2/11/2014 9:17 AM Healthcare Services Specification Project The Business Case for Healthcare SOA...

04/10/23 20:59

Healthcare Services Specification Project The Business Case for Healthcare SOA Standards

Healthcare Services Specification Project The Business Case for Healthcare SOA Standards

HL7 Service-Oriented Architecture SIG

OMG Healthcare Domain Task Force

Open Health Tools

HL7 Service-Oriented Architecture SIG


Open Health Tools

March 2008March 2008

AcknowledgementsAcknowledgements

• Contributions to this content have come from:

– Health Level Seven (HL7)http://www.hl7.org

– Object Management Group (OMG) http://www.omg.org

• With additional contributions from:

– Integrating the Healthcare Enterprise (IHE)http://www.ihe.net

– Open Health Toolshttp://www.openhealthtools.org

What is the Healthcare Service Specification Project? What is the Healthcare Service Specification Project?

• A joint standards development activity occurring in multiple organizations, including Health Level 7 (HL7), the Object Management Group (OMG), Open Health Tools, IHE, and others

• An effort to create common “service interface specifications” tractable within Health IT

• Its objectives are:

– To create useful, usable healthcare standards that address business functions, semantics and technologies

– To complement existing work and leverage existing standards

– To focus on practical needs and not perfection

– To capitalize on industry talent through open community participation

04/10/23 20:59

PolicyBusiness

Drivers

InformationModels

Service Functional

Model

RFP

Profiles

TechnicalSpecifications

Implementations

Requirements

Government, Professional Societies,…

Healthcare Organizations

HL7, openEHR, CEN, …

HL7 Domain Committees, CEN, Standards Bodies (SDOs)


IHE, SDOs, Healthcare Orgs

IHE

OMG, RFP Submitters

Interop Testing

Vendors, OHT, Healthcare Orgs

HSSP is part of the bigger health IT landscape…HSSP is part of the bigger health IT landscape…

HSSP

HL7 Domain Committees

OMG

HITSP

National Programs (e.g. ONC, NEHTA)

CEN

OpenEHR

OHT

IHE

Methodology (SSF),DSTU Feedback,

Consultative support

SFMs, Info Models,

Requirements,Service Profiles

Policy

Service Profiles

Methodology,HL7/SOA Harmonization

SOA Interoperability Specifications

Use Cases,Requirements

TechnicalSpecifications,RFP process

Use Cases,Candidate Standards

Info Models,Semantic Profiles

SOA Interop Specs

RFPRequirements

Integration Profiles,Conformance Testing,

Interoperability Validation

TechnicalSpecifications

Open SourceRef Implementations,

Tools

SOA Interoperability Specifications,

Use Profiles

What type of products do you produce? What type of products do you produce?

• SOA Functional Standards [Service Functional Models]

– CTS II - Terminology Maintenance/Navigation

– CRFQ – Clinical Research Filtered Query

– PASS – Privacy, Access, and Security Services

– HSD – Human Services Directories

• Technical Specifications for balloted Functional Standards

– EIS - Entity Identification Service (such as MPI)

– RLUS - Retrieve/Locate/Update Service

– DSS - Decision Support Service

• Implementation Guidance & White Papers

– Practitioners Guide to SOA in Health Care

– Implementation Guides

2008 HSSP Project Schedule (planned, major milestones)2008 HSSP Project Schedule (planned, major milestones)

Jan: SFM Ballots (CRFQ, Security)

HL7 San Antonio (Jan 13-18)

Jul: Publish SOA Practitioners Guide

Feb: Aug:

Mar: OMG Washington (Mar 10-14) Sep: HL7 Vancouver (Sep 14-19)

OMG Orlando (Sep 22-26)

CTS II SFM Ballot (HL7)

HSD SFM Ballot (HL7)

Apr: SOA in Healthcare Workshop (Chicago) Organized by HSSP

Oct:

May: HL7 Phoenix (May 4-9) Nov:

Jun: OMG Ontario (CA) (Jun 23-27)EIS, RLUS RFP Final submissions DSS RFP Initial Submission

Dec: OMG Santa Clara (Dec 8-12)

