alan boucher
TRANSCRIPT
HIMSS.ORG; Integration & Interoperability Web Cast March 2006
Using Service Oriented Architectures to Support RHIO Development
Alan BoucherDirector, Health Care ArchitectureDigital Health Group, Intel Corporation
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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• 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
Service Oriented Architecture (SOA) Construction
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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 exchangedSource: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer
Glossaries, IEEE, 1990
Semantic interoperability entails a co-ordination of meaning. Semantics is defined as the meanings ofterms and expressions with regard to content description standards. Hence semantic interoperability is“the ability of information systems to exchange information on the basis of shared, pre-established andnegotiated meanings of terms and expressions,” and is needed in order to make other types ofinteroperability work.
Syntactic Interoperability: Conveying agreed upon grammars for semantics & structure.
The challenges of syntactic interoperability become: a) identifying all the elements in various systems (in RHIOs); b) establishing rules for structuring these elements; (between RHIO entities) c) mapping, bridging, creating crosswalks between equivalent elements using schemas etc.; d) agreeing on equivalent rules to bridge different cataloguing and registry systems
Structural interoperability uses agreed upon framework models, such as HL7 Reference InformationModel (RIM), the Clinical Document Architecture (CDA), the ASTM Continuity of Care Record (CCR) oreven models based on the Integrating the Healthcare Enterprise (IHE) - Cross Enterprise DocumentSharing (XDS) Profile, which stores documents as ebXML.
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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Anatomy of a Business Process
Activity
Trigger•Time•Event
Input•Data Required
for Decision/Action
Output•Data produced by Decision / Action
Decision / Action•Steps completed•Decisions Made Next
Activity /
Process
ProcessApproval &Return DataReceive
RequestTo Acquire
Data
DetermineRequestorCredentials
Send RequestTo RHIO
Rules Engine
MakePolicy
Decision Reject Requestor &Return Event
EHR Lookup Service
Op: InitiateEHRlookup()
IA&M Service
Op: AssertionLookup()
Governance Service
Op: PolicyLookup()
Process EHR Service
Op: GetEHRRecord()
Format EHR Service
Op: FormatEHRCCR()
Process Error Service
Op: ReturnError().OR..OR.
ProcessApproval &Return DataReceive
RequestTo Acquire
Data
DetermineRequestorCredentials
Send RequestTo RHIO
Rules Engine
MakePolicy
Decision Reject Requestor &Return Event
Anatomy of a Service
Activity
Trigger•Time•Event
Input•Data Required
for Decision/Action
Output•Data produced by Decision / Action
Decision / Action•Steps completed•Decisions Made
The anatomy of a servicemaps directly to the anatomy of process.Process & data needs drive requirements
for service interfaces
<The Name>
<operations>Policies
&SLAFeatures (capability + output)
Terms (requirements + input)
Created by
A Service
the RHIO
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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Expected Benefits of SOAMicro
(per adaptation)
$ R
etur
n
Time
DevelopmentProductivity
TTD
With SOA
TraditionalDevelopment
RHIOBenefit
Program “development time to release” improves greatly based on services leveraged in design
Program “development time to release” improves greatly based on services leveraged in design
Macro (subsequent adaptations)
$ R
etur
n
Time
RHIOValue
SOA savings realized
Traditional savings
Expected aggregate effects are more $$ available for new RHIO capabilities & improved business processes for RHIO participants
Expected aggregate effects are more $$ available for new RHIO capabilities & improved business processes for RHIO participants
Servic
e Re-
use
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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SOA and HL7: “One RHIO Services Network”RHIO’s may implement their interoperability models in HL7 V3, yet many participating
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
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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The Role of Services in a National Health Care SystemGoal 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 patient-centric 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
ONCHIT ONCHIT
NHIN Framework and Standards
CertificationOf RHIOs
CertificationOf RHIOs
ServicesServices
NHIC – BoardPrivate
NHIC – BoardPrivate
National Health Information Corporation (NHIC)
National Health Information Corporation (NHIC)
P & PP & P CertificationCertification
Certified Private Companies & HISPs
Certified Private Companies & HISPs
Services Bus
Services Bus
StandardsStandards
RHIOsData Models, Data ExchangeGovernance, Policy, Auditing
Orchestration, Transformation & Business Rules
RHIOsData Models, Data ExchangeGovernance, Policy, Auditing
Orchestration, Transformation & Business Rules
