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Shared Services in Health IT (based on SOA principles)
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Shared Services in Health IT (based on SOA principles)

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Shared Services in Health IT (based on SOA principles). What are some of common business services that most Health IT appliocations need? How do we change the paradigm from developing seperate......

Shared Services in Health IT (based on SOA principles). What are some of common business services that most Health IT appliocations need? How do we change the paradigm from developing seperate silo applications to the one based on shared services?

Presentation by Paul Aneja.

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  • 1. Shared Services Strategy (based on SOA for Health IT Applications) Paul Aneja Co-Chair Enterprise Architecture CoP Nov 2009 Draft Work in Progress Paul.aneja@state.or.us
  • 2. Motivation: Shared Services in Health IT Informatics EA WG initiated a focus on Shared Services Action Item: Paul Aneja working with Informatics EA WG and Industry experts to lead development of a Shared Services Strategy for Health IT How can Shared Services improve Health IT? Why do we have so many separate or disparate systems? How do we change the paradigm of building separate health systems to reusing shared services? What can we do get started? This presentation builds upon “Strategies for Improving Health IT Architecture Interoperability” and “SOA Foundation” presentations. Health IT Shared Services Strategy 2
  • 3. Current State Future State
  • 4. Current State: Vertical Applications (Separate, Disconnected, Different Architectures, Technologies, Integration is a challenge…) Division “A” Division “B” Division “C” Division “D” Division “E” Health IT Shared Services Strategy 4
  • 5. “Shared Services” in a Future There are common functions across applications Citizens Programs Shared Services Health Partners Federal/CDC Health IT Shared Services Strategy 5
  • 6. Current State vs. Future Shared Services Impact Current State Shared Services Vertical Applications Vertical Applications Improve Interoperability Improve Interoperability Difficult to share applications Increase sharing Increase sharing Difficult to share applications Functional Duplication Common Functional Services Common Functional Services Functional Duplication Services Oriented Architecture with Services Oriented Architecture with “Point to Point” “Point to Point” Services Bus Services Bus Inconsistent business logic for Inconsistent business logic for Shared services provide consistency Shared services provide consistency same purpose same purpose Minimum Sharing of Applications/Technology Minimum Sharing of Applications/Technology Shared Services Shared Services Investments Investments Different Architectures SOA acts as a Unifying/Overall Architecture SOA acts as a Unifying/Overall Architecture Different Architectures Inefficient – Increases Costs Lower cost over time Lower cost over time Inefficient – Increases Costs Health IT Shared Services Strategy 6
  • 7. Shared Services Starter List for Health IT
  • 8. Shared Services in Health IT (Here is a starting list of potential HIE shared services…) PH Case Reportable Lab Enrollment Health Reporting Surveillance Data Result Shared Get Vital Stats GIS Eligibility Services Immunization Record Service Get Immunization Check Validation Vocabulary Records Service Update Client Authentication Address Demographics HIE Record Matching Foundational Service Provider Validation Service Shared Identification Secure Get Synchronize Security Services Get/Update Messaging HIE Record State HIE Service Exchange PHR Consent EMR Data De-Identify Management Service Subject Health Information Retrieve Discovery Authorized Event Log NHIN Case Follow-up Documents Shared Query for NHIE Service Query Services Documents Registry Audit Log What other Shared Services are needed? Health IT Shared Services Strategy 8
  • 9. Shared Services Strategy Shared Services Strategy Identify Shared Services that can be leveraged Have one National Health Shared Services repository Increase the number of Shared Services over next 2-3 years Actively manage the Shared Services Portfolio Focus on a prioritized set of initial services Adopt, extend and leverage industry SOA and Services standards EA to coordinate shared services across enterprise Work with Federal/industry infrastructure orgs on pilot Training for SOA and services Health IT Shared Services Strategy 9
  • 10. Industry Initiatives (a select list)
