Healthcare integration with IIB

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Healthcare integration with IIB

  1. 1. © 2014 IBM Corporation 1149 Healthcare Integration with IBM Integration Bus Ben Thompson <bthomps@uk.ibm.com>
  2. 2. Please Note IBM’s statements regarding its plans, directions, and intent are subject to change or withdrawal without notice at IBM’s sole discretion. Information regarding potential future products is intended to outline our general product direction and it should not be relied on in making a purchasing decision. The information mentioned regarding potential future products is not a commitment, promise, or legal obligation to deliver any material, code or functionality. Information about potential future products may not be incorporated into any contract. The development, release, and timing of any future features or functionality described for our products remains at our sole discretion. Performance is based on measurements and projections using standard IBM benchmarks in a controlled environment. The actual throughput or performance that any user will experience will vary depending upon many factors, including considerations such as the amount of multiprogramming in the user’s job stream, the I/O configuration, the storage configuration, and the workload processed. Therefore, no assurance can be given that an individual user will achieve results similar to those stated here.
  3. 3. IBM Integration Bus Industry Packs Each pack is a fully supported software product, independently delivered from IBM Integration Bus The purpose of an IIB Industry Pack is to provide industry-specific development accelerators which solve common industry integration problems Help users to deploy working integration solutions in literally a few clicks of the mouse. IIB Industry Pack content is structured around three delivery pillars: Connectors Data Definitions Integration Patterns Monitoring Association for Retail Technology Standards Open Applications Group Data Format Description Language Open Grid Forum Health Level 7 Digital Imaging and Communication in Medicine
  4. 4. IIB Healthcare Pack Landscape 4 Web Services HTTP / JSON SCA Web Services SOAP XML IBM Integration Bus + Healthcare Pack DICOM IDOC, BAPI Proprietary XML Corporate Applications Billing, Payroll, ERP, CRM Web Services SOAP, XML ODBC, JDBC, SQL Medical Imaging Modalities Clinical Repositories Web Services SOAP HTTP MQTT Continua HL7v2 Proprietary RS232 Sterling Connect Direct HIPAA Pharmacy HL7v2 NCPDP Medical Device Integration HL7v2 Cache ODBC Web Services Electronic Master Patient Index Web Services HL7v2 PIX / PDQ Web Services SOAP XML HL7v2 Cache ODBC HL7v3 CDA CCD Home Health DevicesMedical Insurers Medical Applications Legacy Hospital Interface EnginesAnalytics Business Processes Clinical Mobile Applications Decision Management Portal, Web Applications, Electronic Forms Dynamics Siebel SAP
  5. 5. Roadmap IBM's plans, directions, and intent are subject to change or withdrawal Q4 2011 WMB 8.0.0.0 Q1 2014 IIB Healthcare Pack 3.0 Integration Improvements (Error Handling, DFDL) Web User Interface Home Health Pattern Q1 2013 WMB 8.0.0.2 Q4 2013 IIB 9.0.0.1 Q2 2012 WMB Healthcare Pack 7FP2 Medical Device Input Node Pattern HL7 Reports Pattern Medical Device to EMR Q1 2013 WMB Healthcare Pack 8 ATNA Audit & DICOM nodes HL7 DFDL Model Patterns: DICOM, HL7 CDA Data Analysis IIB vNext *The first WMB Healthcare Pack (v7) was released in May 2011
  6. 6. Key Features Pattern-based development tooling - fast integration without detailed knowledge of integration technologies Makes use of proven runtime of IBM Integration Bus Integrates HL7 based clinical repositories & applications • Production ready patterns based around HL7 v2.x • Pattern allows easy customisation • Handles inbound and outbound MLLP socket connections • Message definitions for all chapters of the HL7 v2.x specifications Integrates DICOM based PACS & modalities Processes CDA/CCD documents Direct connectivity to medical equipment - monitors, infusion pumps etc Healthcare-oriented operational views • Single point of visibility and control Electronic Medical Records Patient Administration System PACS & imaging Labs & pharmacy Medical devices Remote Patient Monitoring
  7. 7. Standards STANDARD SUPPORT NOTES HL7 v2.x V2.2 up to v2.7 (inclusive) JAXB bindings provided Data Analysis profile provided2 HL7 v3 Supported directly by IBM Integration Bus HL7 CDA CDA / CDT Continuity of Care Documents (CCD) Consolidated CDA (C-CDA) HITSP (C32 / C83) Data Analysis profile provided2 DICOM C-STORE3 SCU and SCP C-FIND SCU C-MOVE SCU Data Analysis profile provided IHE Profiles PIX Manager PDQ Supplier ATNA Secure Node 2013 European Connectathon in Turkey alongside IBM Initiate 1 HIPAA and NCPDP supported by IBM Integration Bus with WebSphere Transformation Extender (WTX) 2 CDA and HL7 v2 Data Analysis profiles are integrated with the LOINC terminology code system 3 DICOM C-STORE SCP (DICOMInput node) is fully configurable with the target presentation contexts
