10/27/2015 10:17 PM The Healthcare Services Specification Project An Overview May 2006 HL7 NZ SOA-Web Services Seminar Ken Rubin EDS Co-Chair, OMG Healthcare

04/20/23 05:00

The Healthcare Services Specification ProjectAn Overview

The Healthcare Services Specification ProjectAn Overview

May 2006HL7 NZ SOA-Web Services SeminarMay 2006HL7 NZ SOA-Web Services Seminar

Ken RubinEDS

Co-Chair, OMG Healthcare Domain Task Force

Co-Chair, HL7 Services-oriented Architecture [email protected]

Ken RubinEDS

Co-Chair, OMG Healthcare Domain Task Force

Co-Chair, HL7 Services-oriented Architecture [email protected]

© 2006 HSSP Project, http://hssp.wikispaces.com

Reuse with attribution permitted Page 2

OverviewOverview

• Background / Rationale behind HSSP

• HSSP Objectives

• The Impetus for Collaboration

• OMG, HL7, and Operational Concerns

• Project Artifacts

• Dialog: The Value of Participating

• Current Status/Update



““How do you know that the [web-] How do you know that the [web-] services you’re building are not just services you’re building are not just the next generation of stovepipes?”the next generation of stovepipes?”

Janet Martino, LTC, USAF (Retired) to a panel of Healthcare IT Janet Martino, LTC, USAF (Retired) to a panel of Healthcare IT LeadersLeaders

““How do you know that the [web-] How do you know that the [web-] services you’re building are not just services you’re building are not just the next generation of stovepipes?”the next generation of stovepipes?”

Janet Martino, LTC, USAF (Retired) to a panel of Healthcare IT Janet Martino, LTC, USAF (Retired) to a panel of Healthcare IT LeadersLeaders



Why HSSP Was Created Why HSSP Was Created

• Several large provider organizations were each facing challenges in integrating current and emerging systems

– Veterans Health Administration

– Kaiser-Permanente

– SerAPI Project (Finland)

• There were a number of shared beliefs among the founding partners…



In each case…In each case…

• There was active integration and development work

• There was a shared belief that messaging alone was not the optimal solution

• A services-oriented architecture was the target environment

• There was strong commitment to standards

• There was recognition standard services would further interoperability with partners and products

• It was recognized that developing “stovepipe” services would not address business challenges



So, what is HSSP?So, what is HSSP?

• The “Healthcare Services Specification Project”

• Effort to create practical healthcare IT service specifications that address both behavior and information semantics

• A joint sponsored activity by HL7 and OMG

• Current focus activities

– Define a “Roadmap” for Services in Healthcare

– Entity Identification Service (EIS)

– Retreive, Locate, and Update Service (RLUS)

– Common Terminology Service (CTS)

– Decision Support Service (DSS)

– Migration guidance for Web Services in HL7 (SOA4HL7)

– Produce a methodology



Why “services” and not “messages”?*Why “services” and not “messages”?*

• Accepted industry best practice

– A common practice in healthcare but not yet healthcare IT

– Commonplace usage across “IT” outside of healthcare

– Many key products use them but do not expose interfaces

• Services define behavior explicitly and data transport implicitly

– Ensures functional consistency across applications

– Furthers authoritative sources of data

– Minimizes duplication across applications, reuse

• Services do not preclude the use of messages

– Services rely upon underlying transport protocols

– Messages can be used as payloads for service calls

– Messaging infrastructure may be used as underlying transport

*slide adapted from a Veterans Health Administration Presentation, used with permission



So, what about web services?So, what about web services?

• Web services alone (e.g., SOAP/WSDL, etc) do not solve the problem:

– What behaviours do we expect of an MPI?

– What behaviours are not expected or should remain unspecified?

– What confidence do we have that two MPIs can interoperate in an SOA intra- or inter-organization?

– What about information semantics?

– How will business exceptions be managed across instances?

• These issues are not addressed via selection of SOAP/WSDL as a platform

• These issues are not entirely addressed via Web Services as an ITS



Significant Healthcare Standards Development Organizations (SDOs)Significant Healthcare Standards Development Organizations (SDOs)

• HL7

• X.12

• NCPDP

• ASTM

• OMG

• DICOM

• SNOMED

• ICD

• LOINC

• IHE

• CEN TC 251

• ISO TC 215

“Functional” StandardsStructured Doc Standards

Terminology StandardsMessaging Standards

Services StandardsStandards Profiling



HSSP Builds Upon Existing WorkHSSP Builds Upon Existing Work

Ab

ilit

y to

Int

erop

erat

e

High

Low



Overview of Key HSSP ArtefactsOverview of Key HSSP Artefacts

• Service Development Framework (SDF)

– Methodology describing the services specification process

– Integrates life cycle across HL7 and OMG with callouts to existing processes (such as ballots)

– Version 1.0 Baselined in January 2006 (HL7 Phoenix)

• Service Functional Model (SFM)

– Describes in business terms the behaviour of the service

– Identifies relevant information content (e.g., RIM-derived artefacts, terminologies, etc.)

