Slide 0 EHR SD RM - EHR Way Forward … Future State Reference Architecture The Practical Guide for SOA in Health Care Volume II: EHR Immunization and Adverse

Slide 1EHR SD RM - EHR Way Forward … Future State Reference Architecture

The Practical Guide for SOA in Health Care Volume II: EHR Immunization and Adverse Event Reporting Case Study

For presentation at HL7 Rio Workgroup Meeting, 18 May 2010

Five Weeks to Rio, 26 March 2010 Discussion Slides PHONE: +1 770-657-9270 Pass code 071582# WEB: http://my.dimdim.com/hssp

Details available at www.HSSP.wikispaces.com/Reference+Architecture

HL7 “EHR SD RM” [email protected], Project Facilator

GovProjects, EHR, PHER, HSSP co-sponsors


EHR SD RM Milestones

2008 2009 2010

Healthcare SOA

Reference Architecture

(H-SOA-RA)

EHR SD RM Immunization & Response Management

(IRM) Prototype

HSSP Practical Guide for SOA in

Healthcare Volume II: IRM Case

Study __________

EHR SD RM Informative

DSTU

DSTU is Draft Standard for Trial Use (ANSI standards development)

2011

EHR SD RM Normative Standard


Healthcare SOA FrameworkBased on HL7 EHR System Functional Model & Thomas Erl’s SOA Layers HL7 System Functions Direct Care Supportive Information

InfrastructureOther

Business Process

Value Chains

CompositeServices Federated Composition (e.g., Choreograph or Orchestration) Within and Across Business Areas

Core BusinessServices

Functional Areas + Focal Classes




EntityServices

Information Management



Information Reporting and Management

Agnostic Services C r o s s T e c h n I c a l “Common S e r v I c e s”(e.g., Security, Privacy, Auditing, Logging…)

ApplicationServices

Ambulatory Care Systems,In Patient Care Systems

Logistics SystemsFinancial Systems

Decision Support Systems

Data MartsRepositories

Business Objects

ImplementationProfiles

Integrated Healthcare Enterprise (IHE) Profiles

Analysis Profiles Communications Profiles/Stacks

Implementation Profiles

3


SUPPLY CHAIN (ORDER/CHARGE)

ANATOMY OF AN ANCILLARY SYSTEM

AUTHORIZATION

DOCUMENT

RECORDS MANAGEMENT

DECISION SUPPORT

PERFORMANCE

DATA MANAGEMENT

SCHEDULING

IDENTITY

TERMINOLOGY

LABORATORY RADIOLOGY PHARMACY CARDIOLOGY OT/PT/SPEECH

s

CO

RE

B

US

INE

SS

S

ER

VIC

ES

4


HL7 EHR_S-Based Functional Architecture/Services Analysis

Security

Unique ID, Registry, and DirectorTerminology

Information and Records Management

Interoperability

ETCSupport Knowledge Access

Support Clinical Communication Clinical Workflow TaskingClinical Decision Support

Record Patient Specific Instructions Documentation of Care, Measurement, and Results

Orders and Referral Management Care Plans, Treatment Plans, Guidelines, and Protocols

Management of AssessmentSummary Lists

Preferences, Directives, Consents, and Authorizations Manage Patient History

Record Management

Manage Business RulesETC

Pri

mar

y C

are

Cri

tica

l/Em

erg

ency

Car

e

Den

tal

No

n-S

urg

ical

Sp

ecia

lty

Car

e

Lab

ora

tory

Nu

rsin

g

Ph

arm

acy

Po

pu

lati

on

Hea

lth

Beh

avio

ral H

ealt

h

ET

C.

Cro

ss-C

utt

ing

Dir

ect

Car

e/S

up

po

rt F

un

ctio

ns

Infra

stru

ctur

e

Func

tions

Lines of Business

InfrastructureServices•Security•Policy•Records Management•Audit•Terminology•Registry•Workflow•Business Rules•etc

Core ClinicalServices•Entity Identification•Resource Location and Updating Services•Decision Support•Orders Management•Scheduling•Image Management•Etc.

