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CON8008 - Healthcare Modernization with SOA Suite
Steve Schenks, Ascension Health Kevin Mattingly, Ascension Health Sean Keane, Oracle Suresh Sharma, Oracle
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Safe Harbor Statement
The following is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle’s products remains at the sole discretion of Oracle.
Copyright © 2013, Oracle and/or its affiliates. All rights reserved. Oracle Public Information 4
About the presenters
Steve Schenks Kevin Mattingly
Integration Architect,
Ascension Health
Integration Architect,
Ascension Health
Sean Keane Suresh Sharma
Director, Healthcare
Interoperability,
Oracle
Product Strategy Director,
Oracle
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Oracle Healthcare Focus
Analytics Connected Health/
Health Management
Platform
Operational Efficiency
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Oracle Healthcare: A Complete Portfolio
Infrastructure & Mobility •Security
•Care Giver -Mobility
•Identity
•Exchange
•3CI
•Master Data Management
Interoperability
and Integration •SOA Suite for Healthcare
•Master Patient Index
•Healthcare Data Model
•Collaboration
•HIE Solutions
•ACO Solutions- Coordinated Care
•NHIN Connect
•Medical Device Integration
Healthcare Management Platform •Health & Disease
• Management
•Patient & Clinical Portal
•eCommerce
•Patient Discharge Mgt
•Healthcare Retail Solutions
•Translational Research Solutions
•Healthcare Cost Management
Business Performance •Financials
•Supply Chain
•Human Resources
•Strategic Planning
•Talent Management
•Advanced Controls
•Value Chain Planning
•Grants Management
Healthcare Analytics •Financial Performance
•Supply Chain Analytics
•Human Resources Analytics
•Cost Accounting
•Translational Research Analytics
•Molecular Medicine
•Clinical Performance
•Operating Room
Care Management and
Partners •Epic
•Cerner
•McKesson
•Allscripts
•GE
•Orion
•Siemens
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Healthcare – tactical trends
Securing data access and at rest
Increased reporting of data breach Laptops, thumb drives, paper
Data replicated to many unaudited destinations
Meaningful Use Stage 2 is here Greater Patient Engagement, consumerism, retailization
Increased data sharing
Increased usage and demand for Analytics
Oracle Confidential – Internal/Restricted/Highly Restricted 8
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Healthcare – strategic trends
ONC
New focus on interoperabilty and data exchange
Certification and Regulation role
HL7 FHIR Fast Healthcare Interoperability Resource
HL7 V4 (sshhh!), REST, JSON, XML
Increased data sharing across care settings
ACO
Stop replicating data!
Oracle Confidential – Internal/Restricted/Highly Restricted 9
Ascension Information Services Confidential and Proprietary 10
Ascension (www.ascensionhealth.org) is transforming healthcare by
providing the highest quality care to all.
Ascension is directed by the Church to care for those most in need. Our
Catholic philosophy permeates our national health ministries and our promise
to provide
Healthcare That Works
Healthcare That is Safe
Healthcare That Leaves No One Behind
Ascension Health
Ascension Information Services Confidential and Proprietary 11
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Ascension Information Services Confidential and Proprietary 12
As Ascension Health added hospitals and related health facilities, siloed IT
departments were also added in some cases
The majority of the clinical interfaces (2058) and all the PeopleSoft human
resources, finance, supply chain interfaces (1084) are supported by the
Ascension Shared Information Services ("SIS") integration team and run in a
centralized data center.
Other interfaces (approximately 1000) are supported by Health Ministries
themselves and run locally at the Ministry.
Current Environment – Scattered Deployments
Ascension Information Services Confidential and Proprietary 13
Moving to Standardization
Orion
Rhapsody
v 5.1.0
Oracle
Java
CAPS
(JCAPS
5.1.3) Sybase eBiz
Impact
eGate
4.5.3
eGate
TRE 5.0.1
(Clinical)
eGate SRE
Summit
Express
Connect 8
eGate
SRE 5.0.5
(Symphony)
Lawson
Cloverleaf
Sybase
Impact TDM
4.1 / Ebiz
5.5.4
Shared
Integration
Shared Integration Stand-Alone Integration
Oracle SOA Suite
Oracle SOA for Healthcare
Oracle
Managed File Transfer
Oracle Enterprise
Manager 12c Oracle
Database 12c
High-value
Service
Delivery
Governance &
Optimization
Standardization
One Integrated Ministry
Ascension Information Services Confidential and Proprietary 14
Schedule
=
Ascension Information Services Confidential and Proprietary 15
High Level Architecture Overview
Ascension Information Services Confidential and Proprietary 16
IP Virtualization Strategy
Ascension Information Services Confidential and Proprietary 17
Comparison Testing Easing the transition to SOA for Healthcare
Integration Flows Implementing Common Healthcare Message Patterns with SOA for Healthcare
Exception Handling Framework Handling Exceptions with SOA for Healthcare
Custom Operations Dashboard Managing an enterprise environment with SOA for Healthcare
Interfacing in SOA for Healthcare
Ascension Information Services Confidential and Proprietary 18
Comparison Testing
* NOTE: identical (same) production test data is processed in bulk through Legacy and SOA systems. Results are compared to match the legacy interface output against
SOA interface output using same input data.
