Why can you achieve Interoperability through deployment of a SOA corporative strategy. Andalusian Healthcare Service, a case of use.
Achieve a viable pathway to the evolution of systems existing in autonomic environments of wingspan to a business model based on the paradigm SOA. Determine the current state of the habitual environment itself; cases of legacy systems, projects underway, State of the master data and define the necessary lines of work carried out achieve SOA model: architecture, tools and resources, and governance.
Towards Interoperabilityenabling SOA strategy José R. Fernández Engo – Charge of IOP – SOA Strategy at Andalusian Healthcare Ministry – IT Division. firstname.lastname@example.org http://es.linkedin.com/pub/jos%C3%A9-rom%C3%A1n-fern%C3%A1ndez-engo/11/3a0/30
Target:To establish the relationship between the development of a strategy oriented to services and the achievement of the interoperability secondary objectives:achieve a viable pathway to the evolution of systems existing in autonomic environments of wingspan to a business model based on the paradigm SOA determine the current state of the habitual environment itself; cases of legacy systems, projects underway, State of the master data. Define the necessary lines of work carried out achieve SOA model: architecture, tools and resources, governance
We are going to talk about:• ITC in large healthcare systems - situation.• Interoperability• SOA in Healthcare• SOA: a way to interoperability.• Pathway approach.• Impact of the model.• Case of use: Andalusian Healthcare Service
ITC at Healthcare SystemsAt Public Healthcare Systems:• Lack of ITC vision, i.e. technology and INFORMATION• Lack of decision-making capacity in organizations• Usually systems badly equipped• Lack of knowledge about the business• 2 costumers in the value-chain: o professionals: their technologists o citizens: public employees• We‟re in the world… and it‟s moving on: o SNS o epSOS
ITC at Healthcare Systems N1 N2 Fecha, cie9 FTP AP Sin formato AP 1 2 N,cie10 N3 FTP AP AP 4 dblink 9 chino N,a,dN6 AP1 jdbc XMLs 0 HL7 2.3 Loinc, sc AP AP1 7 Fecha,d 5 odbc AP deutsch 6 D, date FTP Datum, monate AP a,d 8 N4 d N5 Id,d Business?
ITC at Healthcare Systems Technology: • Uncoordinated providers, vendors and developments. • developed systems without a project. • Strong dependencies with political decisions without strategies. • Very strong legacies systems • No procedures, no methodologies • No interoperability through systems into the organization As result of the patterns of evolution reflected above we suffer the not provided and forced coexistence of many technologies but some not supported, some obsolete, some incompatible,…
ITC at Healthcare Systems Information: • Systems don‟t share master data • Strongly coupled subsystems – high dependence • No scalability strategy neither vertical nor horizontal • Uncontrolled replica • No global vision about systems -> wheel reinvented usually • No common way to share EHR though different clinical environments (GP, hospital, ambulatory, etc.)
ITC at Healthcare Systems Volume: No strategy or prevision for systems concurrence No strategy to historical data transition neither functional nor technical No volume optimization queries in applications Not prevision about evolution of the data repositories No finished EHR treatment in clinicians view
IOP: what’s that?Integration: technical solution for the exchange ofdata between the two applications.Interoperability: The interoperability is the conditionwhereby heterogeneous systems can exchangeprocesses or data, automatically, keeping themeaning in both ends. Example: speak 2 languages
interoperability IOP level Scope GeneralHealthcare Policies Vision and strategy Structures, processes, incentives Sustainable legal and socio-economic framework Privacy and confidentiality Tools, process, professionals and systems certificationOrganizational Organizational cultureSuppliers/vendors Processes of internal and external servicesofservices Management of change Process reingenieringSemantic Terminologies, clasifications and onthologies scalability Translations sustainability Development and deployment of sustainable architecturesSyntactic MessagingTechnical Technical standards Hardware and software connectivity Security User interface
interoperability between organizationsAchieving interoperability involves achieving the sameat all levels and these levels are interdependent.Unable to establish interoperable policies betweenorganizations if the processes are not defined. Thesecan not be if the significance of the information is not.Unable to achieve semantic interoperability if the wayto management information and semantic is notinteroperable and it is no use to achieve the above ifthe transmission layer technology fails tocommunicate both organizations.
SOA in Healthcare environment: a chip change• Legacy systems are the kernel of business. We‟re going to find situations with no possible or not profitable evolution/change.• No vendor is the best in every business. Although we‟ve a solid and complete normative framework we‟ll need interoperability with no anticipated systems.• Healthcare business is always on the road, with a very high rate of change both clinical and managerial so it requires a innovative and solid framework that facilitate a quick reaction with high quality, no impact in business and a consistent clinical information.
SOA -> IOPSOA model deployment achieve interoperabilitythrough entire organization in all its levels thanks to:• Structured policies• Global application of norms and standards• Consolidate a strong model of governance• A sustainable cycle of life• A deep knowledge of business, its needs and evolutions derived from a complete process model.
DetailedIOP needs: A change in development model Knowledge, knowledge, knowledgeNormalization, standards, common masters tables, business,… productivity, low costs, scalability, … SOA
Semantic interoperability SOA architecture g g g o s o s o N N N v e v e v O O O e r e r e R R R r v r v r M M M n i n i n S S S a c a c a n e n e n - - - c s c s c e e e
Strategy• Take a model scalable, sustainable and consistent• Become experts in our own business.• Set and extend a framework of rules and standards• Adoption of a technology model that allows -> governance, integration, modeling, reuse• Convergence of the systems to the new model project to project in the context of a macro-global project.• Establish responsibilities for information
Pathwayo Adoption of the strategy for the organizationo Modeling the business. Requires participation and time.o Define the business model and government.o Define technology and governance model.o Set of rules and standards, policies and procedures. Semantic.o Define master data of the Organization. How to share.o Convergence of the systems to the new model, project by project, as part of an overall macro-project, ensuring coexistence with the existing. Define the projects. Define the measurement.