– Technology independent

– Includes conformance profiles

• RFPs

• Submissions



Current HSSP Priority Areas Current HSSP Priority Areas

Area Scope and Rationale for PriorityTerminology Services To develop a comprehensive terminology specification

(versioning, maintenance, query, etc.) built upon the current CTS specification.

Selected based upon past precedence, ongoing work interest, and ability to validate the emerging methodology.

Entity Identification To manage and maintain identities within and across domains, localities, or products.

Anticipated to be critical path dependency for other services; foundational work was available from HL7 and OMG.

Record Location and Retrieval

To discover, retrieve, and update records in distributed environments.

Seen as core foundational service to support EHR and healthcare delivery with interest from many national and regional programmes. Location & Retrieval merged upon recognition that location was effective retrieval of metadata.

Decision Support To assess data (such as patient data) and returns specific conclusions as the output.

Seen as a way to significantly reduce effort required and to promote wider adoption of CDSS implementations. Selected based upon strong business need and interests and additional volunteer community.



How the priorities were determined… How the priorities were determined…

• Based on an open selection process

• Brainstorming gave way to successive refinement and downselect

• Priorities determined by business need and resources

• Initial list included Terminology, Entity ID, Record Location, Record Retrieval

• Record Location and Retrieval activities subsequently merged

• Decision Support added later based upon community interest and resources



HL7, OMG, and the CollaborationHL7, OMG, and the CollaborationHL7, OMG, and the CollaborationHL7, OMG, and the Collaboration



What is HL7? What is HL7?

* Slide content courtesy of HL7, used with permission

Health Level Seven (HL7) is an ANSI accredited standards organization (ASO), working in areas of:

• Electronic Data Exchange • Healthcare Messaging

• Arden Syntax• Visual / Context Integration (CCOW)• Clinical Document Architecture (CDA)• Electronic Health Record System (EHRS)

Functional Model• Service-oriented Architecture

Members include providers, vendors and consultants, government & others. There are also now 30+ international affiliates.

ISO’s Open Systems Interconnect (OSI) model:Application Level” – level 7

ISO’s Open Systems Interconnect (OSI) model:Application Level” – level 7



What is OMG?* What is OMG?*

• The Object Management Group--a 15-year-old not-for-profit Computer Industry Standards Consortium

• Home of UML, the Industry’s Modeling Standard and the Model Driven Architecture (MDA)

• Open Membership and Adoption Process

– One-member, One-vote

• Specifications Available Free on our Website

• Vendors using OMG specifications may or may not be OMG members

• Over 500 members including Companies, Government Agencies, Universities

* Slide content courtesy of OMG, used with permission



Collaboration Rationale – Initial Thoughts…Collaboration Rationale – Initial Thoughts…

• HL7 has a world-class functional community

• …but HL7’s strength is not service architecture

• HSSP project needed to leverage talent of a strong architectural community

• OMG has history and demonstrated leadership in service definition and SOA

• OMG provided the ability to interact with multiple vertical domains (pharma, manufacturing, etc.)



The Result… The Result…

• HL7 brings…

– Healthcare semantic interoperability expertise and credibility

– Rich, extensive international community perspective

– Diverse membership base

• OMG brings

– distributed systems architecture and modeling excellence

– Effective, efficient, rapid process

– Premise that standards must be implemented

• Resulting in…

– Services will be identified by the community needing them

– Improved methodology resultant from functional and architectural merging of the two groups

– Facilitation of multi-platform implementation and broader implementation community



The Opportunity Created... The Opportunity Created...

• HSSP is open to any type of participant:

– National, Federal, State, Local Governments

– Payers, Providers, Consultants

– Individual stakeholders

• The process facilitates each party participating to their maximum advantage

– Discussions are “community of interest” focused

• Healthcare discussions in healthcare venue

• Technical discussions in technical venues

• Processes and results are open and available

– All proceedings are published on web and listserv

– Consistent multinational/multicultural participation

• “Guiding Principles” ensure we don’t lose sight of our objectives



Project Operational ConcernsProject Operational ConcernsProject Operational ConcernsProject Operational Concerns



The ApproachThe Approach

• HL7 is leading in service selection, functional elaboration, and conformance criteria

• OMG is leading the technical specification

• Both organizations jointly participating in all activities

• Work products are “owned” by only one organization but used collaboratively (e.g., any product is “hosted” by HL7 or OMG)

• “Operate as one project” is a core principle

• Actively seeking vendor participation

• Eclipse has committed to providing open source implementations

• IHE discussions are underway to profile and demonstrate viability of the implemented solutions



Project OrganisationProject Organisation

• One overarching project with five subproject efforts

• Overall project

– Meets at HL7 and OMG meetings

– Status teleconferences biweekly

– Owns responsibility for planning, marketing, etc.

