Innovation in Healthcare: Transforming Paper to an eSubmissions SOA


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This session will challenges of the U.S. government’s migration from paper-based processes to complete SOA solution integrated across agencies and external partners – a transformation awarded the Best Organization SOA Application by the Federal CIO Council’s Service-Oriented Architectures Community of Practice. Critical to success was the use of open source and open standard technologies. Included in this is rule-based document
handling as well as extended rule directed business processes. Converting backend manual review processes to an automated workflow dashboard with knowledge driven document intelligence to assist the staff
and researchers. This system is now successfully deployed with ability to handle thousands of application submissions a week, resulting in up to 10 gigabytes of data flows weekly. The lessons learned in managing open source and open technology as well as aligning and leveraging both batch and real-time online
tools with desktop applications will be highlighted. Knowing how to exploit the power of XML integration technologies is also crucial. Culture shift for the in-house staff also has to be managed – and the experience of providing help desk support to external partners.

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  • Innovation in Healthcare: Transforming Paper to an eSubmissions SOA

    1. 1. <ul><li>David RR Webber </li></ul><ul><li>Lead Analyst NIH/OD </li></ul><ul><li>Illumonus Group </li></ul><ul><li>Session Title: </li></ul><ul><li>Innovation in Healthcare: Transforming Paper to an eSubmissions SOA </li></ul>Welcome to Transformation and Innovation 2007 The Business Transformation Conference Welcome
    2. 2. Agenda <ul><li>Project History / Background / Goals </li></ul><ul><li>Technology Approach </li></ul><ul><li>SOA Details </li></ul><ul><li>Open Source / Open Standards </li></ul><ul><li>Summary / Review </li></ul>
    3. 3. Project History / Background / Goals <ul><li>Grants Community (healthcare research) </li></ul><ul><li>NIH/OD eRA eReceipts </li></ul><ul><li>Beyond Paper </li></ul>
    4. 4. Grants Community (health research) <ul><li> portal created by Congress </li></ul><ul><li>Central collection point for all government grants information </li></ul><ul><li>Supplemental ability to submit grants via routing service </li></ul><ul><li>Offers central forms facilities for Agencies </li></ul><ul><li>Can authenticate applicants (complex!) </li></ul><ul><li>Health research submissions major community ($4B annual funding) </li></ul>
    5. 5. Applicants - prefer a common view The typical grant applicants’ challenge Juggling all the various different formats and procedures
    6. 6. Agency Delivery Services Client Application Forms S2S Services Grants Management Tools Opportunity Repository Public Grants Portal Certification, Verification Submission Handler / Routing PDF-based web browser deployment + extensible open tools Open source transport web services and secure B2G interfacing Open source transport web services and secure G2G interfacing Exchange infrastructure with XML and PDF content SAML based sign-on and verification services Web html portal services Web based menus and forms / XML-based configuration profiles Adobe LiveCycle with download packages and web management forms
    7. 7. Beyond Paper - NIH Grants Management <ul><li>NIH issues billions of dollars in grant awards to investigators worldwide annually </li></ul><ul><li>Receives 70,000+ research and training grant applications </li></ul><ul><li>Handling 20,000,000+ pages of paper </li></ul><ul><li>Goal - to electronically receive, verify and accept ALL Research/Research related Grant Applications (initially 80:20 rule, then all) </li></ul>
    8. 8. Grants Support Services Components <ul><li>Submission of modular grants </li></ul><ul><li>Submission of full budget grants (no sub-projects or consortia) </li></ul><ul><li>Validation results returned to Submitter system </li></ul><ul><li>Validation service before submission </li></ul><ul><li>Grant image generation by NIH </li></ul><ul><li>View and approve generated image for sign-off of submission (web GUI) </li></ul><ul><li>Investigator Personal profile query and update </li></ul><ul><li>Status inquiries in grant workflow processing </li></ul><ul><li>Notification of peer review assignment </li></ul>