Issue CTS II RFP

Issue HSD RFP

Where would these specifications be usedWhere would these specifications be used

• Inter-Enterprise (such as NHIN, RHIOs, HIE’s)

– By functionally specifying behavior, roles between applications and products are clarified, and the technologies supporting them can be profiled and sharpened

• Intra-Enterprise

– Standardization on functionality allows for better integration of off-the-shelf and custom development environments, and promotes more of a “plug and play” environment

• Intra-Product

– Facilitates vendors ability to integrate third-party value-add components and speed design phase with higher confidence

• Custom-Implementation

– Affords organizations wishing to custom-develop the opportunity to later integrate off-the-shelf

Core Project PrinciplesCore Project Principles

• Leverage each community to its strength

• Organizations jointly participate in all activities

• Work products will be “owned” by only one organization but used collaboratively

• “Operate as one project” as a principle

• Actively seek vendor participation

• Recognize that participation is an investment

OMG

HL7

The HSSP ProcessThe HSSP Process

HL7 DSTU

Service Functional Model

OMG RFP

Technical Specification

ANSI Standard

SFM

Understanding HSSP Artifacts, Roles, AttributesUnderstanding HSSP Artifacts, Roles, Attributes

Owned / Produced by

HL7 Community

RFP Submission Implementation

Defines what a service does but not how

Independent of technical platform

Audience is tech leads, EAs,

tech spec developers

Produced / owned by OMG

community

Translates SFM into technical requirements

ID’s supported technical

platforms

Audience is community with implementation

interest

Produced by OMG Member “Submitters”

Defines the service’s

technical spec

Defines interfaces, platform bindings, and conformance

profiles

Audience is project team

architect, lead developers, etc.

Owned by organizations and vendors

Builds the service that lives behind

the interface

Complies with a “conformance

profile”

Audience are consumers of the

system or service

How are HSSP services expressed? How are HSSP services expressed?

Semantic Space/Universe

Formalism (Structure)

Semantic Signifiers(profile-relevant

semantic structures)

Usage Context(interoperability

paradigm)

FunctionalSubset List

(enumerate Supported Functions)

Ve

rsio

nS

ub

mitt

er

Na

me

Metadata Metadata

Why “services”?*Why “services”?*

• A common practice in healthcare, just not yet in healthcare IT

• Many key products use them but do not expose interfaces

• Ensures functional consistency across applications

• Accepted industry best practice

• Furthers authoritative sources of data

• Minimizes duplication across applications, provides reuse

• Messages can be either payloads in or infrastructure beneath services

• Service-oriented architecture provides the framework for automation of common services

*slide adapted from a Veterans Health Administration Presentation, used with permission

Context of HSSP SpecificationsContext of HSSP Specifications

Ab

ilit

y to

Int

erop

erat

e

High

Low

Two Dimensions of InteroperabilityTwo Dimensions of Interoperability

Sem

antics

Behavioral

UDDI v3

Web Services

Java RMI

HSSP RLUS (Profiled)

OWL-S

CORBA

Ideal Target

HSSP Reference Arch

HSSP EIS

• Behaviorally, there are a lot of solutions

• Need to marry Semantic Interoperability with Behavior

• The touchstone business case is the notion of automated discovery, composition, and delivery

• What can HSSP provide to get us to the goal?

From the RM-ODP Informational Viewpoint

HSSP RLUS

HL7 Messaging

SOA ≠ Web ServicesSOA ≠ Web Services

SOA Web Services

Is a technology platform? No Yes

Is a transport protocol? No Yes

Primary ownership is business-line owned?

Yes No

Affects workflow and business processes? Yes No

Is an enabler for business and IT transformation?

Yes Yes

Is an industry standard? No Yes

The Value of HSSP …The Value of HSSP …

Value Rationale

Promotes deployment ease and flexibility

Specifications will support multiple topologies and technologies

Consistency at the interface level assures asset protection

Standard interfaces means that conformant components are substitutable

Multiple vendor product use/ interoperability

Using compliant products means side-by-side interoperation of multiple product offerings

Increased buyer/product offerings Consumer demand will create increased marketplace competition

Facilitates integration Unity in purpose and consistency in interface eases integration burden

Time to market Availability of an industry-accepted component interface eases product development burden

Requirements definition – influence vendors in a direct way

Participation by provider and payer community is direct expression of business need

Lower cost = wider deployment = higher quality service

How is this project “different”? How is this project “different”?