• “Infrastructure” Subgroup

– Developed and maintains methodology

• Subprojects

– Determine their own deadlines, meeting schedules, etc.

– May be hosted by other committees

– Leverage project infrastructure and methodology



Timeline of Key EventsTimeline of Key Events

1996: First OMG Healthcare Service Spec Adopted (PIDS?)

2003: HL7 ServicesBOF formed

2004 September: HL7, OMG Collaboration MOU

2005 January: Joint Project Chartered

2005 April: Project Kickoff

2006 March: Issue Ballot for Functional Specs

2006 Q4: Technical Specs RFP (planned)

2005 September: Methodology and MetaSpecs Baselined (planned)

2005 October: Interoperability Services Workshop & Conference



2006 HSSP Project Schedule (major milestones)2006 HSSP Project Schedule (major milestones)

Jan: Charter HL7 SOA SIG

HL7UK Information Day

Jul: Issue 4 ballots (3 + 1)

Feb: Announce intention to ballot RLUS

Aug: Ballot review

Mar: Issue RLUS Ballot Sep: HL7 Boca Raton (Reconciliation);

RLUS DSTU Adopted!

OMG Anaheim (Issue RFPs)

Apr: OMG Meeting St. Louis

(RLUS RFP prep)

Oct: Intent to ballot DSS, EIS, CTS2

May: HL7 San Antonio

(RLUS ballot reconciliation)

Nov: HL7 Educational Summit Issue DSS, CTS2 Ballots

Jun: Announce intention to ballot

(3 committee, 1 membership)

Dec: OMG Washington

(Review Initial RFP Submissions)



HSSP Project DifferentiatorsHSSP Project Differentiators

• Active participation from three continents and 15+ organizations

• Significant cross-cutting community involvement• Providers (Kaiser, VHA, Intermountain Health, Mayo)

• Vendors (CSW Group, IBM, PatientKeeper, Universata)

• Value-added Providers (MedicAlert, Ocean Informatics, Eclipse Foundation, etc.)

• Payers (Blue Cross/Blue Shield, Kaiser)

• Integrators (IBM, EDS)

• Governments (Veterans Health Administration, Canada Health Infoway, HealthConnect (Australia), SerAPI (Finland))

• Managing differences between SDOs in terms of membership, intellectual property, and cost models



HSSP In the “Community”HSSP In the “Community”

• HSSP is actively seeking to collaborate with other groups

• HSSP specs have a section citing existing work and its relevance

• Working project relationships with:

– HL7 Clinical Decision Support Technical Committee

– HL7 Vocabulary Committee

– Object Management Group Service-oriented Architecture SIG

– Eclipse Open Healthcare Framework Initiative

• Emerging relationships with:

– Integrating the Healthcare Enterprise (IHE)

– Medical Banking Initiative



Where should I engage?Where should I engage?

Interest Area (including representative communities-of-interest)

Venue

Setting functional priorities; selecting priority services

(Consumers, Providers, Vendors, Integrators)

HL7

Defining behaviour; service capabilities

(Consumers, Providers, Vendors)

HL7

Defining functional conformance/compliance criteria

(Consumers, Regulatory)

HL7

Technical specification, interface specification, evaluation criteria

(Consumers, Regulatory, Integrators)

OMG

Technical conformance/compliance criteria

(Consumers, Regulatory, Integrators)

OMG

Architectural considerations; service interdependencies, SOA

(Integrators, Vendors, Implementers)

OMG

Product development; technical standard creation; API definition

(Vendors, Implementors)

OMG



Dialogue: The Value of ParticipatingDialogue: The Value of ParticipatingDialogue: The Value of ParticipatingDialogue: The Value of Participating



For Product Consumers and Users…The Impacts and Rationale of HSSP SpecificationsFor Product Consumers and Users…The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Promotes deployment ease and flexibility

Specifications will support multiple topologies

Consistency at the interface level assures asset protection

Standard interfaces means that conformant components are substitutable

Multiple vendor product use/ interoperability

Using compliant products means side-by-side interoperation of multiple product offerings

