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Healthcare Services Specification Project An Overview of HSSP
Healthcare Services Specification Project An Overview of HSSP
January 2006January 2006
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]
Page 2
Organization of Today’s ProgramOrganization of Today’s Program
• Present background and rationale behind HSSP
• Discuss and differentiate
– “messages” from “services”; discussion about behavior
– “HSSP Services” from “web services”
• OMG, HL7, and the Collaboration
• Project Operational Concerns
• Project Artifacts
• Dialog: The Value of Participating
Page 3
Organisation of Today’s ProgrammeOrganisation of Today’s Programme
• Present background and rationale behind HSSP
• Discuss and differentiate
– “messages” from “services”; discussion about behaviour
– “HSSP Services” from “web services”
• OMG, HL7, and the Collaboration
• Project Operational Concerns
• Project Artefacts
• Dialogue: The Value of Participating
• Yes! The American is capable of communicating in English ;-) Okay, enough humour…
Page 4
Project context: Why was HSSP created? Project context: Why was HSSP created?
• Several large provider organizations were each facing challenges in integrating current and emerging systems
– US Veterans Health Administration
– Kaiser-Permanente
– SerAPI Project Finland
• There were a number of shared beliefs among the founding partners…
Page 5
Project context: Why was HSSP created? (2)Project context: Why was HSSP created? (2)
• 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
– It was recognized that developing “stovepipe” services would not address business challenges
– There was strong commitment to standards
– There was recognition standard services would further interoperability with partners and products
Page 6
So, what is HSSP?So, what is HSSP?
• An project to create common “service interface specification” standards that are tractable within healthcare IT
• A joint initiative co-sponsored by 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 the best industry talent through open community participation and maximizing each community for its strengths
Page 7
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
Page 8
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.
Page 9
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
Page 10
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
Page 11
OMG, HL7, and the CollaborationOMG, HL7, and the CollaborationOMG, HL7, and the CollaborationOMG, HL7, and the Collaboration
Page 12
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.)
Page 13
Risks/Concerns with the OMG Risks/Concerns with the OMG
• Prior negative history with HL7
• Not a significant number of mainstream healthcare vendors were members
• Prior CORBAmed (health domain) work was largely irrelevant in the healthcare marketplace
• Drastically different membership and intellectual property models ( compared to HL7 )
• Potential for added complexity by involving additional organizational dependency
Page 14
Attractions about the OMGAttractions about the OMG
• Free availability of their standards promotes adoption
• Standards adoption mandates (commercially) available implementations – no shelfware standards
• Proven success at getting competing vendors to work together productively
• Rapid adoption model: 18 months from concept to standard with supporting implementations is common
• Business driven standards. Vendors write the standard so the results are implementable.
• Not academic. Ultimately only submitters influence the standard and the community owns issuance and acceptance of submissions
• Methodology embraces multi-platform standards specifications
Page 15
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
Page 16
The OpportunityThe Opportunity
• Ability to leverage talent from two distinctly different communities
• The whole could be greater than the sum of the parts
– Allows the healthcare community to lead functionally
– Allows the architectural/technology community to lead technically
– Integrated process to produce more usable, business-relevant, timely products
• Process could promote usable, non-shelfware standards
• Promoted availability of commercial implementations/marketplace relevance
• Furthered multi-platform support/solutions
Page 17
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
Page 18
Project Operational ConcernsProject Operational ConcernsProject Operational ConcernsProject Operational Concerns
Page 19
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
Page 20
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
Page 21
2006 HSSP Project Schedule (major milestones)2006 HSSP Project Schedule (major milestones)
Jan: Charter HL7 SOA SIG
HL7UK Information Day
Jul: HL7 Educational Summit
Issue 4 ballots (2 + 2)
Feb: Announce intention to ballot Aug: Ballot review
Mar: Issue ballots for EIS, RLUS
Out of Cycle meeting (tentative)
Sep: HL7 Boca Raton (Reconciliation);
EIS, RLUS DSTU’s Adopted!
OMG Anaheim (Issue RFPs)
Apr: OMG Meeting St. Louis
(RFP prep)
Oct: Intent to ballot DSS
May: HL7 San Antonio
(ballot reconciliation)
Nov: Issue DSS, CTS2 Ballots
Jun: Announce intention to ballot
(2 committee, 2 membership)
OMG Boston (Issue Draft RFPs)
Dec: OMG Washington
(Review Initial RFP Submissions)
Page 22
How is this project “different”? How is this project “different”?
• 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
Page 23
Project ArtefactsProject ArtefactsProject ArtefactsProject Artefacts
Page 24
HSSP Builds Upon Existing WorkHSSP Builds Upon Existing Work
Ab
ilit
y to
Int
erop
erat
e
High
Low
Page 25
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
Page 26
The SFM and Leveraged HL7 ContentThe SFM and Leveraged HL7 Content
• The SFM:
– identifies relevant semantics (including HL7 RIM-derived content, terminologies, constraints, etc)Note: HSSP does not expect to be adding RIM content. When shortcomings exist, the work will be directed to the appropriate existing HL7 Committees.
– includes a section to cite existing external work and explain its relevance
– has a traceability matrix to the EHR Functional Model and Standard
– expressed behaviours are intended to be explicit representations considering HL7 Application Roles, Interactions, etc.
– conformance profiles are one mechanism of addressing localization concerns and implementation variations
Page 27
Dialogue: The Value of ParticipatingDialogue: The Value of ParticipatingDialogue: The Value of ParticipatingDialogue: The Value of Participating
Page 28
Why Participate in HSSP? Why Participate in 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
– Acknowledgement that 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
Page 29
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
Page 30
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
Page 31
ReferencesReferences
• HL7 Website:
• http://www.hl7.org
• OMG Website:
• http://www.omg.org
• Services Project Homepage
• http://groups.yahoo.com/group/ServicesSpec
Page 32
Thank you!Thank you!
Ken Rubin
EDS
+1 703 845 3277 desk
+1 301 335 0534 mobile
Page 33
Supplemental SlidesSupplemental SlidesSupplemental SlidesSupplemental Slides
Page 34
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
Page 35
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
Page 36
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
Page 37
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
Page 38
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
Page 39
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
