Transcript CONNECT: An Open Source Platform for Promoting Military Health

CONNECT: An Open
Source Platform for
Promoting Military Health
David Riley (Contractor)
CONNECT Lead
Mil-OSS, August 3, 2010
The Current State of Affairs: A Disjointed,
Expensive Healthcare System
• U.S. spent approx. $2.2 trillion on health care in
2007 ($7,421/person). This comes to 16.2% of GDP,
nearly twice the average of other developed
nations. (Source: www.whitehouse.gov)
• Only about 8% of the nation's 5,000 hospitals
and 17% of its 800,000 physicians currently use
the electronic health record (EHR) systems
envisioned for the whole nation. Most of today’s
systems are still not interoperable. (Source: CNN)
• Due to lack of interoperable EHRs, tests are
duplicated, information is unavailable at the point
of care, public health information is difficult to track
and health organizations carry a heavy
administration burden.
2
Federal Health Architecture
Advancing the Agenda
c
FHA ensures federal participation in ONC-led initiatives such as the
Nationwide Health Information Network, Nationwide Health Information
Network Direct, EHR adoption, and CONNECT
• E-gov initiative managed by ONC within HHS
3
• 26+ federal agencies participate in FHA
CONNECT
Meeting Multiple Objectives
CONNECT promotes the
widespread adoption of
interoperable health IT.
It uses nationally recognized
standards, conventions and
trust agreements, to address
multiple complex objectives
simultaneously.
CONNECT is a federally
funded, Open Source software
solution that is a:
• Platform for Participation
• Platform for Innovation
Reform
Objectives
Meaningful Use
Objectives
Transparent Government
Objectives
4
Nationwide Health Information Network
Exchange and CONNECT
5
The Nationwide Health Information
Network is a set of standards,
services, and policies that enable
secure health information exchange
over the internet.
CONNECT is a federally funded and
developed open source reference
implementation of the Nationwide
Health Information Network Exchange
standards and services.
• Nationwide Health Information Network
Exchange connects a diverse set of federal
agencies and private organizations to
securely exchange electronic health
information using the Nationwide Health
Information Network services.
(For example: SSA – MedVirginia, DoD, VA
and KP)
• CONNECT is using an effective public –
private collaboration to create a secure,
standard platform for health information
exchange
• Nationwide Health Information Network
Exchange participants save resources by
using CONNECT instead of developing their
own implementation of the Nationwide
Health Information Network Exchange
standards and services
Vision for VLER
The Department of Veterans Affairs (VA) and the Department of Defense
(DoD) have been partnering to meet the President's April 09, 2009
mandate that "Both Departments [VA and DoD] will work together to define
and build a system that will ultimately contain administrative and medical
information from the day an individual enters military service throughout
their military career, and after they leave the military."
6
VLER Reality
Achieving VLER requires cooperation
well beyond the DoD and VA.
DoD
• 60-70% of DoD beneficiary care is provided
by the civilian (i.e. “Network”) sector.
• DoD beneficiaries are one of the largest and
most mobile patient populations.
VA
• Approximately 40% of Veterans receive a portion
of their care outside of VA treatment facilities.
7
Vision for VLER – The Whole Picture
San Diego
8
Hampton
Roads
TBD
CONNECT and Open Source
• CONNECT Code is Released Under
the New BSD License
• Release as Open Source April 2009
• CONNECT Open Source Community
Announcement June 2009
• CONNECT Community Events
– CONNECT Training Seminars/Webinars
– CONNECT Code-A-Thons
• CONNECT Community Focus
– Getting organizations into production
exchanging health information
• Nationwide Health Information Network Exchange
based production
• Non-Nationwide Health Information Network
Exchange based production
9
Nationwide Health Information Network/
CONNECT Implementation Status
Federal Adopters
Test/Demo
Production
Centers for Disease Control & Prevention
Centers for Medicare & Medicaid Services
2010*
2010*
OFM (esMD)
2010*
OCSQ (PQRI)
2010*
OCSQ (C-HIEP)
2010*
CMSO (MITA Claims Submission)
2010*
Department of Defense
Department of Homeland Security
2010
2010*
Department of Veterans Affairs
2009
Food and Drug Administration
2010*
Federal Communications Commission
2010-2011*
Indian Health Service
National Cancer Institute
10
2010*
2010-2011*
National Disaster Medical System
2010*
Social Security Administration
2009
CONNECT and Nationwide Health Information Network
* Planned
Nationwide Health Information Network/
CONNECT Implementation Status
Non-Federal Adopters
Test/Demo
Production
Center for Healthy Communities, Wright State University, Healthlink
2010-2011*
Central Virginia Health Network/MedVirginia
2010*
Community Health Information Collaborative (CHIC)
2010-2011*
Emdeon
2010*
EPIC
2010*
HealthBridge
2010-2011*
Indiana State Department of Health
2010*
Iowa Department of Public Health
2009
Iowa Health Systems
2010*
Kaiser Permanente
2009
MedVirginia
2009
MEDNET in Partnerships
Community Health Information Collaborative (aka HIE-Bridge)
2010*
LACIE –Lewis and Clark Information Exchange
2010*
Emdeon
2010-2011*
Hielix – Phase 1 Contract for the State of North Dakota Statewide HIE
2010*
New York State Department of Health
2009
Orange County ER Connect
11
2010*
Redwood MedNet
2010
Regenstrief Institute, Inc.