    9. 9. NIH Exchange - Design Goals <ul><li>Automated registration of participants </li></ul><ul><li>Ability to self-certify exchange transactions </li></ul><ul><li>Version control and ability to approve partners </li></ul><ul><li>Centralized registry for participant management </li></ul><ul><li>Declared and shared business rule scripting </li></ul><ul><li>Integration through messaging services </li></ul><ul><li>Backend application integration services </li></ul><ul><li>Uses open public specifications and open source </li></ul>
    10. 10. NIH/OD eRA eReceipts <ul><li>National Institutes of Health </li></ul><ul><ul><li>Electronic Receipts Administration </li></ul></ul><ul><ul><ul><li>eReceipts Exchange: </li></ul></ul></ul><ul><ul><ul><ul><li>interface to </li></ul></ul></ul></ul><ul><ul><ul><ul><li>system-to-system support </li></ul></ul></ul></ul><ul><ul><ul><ul><li>“ Commons” web application </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Grants award tracking </li></ul></ul></ul></ul><ul><li>On the web at: </li></ul><ul><ul><li> </li></ul></ul><ul><ul><li> </li></ul></ul>
    11. 11. CIO’s perception of SOA Today <ul><li>Independent of underlying technology </li></ul><ul><li>A general model for offering computing and information services in large, loosely coupled, highly distributed environment. </li></ul><ul><li>The standardized and probably most widely associated implementation technology is web services </li></ul><ul><li>But many look to implement SOA with their foundation technologies such as IBM MQ Series or Oracle A/S </li></ul>
    12. 12. Core eGovernment Requirements <ul><li>Business Perspective – meeting goals / needs </li></ul><ul><li>Community of Practice – fostering open adoption </li></ul><ul><li>Management – formal oversight and methods </li></ul><ul><li>Accessibility – open platform, open system </li></ul><ul><li>Security – certify participants, non-intrusively </li></ul><ul><li>Agility – flexibility of interfaces, content, rules </li></ul><ul><li>Performance – scalability, cost, re-use, maintenance </li></ul>
    13. 13. Help Desk / Culture Transition <ul><li>Old paper based submission knowledge </li></ul><ul><li>New electronic forms submission </li></ul><ul><ul><li>Understand entry process </li></ul></ul><ul><ul><li>Manage verification sign-up </li></ul></ul><ul><ul><li>Link to existing Commons web forms </li></ul></ul><ul><ul><li>Supporting documents generation </li></ul></ul><ul><ul><li>Scanning and digital images </li></ul></ul><ul><ul><li>Reporting and tracking via email </li></ul></ul>
    14. 14. Technology Approach <ul><li>Document Handling - PDF </li></ul><ul><li>Submission Information - XML </li></ul><ul><li>Transports – https, WSDL, ebXML, SSL </li></ul><ul><ul><li>S2Sclient application </li></ul></ul><ul><li>Knowledge Mining support </li></ul>
    15. 15. Technology - Quick History <ul><li>Notion of using Internet to securely exchange digital business information </li></ul><ul><ul><li>PDF started in 1991 by Adobe; 1993 launch </li></ul></ul><ul><ul><li>XML started in 1997 </li></ul></ul><ul><ul><li>B2B work on XML/edi and ebXML </li></ul></ul><ul><ul><li>ebXML specification – May 11 th , 2001 </li></ul></ul><ul><ul><li>Web services – started 2001 as ‘quick fix’ </li></ul></ul><ul><ul><li>WSDL and XSD developed by W3C </li></ul></ul><ul><li>Web services used by Amazon and eBay </li></ul><ul><li>Marketing of SOA emerges </li></ul>
    16. 16. Document Handling – PDF / XML PDF attachments http connection Intake & Processing Applicant Asych Messaging 2 3 Client Side Validation Agency Rules Federal Rules Federal Credential Agency Credential Structure / Data PDF attachments XML forms Upload 1 XML data Intake & Processing Staged Exchanges 5 Agency Rules 4
    17. 17. Packaging / Delivery PDF attachments PDF Form images Intake & Processing Agency Downstream Systems Applicant Asych Messaging 3 Delivery Packaging 1 PDF attachments XML data 6 Delivery ZIP package SOAP package Intake & Processing Asych Messaging Agency Downstream Systems Separate Staged Delivery Indirect feedback XML data XML response Direct feedback Staged Exchanges PDF Form images Generation 5 8 9 7 Agency
    18. 18. Knowledge Mining Support <ul><li>Extract of text from PDF(s) </li></ul><ul><li>Selection of data from XML </li></ul><ul><li>Import to knowledge mining tools (commercial) </li></ul><ul><li>Reporting and querying by NIH staff </li></ul><ul><li>Ability to import profiles into KM tools of reviewers and researchers </li></ul><ul><li>Knowledge mining potential for healthcare research: </li></ul><ul><ul><li>Leveraging Knowledge for Modern Science Management Monday, February 06, 2006 </li></ul></ul><ul><ul><li> </li></ul></ul>
    19. 19. SOA Details <ul><li>Partner Management - CPA </li></ul><ul><li>External Information Services </li></ul><ul><li>Internal Delivery Exchanges </li></ul><ul><li>Security Considerations </li></ul><ul><li>Toward Registry Facilitation </li></ul><ul><li>Acceptance Testing and Version Control </li></ul>