  • 11. Nationwide Health Information Network Standards and Services Profiles describe how to NHIN Profiles implement services for a specific domain like Consumer Preferences Profile consumer preferences for • Store and exchange consumer Other Profiles in Development • GIPSE (Biosurveillance) information sharing or preferences for sharing of personal health biosurveillance information NHIN Services Services describe specific interfaces (web services) Discovery Services used between HIEs to Information Exchange Services discover and exchange • Subject Discovery • Retrieve Documents health-related information • Authorized Case Follow-up • Query Audit Log • Query for Documents • Health Information Event Messaging •NHIE Service Registry Messaging, Security and Privacy Foundation describes the underlying protocols and capabilities Messaging, Security and Privacy Foundation necessary to send and secure messages between NHIE Security Messaging Authorization Framework • Public Key Infrastructure • Message Transport • Requestor Authentication • Encryption • Services Definition • Requestor Authorization • Digital Signature 11 Copyright 2009. Shared Services Strategy Health IT All Rights Reserved. 11
  • 12. IHE Integration Profiles (select) Clinical and PHR Content Security & Privacy Basic Patients Privacy Patient ID Mgmt Emergency Referrals PHR Extracts/Updates Format of the Document Content Consents Establish Consents & Enable ECG associated coded vocabulary and Report Document Format of the Document Content Access Control Patient Lab ResultsDocumentvocabulary and associated coded Document Demographics Query Format of the Content Content vocabulary Scanned Documents and associated coded Cross-Enterprise User Format of the Document Content Patient Identifier Format of theInformation Imaging Document Content and associated coded vocabulary Attestation User Attributes fro Access Control Cross-referencing Format of theSummary Medical Document Content Map patient identifiers across and(associated coded vocabulary Meds, Allergies, Pbs) independent identification Format of the Document Content Document Digital domains and associated coded vocabulary Signature Attesting “true-copy and origin Health Data Exchange Cross-Enterprise Audit Trail & Node Other Document Sharing Authentication Request Form Registration, distribution and access across health enterprises of clinical Centralized privacy audit trail and for Data Capture node to node authentication to create External form with custom documents forming a longitudinal a secured domain. import/export scripting record Cross-Enterprise Document Pt-Pt Reliable Interchange Notification of Cross-Enterprise Document Consistent Time Document Media Interchange Coordinate time across networked Availability Notification of a remote Cross-Community Access systems provider/ health enterprise 12 Health IT Shared Services Strategy 12
  • 13. Health related Standards (select) Others Consistent Time (CT) T16 IETF NTP, SNTP 12367 Audit Trail and Node Authentication (ATNA) T15, T17 IETF RFC-3881, TLS RFC- 12367 Cross Enterprise Document Sharing (XDS.b) TP13 ebRIM, ebRS, ISO 15000 12367 Patient Identifier Cross Referencing (PIX) V2.3.1 ADT TP22 12367 Patient Demographics Query (PDQ) V2.5.1 ADT TP23 12367 Request Form for Data Capture (RFD) TP50 W3C XHTML 2457 Medical Documents (XDS-MS) (XDS- CDA R2, CCD C48 1 Sharing Lab Reports (XD-LAB) (XD- CDA R2 C37 1 Infobutton T81 2 Query for Existing Data (QED) V3 Care Record TP21 3 Immunization Content (IC) CDA R2, CCD C78 3 V2.3.1 VXU C72 3 Cross Enterprise User Authentication (XUA) SAML TP20 35 Cancer Pathology V2 ORU 5 Drug Safety Content CCD C76 56 Digital Signatures (DSG) C26 X.509, W3C XADES 356 Basic Patient Privacy Consents CDA R2 TP30 356 Exchange of Personal Health Records (XPHR) CCD C32 6 13 Health IT Shared Services Strategy 13
  • 14. Informatics EA WG Session Feedback on Shared Services (Sept 2009)
  • 15. Top Challenges: Shared Services (from Informatics EA WG) Service vs. System distinctions How to incorporate all services + find commonality Funding – how to creatively fund? No group owns shared services Shared infrastructure – where should it be? Communicating value of Shared Services metrics for ROI Stronger Architecture governance of Shared Services How do we find Services? – Services Repository Alignment across federal, state agencies Some legal issues in sharing Organizational culture and barriers Funding mandates do not match needs How do we share services from other groups, states, federal agencies? Health IT Shared Services Strategy 15
  • 16. Key Interoperability Solutions for Shared Services (from Informatics EA WG) Define Shared Services (reusable) Lifecycle model- bring PH into existing standards efforts Funding models - “user fee model” or transaction–based (infrastructure tax or tolls) Executive ownership – need for tech support to promote sustainability Stronger Architecture governance of Shared Services Indentify common shared services for PH Catalog of services i.e. open registry PHIN/NHIN convergence ( alignment, integration) Communicating value for reusability Retraining to build in use of best practices Open source, usable, technology neutral PH (Public Health) + HC (healthcare) are on the same team Health IT Shared Services Strategy 16
  • 17. Feedback - Questions & Answers Health IT Shared Services Strategy 17