  8. 8. Putting it all together MQTT DICOM PACS Predicting Deciding Integrating Imaging Modality Patient Report Monitoring Electronic Medical Record Alert Doctor ODBC JDBC SMS
  9. 9. What’s new in the IIB Healthcare Pack IIB Healthcare Pack v3.0 released in March 2014 • 3rd release building on top of existing functions including HL7 connectivity, DICOM, ATNA, MedicalDevice connectivity and Data Analysis Profiles New Web User Interface • Clinical Application monitoring • Operational views to understand flow activity HL7 Transformation Pattern • Generates graphical data maps for creation of HL7 messages from scratch • Assigns for individual fields in the MSH HL7 Error handling enhancments Home Health Pattern • Generates message flows to support a WAN interface • SOAP/HTTP interface using the IHE industry standard “CommunicatePCDData” WSDL • Security PEP node for SAML Token security (with external STS) • Mapping solution for all 3 forms of acknowledgement
  10. 10. Clinical Application Integration PAS Patient Administration System Labs & pharmacy Electronic Medical Records Integrate EMR and clinical applications such as PAS, Pharmacy, Labs HL7 v2.x predominant standard but wide variations in application implementation Pack provides connectors, schemas (HL7, DICOM, ATNA, Data Devices, Data Analysis profiles for CDA and CCD) and development patterns for easy integration Uses many features of IIB including Graphical Mapping tools Requesting Application Receiver Flow Destination Application Sender Flow Filter Transform AckAck HL7 to HL7 DFDL Pattern • MLLP over TCP/IP, Message Validation and Parsing • Journaling • Duplicate checking and Sequencing • Exception Handling • Transformation to canonical XML format • Message & Segment Filtering • Message Distribution
  11. 11. Pattern: HL7 Transformation HL7 messages typically contain many data segments. For example the commonly used ADT_A01 message gives you information about a patient admission: • 23 segments • 2 substructures (contain +6 segments) Each segment can also contain large numbers (tens or hundreds) of individual fields. In total it would not be uncommon for for an HL7 message to contain hundreds of individual fields Creating this message tree structure hierarchy in a flow can be time-consuming, even when you use a graphical mapping tool. Patient Administration System Labs & pharmacy Electronic Medical Records
  12. 12. Pattern: HL7 Transformation Patient Administration System Labs & pharmacy Electronic Medical Records
  13. 13. Patient Administration System Labs & pharmacy Electronic Medical Records
  14. 14. Web User Interface IIB Healthcare pack provides its own Context Root Uses internal HTTP server to serve data Can reconfigure to listen on user port or disable SSL connector configured via mqsichangeproperties Displays built upon REST API queries exchanged with IIB node Clinical Application Monitoring (specific view for HL7 to HL7 patterns) Operational Monitoring (relevant to all patterns involving flows) http://localhost:4414/healthcare
  15. 15. Web User Interface Connected Clinical Applications X Ray Maternity Admissions Out Patients PAS Hospital West Wing Out Patients PAS X Ray West WingX Ray Pattern Instance Hospital_West_Wing Pattern Instance XRay_West_Wing
  16. 16. Built-in Healthcare Data Test Tools
  17. 17. The Continua Alliance Remote Patient Monitoring Defined actors: • Application Hosting Device (AHD) • WAN Interface Associated Standards: • IHE CommunicatePCDData • HL7v2.6
  18. 18. Home Health Pattern Points of variability in the pattern control: • URL fragment to which WAN requests are sent • Support for SAML Token Authorization and Authentication Remote Patient Monitoring
  19. 19. Home Health Pattern Remote Patient Monitoring
  20. 20. Medical Device Input Node IIB HCP provides connectors integration patterns to capture data from bedside medical devices and route observations Medical devices Electronic Medical Records For example, you could use a MedicalDeviceInput in an integration flow to connect to a group of heart rate monitors and transfer the observations to a data warehouse, EMR, or dashboard for remote viewing Why Automate data capture? • Ensure consistency, single source of truth for litigations, reduce errors • Speed data collection, free up clinicians for clinical tasks(!) Each MedicalDeviceInput node gathers readings from one or more physical device and presents the data in a consistent logical format.