    20. 20. What exactly is SOA? <ul><li>SOA still very much dependent on the focus of the advocate </li></ul><ul><li>Some commonly accepted wisdoms </li></ul><ul><ul><li>Using internet TCP/IP based exchanges </li></ul></ul><ul><ul><li>Both “real time” and “batch” services </li></ul></ul><ul><ul><li>Need registry to manage content / services </li></ul></ul><ul><ul><li>Robust Security and Authentication </li></ul></ul><ul><ul><li>Partner profiles - MoU, roles, context </li></ul></ul><ul><ul><li>Rule based business information handling </li></ul></ul><ul><ul><li>Business process formalization </li></ul></ul>
    21. 21. Operational Requirements <ul><li>Outward facing messaging systems </li></ul><ul><li>Formal agreement profiles for business participants </li></ul><ul><li>Business process workflow definitions </li></ul><ul><li>Information exchange rules </li></ul><ul><li>Registry to hold agreements, definitions, scripts / (provides common point of reference for partners to ensure consistent operational practices) </li></ul><ul><li>Internal integration routing and dispatch methods </li></ul><ul><li>User interfacing for entry/control with quick sign-up </li></ul>
    22. 22. 1. Memorandum of Understanding <ul><li>Business Analyst </li></ul><ul><ul><li>Meeting of the Minds </li></ul></ul><ul><ul><li>Business Goals </li></ul></ul><ul><ul><li>Define Scope </li></ul></ul><ul><ul><li>Rough Timeline </li></ul></ul><ul><ul><li>Creation / Best Practice Wizard </li></ul></ul>CPA – Collaboration Profile Agreement 2. Collaboration Protocol Agreements <ul><li>Operations Managers </li></ul><ul><ul><li>Precise Choreography </li></ul></ul><ul><ul><li>Automated </li></ul></ul><ul><ul><li>Messaging Parameters </li></ul></ul><ul><ul><li>Profiles and Templates for creation </li></ul></ul><ul><ul><li>Runtime XML instances </li></ul></ul><ul><ul><li>Configure partner setup </li></ul></ul>3. On-line Registry <ul><li>Systems Administrators </li></ul><ul><li>Manage operational use </li></ul><ul><li>Provide automation access </li></ul>
    23. 23. Rules Applications Workflow and State Management Presentation, Control and Reporting Services Content Management Document Management Application Tracking Shared data repository of key information Web forms system Oracle Database Exchange Services XML Document Handling Registry Registry Services Security & Privacy Customer Management Pluggable Status Tracking External Parties Message Exchanges XML 1 2 3 4 5 6 Rules Open Standards, Open Platform, Open Source Submission Delivery Asynch (pull delivery) Status update notices Applicants B2B Delivery <ul><li>Full S2S Delivery Services – </li></ul><ul><li>Push </li></ul><ul><li>Query/Response </li></ul><ul><li>Pull </li></ul>XML eReceipts Workflow Overview 7 8 Knowledge Mining Integrated front-end system for applicants and partners
    24. 24. S2Sclient Application Integration S2Sclient Installed NIH eReceipts Exchange Transaction Handlers ebXML CPA Partner configurations XML Oracle Processing Rules references transactions Internet Partner’s Grant Tracking System XML XML NIH Grants Systems Partner Setup Forms Validation Services Rules CPA <ul><li>Notices </li></ul><ul><li>Queries </li></ul><ul><li>Results </li></ul><ul><li>Errors </li></ul><ul><li>Updates </li></ul>
    25. 25. Research Cues / Triggers Applicant Profiles Exchange Services S2S exchanges Other Pluggable Status Tracking Pluggable Interfacing Submissions / Exchanges Data Persistence Agent Content Validation Agent Neutral Data Handling Layer Script Script PDF Handling Services Script Script Script Script Delivery Queue Dispatch Queue Registry Services Dispatch Agent Script KBase Handling Partner Profiles Semantic Hierarchies Interfacing KBase Services Knowledge Tools 1 2 3 4 5 6 Web browser / Web services SOA Conceptual Architecture
    26. 26. Leveraging Open Standards <ul><li>Combining best-of-breed solution with both ebXML and Web services working together </li></ul><ul><li>Open source solution components to allow unrestricted integration by partners </li></ul><ul><li>Foundation of ebXML formal interchange model </li></ul><ul><li>Leveraging loose coupling of web services </li></ul>
    27. 27. Role of Registry in the Service Lifecycle Staging Registry Service Provision Publish Discover Consume Version Service Consumption Operate Deploy Specify Certify Plan Production Registry Service Management Publish planned Services Certify in Approval Process Register Versions and Redirect Publish Via Staging Registry Dynamic Run-time Discovery Feedback QoS Asset Management Tools Developer Tools Asset Management Tools Developer Tools Discover Services Registry becomes “System of Record” for Service Lifecycle