Slide 6EHR SD RM - EHR Way Forward … Future State Reference ArchitectureIT PLATFORM

SUPPORT

ANALYTIC

DATA MANAGEMENT

PERFORMANCE

DECISION SUPPORT

RECORDS MANAGEMENT

DOCUMENT

SUPPLY CHAIN: (ORDERS/CHARGES)

SCHEDULING

AUTHORIZATION

TERMINOLOGY

IDENTITY

RADIOLO

GY

LABORATORY

PHARMACY

CLI

NIC

AS

U

T

ES

T O

NLY

O

UT

PA

TIE

NT

OT

HE

R

INP

AT

IEN

T E

R

CARDIOLO

GY

PT/O

T/SPEECH

DIETARY

SPECIALTY CARE

Ancillary Systems

Co

re B

usi

nes

s S

ervi

ces

INTEGRATEDREQUIREMENTS

DESIGNS: Putting the H-SOA-RA

Pieces Together

RESPIRATORY

Fed

erat

ed B

usi

nes

sS

ervi

ces

Ag

no

stic

S

ervi

ces

Federated Services, may be categorized by: -- Encounter Types -- CMS billing category -- Record type -- Care setting type -- etc.

Data sets are defined for each system functional-

capability-service module 6In

ter-

Age

ncy

Inte

r-S

ervi

ceA

cros

sP

rovi

ders


EHR SD RM AgendaHSSP Practitioners Guide Volume II

Immunization and Adverse Event Reporting PrototypeFrom HL7 and HITSP Artifacts

Item Max Time

Roll Call and Introductions 3 min

Overview Agenda 2 min

Requirements/ Architecture Development Cycle 7 min

Candidate Core Clinical Services 15 min

Candidate Cross Cutting Direct Care Support Functions/ Services 15 min

Candidate Infrastructure Services 15 min

Wrap Up 2 min


EHR SD RM Supporting Requirements/ Architecture Development Cycle

EHR SD RMEHR SD RM

RequirementsAnalysis

RequirementsAnalysis

Architecture Design

Architecture Design

Stakeholder Requirements

Definition


DefinitionRequirements Loop

Verification & ValidationLoop

DesignLoop

PROCESS INPUTS-Required Capabilities-Environments-Constraints

PROCESS OUTPUTS-System Architecture, -System & Test Specifications-Configuration Management Baselines

Test Specifications

Test Specifications

Conformance Criteria

Capabilities - Functions,Information Model

Information Exchanges

Functions – Dependencies

Function orService

Interface Design

Specifications

Compliance means a system provides support for a given standard.Conformance is a recognition of formal testing, that prove that a system provides 100% support for a given standard.


EHR SD RM Supporting Requirements/ Architecture Development Cycle


– What is the system supposed to do?

– Where will the products of the system be used?

– Under what conditions will the products be used?

– How often? How long?

– Who will use the products of the system?

Requirements Analysis (“HOW?” using “Action Verbs”)

– Analyze functions and Services

Decompose higher level functions to lower level functions

Allocate performance requirements to the functions

Architecture Design (Which hardware/ software elements)

– Define the physical architecture

Each part must perform at least one function

Some parts may perform more than one function

Requirements Loop

Ensure all requirements are covered by at least one function

Ensure all functions are justified by a valid requirement (no unnecessary duplication)

Design Loop

Ensure all functions are covered by at least one hardware or software element

Ensure all elements of physical architecture are justified by a valid functional requirement (no unnecessary duplication)

Verification & Validation (V&V) Loop

Each requirement must be verifiable that the solution meets requirements and validated that it meets the user’s needs and expectations.

V&V can be accomplished by: Inspection, Analysis, Demonstration, Test


EHR SD RM Supporting Requirements & Architectural Processes

2010 slide


The HL7 Services-Aware Interoperability Framework (SAIF)

SAIF Contains: Enterprise Conformance and Compliance Framework (ECCF) is based on RM-ODP Behavioral Framework (BF)

– Interoperability Scenarios supporting the RM-ODP Computational Viewpoint Governance Framework (GF)

– Governance is the overarching policy structure and set of related processes by which a group exercises its authority and demonstrates accountability for accepted responsibilities within a particular jurisdiction.