Launch Plano Business Modeling SOAo Acquisition and implementation of physical architecture.o Implementation of SOA office. Where to look. Dissemination.o Location of the organizations master datao Selection, adoption and dissemination of standards. Certification.o What we have and what we don‟t have -> prioritizationo Development and adaptation of services designed and / or existing.o Decoupling applications.
Model impact• Impact on recruitment o Uniformity of support o Uniformity of technology o Consistency of performance o Ease in developing specifications o Use of certifications• Development impact o Reference documents o Centralized Support o Availability of infrastructure• Impact on knowledge management o It internalizes business knowledge o It spreads business knowledge
Model impact• Improvement internal control projects. Knowledge inside the organization.• Decoupling between applications.• Ensures interoperability of the organization both internally and externally• Ensures scalability and sustainability• Technologies upper level independent of platforms and languages• Ensures reuse. „Snowball„ effect.
Conclusions I• The deployment of an SOA strategy enables and strengthens the conditions necessary to achieve interoperability both internally and externally at all levels by: o The adoption of a strategy and a defined policy information (policy IOP) o The definition, modeling and consolidation processes of the organization (organizational IOP) o The launch of the services that establish and unify the interpretation of the information in the organization (IOP semantics) o The adoption of a syntax-based communication standards common to all systems (IOP syntactic) o The deployment of a physical architecture information management and communications standards-based technology, which ensures the exchange of information at the physical (technological IOP)
Conclusions II• They share the same needs for clear governance, methodological and understood by the organization to ensure scalability and sustainability.• In organizations “on the road” the recommended pathway of an approach that combines vision top - down and bottom - up since it is not feasible delete the non interoperable legacy systems immediately .• These should be isolated as soon as possible by services - facade to undertake its evolution with guarantees.• The impact on the organization model is extensive and undeniable but must be prioritized actions to consolidate developments.
S.S.P.A.: an approach• Population: 8,3 M• Professional> 80 k• Nº GP centers: 1.500• Hospitals: 29 + 25 CHARES• GP concurrent users: >9000• Nº appointment: 400M• Nº EHR: 8,8 M• Electronic prescription and dispensation use: 58%
S.S.P.A. original project: Diábaco Base de Datos de MTI: Usuarios, Citas, Explotación (Indicadores) Explotación Urgencias Salud Responde Navegador Hª Registros Garantías Citación y Peticiones RIS InterS@s u Pruebas Analíticas (2) tools COMUNES tools Receta XXI Prescripción PACS Vacunas U C HOSPITALIZACIÓN (1) P R O R G N I E S MEDICINA ENFERMERÍA M A N U Estaciones C L AGD R I T REGISTRO ADMVO Clínicas I A A A S S(1) En desarrollo Subsystems OPERADORES BDU ESTRUCTURA(2) En pilotaje Estructurales
S.S.P.A. reality 2009: Diábaco (PKI) Base de Datos de MTI: Usuarios, Explotación Citas, UrgenciasSalud Responde Navegador Hª Citación y Peticiones RIS A monolit with: Registros SQL ServerGarantíasInterS@s W2000 u Pruebas Analíticas (2) tools COMUNES InformixReceta XXI Prescripción Oracle 8, 10, 11 Vacunas Weblogic PACS Visual Basic, VB.NET U C IIS HOSPITALIZACIÓN (1) Clipper P R R G O Java… N Dbase I M E N S U MEDICINA ENFERMERÍA W2003AGD A R C I L T REGISTRO ADMVO I A A A S S OPERADORES BDU ESTRUCTURA
S.S.P.A. steep 1 Logical model BUSINESS: PROCESS AND FUNCTIONAL SERVICES Standard modelling (BPML,…) External modelling services Internal and provider t external s e consumers c Standard Messaging (HL7…) h Routing Audit n service Service Compose service service ext. Authentication/Authorizat ESB o ion l oE T L master Org. g Own Commerci data Data Legacy al Legacy yStandard data modelling– directory, terminologies, ontologies, etc. (CEN – CIE - SNOME
S.S.P.A. steep 2business architecture BAM: business process monitoring G O V BPM: Business process modeling E S R O N A ESB C A N CESB h1 ESB h2 ESB h3 ESB hn E
S.S.P.A. steep 4 documentation• Functional profile o Business definition and modelling o Cases of use• Operative profile: deployment• Compose services• Atomic services• Master Data tables• Norms and standards• Map of systems: SOA view• Map of process• Use of services contracts• Procedures
S.S.P.A. steep 5 methodology resources Personal Users Prescriptions Evolutionresources Personal Users Prescriptions Diraya, Receta XXI, BDU, MACO, estructura, etc
S.S.P.A.: launched - DAEHOSPITAL BDU BDU AGD DAE C. Externas y Urgencias (EG,EM,….) MACO Estructura MACO Estructura Concepto Inicial
S.S.P.A.: achieved• Deployment of the Technical Office of interoperability• Acquisition and extension of architecture based on federated ESB systems• Home care circuits modeling• Launching methodology to detect services based on modeling• DAE Project Extension to 21 hospitals in two years with incidences ratio <15/month• Extension of the model to other far-reaching corporate systems (MPA - Corporate LIS, Logistic, etc.)• Launching a website to disseminate the strategy• Commissioning of all sectors of documentation• Starting the master table model• General reuse services