An overview of the Message Broker Healthcare Connectivity Pack and how it connects HL7 clinical applications

1. © 2012 IBM Corporation
Healthcare Connectivity Pack
Connecting Clinical Applications
Ant Phillips
antphill@uk.ibm.com

2. © 2012 IBM Corporation
Use Restrictions
The Program is capable of being used as a medical device data system to transfer, store, and convert data from one
format to another. The Program may occasionally transmit data to bedside medical devices (e.g., for polling and telemetry).
However, the Program itself is not a medical device.
The following uses of the Program are prohibited:
a. use to control any bedside medical device for clinical, therapeutic or treatment purposes (for example, but without
limitation, the administration of medication, anaesthetics, saline solutions and the like);
b. use for active patient monitoring (i.e., where the Program is used as the sole means of monitoring life-critical patient data
, e.g. heart rates);
c. use for decision support (i.e., where the Program is used as the main basis to determine patient-specific treatment or
immediate clinical action); or
d. use in any active monitoring that depends on the timeliness of data transmission.
Indemnity to IBM
Licensee will indemnify International Business Machines Corporation and its affiliated companies against any and all third
party claims and liability arising directly or indirectly from any use of the Program by or for Licensee for a use or purpose
that is prohibited by the provisions of the foregoing section, "Use Restrictions".
As of December 11th
2012, WebSphere Message Broker Connectivity Pack for Healthcare is currently available for purchase
through the Passport Advantage program only for use in the following specific countries :
Australia; Austria; Canada; Chile; China; Colombia; Denmark, Finland; Germany; Italy; Malaysia, Mexico; Netherlands; New Zealand; Norway; Poland;
Portugal, Singapore; Spain, Switzerland; Sweden, United Kingdom; United States of America
For the current list of licensed geographies please see the following URL:
http://www-01.ibm.com/software/integration/wbimessagebroker/healthcare/license/index.html
Important Disclaimer and Availability Information
WebSphere Message Broker Connectivity Pack for Healthcare

3. © 2012 IBM Corporation
Where Does It Fit?
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Patterns for Simplified Development
 Creates top-down, parameterized connectivity solutions
 Reduces common problems in flow development
 Communicates best practices to the broker community
 Reduces time-to-value for solution development
 Complements regular solution development in broker

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Connecting Clinical Applications
 Ensure data is consistent across healthcare applications
– Consistent regardless of the patient’s point of entry
– Ensure data is entered once and only once!
– For example, admissions are reflected across all interested systems
 Reduce effort on clinical and administrative staff
– Changes to demographics are reflected in all interested systems
– Reduces human error from duplicate data entry
 Integration done using good practice and architectural principles
– Enterprise service bus abstracts away point-to-point integrations
– Facilitates better reuse and faster time-to-value for new projects

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Connecting Clinical Applications
 Production ready pattern based on HL7 MLLP v2.x
 Mediates between HL7 clinical applications (1:1 and 1:many)
– Focus on ADT, ORU and ORM messages from HL7 standard
 Easy to extend with custom transformation logic
 Pattern has excellent multi-threaded performance characteristics
– Sender and receiver message flows decoupled by WebSphere MQ queues
 Supports message validation, duplicate detection, sequencing, and retry
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Duplicate Detection
 Message control identifier (MSH.10) used as key for duplicate detection
MSH|^~&|ADT1|MCM|LABADT|MCM|198808181126|SECURITY|ADT^A01^ADT_A01|MSG00001-|P|2.5
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MSH|^~&|MB7BROKER.RECEIVER| |ADT1|MCM|201012340084041||ACK|460f99f3a25ca40bd50f|P|2.5

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Segment Filtering
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 Segment filtering removes segments on a per destination basis
MSH|^~&|LABORM||||200603081747|security|ORM^O01^ORM_O01|1|P^I|2.5
BLG|D|CH|accountid|01
CTI|sponsorstudyID|studyphaseidisDE|schedultimepointisCE

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Journaling
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 Journaling writes a copy of every inbound HL7 message to a queue

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Remainder Processing
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 Additional fields and segments not in the model can be saved to a queue

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Siemens Invision (ADT, BAR, ORU) IMPAC IntelliLab (ADT) Chartlinc (ADT, BAR, ORU)
Emtek (ADT, ORU, ORM) PCN (ADT, SIU) Cerner Pathnet (ADT, ORM, ORU)
IMS (different custom
transcriptions)
GE Logician (ADT, SIU) Xtend (ADT)
APOLLO (ADT) BEDTRACKING (ADT) RehabManager (ADT)
DOMINATOR (ORM) Millbrook (ORU) Cerner RadNet (ADT, ORM, ORU)
Omnicell (ADT) Midas (ADT) MedTrack (ADT)
EPIC (ADT, ORU, ORM, MDM) Meditech (ADT, ORU) McKesson
GE IDX FUJI Cerner Millennium
Power Scribe PineStar AllScripts
Selection of applications integrated using IBM Integration Bus and HL7:
A
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Connecting Clinical Applications