SAIF Principles: Applicable within each of HL7’s three Interoperability Paradigms (IPs),

– (i.e., messages, documents, and services). Provide support for measurable conformance and compliance. Define appropriate governance structures and processes. Provide support for directly implementable solutions. Address the growing disparity between the various solution sets emerging from HL7. Utilize existing V3/RIM artifacts and expertise to the maximum degree possible.


HL7 SAIF ResponsibilitiesConformance and Compliance Framework (ECCF)

Consistency

Tra

ceab

le

Implementation“Where”

Behavior“How”

Content“What”

Policy“Why”



HL7 SAIF Specification Stack ViewsConformance and Compliance Framework (ECCF)

Consistency

Tra

ceab

le

ImplementationBehaviorContentPolicyTopic

Specification

Enterprise / Business View

“WHY”

Information View

“WHAT”

Computational View

“HOW”

Engineering View

“WHERE”

Conceptual

Business Context, Reference Context

Domain Analysis (Information) Model

Collaboration Analysis, Functional Profile(s), Service Roles and

Relationships

Existing Platform capabilities

Platform-

Independent

Business Governance Project-oriented Domain Information Model,

Constrained Information Model, Localized Information Model, Hierarchical Message

Definition

Collaboration Types, Interface Specification and Functional

Groups, Interaction Types and Collaboration Participations,

Contracts Parts

Existing Platform models, libraries, etc.

Platform-

Specific

Rules, Procedures Localized Information Model, Transforms, Schema

Collaboration scripts, Orchestrations, Realized

Interfaces

Execution Context, Platform Bindings, Deployment Model


HITSP WithinHL7 SAIF ECCF Specification Stack

Topic

Specification


“WHY”

Information View

“WHAT”

Computational View

“HOW”

Engineering View

“WHERE”

Conceptual




Relationships


Platform-

Independent



Definition



Contracts Parts


Platform-

Specific



Interfaces


Consistency

Tra

ceab

le

HITSP DAHITSP CAP

Harmonization Requests/ Use Case

HITSP CAP

HITSP Transaction,

Transaction Package and Service

Collaboration

HITSP Component

HITSP IS

ImplementationBehavior

HITSP Security

EHR-S FM is EHR System Functional ModelEHR SD RM is EHR System Design Reference ModelRIM is Reference Information ModelFHIMS is Federal Health Information Model & StandardsDA is Data Architecture

ContentPolicy


HL7, HITSP, HSSP, FHIMS, NIEM and NHIN WithinHL7 SAIF ECCF Specification Stack

Topic

Specification


“WHY”

Information View

“WHAT”

Computational View

“HOW”

Engineering View

“WHERE”

Conceptual




Relationships


Platform-

Independent



Definition



Contracts Parts


Platform-

Specific



Interfaces


Consistency

Tra

ceab

le

HL7 RIMFHA FHIMSHITSP DA

HITSP Capability

HL7 EHR-S FMHarmonization

Requests/ Use Case HITSP Capability

NIEM IEPs, HITSP Transaction,

Transaction Package and Service

Collaboration

HITSP Component

NIEM Information Exchange Package

HL7 EHR-S FMHITSP Security

FrameworkHITEC MU

HITSP IS

EHR-S FM is EHR System Functional ModelEHR SD RM is EHR System Design Reference ModelHITEC MU is HITEC Meaningful Use Objectives/ CriteriaNIEM IEPs is National Information Exchange Model Information Exchange PackagesRIM is Reference Information ModelFHIMS is Federal Health Information Model & StandardsDA is Data Architecture