POTENTIAL
DEFECT FIXING
Potential defects proactively fixed to expedite testing and Cut-over validation.
SMOOTH
DEPLOYMENT
Typical scenarios which may create issues in Production Environment are mitigated by proactive planning.
OPTIMAL USE
OF END USER TIME
Code that has gone through output
comparison against the scenarios that occur
in 1 month of production data is deployed on
UAT\Production servers enabling optimal
UAT thus reducing test cycle durations.
Testing with 1 month of input and
output Production Data.
The scenarios that occur in 1 month
of production data get tested *
Typical technical scenarios captured
and tested prior to comparison Migrated Interface functionality
matches Legacy Interface functionality
Compare Results
Legacy Output
A
SOA Output
A’ =
Ensures we are validating existing functionality.
Typical end-to-end testing is not required because no new
functionality is introduced.
Ascension Information Services Confidential and Proprietary 19
Comparison Testing - Architecture
Ascension Information Services Confidential and Proprietary 20
Integration Flow – High Level
1 Mediator
Mediator
AMediator
Source 1
Source 2
Source 3
Destination A
Destination B
Destination C
2 Mediator
Mediator Ba
Mediator3a Mediator
Mediator
C
Mediator
Mediator
MessageType
1
MessageType
1
SSHISSHI
Source Interface Leg Destination Interface Leg
Routing Transformation
3b
MessageType
2 Mediator
Bb
MessageType
2
A
C
C
*Primary constraint is FIFO. Must be maintained by source.
Ascension Information Services Confidential and Proprietary 21
Integration Flow - Scenarios
Source with Single Message Format
1 Mediator
Mediator
Source
Destination A
Destination B
Destination C
Mediator B
Mediator
A
C
SSHI SSHIADT
ADT
ADT
ADT
1
Mediator
Mediator
Source
Destination A
Destination B
Destination C
Mediator B
Mediator
A
C
SSHI
ADTADT
ADT
ORU2
SSHI
ORU
Source with Multiple Message Formats
Ascension Information Services Confidential and Proprietary 22
Integration Flow - Scenarios
Destination with Single Message Format
Destination with Multiple Message Formats
1 Mediator MediatorSource 1
Destination
AADT
ADT
2 Mediator MediatorSource 2 AADT
SSHI SSHI
ADT
1 Mediator MediatorSource 1
Destination
AADT
ADT
2 Mediator MediatorSource 2 AORU
SSHI SSHI
ORU
Ascension Information Services Confidential and Proprietary 23
Integration Flow - Scenarios
HL7 and Non-HL7 Batch File
Non-HL7 Batch File – Utilizes SOA Suite File Adapter
HL7 Batch File – Utilizes SOA Suite HealthCare Adapter and SSHI Endpoint
MFT Solution – Short-term: Accenture developed AFPO MFT solution
– Long-term: Oracle SOA Suite 12c MFT
Ascension Information Services Confidential and Proprietary 24
Exception Handling Framework
SISAI Event Handler Publisher
Event Delivery Network
Logging Subscriber
SISAI_ERROR_LOG (Table)
ADF DashBoard
ServiceNowTicket
Creation
NotificationSubscriber
B2B_INSTANCEMESSAGE(View)
SISAI Event Handler Subscriber
Consists of the following:
• Logging
• Exception Handling
• Notifications
Custom Operations Dashboard was developed for
viewing errors and message data.
Ascension Information Services Confidential and Proprietary 25
Exception Handling Framework
SSHI/B2B layer: Any exception in the SSHI layer like the unavailability of the End Points, TCP/MLLP/FTP protocol
error, Document translation error etc. results in an exception thrown by the SSHI layer.
SOA Composite layer: Any exception
related to routing and transformations
occurring in the Mediator component
would be result in an exception thrown
by the Composite layer.