    28. 28. Open Source / Open Standards <ul><li>XML handling </li></ul><ul><li>PDF and supporting tools </li></ul><ul><li>Open platform needs </li></ul><ul><li>Open source transport foundations </li></ul><ul><li>Rule based approach – (JBoss Rules/OASIS CAM) </li></ul><ul><li>Technology integration resolution </li></ul>
    29. 29. Open Source Components Used <ul><li>XML handling – Java XMLBeans (BEA) </li></ul><ul><li>PDF handling – iText function library </li></ul><ul><li>Transport – </li></ul><ul><ul><li>Apache SOAP </li></ul></ul><ul><ul><li>freebXML Hermes v1.1 </li></ul></ul><ul><ul><li>“ S2Sclient” developed – grants application B2B applicance </li></ul></ul><ul><li>Rules engines – </li></ul><ul><ul><li>JBOSS Rules (DROOLS) (Java rules interface conformant) </li></ul></ul><ul><ul><li>CAM (OASIS) </li></ul></ul><ul><ul><li>Both have Eclipse editors for easy rule entry </li></ul></ul><ul><li>Application Servers – </li></ul><ul><ul><li>Tomcat OSS / Oracle App Server (not OSS) </li></ul></ul><ul><li>Database persistence </li></ul><ul><ul><li>DerbyDB – embedded in S2Sclient </li></ul></ul>
    30. 30. Summary / Review <ul><li>Becoming Center of Excellence </li></ul><ul><li>Supporting Agency Re-Use </li></ul><ul><li>Next Steps – </li></ul><ul><ul><li>Business Processes – (BPSS) </li></ul></ul><ul><ul><li>Knowledge Mining extending </li></ul></ul><ul><ul><li>Rule based handling – (JBoss Rules / CAM / PDF) </li></ul></ul><ul><ul><li>S2Sclient - “ebXML B2B Appliance” </li></ul></ul>
    31. 31. Lessons Learned <ul><li>Providing self-service facilities is key to rapid adoption </li></ul><ul><li>Infrastructure exists today off-the-shelf to create pre-built templates for industry domains </li></ul><ul><li>Using open specifications allows integration into wide range of environments </li></ul><ul><li>Open source solutions allows partners to readily obtain technology </li></ul><ul><li>Use of partner id concept to manage partners and versioning interchanges </li></ul>
    32. 32. Challenges / Opportunities Today <ul><li>Exposing synchronous and asynchronous interfacing to control content access </li></ul><ul><li>Open source solution components to allow unrestricted integration by partners </li></ul><ul><li>Leveraging loose coupling of web services </li></ul><ul><li>Combining best-of-breed solution with both ebXML and Web services working together as formal model </li></ul><ul><li>Industry best-practices and lessons learned (who has solved similar needs?) </li></ul>
    33. 33. Beyond Grants Applications <ul><li>The ability to interface quickly and easily to external parties with limited resources is not just a grants applications need </li></ul><ul><li>Secure reliable verifiable common communications infrastructure based on open public specifications </li></ul><ul><li>Other potential applicable areas: </li></ul><ul><ul><li>HHS - Cancer Research Centers </li></ul></ul><ul><ul><li>CDC – Emergency Alerting systems </li></ul></ul><ul><ul><li>NSF – National Science Foundation grants </li></ul></ul><ul><ul><li>Navy – Medical Services coordination </li></ul></ul><ul><ul><li>FEMA – Emergency supply chain delivery </li></ul></ul><ul><ul><li>DHS – Intra-agency information sharing </li></ul></ul><ul><ul><li>EPA – External regulatory reporting </li></ul></ul>
    34. 34. Thank You <ul><li>David RR Webber </li></ul><ul><li>Lead Analyst, NIH/OD </li></ul><ul><li>Illumonus Group </li></ul><ul><li>Contact Information: </li></ul><ul><li>drrwebber@ </li></ul>Thank You
    35. 35. Acronym Soup <ul><li>WSDL – web service description language </li></ul><ul><li>SOAP – simple object access protocol </li></ul><ul><li>ebXML – e-Business XML </li></ul><ul><li>REST – Representational State Transfer – http-based exchanges </li></ul><ul><li>XSD – XML Schema (structure / layout) Definition </li></ul><ul><li>XML – eXtensible Markup Language </li></ul><ul><li>W3C – World Wide Web consortium </li></ul><ul><li>B2B – business to business </li></ul><ul><li>MoU – Memorandum of Understanding </li></ul><ul><li>CPA – Collaboration Protocol Agreement (see also CPPA) </li></ul><ul><li>TCP/IP – internet communications syntax </li></ul>
    36. 36. Project and Technology Resources <ul><li>NIH eRA Project site – http:// </li></ul><ul><li>NIH Grants site - http:// / </li></ul><ul><li>Commons online site – https:// /commons/ </li></ul><ul><li> online site – http:// </li></ul>
    37. 37. Technology Resources <ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>