Transcript Service-Oriented Architecture: RHIO Interoperability Models

HIMSS.ORG; Integration & Interoperability
Web Cast March 2006
Using Service Oriented Architectures to
Support RHIO Development
Alan Boucher
Director, Health Care Architecture
Digital Health Group, Intel Corporation
Today’s Agenda
• Service Oriented Architecture (SOA) Overview
–
–
–
–
–
Service Oriented Architecture Construction
Interoperability (Semantic, Syntactic & Structural )
Anatomy of a Business Processes & Services
Expected Benefits of a Service-Based Architecture
SOA and HL7: “One RHIO Services Network”
• The Role of Services in a National Health Care System
– Using Best Known Methods
• The Role of Services in RHIOs & RHINs
– Service Delivery in a Centralized Model
– Service Delivery in a Peer-to-Peer Model
– RHIO Architecture Development
• Summary & Next Steps for RHIOs & RHINs
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Service Oriented Architecture (SOA)
Construction
• Service-oriented architecture: A design approach to standardize functions
or services, so that numerous dissimilar applications and technologies can
share them—both inside and outside of the providing entity
• Service: A distinct, self-contained, well-defined function or capability that
operates through a contractually defined service interface
• Service Interface: A technology and implementation independent way to
systematically define a service’s:
• Features, i.e. capability and output
• Terms, i.e. requirements and input
• and SLA, i.e. operating performance and quality of service
Key principle:
Contractual separation of concerns between a
service provider (RHIOs) and Service Consumer’s
(Patient, Provider, Payer & Pharma) through an interface
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
SOA’s & Interoperability
• Main Entry: in•ter•op•er•a•bil•i•ty
: ability of a system … to use the parts or equipment of another
system
Source: Merriam-Webster web site
• Interoperability
: ability of two or more systems or components to exchange
information and to use the information that has been exchanged
Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer
Glossaries, IEEE, 1990
Syntactic Interoperability: Conveying agreed upon grammars for semantics & structure.
Semantic interoperability entails a co-ordination of meaning. Semantics is defined as the meanings of
The
challenges
of syntactic interoperability
become:
Structural
interoperability
uses agreed
upon
frameworkstandards.
models, such
as HL7
Reference
Information
terms and expressions
with regard
to content
description
Hence
semantic
interoperability
is
a)
identifying
all the elements
in Architecture
various systems
(in RHIOs);
Model
(RIM),
the
Clinical
Document
(CDA),
the
ASTM
Continuity
of
Care
Record
(CCR)
or
“the ability of information systems to exchange information on the basis of shared, pre-established and
b)
establishing
rules
for
structuring
these
elements;
(between
RHIO
entities)
even
models
based on
Integrating
the Healthcare
Enterprise
Cross
Enterprise
Document
negotiated
meanings
ofthe
terms
and expressions,”
and is
needed in(IHE)
order- to
make
other types
of
c)
mapping,
bridging,
creating
crosswalks
between
equivalent
elements
using
schemas
etc.;
Sharing
(XDS)
Profile,
which
stores
documents
as
ebXML.
interoperability work.
d)
agreeing on equivalent rules to bridge different cataloguing and registry systems
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Anatomy of a Business Process
Trigger
•Time
•Event
Decision / Action
•Steps completed
•Decisions Made
Activity
Output
•Data produced by
Decision / Action
Input
•Data Required
for
Decision/Action
Receive
Request
To Acquire
Data
Determine
Requestor
Credentials
Make
Policy
Decision
Send Request
To RHIO
Rules Engine
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Using Service Oriented Architectures to Support RHIO Development
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Next
Activity
/
Process
Process
Approval &
Return Data
Reject
Requestor &
Return Event
Anatomy of a Service
Trigger
•Time
•Event
The anatomy of a service
maps directly to the anatomy of process.
Process & data needs drive requirements
for service interfaces
Decision / Action
•Steps completed
•Decisions Made
Activity
Input
•Data Required
for
Decision/Action
Output
•Data produced by
Decision / Action
<The Name>
Created by
<operations>
the RHIO
Features (capability + output)
Terms (requirements + input)
Receive
Request
To Acquire
Data
EHR Lookup Service
Op: InitiateEHRlookup()
A Service
Determine
Requestor
Credentials
IA&M Service
Op: AssertionLookup()
Make
Policy
Decision
Policies
&
SLA
Process
Approval &
Return Data
Send Request
To RHIO
Rules Engine
Governance Service
Process EHR Service
Format EHR Service
Op: PolicyLookup()
Op: GetEHRRecord()
Op: FormatEHRCCR()
Reject
Requestor &
Return Event
Process Error Service
.OR.
