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Expanded SOA White Paper

Expanded SOA White Paper. Detailed Profile Proposal for 2008/09 presented to the IT Infrastructure Planning Committee Alean Kirnak Joe Natoli Et al November 18, 2008. Public Health Use Case.

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Expanded SOA White Paper

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  1. Expanded SOA White Paper Detailed Profile Proposal for 2008/09 presented to the IT Infrastructure Planning Committee Alean Kirnak Joe Natoli Et al November 18, 2008

  2. Public Health Use Case • In 2007-2009, Public Health Data Standards Consortium (PHDSC), the American Immunization Registry Association (AIRA), and Software Partners developed the Immunization Content (PCC) Profile and the Pediatric Demographics supplement • This work suggests new public health models • PHDSC white paper*: silos repeat functionality and don’t talk to each other • New standards offer new workflow possibilities and related cost savings * Building the roadmap for health information systems interoperability for public health

  3. IHE, SOA and Economics How can IHE profiles plus SOA reduce public health costs? • Decentralized, user-centric workflow • Reduction in connectivity costs by transforming order(N2) costs to order (N)

  4. Numerous Use Cases within Public Health • Cancer Registries • Chronic Disease Management Solutions • Quality Reporting • Biosurveillance • Adverse Event Reporting • Organ Donor Registries • Immunization Information Systems

  5. Common Workflow

  6. IIS Workflow: Directly Connected User • retrieve immunization and other clinical data • validate immunization history • determine patient status (vaccines due, etc.) • Administer and record vaccines • forecast next due date • provide an official record - “yellow card“ • save data in IIS • (IIS may forward to other interested provider)

  7. Retrieve patient data

  8. Validate, recommend, record

  9. Web-based Architecture Stakeholders Web-based Application Data Stores Identity Resolution (PIX/PDQ) Retrieval/Update of Data (XDS, Immunization Content) Decision Support (Current PCC proposal) (Pub/Sub) Immunization Information System (IIS)Data Store Hospital #2 Clinic #2 Hospital #1 user Clinic #1 user Other provider user Other user

  10. IIS Workflow: Provider with EHR • retrieve immunization and other clinical data • validate immunization history • determine patient status (vaccines due, etc.) • administer and record vaccines • forecast next due date • provide an official record - “yellow card“ • save data in electronic health records (EHR) system • send the data to the IIS • (forward to other interested providers)

  11. Retrieve Medical Summary

  12. Validate, recommend, record

  13. Send Immunization Content to IIS

  14. IIS Receives Immunization Content

  15. Document Repository Receives Immunization Content … <administerableMaterialclassCode="MMAT" determinerCode="INSTANCE"> <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" /> <templateId root="2.16.840.1.113883.10.20.1.53" /> <code code="20" codeSystem="2.16.840.1.113883.6.59" displayName="DTap" /> …

  16. Public Health Nurse or Patient PHR

  17. Public Health Nurse or Patient PHR

  18. Public Health Nurse or Patient PHR

  19. Public Health Nurse or Patient PHR

  20. IIS Service-Oriented Architecture Service Bus Data Stores Stakeholders XDS Document Registry Hospital #1 EMR Decision Support Service (PCC - proposed) Other Data Store Master Person Index SDIR (MPI, immunization data) Clinic #2 Hospital #2 Other Service (yellow card?) Security Transformation Patient Identification Service (PIX/PDQ) Locate, Retrieve and Update Service (XDS, IC, content) Clinic #1 EMR XDS Document Repository Web-based EMR interface for small providers Other patient or provider Interface

  21. Reduced Costs • Mathematics of connections • N2 -> N • User-centric workflow • No double data entry • Many more benefits Status quo suggested SOA

  22. What IHE issues need to be explored? • Multiple versions (i.e. PIX/PDQ) • Scattered documentation • Lack of uniformity among services • More semantic specification including possible formalisms

  23. Open Issues Experience of some of the authors to date: • Mechanism for payload specification • Harmonization of multiple HL7 artifacts (as in harmonization of HL7 Immunization and Care Provision standards in creating the PCC Immunization Content profile) • Common approaches taken in multiple service specifications • How to build upon existing IHE profiles • Methods for specifying operations semantics

  24. What Standards and SDO Activities to Consider • Existing Web Services Glossy • HL7 Service-Aware Enterprise Architecture Framework (SAEAF) • HL7 HSSP Service Functional Models • HL7 SOA Practical Guide • HSSP service specifications in OMG • Entity Identification Service (EIS) • Retrieve, Locate and Update Service (RLUS) • Decision Support Service (DSS) • ?DICOM activities • ?HITSP Framework group • Existing IHE profiles

  25. Authors • Alean Kirnak, Software Partners LLC (Dave Shields) • Joseph Natoli, Intel (Josh Painter) • Anna Orlova, Public Health Data Standards Consortium (PHDSC) • Charles Parisot, GE Medical • Karen Witting, IBM • Michael Nusbaum (for Canadian Health Infoway) • Ana Estelrich (for QRPH) • ?Author from Epic (VassilPeytchev) • ?Author from PCC (Keith Boone)

  26. Effort • Medium but flexible

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