Transcript HL7 2009

HL7 Roadshow 2009
Connected Healthcare
Jose Sueiras, March 2009
Integration solutions using Ensemble
• HealthShare.
– Building an EHR
• CSC - TIE
– Trust Integration Engine
• Implementing Spine Compliance
– i.e. TrakCare
InterSystems Integration Technology
• HL7 Features
HL7
– Schemas. Virtual documents.
Message Router (Rules).
• Integration platform.
Ensemble
Cache
–
Adapters, BPM, Data
transformation.
– Management, Monitoring..
• Database / Application
Server OO.
– SOAP,XML,EJB,COM…
– ODBC, JDBC
HealthShare. Architecture
Hospital/CHC
CIS
RIS
HIS
Healthshare
Gateway
Etc.
ECR
Healthshare
Gateway
EMR
Healthshare
Hub
EMPI
ECR
LIS
Physician's
Practice
Healthshare
Gateway
ECR
Laboratory
Regional & National EHR
Viewer
RAD
EMPI
Point of Care
LAB
GP 1
EMPI HUB
Hospital
PAS
GP 2
Edge Gateway
GP 3
Gateway
OPR
Edge Gateway
A&E
Clinic
Repository
ICU
Edge Gateway
Clinical
Repository
Edge Gateway
HealthShare – The Components
Hub
Edge
Gateway
Access
Gateway
One shared resource for the exchange.
Primarily responsible for managing identifiers (EMPI)
Many distributed resources across the exchange
Primarily responsible for managing data collection & caching
Many distributed resources across the exchange
Provider portal for querying the exchange and viewing results
Main Features
• Patient Identity Management
– Identity Hub as clinical record locator
– Identity Policy and Service most commonly centralised. Fuzzy logic algorithms.
– Use of (existing) national numbers (Social Security Number / NHS number)
• User Provisioning & Consent
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–
–
–
–
–
User Access and Consent policy and service is typically centralised
Access/Consent policy not typically defined / controlled by those who need to use the systems
Clinicians may perform different roles at different times in different facilities.
Time-based nature of “legitimate user relationship” & “consent”
Integration of Smartcards and biometrics
Requirement for tamper-proof audit and governance databases / message archives
• Data aggregation / normalization
– Variable quality of data source systems
• Data Capture – push/pull
• Structured & Unstructured data
– Coded / Non-Coded data – differing coding regimes & purposes
– Numerous (converging) Standards for Normalisation
• CCR, CDA, CCD
InterSystems Ensemble Trust
Integration Engine (TIE)
• Connecting applications in the Trust with the applications
supplied by CSC
• Integrate applications within the Trust. (Upgrade)
CSC Data Message Architecture
TIE
TIE
TIE
TIE
TIE
TIE
TIE
Spine
Messages
Data
Message
Hub
Central
Trust DB
CSC Data Message Architecture
Ensemble
Ensemble
Ensemble
Ensemble
Ensemble
Ensemble
Ensemble
TIE
TIE
TIE
TIE
TIE
TIE
TIE
Spine
Messages
Data
Message
Ensemble
Hub
Central
Trust DB
TIE. Ensemble Production
HL7
Message
External Applications
HL7
Business
Operations
HL7
Business
Processes
HL7 Outbound Adapter
HL7 Inbound
Adapter
Client Applications
HL7
Business
Services
Plymouth Hospitals NHS Trust
Ensemble
“Spine Compliant”. CFH Definition
Patient Demographics Service (PDS)
Access/Update
Access Control Framework (SDS, SSB)
Transaction Messaging (TMS)
Basic Connectivity (N3)
“PDS Compliance”
patient demographics
NHS Number
“IG Compliance”
Authentication. Authorization
EBXML/HL7V3/MIM
NPfIT services.
Firewalls/routers
“Spine Compliant” CFH Definition.
GP System
Summary
Record
NPFIT-FNT-TO-TIN-0830
NHS Acute/
Community/
Mental Health or
ISTC
EPR/PAS
Community
Pharmacy
Urgent Care
Choose and
Book (CAB)
Choose and
Book (CAB)
Electronic
Prescriptions
Summary
Record
NPFIT-FNT-TO-TIN-1032
NPFIT-FNT-TO-TIN-1032
NPFIT-FNT-TO-TIN-1050
NPFIT-FNT-TO-TIN-0830
GP2GP
Transfer
NPFIT-FNT-TO-TIN-0402
Electronic
Prescriptions
NPFIT-FNT-TO-TIN-1050
PDS/IG Compliance
(PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)
“Spine Compliant”. CFH facts
• It takes about 9 – 12 months to “become compliant” from
scratch
• “Compliance” is specific to a functionality, spine version
and supplier software version – not a general status
• Spine Compliance must be maintained – it is not static
Ensemble. Spine FW
• Web services and ebXML toolkit.
• XML – Object mapping
• BPM capabilities
– Message patterns
– Alert generation. Error handling workflow
• Data transformation.
– HL7 2.x schemas. Hl7 v3
• Storage
– Guarantee message delivery.
– SDS Cache
• Monitoring. Management
Ensemble based solution for
TrakCare
• PDS and C&B compliance.
• Authentication and authorization process integrated in a
single sign on architecture.
– Smart cards
• TrakCare is easily configurable to interact with other
systems using HL7 v2.x messages
• Use Ensemble to implement a MHS that will talk to TRAK
using HL7 v2.4
Ensemble based solution for
TrakCare
Ensemble. MHS
Routing
DTL
Spine
ebXML
W.S.
BPM
TCP
WF Errors
HL72.4
HL7 Version 3
SDS Cache
TRAKCare
Spine. Iteration example
Ensemble MHS
Intermediary MHS
TRAK
Request Available Slots
PRSC_IN080000UK07 / ebXML
Persist
MCCI_IN010000UK13 / ebXML ACK
2.4 SQM_S25 / TCP
2.4 SQR_S25 / TCP
Persist
Respond Available Slots
PRSC_IN090000UK09/ ebXML
Persist
MCCI_IN010000UK13 / ebXML ACK
Message Processing
Conclusions
• Ensemble is a versatile integration platform
• Unified development environment that promotes rapid
development
• Especially suited for healthcare
– HL7 and other standards
• High performance solutions at different scales
Questions?
Questions??
• [email protected]
• www.intersystems.co.uk/TIE