Towards Interoperability

enabling SOA strategy

José R. Fernández Engo – Charge of IOP – SOA Strategy at Andalusian Healthcare Ministry – IT Division.

jose.fernandez.engo.sspa@juntadeandalucia.es

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 Systems At 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

And Spain is a reference…

ITC at Healthcare Systems N1 N2

N6

N5

N4

N3

AP1

Business?

AP2

AP15

AP7

AP9

AP4

AP6

AP8

AP10

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Datum, monate

FTP

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jdbc

dblink

FTP

odbc

HL7 2.3

Sin formato

XMLs

deutsch

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 of data between the two applications.

Interoperability: The interoperability is the condition whereby heterogeneous systems can exchange processes or data, automatically, keeping the meaning in both ends. Example: speak 2 languages

interoperability

IOP level Scope General Healthcare Policies Vision and strategy

Structures, processes, incentives Sustainable legal and socio-economic framework Privacy and confidentiality Tools, process, professionals and systems certification

scalability sustainability

Organizational Suppliers/vendors ofservices

Organizational culture Processes of internal and external services Management of change Process reingeniering

Semantic Terminologies, clasifications and onthologies Translations Development and deployment of sustainable architectures

Syntactic Messaging

Technical Technical standards Hardware and software connectivity Security User interface

interoperability between organizations

Achieving interoperability involves achieving the same

at all levels and these levels are interdependent.

Unable to establish interoperable policies between

organizations if the processes are not defined. These

can not be if the significance of the information is not.

Unable to achieve semantic interoperability if the way

to management information and semantic is not

interoperable and it is no use to achieve the above if

the transmission layer technology fails to

communicate 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 -> IOP SOA model deployment achieve interoperability

through 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.

Detailed

IOP needs: A change in development model

Knowledge, knowledge, knowledge Normalization, standards, common masters tables,

business,… productivity, low costs, scalability, …

SOA

Semantic interoperability SOA architecture

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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

Pathway

o Adoption of the strategy for the organization

o 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 Plan o Business Modeling SOA

o Acquisition and implementation of physical architecture.

o Implementation of SOA office. Where to look. Dissemination.

o Location of the organization's master data

o Selection, adoption and dissemination of standards. Certification.

o What we have and what we don‟t have -> prioritization

o 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.

future: Electronical continuity of care

future: BAM on process

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:

BDU ESTRUCTURA OPERADORES

u tools COMUNES

Prescripción

Citación y Peticiones

Pruebas Analíticas (2)

Navegador Hª RIS

PACS

InterS@s

HOSPITALIZACIÓN (1)

Vacunas

Salud Responde

Receta XXI

Registros Garantías

Explotación

tools

Estaciones Clínicas

Subsystems Estructurales

Base de Datos de Explotación

MTI: Usuarios, Citas,

Urgencias

Diábaco

(Indicadores)

(1) En desarrollo

(2) En pilotaje

AGD REGISTRO ADMVO

MEDICINA ENFERMERÍA

CONSULTAS

URGENCIAS

PRIMARIA

S.S.P.A. reality 2009:

BDU ESTRUCTURA OPERADORES

u tools COMUNES

Prescripción

Citación y Peticiones

Pruebas Analíticas (2)

Navegador Hª RIS

PACS

InterS@s

HOSPITALIZACIÓN (1)

Vacunas

Salud Responde

Receta XXI

Registros Garantías

Base de Datos de Explotación

MTI: Usuarios,

Citas, Urgencias

Diábaco (PKI)

AGD REGISTRO ADMVO

MEDICINA ENFERMERÍA

CONSULTAS

URGENCIAS

PRIMARIA

A monolit with: W2000 Oracle 8, 10, 11 Visual Basic, VB.NET Clipper Dbase W2003

SQL Server Informix Weblogic IIS Java…

S.S.P.A. steep 1 Logical model

BUSINESS: PROCESS AND FUNCTIONAL SERVICES

master data Own

Legacy Commercial Legacy

ESB ESB

Internal and external

consumers

Internal and external

consumers

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service service

service service

Service ext.

Service ext.

service service

Org. Data

Standard Messaging (HL7…)

Standard data modelling– directory, terminologies, ontologies, etc. (CEN – CIE - SNOMED)

Routing Audit

Compose Authentication/Authorizat

ion

Standard modelling (BPML,…) External services provider

s

modelling

E T L

S.S.P.A. steep 2 business architecture

BAM: business process monitoring

BPM: Business process modeling BPM: Business process modeling

ESB C ESB C

ESB h1 ESB h1 ESB h2 ESB h2 ESB h3 ESB h3 ESB hn ESB hn

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S.S.P.A. steep 3 physical architecture

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

Diraya, Receta XXI, BDU, MACO, estructura, etc Diraya, Receta XXI, BDU, MACO, estructura, etc

resources resources Personal Personal Users Users Prescriptions Prescriptions

Evolution Evolution

resources Personal Users Prescriptions

S.S.P.A.: launched - DAE HOSPITAL HOSPITAL

C. Externas y Urgencias C. Externas y Urgencias DAE (EG,EM,….) DAE (EG,EM,….)

MACO MACO Estructura Estructura

BDU BDU

MACO MACO Estructura Estructura

BDU BDU AGD AGD

Concepto Inicial

S.S.P.A.: launched - DAE

ESB HOSPITAL ESB HOSPITAL

External External ADM HIS ADM HIS

Medical Medical

ESB CENTRAL ESB CENTRAL

RIS RIS Nursering Nursering Farmacy Farmacy …. ….

EHR EHR

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

Thanks

jose.fernandez.engo.sspa@juntadeandalucia.es

http://es.linkedin.com/pub/jos%C3%A9-rom%C3%A1n-fern%C3%A1ndez-engo/11/3a0/30