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Report Generation

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Report Generation
 Production ready pattern to generate reports from HL7 MLLP v2.x
– Out-of-the-box solution for text-based reports and file distribution
– Easily customised for different destinations (FTP/sFTP/email)
– Inbound HL7 message used as the input data for a report template
 Standard set of connectivity options for the inbound HL7 MLLP
– Transport options including leading/trailing bytes, port number and timeout
– Acknowledgments, duplicate checking and journaling (audit)
– Source feed provided either direct to queue, or published to topic
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14. © 2012 IBM Corporation
Report Generation
 Flexible text based report creation using PHP templates
– Complete access to the HL7 message within the template
– Fully featured PHP 5.2 runtime embedded within IBM Integration Bus
– Enables access to the most popular scripting language worldwide
 Hundreds of extension functions provided in the PHP runtime
– Can be combined with database nodes for table lookups
– Easy to break down complex problems into reusable scripts
– Deployment to any platform supported by IBM Integration Bus
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15. © 2012 IBM Corporation
HL7 Processing Nodes

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HL7 MLLP Nodes
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 These nodes encapsulate the MLLP protocol and HL7 message parsing
– Nodes handle de-duplication, validation, acknowledgments and timeout handling
– Easy to use nodes enable new HL7 message processing scenarios
– Examples include HL7 to data warehouse and HL7 device aggregator integration

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IBM Integration Bus Built-In Nodes
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The HL7 patterns use a variety of IBM Integration Bus built-in nodes
HL7 v2 MLLP protocol is built on top of TCP/IP connections
Messages must be kept in order as they are transformed and routed
– Sequencing nodes enable high performance multi-threaded processing
Persistent messages ensure data is kept safe and secure
HL7 pattern instances can be extended in many different ways!

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▪IBM Integration Bus has several transformation options:
▪ Mapping
▪ XSLT
▪ ESQL
▪ Java
▪ PHP
▪ .NET
▪Reflects the importance of transformation in connectivity solutions
▪ User-defined nodes supported for Java and C/C++
▪Every transformation option has strengths and weaknesses!
– Performance and scalability
– Backend integration
– Skill sets and learning curve
– Developer usability
– Portability and maintenance
 Use a transformation technology appropriate to the problem at hand!
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Transformation Options

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 Enable record and replay of in-flight data
– Comprehensive audit of messages, web, ERP, file and other data
– Completely dynamic configuration requiring no application changes
 Data recording, capture and store to database
– Graphically configure binary, text, XML payload capture
– Includes whole, partial and multi-field data from any message
 Web tooling to view and query data
– Search and filtering to identify important messages
 Replay for redelivery or flow reprocessing
– Replay selected data to flows or applications
– User selects destinations from auto-populated drop-down list
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Record and Replay

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 IBM Integration Bus Explorer is our rich client administration application
– Provides a secure broker administration and monitoring environment
 Enhancements provide insight into the healthcare environment
– How many HL7 MLLP messages have been processed?
– Are my clinical applications connected and working?
– What status messages have been sent from my medical devices?
– When were the TCP/IP connections last created and dropped?
– Visual warnings when queues approach limits and applications disconnect
Operational Monitoring

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Resource Monitoring
▪IBM Integration Bus Explorer has a wealth of monitoring tools!
▪ Statistics monitor resource usage across execution groups
▪ Range of options to update and visualise the resource statistics

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Performance Monitoring
▪Monitoring also provided on individual message flows
▪ Quick and easy way to identify hot spots in your solutions!

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Monitoring Clinical Applications
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 Displays the current state of all clinical application connections
– Warning visuals highlight when connectivity is lost to a clinical application
– Monitoring automatically updates when new pattern instances are deployed
– Filtering provides fast access to applications of interest based on search terms

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Queue Monitoring
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 Queues ensure data is never lost as it flows through IBM Integration Bus
– Warning visuals highlight when queues approach their maximum depth limit
– Quick health check provided by the queue depth and last message received time
– Queue messages can be encrypted if strong security is required for data-at-rest

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HL7 Message Definitions

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HL7 Message Set
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 Message set models the HL7 specification and the chapter definitions:

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Customizing the HL7 Pattern
 Customisation points for every destination and source system
– Graphical mapper provides an intuitive option for customising messages
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Unit Test and Debug

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Testing the HL7 Pattern
 Test application makes it easy to send messages to IBM Integration Bus
– Wide range of HL7 test messages also provided as resources for the pattern
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Testing the HL7 Pattern
 Healthcare receiver acts as an HL7 destination clinical application
– Range of acknowledgment options provided (file, none and auto)
– Message framing options also available for custom HL7 MLLP messages
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32. © 2012 IBM Corporation
Testing the HL7 Pattern
 Results display HL7 messages as they are sent and received
– Batch sending of messages useful for regression testing scenarios
– Messages received and acknowledgments can be copied to the clipboard
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Debugging the HL7 Pattern
 IBM Integration Bus has excellent real time debugging facilities built-in:
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Unit Test Client
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Healthcare Connectivity Pack
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