• Active participation from three continents and 15+ organizations

• Significant cross-cutting community involvement– Providers & Payers (Blue Cross/Blue Shield, DoD Military Health

System, Duke University, Kaiser-Permanente, Mayo Clinic, Veterans Health Administration)

– Vendors, Integrators, Value-added Providers (Booz-Allen Hamilton, CSW Group, EDS, IBM, Initiate Systems, Intel, Northrop-Grumman, Ocean Informatics, Software Partners, 88Solutions)

– Governments (Canada Health Infoway, DoD Military Health System (MHS), National Cancer Institute, NeHTA (Australia), SerAPI (Finland), Veterans Health Administration, Victoria Health (Australia))

• Managing differences between SDOs in terms of membership, intellectual property, and cost models

Why should I participate in HSSP? Why should I participate in HSSP?

• This effort is focused on and driven by business-need

– It is not an “academic exercise” striving for perfection

– Standards must be used to be useful

– Focused on the practical and achievable

– Short timelines

– Based upon business value and ROI

• Leveraging talent from multiple communities

• Being run like a “project” and not a committee

• We recognize that participation is an investment and not an expense

Why participate in standards at all? Why participate in standards at all?

• This is happening, with or without you. We’d rather it be with you…

• Unparalleled Networking. Standards work provides

access to the industry’s best and brightest

• Benefit from “lessons learned” from others. Someone else may have already solved your biggest problem.

• Industry Leadership. Standards work provides a platform

for you to establish market presence.

• Risk avoidance. Increasingly, standards compliance is mandatory. Make them work for you and not against you.

How do I Participate?How do I Participate?

• Participation is open to everyone. You don’t need to be a member (though we encourage you to do so)

• Join appropriate standards organizations

– HL7 for functional work

– OMG for technical specification work

• Allocate resources to actively engage in the project

– Engage existing, knowledgeable resources in the areas they are working already.

– Subgroups form based on industry need and priority

– Teleconferences are weekly; meetings approximately bimonthly

Who should I involve?Who should I involve?

• Involve the staff that can best address your business needs:

– You will get out what you put in. Senior staff will drive more value and ROI to you than a junior associate.

– Organizations that commit resources garner more influence and more mindshare

– Your business interests are being represented by your attendees

ReferencesReferences

All HSSP artifacts and work in process are open. Visit us at:

• http://hssp.healthinterop.org

Supplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and ImpactsSupplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and Impacts

What Participants are Saying… What Participants are Saying…

• “Kaiser Permanente I.T. is currently transitioning to an SOA-based approach to business and systems integration. Availability of industry standard services will bring many benefits towards this goal in terms of speed of implementation, flexibility and reduced cost. I am very pleased that both HL7 and OMG are committed to this timely effort.”, Alan Honey, Enterprise Architect (Principal), Kaiser-Permanente

• “The creation of a health Informatics infrastructure based upon a service-based architecture grounded in comparable data has the potential to improve healthcare delivery and greatly enhance patient safety.”, Peter L. Elkin, MD, FACP, Professor of Medicine, Mayo Clinic College of Medicine

• “The Eclipse Foundation is pleased to support an open source project dedicated to building frameworks, components, and exemplary tools to make it easy and cost-effective to build and deploy healthcare software solutions. This Eclipse Open Healthcare Framework project will leverage the Eclipse Platform developed by IBM, Intel, Wind River, Actuate, Borland, BEA, Computer Associates and others.” Mike Milinkovich, Executive Director, Eclipse Foundation

• “The time is now and the place is here in this joint OMG/HL7 project. Never before has the industry been closer to cogent, clear healthcare IT data model and service standards that can provide true interoperability in a short timeframe, with open-source implementations making availability abundant.”, Richard Mark Soley, Ph.D., Chairman and CEO, OMG

For Product Consumers and Users…The Impacts and Rationale of HSSP SpecificationsFor Product Consumers and Users…The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Promotes deployment ease and flexibility

