04/19/23 19:51

Healthcare Services Specification Project The Business Case and Importance of Services

Healthcare Services Specification Project The Business Case and Importance of Services

HL7 Service-Oriented Architecture SIG

OMG Healthcare Domain Task Force

HL7 Service-Oriented Architecture SIG

OMG Healthcare Domain Task Force

October 2007October 2007

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BackgroundBackground

• This presentation represents the collective input and thinking from the collective participants involved in the Healthcare Services Specification Project (HSSP).

• Contributions to this content have come from

– The Object Management Group (OMG) community

– The Health Level Seven (HL7) community

– The Eclipse Open Healthcare Framework community

• This presentation is intended to describe the purpose, role, and importance of industry-standard service interface specifications

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

• A common practice in healthcare, just not yet in healthcare IT

• Many key products use them but do not expose interfaces

• Ensures functional consistency across applications

• Accepted industry best practice

• Furthers authoritative sources of data

• Minimizes duplication across applications, provides reuse

• Messages can be either payloads in or infrastructure beneath services

• Service-oriented architecture provides the framework for automation of common services

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

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What is the Healthcare Service Specification Project? What is the Healthcare Service Specification Project?

• An effort to create common “service interface specifications” tractable within Health IT

• A joint standards development project involving Health Level 7 (HL7) and the Object Management Group (OMG)

• Its objectives are:

– To create useful, usable healthcare standards that address functions, semantics and technologies

– To complement existing work and leverage existing standards

– To focus on practical needs and not perfection

– To capitalize on industry talent through open community participation

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What are threads of active work? What are threads of active work?

• SOA Functional Standards

– CTS II - Terminology Maintenance/Navigation, CRFQ (Clinical Research Filtered Query), Security, Provider and Services Directory

• Technical Specifications for balloted Functional Standards

– Entity Identification, Retrieve/Locate/Update, Decision Support

• Implementation Guidance & White Papers

– HSSP Reference Architecture, Implementation Guides

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Current SpecificationsCurrent Specifications

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And what is HSSP working on next?And what is HSSP working on next?

• Reference Architecture•Taxonomies, Business Rules, Choreographies

• Profile Methodologies• Template Registry • Service Meta-model • Evangelizing SOA within the Healthcare community

• Further Service Specifications

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2008 HSSP Project Schedule (planned, major milestones)2008 HSSP Project Schedule (planned, major milestones)

Jan: SFM Ballots (CRFQ, Security)

HL7 San Antonio (Jan 13-18)

Jul:

Feb: Aug:

Mar: OMG Washington (Mar 10-14)

EIS, RLUS RFP Final submissions DSS RFP Initial Submission

Sep: HL7 Vancouver (Sep 14-19)

OMG Orlando (Sep 22-26)

Apr: SOA in Healthcare conference (Chicago) Organized by HSSP

Oct:

May: HL7 Phoenix (May 4-9)(possible CTS II, Provider/Services Directory SFM Ballots)

Nov:

Jun: OMG Ontario (CA) (Jun 23-27) Dec: OMG Santa Clara (Dec 8-12)

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Where would these specifications be usedWhere would these specifications be used

• Inter-Enterprise (such as NHIN, RHIOs, LHINs)

– By functionally specifying behavior, roles between applications and products are clarified, and the technologies supporting them can be profiled and sharpened

• Intra-Enterprise

– Standardization on functionality allows for better integration of off-the-shelf and custom development environments, and promotes more of a “plug and play” environment

• Intra-Product

– Facilitates vendors ability to integrate third-party value-add components and speed design phase with higher confidence

• Custom-Implementation

– Affords organizations wishing to custom-develop the opportunity to later integrate off-the-shelf

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The ApproachThe Approach

• HL7 to lead in service selection, functional elaboration, and conformance criteria

• OMG to lead in technical specification

• Both organizations jointly participate in all activities

• Work products will be “owned” by only one organization but used collaboratively

• “Operate as one project” as a principle

• Actively seek vendor participation

• Engage IHE community

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OMG

HL7

The HSSP ProcessThe HSSP Process

HL7 DSTU

Service Functional Model

OMG RFP

Technical Specification

ANSI Standard

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The Value of Collaboration The Value of Collaboration

• HL7 brings…– Healthcare semantic interoperability expertise

– 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

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Context of HSSP SpecificationsContext of HSSP Specifications

Ab

ilit

y to

Int

erop

erat

e

High

Low

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Two Dimensions of InteroperabilityTwo Dimensions of Interoperability

Sem

antics

Behavioral

UDDI v3

Web Services

Java RMI

HSSP RLUS (Profiled)

OWL-S

CORBA

Ideal Target

HSSP Reference Arch

HSSP EIS

• Behaviorally, there are a lot of solutions

• Need to marry Semantic Interoperability with Behavior

• The touchstone business case is the notion of automated discovery, composition, and delivery

• What can HSSP provide to get us to the goal?