Op: ReturnError()
Expected Benefits of SOA
Micro
Macro
(per adaptation)
(subsequent adaptations)
With SOA
SOA savings realized
RHIO
Value
$ Return
$ Return
RHIO
Benefit
TTD
Time
Traditional
Development
Development
Productivity
Traditional savings
Time
Program “development
time to release”
improves greatly
based on services
leveraged in design
Expected aggregate effects
are more $$ available for new
RHIO capabilities & improved
business processes for RHIO
participants
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
SOA and HL7: “One RHIO Services
RHIO’s may implement their interoperability models in HL7 V3, yet many participating
Network”
organizations still use HL7 V2, X.12, NCPDP & others.
How will HL7 “play” in an SOA implementation?
•
RHIO SOA framework’s should be built with industry standard (commonly acceptable)
infrastructures, tools & methods (commercial & open source)
•
HL7 should be implemented on an SOA framework as;
– Content: HL7 defines information content and should be a separate element from Messaging
• e.g. RHIO data should be separated from transport, messaging & infrastructure, which will
evolve over time. SOA messaging architecture’s typically support varying messaging &
transports, including web services.
– Support multiple standards related to RHIO records (HL7, DICOM, X.12, NCPDP etc)
– Develop “common” HL7 service extensibilities:
• Business - Patient Consent, Record Locators, RHIO Entity Identification, Semantic Libraries &
Normalization
• Infrastructure – Authentication & Authorization, Governance & Policy, Security, Auditing
• Data Services - Data Mining, Disease Management, Outcomes-based Medicine, Pharma
Interactions, e-Pharma Gateways
• Financial Services - Scheduling Services, SMB Concierge, Claims Mgmnt, HSA, CMS etc..
• Gov’t extensibility – Epidemic / Pandemic Management, Bio-terrorism, DHS, CDC etc
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Using Service Oriented Architectures to Support RHIO Development
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The Role of Services in a National Health
Care System
Goal 1: Inform Clinical Practice: Incentives
for EHR adoption and create tools that
ensure 100% success in EHR
implementation and use.
Goal 2: Interconnect Clinicians: Identify
interoperability as a major milestone for
achieving improved health care delivery;
encourage regional health care information
exchanges and a National health
information network.
Goal 3: Personalize Care: Foster patientcentric care delivery and more informed
health care consumers.
Goal 4: Improve Population Health:
Encourage the collection, analysis, and
dissemination of timely and accurate
information that impact public health.
© 2005 The Interoperability Consortium
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Using Service Oriented Architectures to Support RHIO Development
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Organizational Information between RHIOs & the NHIN
NHIN Framework and Standards
Certification
Of RHIOs
ONCHIT
PMO
Contract
Contract
NHIC – Board
Private
National Health Information
Corporation (NHIC)
Services
Certified Private
Companies & HISPs
National Health
Technology Standards and
Certification (NHTSC)
P&P
Standards
Certification
Exposed Services (Pub / Sub)
Services Bus
RHIOs
Data Models, Data Exchange
Governance, Policy, Auditing
Orchestration, Transformation &
Business Rules
Services Bus
Exposed Services (Pub / Sub)
Pharma
Payors
(including CMS)
Employers
Providers
Doctors
Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Citizen Service
© 2005 The Interoperability Consortium
Best Known Methods… learning from the NHS UK
NHS Care
Record Service
SPINE (NASP)
delivers national
services
TMS
processes all
messages
Personal
Demographic
Service (PDS)
Electronic
Booking
Services
Services
Personal SPINE
Information
Service (PSIS)
NHIN
Services
Electronic
Transmission of
Prescription
Services
Data Services for
Secondary Uses
Services
RHIOs
Data Models, Data Exchange
Governance, Policy, Auditing
Orchestration, Transformation & Business
Rules
Bi-directional Message Traffic
RHIO Gateway Services Bus
Local Data & Applications
LSPs
deliver a range of local
applications, services &
functionality
Exposed Services (Pub / Sub)
Pharma
Providers
SHAs / Trusts / Units /
Primary Care /
Social Care
Payors
care & services
(including CMS)
for patients
Employers
Major IT Project for 50M+ UK NHS
Patients & Citizens
(the ~Size of California)
•Live, interactive 24x7 patient record service
across care settings and organizations
• Service-Providers deliver support and
software for patient record and infrastructure
services
• Services delivered based on patient
confidentiality and security
• Performance and Security are core to TMS &
SPINE design
• Services allow for horizontally scaleable
infrastructure
• Services decrease deployment time for
individual clusters\
• Services accelerate implementation of
Citizen Services
Gateway require zero-coding for local clusters
• Services improved stability, resilience and
availability
IPAs, Doctors
A Cluster
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Applying Best Known Methods..
