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Healthcare Integration | Opening
the Doors to Communication
Ramraj Rajkumar
https://www.linkedin.com/in/ramrajkumar
Overview Introductions
Healthcare Integration - background
Healthcare Integration Requirements
BizTalk Offering for Healthcare Integration
Case studies
Q&A
About Myself VP of Integration Services at Dapasoft
Previously at Microsoft Worked on BTS Product team (Specifically the HL7 Accelerator)
10+ years of experience in Healthcare Interoperability solutions
Dapasoft and Corolar
Systems Integration partner for Microsoft
• Based in Toronto, Canada
Healthcare integration solutions & services
Healthcare integration
Application development
Portals and collaboration
Business Intelligence
Microsoft .NET
Background
10 years ago …
Why do I need an Integration Engine / ESB / Interface Engine?
Healthcare Integration
HL7 DataCategory Type of Data Fields detail
Patient Administration
Patient DemographicsVisit InformationInsurance InformationAllergy InformationDiagnosis InformationEtc.
Patient Name, Address, phone numbers, patient location, attending doctor, consulting doctor, admit date/time, discharge date/time, Insurance Company Name/Address, Insurance Group Number, Policy Number, Plan ID, Allergy Code, Allergy Severity Code, Diagnosis Code, Diagnosis Description, Diagnosis date/time, Diagnosis type, Etc.
Order Entry Lab OrderPharmacy OrderImaging OrderHospitality OrderClinical Order InformationEtc.
Accession Number, Order Request date/time, Result date/time, Collection Volume, Specimen Received date/time, Ordering Doctor, drugs, dispensing, allergies, quantities, Etc.
Laboratory Results Lab Result InformationLab Specimen InformationEtc.
Result Value Type, Result Value, Result Units, Reference Range, Abnormal Flags, Result Status, Etc.
Scheduling Appointment InformationResource RequestsService RequestsEtc.
Appointment date/time, appointment duration, Requested Service ID, Requested Resource ID, Location resource ID, Location Type, Etc.
Other domains … …
Healthcare Integration Scenarios
Health System Integration
External Integration
Integration to Patient centric systems
Integration and BI
https://www.ehealthontario.on.ca/images/uploads/vendor_sessions/eHealthBlueprint_Handout.pdf
Now …
Does your ESB provide …?
Healthcare Integration
Healthcare Integration
Healthcare Interoperability Challenges
Healthcare Interoperability Requirements Mission critical 24x7 environments
Established and emerging standards HL7 v2, v3, CDA, CCDA, XDS, FHIR, and others Complex message formats Versioning
Legacy and modern protocols MLLP, WS, REST and others
Complex environments Typical environment 100+ Interfaces (Inter-dependencies) > 1M real-time transactions per day Ordered delivery
Healthcare Interoperability Requirements Non functional requirements
Privacy / security Audit HA / DR Low latency near real-time delivery Ability to handle operational downtimes Ability to queue 1M+ transactions Archiving requirements 90 – 120 days data retention Message search, edit, resubmit
Functional requirements terminology services Validation and processing rules (XSD, BRE, others)
Real time deployments
Infrastructure and Interface level monitoring
Extensibility
What Are healthcare customers looking for? Technology that has pre-built healthcare functionality
Support for standards Protocols Business rules
Terminology management, validation rules, etc.
Proven best practice Get it right the first time Repeatable templates Analysts vs Developers
Vendor / Software stability and supportability
Interface Life Cycle Management
22
ESB and Healthcare
Healthcare Integration engine Landscape Niche Healthcare Integration vendors
Rich HL7 / Healthcare capabilities
Difficult to support broad use cases
Enterprise ESB Horizontal platforms Very powerful
Lack of vertical features
Requires significant architecture and development experience
BizTalk Server
FoundationalTechnology
HL7 v2 Solution
Faster Time to Value
HL7 Accelerator for BizTalk Server
Architectural decisions Orchestrations vs Messaging Ordered delivery, low latency, etc.
Archiving Tracking, BAM, Custom solution
Monitoring SCOM, 3rd party tools, Interface monitoring
Queuing MessageBox, SB, MSMQ, SQL, Custom solution
Solution templates Structure Isolation, reusability
Integration Dashboard
Support for HL7 standards and rules Schema support, rules implementation, etc.
Need patterns, tools and proven best practices for supporting common Healthcare Interoperability challenges
Corolar/BizTalk as Healthcare Information Platform
Corolar
BizTalk and Corolar
Corolar – Interface Lifecycle Management
Corolar – Clinical Data Repository
Corolar – Patient Centric Data
Case studies
Hamilton Health Sciences
Integration of Mission critical applications including EPIC, MEDITECH and others
Regional Integration Service Provider• Serves population of 2.3M
• Over 1000 beds
• Regional Service provider
MS Case study https://customers.microsoft.com/Pages/CustomerStory.aspx?recid=13804
Markham Stouffville Hospital
MS Case study https://customers.microsoft.com/Pages/CustomerStory.aspx?recid=13797
• Serves population of 400K
• Approx 240 beds
• Achieved HIMSS Analytics Stage 6 EMR adoption model
Integration of Mission critical applications including MEDITECH 6.0
Integration to numerous HIE initiatives
BizTalk and Azure
What’s Next
Why do I need integration in the cloud?
Healthcare and Cloud concerns Security and Privacy
Latency Real-time scenarios
Control
Knowledge and Resource availability
Healthcare Services Industry specific toolkits / Services
IHE Profiles ▪ XDS
HL7 v2 / MLLP ▪ CCDA
HL7 v3 ▪ FHIR
Etc.
CDR in the cloud