From the RM-ODP Informational Viewpoint

HSSP RLUS

HL7 Messaging

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What Participants are Saying… What Participants are Saying…

• “Kaiser Permanente I.T. is currently transitioning to an SOA-based approach to business and systems integration. Availability of industry standard services will bring many benefits towards this goal in terms of speed of implementation, flexibility and reduced cost. I am very pleased that both HL7 and OMG are committed to this timely effort.”, Alan Honey, Enterprise Architect (Principal), Kaiser-Permanente

• “The creation of a health Informatics infrastructure based upon a service-based architecture grounded in comparable data has the potential to improve healthcare delivery and greatly enhance patient safety.”, Peter L. Elkin, MD, FACP, Professor of Medicine, Mayo Clinic College of Medicine

• “The Eclipse Foundation is pleased to support an open source project dedicated to building frameworks, components, and exemplary tools to make it easy and cost-effective to build and deploy healthcare software solutions. This Eclipse Open Healthcare Framework project will leverage the Eclipse Platform developed by IBM, Intel, Wind River, Actuate, Borland, BEA, Computer Associates and others.” Mike Milinkovich, Executive Director, Eclipse Foundation

• “The time is now and the place is here in this joint OMG/HL7 project. Never before has the industry been closer to cogent, clear healthcare IT data model and service standards that can provide true interoperability in a short timeframe, with open-source implementations making availability abundant.”, Richard Mark Soley, Ph.D., Chairman and CEO, OMG

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What has the HSSP delivered?What has the HSSP delivered?

• HL7 DSTUs:

– Decision Support Service (DSS) receives patient data as the input and returns patient-specific conclusions as the output

– Retrieve, Location, and Update Service (RLUS) provides a set of interfaces for accessing and managing health information

– Entity Identification Service (EIS) for identification of patient, providers and other entities participating in the care

• OMG-issued technical Requests for Proposal (RFPs) finalized or drafted for all DSTUs

– Initial Submissions received for RLUS and EIS

• A Service Development Framework (methodology) for developing the service specifications

• An informative HL7 ballot document on the SOA4HL7 Messaging-to-SOA Transition Methodology

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How is this project “different”? How is this project “different”?

• Active participation from three continents and 15+ organizations

• Significant cross-cutting community involvement– Providers & Payers (Blue Cross/Blue Shield, DoD Military Health

System, Kaiser-Permanente, Mayo Clinic, Veterans Health Administration)

– Vendors & Integrators (CSW Group, EDS, IBM, Initiate Systems, Intel, Northrop-Grumman, Software Partners)

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

– Governments (Veterans Health Administration, DoD Military Health System (MHS), National Cancer Institute, Canada Health Infoway, NeHTA Australia, SerAPI (Finland))

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

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Approach is producing a Comprehensive SolutionApproach is producing a Comprehensive Solution

• HL7

– Story Boards

– Application Roles

– Payloads

– CIMs and LIMs

– Control Act and Transmission Wrappers

– HMD

• Services

– Interaction Payload

– Interaction Contracts

– Interactions

– [Compositions]

• HSSP SOA

– Conformance Profiles

• Semantic + Functional

• Model Pedigree

– Profile and Template Registries

– Conformance Testing (Governance)

– Functional Models for Core and Business services

– Methodology for HL7 to Service Mapping

– Support for Federation, Forwarding, and Orchestration

Ontology for Service Description and Discovery

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Why should I participate? [One]Why should I participate? [One]

• This effort is focused on and driven by business-need

– It is not an “academic exercise” striving for perfection

– Acknowledgement that for standards to be useful they must be used

– Focused on the practical and achievable

– Short timelines

– Based upon business value and ROI

• Leveraging talent from two standards communities

• Up-front commitment ensures community engagement

• Being run like a “project” and not a committee

• Recognize participation as an investment and not an expense

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Why should I participate? [Two]Why should I participate? [Two]

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

• Significant “networking” opportunities—you will gain access to the best and brightest in the industry and the world

• 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

• Establish market presence and mindshare as industry leader

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How do I Participate?How do I Participate?

• Join appropriate standards organizations

– HL7 for functional work

– OMG for technical specification work

– Join both

• Allocate resources to actively engage in the project

– Engage existing, knowledgeable resources in the areas they are working already.

– Subgroups form based on industry need and priority

– Teleconferences are weekly; meetings approximately bimonthly

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Who should I involve?Who should I involve?

• Involve the staff that can best address your business needs:

– The benefits you receive will depend upon your investment

– Organizations that commit resources garner more influence and more mindshare

– Your business interests are being represented by your attendees

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ReferencesReferences

• HL7 Website:

• http://www.hl7.org

• OMG Website:

• http://www.omg.org

• Services Project Homepage

• http://www.healthinterop.org

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Supplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and ImpactsSupplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and Impacts

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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

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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

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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

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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

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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

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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