Deployable RHIO Service Technologies
Isochronous &
Asynchronous
messaging
Reliable Messaging &
Queue Management
SOAP Encapsulated
XML
HTTP SSL
VPN SSL
VPN PtP
AAA, Data Security
Audit, Monitoring & Management
Data Transform
HL7 Wrapper
Service
Business
Rules,
Algorithms
HL7 v2.x, v.3,
HL7 CDA,
ASTM
CCR,
Container
openEHR etc..
Meta Data Store
AAA, Data Security
Audit, Monitoring & Management
Option: File Exchange Formats
could be <encapsulated> XML
in the cloud
Payor, Provider, Pharma, Physician
Organizations
RHIOs & RHINs
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Queue
Queue
HL7 Content Model
Internet
or
XML, ebXML, other
XML Firewall
XML Firewall
Data Transform
HL7 Wrapper
Service
Business
Rules,
Algorithms
HL7 v2.x,
v.3, HL7
CDA, ASTM
CCR,
Container
openEHR etc..
Meta Data Store
Orchestration
Messaging Bus
Queue
Queue
Orchestration
Messaging Bus
Deployable Business Rules
RHIO Standard Transforms (XSLTs)
Publish & Subscribe Services
Development of Common Services &
Libraries, Directories & Registries
High-Level Service Operations in RHIOs & RHINs
WbS Management, Routing
& Governance Services
RHIO Object IdM Access
RHIO / RHIN
Services
Directories
Assign Data Resources
Based on
HISP or RHIO / RHIN
Object Identity (IdM)
Published
Web & Data Services
Access based
on Object IdM
Federated
Services Model
Data / Web
Service
Requestor
HISP Objects:
Physicians,
Providers, Payor’s
GVT Entities and
Commercial Services
Bind or Latent Bind
Web Service & Data
Components to Object
IdM
Data / Web
Service
Provider
Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
HISP/ RHIO / RHIN
Data Access
Data Provider
Services create New Opportunities for RHIOs
RHIOs must build self-sustaining business
models through Services
Patient Browse
Container
RHIO
Access Portal
RHIOs & RHINs
RHIO Participating Organizations
Orchestration
Messaging Bus
AAA, Data Security
Audit, Monitoring & Management
Service
Container
Data Transform
Business Rules, Algorithms
Meta Data Store
AAA, Data Security
Audit, Monitoring & Management
Loosely-Coupled Services
RHIO UDDI
Services Registry
Service Request
Specialist
Physician
Billing
Specialist
Authorization
Identity
Authentication
Policy & Consent
Mgmt
Audit
Storage
Provider
Directory
Record
Locator
Services
Additional RHIO Services
Search
RHIO
Storage
Patient
Consent
Primary Care
Physician
Workflows
Commercial
Messaging
Content Mgmt Physician Concierge Services
Claims
Processing
Payor
Authorizations
Data
Analytics
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Queue
Queue
XML Firewall
Meta Data Store
XML Firewall
Business Rules, Algorithms
Service
Container
Queue
Queue
Data Transform
Orchestration
Messaging Bus
Peer-to-Peer RHIO SOA Model
RLS Lookup and Access
Peer-to-Peer Data & Transformation
Patient Directory
Consent Services
Payor
Authorizations
RLS
Meta-data
RHIO
Entity
Peer
GW
SOAP
RHIO UDDI
Services Registry
Claims
Processing
Data
Analytics
RLS
Meta-data
RHIO
Entity
Peer
GW
SOAP
RHIO
Entity
Peer
Provider
Directory
RLS
Meta-data
GW
RHIO
Entity
Peer
SOAP
(RLS) Data Providers – Doctors, Facilities, Payors etc..
