© 2014 IBM Corporation

1149AHealthcare Integration with IBM Integration BusBen Thompson <bthomps@uk.ibm.com>

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.

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:

ConnectorsData 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 Communicationin Medicine

IIB Healthcare Pack Landscape

3

Web ServicesHTTP / JSON

SCAWeb Services

SOAP XML

IBM Integration Bus + Healthcare Pack

DICOM

IDOC, BAPIProprietary XML

Corporate ApplicationsBilling, Payroll, ERP, CRM

Web ServicesSOAP, XML

ODBC, JDBC,SQL

Medical ImagingModalities

Clinical Repositories

Web ServicesSOAP HTTP

MQTTContinua

HL7v2Proprietary

RS232

SterlingConnect

DirectHIPAA

Pharmacy

HL7v2NCPDP

Medical DeviceIntegration

HL7v2Cache ODBCWeb Services

Electronic MasterPatient Index

Web ServicesHL7v2

PIX / PDQ

Web ServicesSOAP XML

HL7v2Cache ODBC

HL7v3CDA CCD

Home Health DevicesMedical Insurers

Medical Applications

LegacyHospital Interface EnginesAnalytics Business Processes

Clinical Mobile Applications

Decision Management

Portal, Web Applications, Electronic Forms

DynamicsSiebel

SAP

Roadmap

IBM's plans, directions, and intent are subject

to change or withdrawal

Q4 2011WMB 8.0.0.0

Q1 2014IIB Healthcare Pack 3.0

Integration Improvements (Error Handling, DFDL)Web User Interface

Home Health Pattern

Q1 2013WMB 8.0.0.2

Q4 2013IIB 9.0.0.1

Q2 2012WMB Healthcare Pack 7FP2

Medical Device Input NodePattern HL7 Reports

Pattern Medical Device to EMR

Q1 2013WMB Healthcare Pack 8

ATNA Audit & DICOM nodesHL7 DFDL Model

Patterns: DICOM, HL7CDA Data Analysis

Q4 2014?IIB vNext

*The first WMB Healthcare Pack (v7) was released in May 2011

Key Features

Pattern-based development tooling - fast integration without detailed knowledge of integration technologiesMakes use of proven runtime of IBM Integration BusIntegrates 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 & modalitiesProcesses CDA/CCD documentsDirect connectivity to medical equipment - monitors, infusion pumps etcHealthcare-oriented operational views

• Single point of visibility and control

Electronic

Medical

Records

Patient

Administration

System

PACS &

imaging

Labs &

pharmacy

Medical

devices

Remote Patient

Monitoring

What’s new in the IIB Healthcare PackIIB 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

Clinical Application Integration

PAS

Patient

Administration

System

Labs &

pharmacy

Electronic

Medical

Records

Integrate EMR and clinical applications such as PAS, Pharmacy, LabsHL7 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

RequestingApplication

ReceiverFlow

DestinationApplication

SenderFlowFilter 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

Pattern: HL7 TransformationHL7 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

Pattern: HL7 TransformationPatient

Administration

System

Labs &

pharmacy

Electronic

Medical

Records

Patient

Administration

System

Labs &

pharmacy

Electronic

Medical

Records

Built-in Healthcare Data Test Tools

Web User Interface

IIB Healthcare pack provides its own Context RootUses internal HTTP server to serve dataCan reconfigure to listen on user port or disableSSL connector configured via mqsichangepropertiesDisplays built upon REST API queries exchanged with IIB nodeClinical Application Monitoring (specific view for HL7 to HL7 patterns)Operational Monitoring (relevant to all patterns involving flows)

http://localhost:4414/healthcare

Web User InterfaceConnected Clinical Applications

X Ray

Maternity

Admissions

Out Patients

PAS Hospital West WingOut Patients

PASX Ray West WingX Ray

Pattern InstanceHospital_West_Wing

Pattern InstanceXRay_West_Wing

Medical Device Input Node

IIB HCP provides connectors integration patterns to capture datafrom 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.

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 ConnectionDeviceID_001

Device ConnectionDeviceID_003

Device ConnectionDeviceID_002

Measurement SetMeasurementSet_001

Measurement SetMeasurementSet_002

Medical Device - Configurable ServiceMedical

devices

Electronic

Medical

Records

Medical Device – Device ConnectionMedical

devices

Electronic

Medical

Records

Medical Device – Measurement SetMedical

devices

Electronic

Medical

Records

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

Siemens SC8000

Siemens SC7000

Siemens SC 6802 XL

Siemens SC 6002 XL

Siemens Kappa XLT

Siemens Kappa

Siemens Gamma XL

Siemens Gamma X XL

Siemens Gamma

Siemens Delta XL

Siemens Delta

Philips Viridia 26

Philips Viridia 24

Philips IntelliVue MP90

Philips IntelliVue MP70Medical Virtual Monitor 2GE Dash 3000Draeger Cicero

Philips IntelliVue MP60Medical Virtual Monitor 1GE Dash 2000Draeger Cato

Philips IntelliVue MP50Medical Virtual DeviceDraeger SavinaDraeger 8004

Philips IntelliVue MP5GE Tramscope 12CDraeger Evita CapnostatDraeger 8000IC

Philips IntelliVue MP40GE Tramscope 12Draeger VitaraDraeger 8000

Philips IntelliVue MP30GE Solar 9500Draeger SullaDatex Ohmeda S/5

Philips IntelliVue MP20GE Solar 8000NDraeger PM8040Datex Ohmeda CS/3 Compact

Philips CMSGE Solar 8000Draeger PM8030Datex Ohmeda CS/3

Nellcore NPB-395GE Solar 7000Draeger PM8014Datex Ohmeda Cardiocap/5

Nellcore NPB-195GE Eagle 4000NDraeger JulianDatex Ohmeda AS/3

Somanetics InvosNellcore NPB-190GE Eagle 4000Draeger Evita4 Dura2Alaris Asena TIVA

Siemens Vista XLMedical Virtual Ventilator 2GE Eagle 3000Draeger Evita2Alaris Asena GS

Siemens VistaMedical Virtual VentilatorGE EagleDraeger EvitaAlaris Asena GH

Siemens SC9000Medical Virtual Monitor 3GE Dash 4000Draeger CiceroEMAlaris Asena CC

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

The Continua AllianceRemote Patient

Monitoring

Defined actors:• Application Hosting Device (AHD)• WAN Interface

Associated Standards:• IHE CommunicatePCDData • HL7v2.6

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

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

Example DICOM ScenarioCollect Studies for Patient Admission

PACS &

imaging

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 documentsAnalyze a set of sample documents according to their data contentThe 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.

Questions and More Information!

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