Ascension Information Services Confidential and Proprietary 26
Exception Handling Framework
Source System SSHI AdapterRouting
Mediator
Transformation Mediator
Transformation Mediator
SSHI Adapter
SSHI Adapter
Destination System
Destination System
External Sender
Inbound HL7 Processing
Routing and Transformation(SOA Composite)
Outbound HL7 Processing
External Receiver
B2B Exception Handler SOA Exception Handler
Custom Component Custom Component
SISAI Exception Handling Framework
B2B_EXCEPTION_QUEUEFault Policy
SOA Infra DB
SISAI Event Handler Publisher
Event Delivery Network
SISAI Event Handler Subscriber
Logger
ServiceNowTicket
Creation
Notification
Ascension Information Services Confidential and Proprietary 27
Custom Operations Dashboard
Problem
Ascension Health has approximately 2750 endpoints spread across 26 Health Ministries. The number of endpoints
dictates that multiple SOA for Healthcare domains must exist – current implementation plan includes 6 domains.
Solution
In order to effectively monitor and get a complete picture of the Healthcare transactions and endpoints across the
multiple domains, Ascension in partnership with Accenture is developing a Custom Operations Dashboard that will
provide the single view across all Healthcare endpoints. The Operations Dashboard will include the following
functionality:
• Endpoint Dashboard: allows for a ‘rollup’ status by Ministry. This dashboard utilizes the B2B_InstanceMessage view as well
as a custom table used to store the errors / notifications produced by SOA and SOA for Healthcare.
• Errors: allows for the searching and viewing of errors that occur in any of the domains.
• Messages: allows for the searching and viewing of transactions that are received or sent via any of the domains
Ascension Information Services Confidential and Proprietary 28
Operations Dashboard – Endpoint Dashboard
Provides an status overview of all endpoints. Status is based on the last message processed. It is not used for monitoring.
Ascension Information Services Confidential and Proprietary 29
Operations Dashboard – Errors
Allows for searching and displaying of error messages that occur across all domains
Ascension Information Services Confidential and Proprietary 30
Operations Dashboard – Errors - Detail
Displays detailed information for selected error.
Ascension Information Services Confidential and Proprietary 31
Operations Dashboard – Messages
Allows for searching of data messages – both metadata and payload. Displays messages based on search results.
Ascension Information Services Confidential and Proprietary 32
Operations Dashboard – Messages - Detail
Displays detailed information for selected message.
Ascension Information Services Confidential and Proprietary 33
Operations Dashboard – Messages - Detail
Displays selected message payload.
Ascension Information Services Confidential and Proprietary 34
FY14-Q4 (Apr-Jun 2014)
FY15-Q1 (Jul-Sep 2014)
FY15-Q2 (Oct-Dec 2014)
FY15-Q3 (Jan-Mar 2015)
FY15-Q4 (Apr-Jun 2015)
FY16-Q1 (Jul-Sep 2015)
FY16-Q2 (Oct-Dec 2015)
FY16-Q3 (Jan-Mar 2016)
FY16-Q4 (Apr-Jun 2016)
FY17-Q1 (Jul-Sep 2016)
FY17-Q2 (Oct-Dec 2016)
Group 1:
1a. IDLEW (2/9/15), 1b. TXWAC (3/20/15), 1c. WIMIL (3/31/15), 1d. MIGRA (5/28/15), 1e. TXAUS (12/23/15)
1a 1c 1b 1d 1e
Alpha: MDBAL (11/14/14) A
Beta: FLJAC (1/27/15) B
Group 2:
2a. INEVA (1/29/16), 2b. ININD (6/30/16)
2a 2b
Group 3: SY-SR (12/23/16) 3
Group 4:
4a. DCWAS (5/18/16), 4b. ALMOB (5/31/16), 4c. NYBIN (10/24/16), 4d. MIDET (10/31/16),
4e. ALBIR (12/23/16)
4a 4b 4c 4d 4e
Group 5:
5a. CTBRI (11/30/16), MIKAL (11/30/16), MITAW (11/30/16)
5b. WAPAS (12/23/16), TNNAS (12/23/16), FLPEN (12/23/16),
MISAG (12/23/16)
5a 5b
Note: Durations/dates for Groups 6 (AZTUC & NYNIA), 7 (ILARL), 8 (MOKAN)
and 9 (Marian Health Ministries) are to be determined.