HSSP & NHIN ConnectServices

Tomcat, JBoss, J2SE, Eclipse,

GlassFish ESB, OpenSSO

ImplementationBehaviorContentPolicy


IS10 IRM HITSP

Constructs Mapped to Standards


EHR SD RM AgendaHSSP Practitioners Guide Volume II

Immunization and Adverse Event Reporting PrototypeFrom HL7 and HITSP Artifacts

Item Max Time



Requirements/ Architecture Development Cycle 7 min

Candidate Core Clinical Services 15 min

Candidate Cross Cutting Direct Care Support Functions/ Services 15 min

Candidate Infrastructure Services 15 min

Wrap Up 2 min

Walk through

EHR-S FM


DRAFT Table of Contents for HSSP Practitioners Guide Volume II

See “HSSP Practitioners Guide Volume II May 2010 – DRAFT-A.Docx”

– Note that the version will change each week … A, B, C D, … till HL7 Rio

Versions available at www.HSSP.wikispaces.com/Reference+Architecture

– Weekly Agenda/Minutes

– Weekly Read Ahead Slides

– Weekly updated “HSSP Practitioners Guide Volume II May 2010 DRAFT-A.Docx”


We are inviting all interested to participate in the 11th International HL7 Interoperability Conference (IHIC-2010), to be held in Rio de Janeiro, Brazil on May 2010. This time will be the first for IHIC in South America. Following the success of previous IHIC venues in Kyoto(2009), Crete (2008), New Zealand (2007), Germany (2006), Taiwan (2005), Mexico (2004), IHIC2010 aims to serve as a meeting place for more than 30 HL7 affiliates around the world as well as individuals interested in interoperability and standards, to share their HL7 implementation experience and strengthen their shared vision. The paper submissions are invited to show to the international community successful experiences using HL7 V3 and CDA R2 interoperability between informatics applications using standards. Also, results and experiences from the collaborative use of standards are most welcome, especially if they are related to HL7 standards.

Topics of interest include but are not limited to the following:

• HL7 implementation experience from regional, trans-regional, or national implementation:

• HL7 v2.x and 3.0 messages• Clinical Document Architecture (CDA)• Imaging Diagnostics and DICOM Standard• Use of HL7 in IHE profiles• Terminologies, Ontologies and Coding Systems: use of local and internationalstandards• Use of other standards in combination with HL7 standards: ASTM, ISO, CEN, etc.Business Models, regional & large scale deployment:• Electronic Healthcare Record: from strategy to implementation• Legal and regulatory issues.• Epidemiology, disease surveillance and control• Geographical information systems for population health• Disaster medicine, emergency management and public health

This year, along with the successful “Show me your CDA!” track, IHIC will also incorporate the "Send me your CDA!" HL7 CDA Interoperability Showcase to display basic interoperability of applications using a HL7 V3 and HL7 CDA R2 standards. All submitted papers will be reviewed based on their technical quality and merit by the technical committee and reviewers. Papers that describe research and experimentation are encouraged. All paper submissions will be handled electronically using IEEE format, and detailed instructions on submission procedure will be available on IHIC2010 web pages (http://www.ihic2010.hl7.org.ar/). Accepted papers will be published online. For other information, please contact IHIC2010, ([email protected])

Important Dates:• Call For papers : November 2, 2009• Deadline for submissions extended to February 15, 2010• Evaluation and notification, March 15, 2010• Camera-papers ready due : April 15, 2010

Call for Participation – HL7 in Rio


Agenda



Overview of HSSP Practitioners Guide Volume I 10 min

Overview of Services Aware Interoperability Framework (SAIF) 10 min

Overview of EHR System Design Reference Model (EHR SD RM) 10 min

Overview of candidate HSSP Services for use in HSSP Practitioners Guide Volume II 10 min

Overview of DRAFT Table of Contents for HSSP Practitioners Guide Volume II 13 min

Wrap Up 2 min


Wrap Up

Any new attendees?

Agenda Time Metrics

Volunteers to help prepare for next week’s meeting?

– Do we need one-on-one working meetings?

Suggestions for Improvement

Next Meeting April 2, 2010 at 12:30 Eastern Time

– PHONE: +1 770-657-9270 Pass code 071582#

– WEB: http://my.dimdim.com/hssp

Documents

Slide 0 EHR SD RM - EHR Way Forward … Future State Reference Architecture The Practical Guide for SOA in Health Care Volume II: EHR Immunization and Adverse