Increased buyer/product offerings Consumer demand will create increased marketplace competition

Facilitates integration Unity in purpose and consistency in interface eases integration burden

Time to market Availability of an industry-accepted component interface eases product development burden

Requirements definition – influence vendors in a direct way

Participation by provider and payer community is direct expression of business need

Lower cost = wider deployment = higher quality service



Product Vendor …The Impacts and Rationale of HSSP SpecificationsProduct Vendor …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Market opportunity – ability to grow business / “Grow the pie”

Standardization of interfaces eases cost-of-entry to markets

Conformance adds legitimacy to product offering

Consumers view conformance as a confidence metric

Reduced time and cost to market

• Use of 3rd party components

• Simplify / reuse of design

Ability to reuse design ideas, incorporate off-the-shelf components into value-add offerings

Participation provides the ability to influence the standard

You can shape the standard to be supportive of your product architecture



Regulatory/Policy/Legislative …The Impacts and Rationale of HSSP SpecificationsRegulatory/Policy/Legislative …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Establishing objective assessment criteria:

Measurement criteria for regulatory compliance

Inclusion of rigorous conformance assertions benefits compliance and verification

Allows for technology change within the regulation

Concurrent support of multiple technologies allows for technology evolution

Offering an easy/easier solution that is complete and actionable / ease the path to adoption:

How do we “Pick the winning horse”?

“Opportunity cost” of using the wrong standard has big implications

HSSP integrates function/ behavior, data, and protocol promoting an integrated solution set

Solution that complements existing standards

HSSP is using HL7 semantics, OMG processes, IHE testing, and established technology protocols



Research …The Impacts and Rationale of HSSP SpecificationsResearch …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Promotes accessibility to “raw” information

Strong emphasis on semantically rigorous data and query/retrieval

Enabler for collaborative studies, e.g. de-identification, retrieval, etc.

Leveraged use of identity service enables de-identification

Enlarges cell and sample sizes based on interoperability

Facilitates responsiveness to bio-surveillance requirements

Standard interfaces accommodate dynamic and emerging strategies and tools

Enables construction of higher-order service stacks with less investment

Composable nature of services promotes construction



Implementer/Integrator …The Impacts and Rationale of HSSP SpecificationsImplementer/Integrator …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Reduced integration time and cost resulting from the use of standard tooling

Use of standard in off-the-shelf tools facilitates their use

Risk mitigation (skill portability/ training advantage, vendor independence, substitutability)

By training staff in the standard, skills are portable across tools

Creates a value offering opportunity based on the ability to deliver using these service standards

Allows staff and solutions to build upon the use of the standard and not technologies

Improved ability to deliver and support interfaces that have been implemented

Using services speeds project design phases and promotes reuse



SDOs …The Impacts and Rationale of HSSP SpecificationsSDOs …The Impacts and Rationale of HSSP Specifications

Impacts Rationale

Useable standards Emphasis on practicality

Market-focused standards based on commercial implementations

Shortens time required to develop specifications and encourages collaboration

Promotes harmonization, cooperation, cohesion among standards communities

Integration of function, data, and technology promotes leveraged reuse

More members/involvement = more revenue & better specs

Practical, market-focus and iterative timeline promotes participation and results



The Bottom Line…The Bottom Line…The Bottom Line…The Bottom Line…



Why participate in Standards? Why participate in Standards?

• This is happening—the only way to influence the outcome is to engage

• Prime opportunity to directly engage with complementing stakeholder groups (provider-to-vendor, vendor-to-payer, SDO-to-SDO, etc)

• Benefit from “lessons learned” from others

• Reduce design burden

• Significant networking opportunities

• Establish/maintain market presence as thought-leader



Why HSSP? Why HSSP?

• Relentless focus on added business value for healthcare and project participants

– focused on and driven by business-need

– not an “academic exercise” striving for perfection

– “Standards must be used to be useful”

– Emphasis on practical, achievable, & marketplace-relevant

• Without these standards, we’re building “service stovepipes”

• Aggressive timelines encourage progress

• Assembled community of top industry talent

• Project structure promotes targeted participation



ReferencesReferences

• HSSP Wiki

• http://hssp.wikispaces.com

• HL7 Website:

• http://www.hl7.org

• OMG Website:

• http://www.omg.org



Thank you!Thank you!

Ken Rubin, EDS

+1 703 845 3277 desk

+1 301 335 0534 mobile

[email protected]

Documents

10/27/2015 10:17 PM The Healthcare Services Specification Project An Overview May 2006 HL7 NZ SOA-Web Services Seminar Ken Rubin EDS Co-Chair, OMG Healthcare