe coordinates national deployment activities across the continent. IHE France operates under ANS oversight and is the primary vehicle through which HL7 FHIR French profiles and SNOMED CT national release adaptations are aligned with IHE integration profiles in the French health IT ecosystem.

Relevance to EHDS

The EHDS regulation (EU 2025/327) mandates HL7 FHIR for EHR exchange but does not specify which IHE profiles to use. The European Commission’s eHealth Network and ANS are actively working with IHE Europe to identify the required profile set, making IHE the de facto implementation specification layer for EHDS technical compliance.

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