2010-2011*
Southeastern Michigan Health Association
2010-2011*
Thayer County Health Services
2009
Washington State Department of Health
2010*
CONNECT
CONNECT and Nationwide Health Information Network
* Planned
Vendors Solutions with CONNECT
Reflection Technologies
12
Nationwide Health Information Network Exchange
Specifications and Operational Infrastructure
Transaction Profiles
Utilize exchange patterns for specific transactions
CMS CARE
Doc Submission
CDC GIPSE
HIEM
MITA
Eligibility Verification
Discovery and Information Exchange Services
Rely on foundations to enable exchange patterns
Discovery
Pull
Push
Patient
Discovery
Services
Registry
Query &
Retrieve Docs
Eligibility
Verification
Doc
Submission
Pub/Sub
HIEM
Messaging, Security, & Privacy Foundations
Enable private, secure, and interoperable communication of health information
Messaging Platform
Authorization
Framework
Access Control
Policy
Operational Infrastructure
Runtime systems that support the Nationwide Health Information Network Limited
Production Exchange
Security Infrastructure
(managed PKI)
13
Web Services Registry
CONNECT Adapter:
Organizational SOA Starter Kit
Enterprise Service Components:
– Master Patient Index
– Policy Engine
– Redaction Engine
– Audit Services
– Document Registry/
Document Repository
– Subscription Repository
– Re-identification Service
– Entity Integration Services
– SDK Services
14
CONNECT 3.0 and Beyond
CONNECT 3.0 Release, June 18, 2010
• Deferred Services for Patient Discovery & Document
Submission (XDR)
• LiFT (Large Image & File Transfer) Support for
Document Submission (XDR)
• Policy & Redaction Updates
• SOAP 1.2 Enhancements on Internal Interfaces
between GW and Adapter
• Secure & Unsecured Interfaces for Patient Discovery
• Support New Profile for ESMD (Electronic Submission
of Medical Documentation)
• FIPS Enhancements for JBOSS
• Database Support for Oracle
• Enhancements to Support OCSP Certificate Revocation
• Performance Testing Enhancements
15
3.0
What’s cooking for CONNECT 3.1?
• CONNECT Core Gateway Refactoring
– Java Library Architecture Enhancements
– Separation of Web Services and Business
Logic via component proxies in Spring
Framework
– Enables CONNECT portability to many
environments in the future
– Enables the use of other technologies in the
future e.g. REST, XMPP, SMTP, etc
– Improves CONNECT performance when
adapter and gateway reside on the same
machine.
– Reduces the number of web service calls
• Deferred Document Retrieve and
Query Services
16
What’s cooking for CONNECT 3.1?
• Large Image and File Transfer
(LiFT for Document Retrieve
• Large File Support for
Document Retrieve
• Logging Enhancements
• Administrative Distribution Service
• Support for Secure and Unsecure
connectivity between the Adapter and Gateway
• Performance Testing Enhancements
• Automate Performance Testing as part of testing suite
17
Work anticipated in CONNECT 3.2
• Support for pluggable protocols and
dynamic protocol negotiation
• Support for Nationwide Health
Information Network Direct
• Emerging Services for Resource
Management/Logistics
• Emerging Services to support
Meaningful Use and Health Care
Reform
• Identity Management Services
• Semantic Services
18
Upcoming Events
August 2-5, 2010 in Washington, DC
Military Open Source Software Conference
September 7, 2010 in Washington DC
Enterprise Architecture 2010 Conference
September 21-22, 2010 in Rochester, MN
CONNECT Code-A-Thon at the Mayo Clinic
19
CONNECT Community Portal
http://www.connectopensource.org
20
CONNECT Architecture:
Message from Nationwide Health
Information Network
21
CONNECT Architecture: Message to
Nationwide Health Information Network
22