Trust
Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
GW
SOAP
RHIO
Entity
Peer
Centralized RHIO SOA Model
NHIN
NHIN
NHIN
Service Abstraction Layer
GW
GW
“On behalf of” Trust
HISP
HISP
Governance
Governance
Additional RHIO Services
Patient Consent
Record Locator Services
RHIO Storage
Provider Directory
Claims Processing
Data Analytics
Payor Authorizations
Additional RHIO Services
Structured Data, stored in each RHIN,
Accessed & Transformed via RHIO Services
RHIO UDDI Services Registry
RHIO UDDI Services Registry
RHIO
RHIO
GW
GW
Search
Authorization, Authentication & Auditing
Identity
Physician Concierge Services
Commercial Messaging
Custom Service-based Workflows
Patient Consent
Record Locator Services
RHIO Storage
Provider Directory
Claims Processing
Data Analytics
Payor Authorizations
Search
Authorization, Authentication & Auditing
Identity
Physician Concierge Services
Commercial Messaging
Custom Service-based Workflows
Service Abstraction Layer
Web
Patient
Web/GW
Doctor
GW
GW
GW
Web
Web/GW
GW
Web
GW
Provider
Pharma
Payor
Patient
Doctor
Provider
Pharma
Payor
Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
The RHIO Business
RHIO Business Architecture Segmentation
Architecture
STRATEGY
FOCUSED
RHIO
BUSINESS STRATEGY
PROCESS
DRIVEN
RHIO BUSINESS PROCESS
EXECUTION AND MONITORING
SERVICE
ORIENTED
SERVICE ORIENTED
INFRASTRUCTURE & COMPOSITION
PLATFORM COMPONENTRY
PLATFORM
DEFINITION
JAVA
.Net
LAMP
Packaged Apps.
http://www.momentumsi.com/index01.html
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Using Service Oriented Architectures to Support RHIO Development
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RHIO SO Architectural Considerations
Platform
Architecture
• J2EE
• .Net
Domain
Architectures
Architectural
Constructs
Deployment
Architectures
Architectural
Themes
• Application
• Integration
• Data
• Participants
• Patterns
• Practices
• Network
• Computing
• Distribution
• Model Driven
• Service Oriented
• Process Driven
Reference
Architectures
RHIO
Architecture
Models
Specific
RHIO
Objectives
Gray Boxed
Architecture
• Semi-Packaged Apps
• App Frameworks
• Model 1
• Model 2
Architectural
Requirements
Candidate
Architectures
• The Proposed
RHIO Architecture
Black Boxed
Architecture
• Packaged Apps
• ASP / leased systems
Solution
Architecture
• The Actual RHIO
Architecture
http://www.momentumsi.com/index01.html
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
Summary & Next Steps
• Evolution to SOA is inevitable in most industries;
• RHIOs have a green field opportunity to drive “industry change”
• SOA’s impact is profound but evolutionary – won’t be fully realized on initial deployment
• SOA development is a journey with multiple phases of increasing maturity
• The aim of any SOA should be based on clear Business Benefit and Implementation Goals
up front.
• RHIOs must;
• Develop architectural decisions in a consistent & standardized way
• Develop SOA methodologies for interacting with all entities & organizations in viable
process driven manner
• Enable new business processes and capabilities for all entities whether they be large or
small;
• Business - Patient Consent, Record Locators, RHIO Entity Identification, Semantic
Normalization
• Infrastructure – Authentication & Authorization, Governance & Policy, Security, Auditing
• Data Services - Data Mining, Disease Management, Outcomes-based Medicine, Pharma
Interactions, e-Pharma Gateways
• Financial Services - Scheduling Services, SMB Concierge, Claims Mgmnt, HSA, CMS etc..
• Gov’t extensibility – Epidemic / Pandemic Management, Bio-terrorism, DHS, CDC etc
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
HIMSS.ORG; Integration & Interoperability
Web Cast March 2006
Using Service Oriented Architectures to
Support RHIO Development
Alan Boucher
Director, Health Care Architecture
Digital Health Group, Intel Corporation
Backup
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast
SOA Philosophies
1. Consumers and Producers are Loosely Coupled
•
•
•
•
Provide Functional Encapsulation
Factor Out Non-Functional Concerns
Force Ubiquity at the Edge of the Service
Performance is an Implementation Decision
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Using Service Oriented Architectures to Support RHIO Development
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SOA Philosophies
2. Leverage Network Computing and Resource
Virtualization
•
•
•
Network the Services
Provide mediation in the network
Resolve resources at runtime (latent bind)
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Using Service Oriented Architectures to Support RHIO Development
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SOA Philosophies
3. Systems are Loosely Bound
• Integration and Composition are One
• Functionally Structured
• Operationally Amorphous
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Using Service Oriented Architectures to Support RHIO Development
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SOA Philosophies
4. RHIO Service Networks Scale Efficiently
•
•
•
The RHIO Vocabulary is Managed
Facilitate Service Use and Reuse
Create Federated Solutions
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Using Service Oriented Architectures to Support RHIO Development
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SOA Philosophies
5. SOA Enables new Opportunities
•
•
HC Enterprise Boundaries are Removed
•
•
The Value of Data is Redistributed
Unstructured Data Finds Structure and
Meaning
All Service Network Users have the same
Value / Impact in the System
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Using Service Oriented Architectures to Support RHIO Development
March 2006 HIMSS.org Web Cast