Specifications will support multiple topologies

Consistency at the interface level assures asset protection

Standard interfaces means that conformant components are substitutable

Multiple vendor product use/ interoperability

Using compliant products means side-by-side interoperation of multiple product offerings

Increased buyer/product offerings Consumer demand will create increased marketplace competition

Facilitates integration Unity in purpose and consistency in interface eases integration burden

Time to market Availability of an industry-accepted component interface eases product development burden

Requirements definition – influence vendors in a direct way

Participation by provider and payer community is direct expression of business need

Lower cost = wider deployment = higher quality service

Product Vendor …The Impacts and Rationale of HSSP SpecificationsProduct Vendor …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Market opportunity – ability to grow business / “Grow the pie”

Standardization of interfaces eases cost-of-entry to markets

Conformance adds legitimacy to product offering

Consumers view conformance as a confidence metric

Reduced time and cost to market

• Use of 3rd party components

• Simplify / reuse of design

Ability to reuse design ideas, incorporate off-the-shelf components into value-add offerings

Participation provides the ability to influence the standard

You can shape the standard to be supportive of your product architecture

Regulatory/Policy/Legislative …The Impacts and Rationale of HSSP SpecificationsRegulatory/Policy/Legislative …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Establishing objective assessment criteria:

Measurement criteria for regulatory compliance

Inclusion of rigorous conformance assertions benefits compliance and verification

Allows for technology change within the regulation

Concurrent support of multiple technologies allows for technology evolution

Offering an easy/easier solution that is complete and actionable / ease the path to adoption:

How do we “Pick the winning horse”?

“Opportunity cost” of using the wrong standard has big implications

HSSP integrates function/ behavior, data, and protocol promoting an integrated solution set

Solution that complements existing standards

HSSP is using HL7 semantics, OMG processes, IHE testing, and established technology protocols

Research …The Impacts and Rationale of HSSP SpecificationsResearch …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Promotes accessibility to “raw” information

Strong emphasis on semantically rigorous data and query/retrieval

Enabler for collaborative studies, e.g. de-identification, retrieval, etc.

Leveraged use of identity service enables de-identification

Enlarges cell and sample sizes based on interoperability

Facilitates responsiveness to bio-surveillance requirements

Standard interfaces accommodate dynamic and emerging strategies and tools

Enables construction of higher-order service stacks with less investment

Composable nature of services promotes construction

Implementer/Integrator …The Impacts and Rationale of HSSP SpecificationsImplementer/Integrator …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Reduced integration time and cost resulting from the use of standard tooling

Use of standard in off-the-shelf tools facilitates their use

Risk mitigation (skill portability/ training advantage, vendor independence, substitutability)

By training staff in the standard, skills are portable across tools

Creates a value offering opportunity based on the ability to deliver using these service standards

Allows staff and solutions to build upon the use of the standard and not technologies

Improved ability to deliver and support interfaces that have been implemented

Using services speeds project design phases and promotes reuse

SDOs …The Impacts and Rationale of HSSP SpecificationsSDOs …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Useable standards Emphasis on practicality

Market-focused standards based on commercial implementations

Shortens time required to develop specifications and encourages collaboration

Promotes harmonization, cooperation, cohesion among standards communities

Integration of function, data, and technology promotes leveraged reuse

More members/involvement = more revenue & better specs

Practical, market-focus and iterative timeline promotes participation and results

Composition of Profiles - ExampleComposition of Profiles - Example

Conformance Profile- Name- Version- Date- etc

Functional Profile- Name- Version- Capability 1- Capability 2- Capability N….

Semantic Profile- Information Model ID- Version- Source- etc

Entity Identification ServicePatient Cross Reference ProfileVersion: 1.0Date: 10/22/2007Description: …………..

Entity Cross-ReferenceVersion 1.0- Link Entity- Unlink Entity- List Linked Entities

HL7 RIM V2.14 Patient- HL7 RIM- V2.14- Model: Set of traits taken from

Patient Billing Account RMIM (FIAB_DM000000UV01).

(EIS SFM included sample model)

2/11/2014 9:17 AM Healthcare Services Specification Project The Business Case for Healthcare SOA...

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