  21. 21. Medical Device - Input Node One to one relationship between a MedicalDeviceInput node and its configurable service Configurable Services relate “Device Connections” and “Measurement Sets” Medical devices Electronic Medical Records Medical Device Configurable Service Device Connection DeviceID_001 Device Connection DeviceID_003 Device Connection DeviceID_002 Measurement Set MeasurementSet_001 Measurement Set MeasurementSet_002
  22. 22. Medical Device - Configurable Service Medical devices Electronic Medical Records
  23. 23. Medical Device – Device Connection Medical devices Electronic Medical Records
  24. 24. Medical Device – Measurement Set Medical devices Electronic Medical Records
  25. 25. Medical Device – Supported Devices The Medical Device Input node currently supports connections from: • Patient Monitors (GE, Philips, Somanetics, Tyco) • Anaesthesia Workstations (Draeger) • Infusion Pumps (Cardinal Health) • Ventilators (Draeger) Medical devices Electronic Medical Records Alaris Asena CC Draeger CiceroEM GE Dash 4000 Medical Virtual Monitor 3 Philips IntelliVue MP90 Siemens SC9000 Alaris Asena GH Draeger Evita GE Eagle Medical Virtual Ventilator Philips Viridia 24 Siemens Vista Alaris Asena GS Draeger Evita2 GE Eagle 3000 Medical Virtual Ventilator 2 Philips Viridia 26 Siemens Vista XL Alaris Asena TIVA Draeger Evita4 Dura2 GE Eagle 4000 Nellcore NPB-190 Siemens Delta Somanetics Invos Datex Ohmeda AS/3 Draeger Julian GE Eagle 4000N Nellcore NPB-195 Siemens Delta XL Datex Ohmeda Cardiocap/5 Draeger PM8014 GE Solar 7000 Nellcore NPB-395 Siemens Gamma Datex Ohmeda CS/3 Draeger PM8030 GE Solar 8000 Philips CMS Siemens Gamma X XL Datex Ohmeda CS/3 Compact Draeger PM8040 GE Solar 8000N Philips IntelliVue MP20 Siemens Gamma XL Datex Ohmeda S/5 Draeger Sulla GE Solar 9500 Philips IntelliVue MP30 Siemens Kappa Draeger 8000 Draeger Vitara GE Tramscope 12 Philips IntelliVue MP40 Siemens Kappa XLT Draeger 8000IC Draeger Evita Capnostat GE Tramscope 12C Philips IntelliVue MP5 Siemens SC 6002 XL Draeger 8004 Draeger Savina Medical Virtual Device Philips IntelliVue MP50 Siemens SC 6802 XL Draeger Cato GE Dash 2000 Medical Virtual Monitor 1 Philips IntelliVue MP60 Siemens SC7000 Draeger Cicero GE Dash 3000 Medical Virtual Monitor 2 Philips IntelliVue MP70 Siemens SC8000
  26. 26. Pattern: Medical Device to EMR Production ready pattern to integrate medical devices with an EMR • Converts device measurements into HL7 observation results (ORU R01) • Supports alerts, discrete variables and waveforms (continuous sampling) • Observation results are easily customised for different HL7 destinations Standard set of connectivity options for the outbound HL7 MLLP • Transport options including leading/trailing bytes, port number and timeout • Acknowledgments, automated retry and journaling (audit) • Source feed provided either direct to queue, or published to topic Medical devices Electronic Medical Records
  27. 27. DICOM Nodes Provides flow of image and supporting data between medical image archives and modalities Both inside & between care establishments Support for common DICOM commands including MOVE, FIND and STORE Images are routed as XML messages and stored on the file system PACS & imaging PACS PACS DICOM nodes: • IBM Integration Bus can act as both a client (SCU) and server (SCP) • Metadata for DICOM images are propagated through IBM Integration Bus as XML messages • Message does not contain the pixel data (this is stored on the file system!) • Shared file system locations (NFS) supported DICOM Pattern provided for WebService DICOM Test Application
  28. 28. Example DICOM Scenario Collect Studies for Patient Admission PACS & imaging IBM Integration Bus Healthcare Pack