ProvidersProvidersPayors (including CMS)
Employers
Payors (including CMS)
Employers
Citizen ServiceCitizen ServiceDoctorsDoctors
PharmaPharma
Exposed Services (Pub / Sub)Exposed Services (Pub / Sub)
Organizational Information between RHIOs & the NHIN
Exposed Services (Pub / Sub)Exposed Services (Pub / Sub)
PMO
National Health Technology Standards and
Certification (NHTSC)
National Health Technology Standards and
Certification (NHTSC)
Contract Contract
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
© 2005 The Interoperability Consortium
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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Best Known Methods… learning from the NHS UK
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 Gateway require zero-coding for local clusters
• Services improved stability, resilience and availability
Data Services forSecondary Uses
Services Services Services Services Services
SHAs / Trusts / Units /Primary Care / Social Carecare & servicesfor patients
LSPsdeliver a range of local applications, services & functionality
TMSprocesses all messages
SPINE (NASP)delivers national services
Electronic Booking
PersonalDemographicService (PDS)
Personal SPINEInformation
Service (PSIS)
Electronic Transmission of
Prescription
A Cluster
Bi-directional Message Traffic
NHS CareRecord Service
Local Data & Applications
RHIO Gateway Services BusRHIO Gateway Services Bus
ProvidersProviders
Citizen ServicesCitizen Services
IPAs, DoctorsIPAs, Doctors
PharmaPharma
Exposed Services (Pub / Sub)Exposed Services (Pub / Sub)
RHIOsData Models, Data ExchangeGovernance, Policy, Auditing
Orchestration, Transformation & Business Rules
RHIOsData Models, Data ExchangeGovernance, Policy, Auditing
Orchestration, Transformation & Business Rules
NHINNHIN
Payors (including CMS)
Employers
Payors (including CMS)
Employers
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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Internet
OrchestrationMessaging Bus
ServiceContainer
Data Transform
Business Rules, Algorithms
Meta Data Store
Audit, Monitoring & Management
AAA, Data Security
Que
ue
Que
ue
XM
L F
irew
all
Payor, Provider, Pharma, PhysicianOrganizations
RHIOs & RHINs
OrchestrationMessaging Bus
Que
ue
Que
ueService
Container
Data Transform
Business Rules, Algorithms
Meta Data Store
Audit, Monitoring & Management
AAA, Data Security
XM
L F
irew
all
Deployable Business RulesDeployable Business RulesRHIO Standard Transforms (XSLTs)RHIO Standard Transforms (XSLTs)Publish & Subscribe ServicesPublish & Subscribe ServicesDevelopment of Common Services & Development of Common Services & Libraries, Directories & RegistriesLibraries, Directories & Registries
Isochronous & Isochronous & Asynchronous Asynchronous messagingmessagingReliable Messaging & Reliable Messaging & Queue ManagementQueue Management
SOAP Encapsulated SOAP Encapsulated XMLXMLHTTP SSLHTTP SSLVPN SSLVPN SSLVPN PtPVPN PtP
Applying Best Known Methods..Deployable RHIO Service Technologies
HL7 WrapperHL7 v2.x, v.3, HL7 CDA, ASTM CCR,
openEHR etc..
HL7 WrapperHL7 v2.x, v.3, HL7 CDA, ASTM CCR,
openEHR etc..
HL7 Content Modelor
XML, ebXML, other
Option: File Exchange Formats could be <encapsulated> XML
in the cloud
High-Level Service Operations in RHIOs & RHINs
Data / WebService Provider
PublishedWeb & Data Services
Access based on Object IdM
Assign Data ResourcesBased on
HISP or RHIO / RHINObject Identity (IdM)
HISP/ RHIO / RHIN Data AccessData Provider
RHIO / RHIN
Services Directories
Data / Web Service
Requestor HISP Objects:
Physicians, Providers, Payor’s GVT Entities and
Commercial Services
WbS Management, Routing & Governance Services
Federated Services Model
Federated Services Model
Business Integration
Layers
Bind or Latent Bind Web Service & Data
Components to Object IdM
Polic
y, Id
M &
WbS
Invo
catio
n
RHIO Object IdM Access
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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Services create New Opportunities for RHIOs
RHIO Participating Organizations RHIOs & RHINsOrchestration
Messaging Bus
ServiceContainer
Data Transform
Business Rules, Algorithms
Meta Data Store
Audit, Monitoring & Management
AAA, Data Security
Que
ue
Que
ue
XM
L F
irew
all
OrchestrationMessaging Bus
Que
ue
Que
ueService
Container
Data Transform
Business Rules, Algorithms
Meta Data Store
Audit, Monitoring & Management
AAA, Data Security
XM
L F
irew
all
RHIO Access Portal
Patient BrowseContainer
RecordLocatorServices
RHIOStorage
PayorAuthorizations
PatientConsent
ProviderDirectory
ClaimsProcessing
RHIO UDDI Services Registry
DataAnalytics
Loosely-Coupled Services
Primary CarePhysician
BillingSpecialist
SpecialistPhysician
Service Request
Search Authorization
Authentication WorkflowsPolicy & Consent
Mgmt
Identity
Additional RHIO Services
Storage Audit CommercialMessaging
Content Mgmt Physician Concierge Services
RHIOs must build self-sustaining business models through Services
RHIOEntityPeer
RHIOEntityPeer
RHIOEntityPeer
RHIOEntityPeer
Trust
RHIOEntityPeer
RLS Lookup and AccessPeer-to-Peer Data & Transformation
(RLS) Data Providers – Doctors, Facilities, Payors etc..
