architecture, interoperability, standards - recent research in ehp finland network

Introduction: eHealth Partners Finland
Finnish Agency for Technology and Innovation Tekes grants no. 40140/06 and 70030/06
www.uku.fi/ehp
China-Finland eHealth Partnership meeting, Helsinki, 6 Sep 2007
Dr. Juha Mykkänen
University of Kuopio, Health Information Systems R&D Unit
Draft 1 to Board meeting 3
eHealth Partners Finland
recent results, including examples
applied research responding to challenges related to systems development and interoperability in healthcare
point-to-point integration solutions, expensive tailoring, heterogeneity in technologies, requirements, and standards
central elements of solutions
separation of care management from health information
formalised requirements, processes and practices
common concept models, vocabularies and terminologies
validation in practice in hospitals and products
regional scheduling (HL7 v3), clinical decision support interfaces, specification of core services (e.g. code sets, context management), patient groupings (for billing/statistics, e.g. DRG), patient lists
Service-oriented architecture and development guidelines: service identification, process modeling, architecture specification
education related to SOA and HL7 version 3
Healthcare Services Specification Project and HL7 (international)
joint HL7/OMG effort for standardizing services and SOA approaches for healthcare: EIS, RLUS, DSS, CTS2
SOA for HL7, dynamic model enhancements to HL7 version 3
Electronic + Personal Health records, Scheduling, Infrastructure etc.
participation in national initiatives in Finland
specification of core data sets and speciality data sets
specification and certification related to national health IT services
national standards work: HL7 version 3, CDA r2, social services
IHE (integrating healthcare enterprise) initiative in Finland
e-hospital architectural guidelines development - applying SOA locally for enterprise architecture (continues via further projects in Finland and IMIA)
Comparison of model-centric approaches for development of health information systems
Methods for service-oriented development of systems and integration solutions
interface and service definitions for
clinical decision support
patient groupings for billing, benchmarking etc. (e.g. DRG)
code sets,
(used in the evaluation framework and national recommendations in Finland)
medicine and healthcare
service and API interfaces
data communications
Methods for service-oriented development of systems and integration solutions
interface and service definitions for
clinical decision support
patient groupings for billing, benchmarking etc. (e.g. DRG)
code sets,
Korpela et al.
EHR repository
1.
2.
3.
1. Common, shared and centralized services 2. Context management, added value services 3. Loosely-coupled messages, documents, cross-facility invocations
Property and infrastructure management
Sales, CRM, marketing, PR
Patient grouping, DRG
Methods for integration solutions and service-oriented development of health information systems
interface and service specifications
related testing, certification and conformance research
model-centric approaches in relation to the phases of information systems development
practical large-scale approach (good example in Finland): agreed data sets, shared services, open standards
clear separation of patient and professional needs
combination of international and local standards
architectures and interoperability
several solution models need to be combined
hospital / health centre-specific starting points must be acknowledged
all work must be based on accurate requirements specification and supported by evaluation
Architectures and standards in healthcare
‘Architecture’ defines how elements and relations between them make up a whole – e.g., an e-hospital architecture
Organizational view: Who uses, who stores, who maintains; workflows, processes, service chains – IHE (Integrating the Healthcare Enterprise) workflows, etc.
Functional view: What the system elements should provide; – HL7 EHR-S Functional Model, HL7-OMG HSSP, etc.
Technological view: How system should be implemented – HL7-OMG Services Spec. Project HSSP, Eclipse, etc.
Information view: Data elements, coding, structures, stores – HL7 RIM (Reference Information Model), HL7 CDA (Clinical Document Architecture), OpenEHR, etc.
Adapted from RM-ODP model, ISO/IEC 1995
Korpela et al.
Theme: flexibility, integration and interoperability in healthcare applications
project in the FinnWell programme of Tekes, Sep 04 – Aug 07
14 software companies, 4 public health service provider organizations, 3 research units (University of Kuopio)
Healthcare processes and services software products
Service-oriented architectures (SOA)
Web services
open Internet technologies, service interfaces in software products, support for multiple implementation technologies and tools
Application interfaces, application integration and service-oriented application design
based on integration results (interfaces, methods) from the PlugIT project
HIS (Health Information Systems) R&D Unit
Shiftec Unit (Dept. of Health Policy and Management)
Software engineering (Dept. of Computer Science)
Healh care organizations
Hospital district of Northern Savo
Hospital district of Satakunta
Commit; Oy
Datawell Oy
interfaces and application services responding to the needs of health professionals, information management and application development
e.g. clinical context integration, scheduling, OID identifiers, DRG grouping, patient record location and access, clinical decision support etc.
Service interfaces and standardization
HL7 Finland Common Services SIG background project
National recommendations for the development and organization of standardization to support health information systems
Collaboration
international (e.g. HL7, OMG, Eclipse, research collaboration)
[email protected] , University of Kuopio, HIS R&D Unit
4.bin
Collaborative process between stakeholders
Evaluate your current state from activity/service viewpoint
Identify target: How activities/services to be supported by ICT
Identify your migration path with phases, specify Phase 1
Select an initial portfolio of products with a shared architecture
Select your trustworthy key solution provider with a consortium
eHealth Partners Finland is a consortium of international-level research groups and companies willing to contribute along your path to e-hospital
Korpela et al.
complexity, legality, communication, multi-professionality, exceptions
externalisation of healthcare processes from HISs
requires flexibility of architectures, definition of migration paths
explosion of potential interoperability solutions
architectures, evaluation of standards, development and maintenance costs
evidence
collection of application experience of domain-neutral best practices in HIS
generic innovation vs. local introduction
reduced local tailoring, increased reuse on many levels
gaps: product development - healthcare process development - academia?
structured and coded information, shared terminologies, ontology-based semantics
clinical decision support, integration and adaptation of HIS into defined or even evidence-based workflows
Service-oriented architectures
process management and automation (vs. exceptional healthcare workflows)
infrastructure services (e.g. EHR access, codes and terminolofies, access control) and added value services (e.g. decision support)
e.g. Healthcare Services Specification Project / HL7+OMG
Profiles = constraints on application of generic mechanisms
technical: e.g. Web services interoperability (WS-I)
functional: e.g. HL7 EHR-S Functional Model
semantic: e.g. CEN/OpenEHR archectypes, HL7 templates
standardisation: e.g. Integrating Healthcare Enterprise (IHE)
Administration and management
Integration, data access
services
services
Context
-specification guidelines
Project
plan
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architecture, interoperability, standards - recent research in ehp finland network

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