  29. 29. Data Analysis Recursive nature of CDAs makes working from the schema very difficult • component, section, entry and entryRelationship to mention just a few! • Great flexibility in representing and modelling rich clinical statements IIB Data Analysis helps you to rapidly understanding the structure of clinical documents Analyze a set of sample documents according to their data content The Healthcare Connectivity Pack provides four built-in Data Analysis Profiles for HL7v2, HL7 CDA, HL7v2 (ORU), and DICOM. It is pre-configured with CDA, C-CDA, CCD, HITSP (C32 and C83) template IDs and set up for use with a LOINC gloddary of terms to make clinical codes more readily understandable.
  30. 30. Clinical Document Data Analysis Understanding your clinical documents is the vital first step • Recursive nature of CDAs makes working from the schema very difficult • component, section, entry and entryRelationship to mention just a few! • Great flexibility in representing and modelling rich clinical statements The Healthcare Connectivity Pack understands clinical documents • IBM Integration Bus is configured with a CDA Data Analysis Profile • Load example documents representing your implementation guide(s) • Pre-configured with CDA, C-CDA, CCD, HITSP (C32 and C83) template IDs • A glossary of LOINC terms is built-in so that codes are understandable Import your source documents into a Data Analysis project – the summary page shows you how many documents were loaded, validation issues, and information about missing LOINC codes
  31. 31. Navigating Documents The Data Analysis project shows you the meaning of different parts of your documents Search for clinical concepts across all your source documents See where the relevant information is actually stored in your documents Data Analysis Profile identifies key sections in the clinical document • Navigate easily from the logical model to your source documents • Multiple example documents can be loaded into your Data Analysis project • Cardinality of the clinical data can be explored across the document set
  32. 32. Target Model The target model represents the information you want extracted • The goal is to identify and map out the relevant clinical information • The Data Analysis Profile creates an XML schema for the target model • Typically large amounts of the clinical document is not relevant Simply drag-and-drop your clinical data onto the target model • By default all attributes and elements are assumed to be required • Refine the target model by removing unnecessary data and renaming elements • Often this refinement means removing structural attributes like classCode The target model contains just the information you want to extract from the source documents – the tooling creates an XML schema to represent this simplified model
  33. 33. Generation Generate the map, XSD, XSLT and subflow from the target model • The XSD defines a schema for the data specified in the target model • The map (MSL) extracts data in CDAs into the target model • As with XML schemas, maps can be deployed direct to IBM Integration Bus The XPATH expression shows what has been mapped automatically • Clearly building this kind of expression by hand would be tedious (at best!)
  34. 34. Questions and More Information!
  35. 35. Legal Disclaimer • © IBM Corporation 2014. All Rights Reserved. • The information contained in this publication is provided for informational purposes only. While efforts were made to verify the completeness and accuracy of the information contained in this publication, it is provided AS IS without warranty of any kind, express or implied. In addition, this information is based on IBM’s current product plans and strategy, which are subject to change by IBM without notice. IBM shall not be responsible for any damages arising out of the use of, or otherwise related to, this publication or any other materials. 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