GW
RLSMeta-data
RLSMeta-data
RLSMeta-data
GW GW GW
Peer TrustDNS Like Services
SOAP SOAP SOAP SOAP
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
Patient DirectoryConsent Services
ProviderDirectory
ClaimsProcessing
RHIO UDDI Services Registry
DataAnalytics
PayorAuthorizations
Peer-to-Peer RHIO SOA Model
Service Abstraction Layer
RHIO RHIO
HISPGovernance
HISPGovernance
NHIN
Service Abstraction Layer
NHINNHIN
GW
GW GW
GWTrust Domain
Trust Domain
Trust Domain
“On behalf of” Trust
Doctor
GW
Provider Pharma Payor
GW GWWeb/GW
Patient
Web
Doctor
GW
Provider Pharma Payor
Web GW
Patient
Web Web/GW
RHIO UDDI Services Registry
Record Locator ServicesRHIO Storage
Payor Authorizations
Patient Consent
Provider DirectoryClaims ProcessingData Analytics
SearchAuthorization, Authentication & Auditing
Custom Service-based Workflows
Identity
Additional RHIO Services
Commercial MessagingPhysician Concierge Services
RHIO UDDI Services Registry
Record Locator ServicesRHIO Storage
Payor Authorizations
Patient Consent
Provider DirectoryClaims ProcessingData Analytics
SearchAuthorization, Authentication & Auditing
Custom Service-based Workflows
Identity
Additional RHIO Services
Commercial MessagingPhysician Concierge Services
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
Centralized RHIO SOA Model
Structured Data, stored in each RHIN,Accessed & Transformed via RHIO Services
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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PROCESSDRIVEN
STRATEGYFOCUSED
PLATFORMDEFINITION
SERVICEORIENTED
Th
e R
HIO
Bu
sin
ess
Architecture
RHIOBUSINESS STRATEGY
SERVICE ORIENTED INFRASTRUCTURE & COMPOSITION
PLATFORM COMPONENTRY
JAVA .Net LAMP
RHIO BUSINESS PROCESSEXECUTION AND MONITORING
Packaged Apps.
RHIO Business Architecture Segmentation
http://www.momentumsi.com/index01.html
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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RHIO SO Architectural Considerations
http://www.momentumsi.com/index01.html
PlatformArchitecture
Black Boxed Architecture
DomainArchitectures
• Application • Integration • Data
• J2EE• .Net
• Packaged Apps• ASP / leased systems
ReferenceArchitectures• Model 1• Model 2
CandidateArchitectures
• The Proposed RHIO Architecture
SolutionArchitecture
• The Actual RHIO Architecture
Gray Boxed Architecture• Semi-Packaged Apps • App Frameworks
ArchitecturalRequirements
Specific RHIO
Objectives
ArchitecturalConstructs
• Participants • Patterns• Practices
ArchitecturalThemes
• Model Driven • Service Oriented• Process Driven
DeploymentArchitectures
• Network• Computing• Distribution
RHIOArchitectureModels
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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
Alan BoucherDirector, Health Care ArchitectureDigital Health Group, Intel Corporation
HIMSS.ORG; Integration & Interoperability Web Cast March 2006
Using Service Oriented Architectures to Support RHIO Development
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
21
Backup
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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)
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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SOA Philosophies
3. Systems are Loosely Bound
• Integration and Composition are One
• Functionally Structured
• Operationally Amorphous
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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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
Using Service Oriented Architectures to Support RHIO DevelopmentMarch 2006 HIMSS.org Web Cast
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SOA Philosophies
5. SOA Enables new Opportunities
• HC Enterprise Boundaries are Removed
• Unstructured Data Finds Structure and Meaning
• The Value of Data is Redistributed
• All Service Network Users have the same Value / Impact in the System