1. Functional Model complete (5/16/14)
2. Org Structure and Capacity Planning detailed (7/2/14)
3. Roles and Responsibilities finalized (7/16/14)
1. Training materials developed (9/12/14)
2. Trainers (4) equipped to conduct training (12/24/14)
1. Development (DEV) Run Time Environment available (6/20/14)
2. System Integration Test (SIT) Run Time Environment available (7/11/14)
3. User Acceptance Test (UAT) Run Time Environment available (9/5/14)
1 2 3 5 6 4
1 2 3 4 5
A. Ready to Support Alpha Go-Live (9/4/14)
B. Ready to Support Beta Go-Live (11/6/14)
C. Ready to Support Group 1 Go-Live (12/4/14)
1 2 A B C D E F G
Milestones Timeline
PLATFORM DEVELOPMENT
INTERFACE DEVELOPMENT & CUT-OVER (BY MINISTRY)
SIS-AI ORGANIZATIONAL DESIGN & OPERATING MODEL
SIS-AI TRAINING & TRANSITION
4. Production (PRD) Run Time Environment available (10/24/14)
5. Monitoring Dashboard is operational (11/14/14)
6. Oracle to advise on 12c version upgrade (TBD)
4. Resource Transition Plan complete (8/1/14)
5. Operating Model complete (9/12/14)
6. Org Blueprint complete (10/1/14), Operations Manual complete (10/1/14)
& Performance Metrics Deliverable complete (10/1/14)
D. Ready to Support Group 2 Go-Live (11/2/15)
E. Ready to Support Group 3 Go-Live (8/4/16)
F. Ready to Support Group 4 Go-Live (3/3/16)
G. Ready to Support Group 5 Go-Live (9/2/16)
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Connectivity Cloud
Apps Services Platform
On-premises
Apps Mainframe DB
Business to Business
EDI XML Industry
Analytics Business Activity Monitoring Event Processing
Orchestration BPEL Process Manager Business Rules
Service Virtualization & Mediation Service Bus
Oracle SOA Suite
• Simplifies development and management
• Standards-based, open infrastructure interoperates with your existing IT
• Consistent tooling - Single development, deployment and management platform
Unified Integration Across Cloud, Mobile, and On-premise
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
• 30 % memory footprint reduction
• Startup acceleration
• Pre-tuned database profiles
• Active-active support
SOA Suite 12c Key Features
• One-click install
• Everything in JDeveloper
• Debugger & tester
• Templates
• First class support for mobile-friendly standards (REST, JSON, …)
• Automated conversions REST/SOAP
• Cloud adapters to simplify on-prem to cloud integration
• Managed File Transfer (MFT) for file-based integration
• Certifications on Oracle Public Cloud
Developer
Productivity
Web Scale Mobile
Cloud
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Oracle SOA Suite for healthcare integration
TR
AN
SP
OR
T
WS-HTTP
FILE
FTP
SFTP
JMS
MFT
HL7 v2.X
Custom
BA
CK
EN
D
INT
ER
FA
CE
MLLP
HLLP Translation
Validation
Mapsets
Sequencing
Callout
Batching
ACK
Handling
HealthCare Runtime Engine
Database
Healthcare Console
Resubmission SOA
Composite
Enterprise Manager Document
Editor
Document
Handling
HL7 v3.0
External
System
Route, Transfer,
Integrate
Interface Configuration,
Dashboards, Monitor
Healthcare Message creation,
customization, testing
Systems
Management
Healthcare Runtime Engine
Translation ACK Handling Sequencing Validation
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
IOT in Healthcare Scenario : Correlating a Patients Diagnosis with Devices Reading for More Accurate Alarm Evaluation and Enhanced Patient Care
Oracle Confidential – Internal/Restricted/Highly Restricted 39
Correlation scenario: Scale: 3 lb weight gain BP cuff: Slight elevation in BP Pulse: Slight increase in pulse –Alone, each data point may not be reason for concern – Together they may indicate a potential emergency – Local analytics triggers a query to the patient, and sends data along with patient feedback in a single alert to the care provider or hospital
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Raspberry Pi with OEP Server and Web Server
Cloud Services
Healthcare 2 Home IOT Flow Receives JSON data and converts into HL7 and invokes SOA Healthcare Adapter and stores the information into tables
Sensors Installed on Healthcare IOT Device and sends captured results
Gateway becomes SMART with OEP Embedded. It analyzes temperature data to identify temperature fluctuations
SOA Healthcare sends data to endpoints
Send to EMR System
Portal to observe the result and analyze
UI (Oracle Portal) To present the captured data
1 2
3 Sends Temperature, Breathing and SPO2 results to REST Service
4 5
6
7
8
Temperature Sensor
SPO2 Sensor
Breathing Sensor
Oracle SOA Oracle SOA Healthcare
JSF/ADF Mobile ADF /ADF Mobile
EMR
DB