Post on 26-Mar-2015
Slide 1EHR SD RM - EHR Way Forward … Future State Reference Architecture
HSSP Practitioners Guide Volume II Immunization and Adverse Event Reporting Prototype
From HL7 and HITSP Artifacts
For presentation at HL7 Rio Workgroup Meeting, May 2010
Six Weeks to Rio, 19 March 2010 Minutes 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” Lead Project Stephen.Hufnagel.ctr@tma.osd.mil, Editor
GovProjects, EHR, PHER, HSSP co-sponsors
Slide 2EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Item Max Time
Roll Call and Introductions 3 min
Overview Agenda 2 min
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
Slide 3EHR SD RM - EHR Way Forward … Future State Reference Architecture
The Practical Guide for SOA in Health CareA real-world approach to planning, designing, and deploying SOA.
Version 1.0, December 2008 An informative reference for leaders and decision-makers. Produced by the Healthcare Services
Specification Project (HSSP): A collaborative effort between Health Level Seven (HL7) and the Object Management Group.
The figure illustrates a macro-view of a SOA. It depicts five overlapping boundaries, each of which represents a context within the business and architecture:
• The Inter-organisational Boundary (outermost) represents inter-organisational considerations, such as policies, sharing agreements, and business partners.
• The System Boundary represents the physical platforms on which software and systems run, including servers, networks, and so on.
• The Application Boundary represents the software running on those platforms, inclusive of applications and data.
• The Business Process / Orchestration Boundary manages the intersection between software and workflow, and would manage coordination among multiple software components that all must interact to satisfy business needs.
• Finally, the Service Implementation Boundary depicts the implementations themselves, interacting across a service bus, and realizing the architecture.
Slide 4EHR SD RM - EHR Way Forward … Future State Reference Architecture
The Practical Guide for SOA in Health CareTable 3. SampleHealth Business Function Map
Healthcare-Unique Services Business Svcs SOA Infrastructure Svcs
Business Line
Order Entry
Order Fulfillment
Patient Evaluat
ion (DSS)
Lab Data
Retrieval
Pharmacy Data
Retrieval
EHR Alert/ Event Mgmt
Master Person Index
Terminology Service
Demographics
Billing
Scheduling
Auditing
Service
Exception Mgmt
Business Process Mgmt (BPM)
Authenticat
ion
Services Director
y
Access Control
Pharmacy X X X X X X X X X X X X X X X
Laboratory X X X X X X X X X X X X X X X X
Patient Administration X X X X X X X X X
Order Entry/Mgmt X X X X X X X X X X X X X X X
Scheduling X X X X X X X X X X
Registration X X X X X X X X X X
Care Management X X X X X X X X X X X X X X X X X X
Referrals/Referral Mgmt X X X X X X X X X X X X X X X X X X
Nursing X X X X X X X X X X X X X X X X X X
Emergency Department X X X X X X X X X X X X X X X X X
Patient Billing X X X X X X X X X X X X X
Imaging/Radiology X X X X X X X X X X X X X X
Clinical Decision Support X X X X X X X X X X X
Facilities Management X X X X X X X
Nutrition Mgmt (Dietetics)
X X X X X X X X X X X X X X X X X
Slide 5EHR SD RM - EHR Way Forward … Future State Reference Architecture
The Practical Guide for SOA in Health Care
Slide 6EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Roll Call and Introductions 3 min
Overview Agenda 2 min
Overview of HSSP Practitioners Guide Volume I 10 min
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
Slide 7EHR SD RM - EHR Way Forward … Future State Reference Architecture
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.
Slide 8EHR SD RM - EHR Way Forward … Future State Reference Architecture
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
Slide 9EHR SD RM - EHR Way Forward … Future State Reference Architecture
HL7 SAIF ResponsibilitiesConformance and Compliance Framework (ECCF)
Consistency
Tra
ceab
le
Implementation“Where”
Behavior“How”
Content“What”
Policy“Why”
Slide 10EHR SD RM - EHR Way Forward … Future State Reference Architecture
HITSP WithinHL7 SAIF ECCF Specification Stack
Topic
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
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 Harmonization
Framework
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
10
ContentPolicy
Slide 11EHR SD RM - EHR Way Forward … Future State Reference Architecture
HL7, HITSP, FHIMS and NHIN WithinHL7 SAIF ECCF Specification Stack
Topic
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
Consistency
Tra
ceab
le
HL7 RIMFHA FHIMSHITSP DAHITSP CAP
Harmonization Requests/ Use Case
HITSP Capability
HITSP Transaction,
Transaction Package and Service
Collaboration
HITSP Component
HL7 EHR-S FMHITSP
Harmonization Framework
HL7 EHR SD RM
HITSP IS
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
NHIN ConnectServices
Tomcat, JBoss, J2SE, Eclipse,
GlassFish ESB, OpenSSO
11
ImplementationBehaviorContentPolicy
Slide 12EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Roll Call and Introductions 3 min
Overview Agenda 2 min
Overview of HSSP Practitioners Guide Volume I 10 min
Overview of Services Aware Interoperability Framework (SAIF) 10 min
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
Slide 13EHR SD RM - EHR Way Forward … Future State Reference Architecture
Federal Enterprise Architecture (FEA)www.whitehouse.gov/omb/egov
Performance Reference Model - The FEA PRM is a framework to measure the performance of major IT initiatives and their contribution to program performance. The PRM leverages performance measurement best practices from the public and private sectors, including the Balanced Scorecard, Baldrige Criteria, Value Measurement Methodology, program logic models, the value chain, and the theory of constraints. There is an increased emphasis placed on linkage of investment to agency program performance and the PRM will help agencies produce enhanced performance information. Furthermore, the PRM will assist in: improving the alignment of program goals and objectives with Mission Area goals and objectives; improving communication of program contributions such as technology (input) to outputs and outcomes; and in identifying improvement opportunities that span traditional organizational boundaries.
Business Reference Model - The Business Reference Model (BRM) is a functional-driven framework for describing and organizing the day-to-day business operations of the Federal Government into Lines of Business (LOBs), independent of the agencies that perform the business operation. The BRM is the first layer of the Federal Enterprise Architecture and it is the organizing construct for the analysis of the other four reference models: performance, service components, data, and technology.
Service Component Reference Model - The Service Component Reference Model (SRM) is a functional framework to evaluate to identify government-wide opportunities to leverage IT investments and assets from a service perspective. This model helps understand the services delivered by the government and assess if there is an opportunity to group like services and create leverage opportunities, such as reuse or shared services.
Data Reference Model - The Data Reference Model (DRM) describes at an aggregate level, the data and information required to support the Lines of Business (LOBs). The three elements of data exchange that have been standardized include data description, data context, and data sharing. Establishing a common data model streamlines the information exchange process within and across the Federal Government and facilitates the ability to identify duplicative data resources.
Technical Reference Model - The Technical Reference Model (TRM) establishes a common technical framework for categorizing standards, specifications, and technologies that support and enable the delivery of services. This framework can be leveraged to support the development, delivery, and exchange of business and application components (Service Components) that may be leveraged in a Component-based or Service Oriented Architecture (SOA). Furthermore, it also serves as the foundation to advance the re-use of technology and best practices from each of the Service Components on a government-wide basis.
Slide 14EHR SD RM - EHR Way Forward … Future State Reference Architecture
Functional Analysis Object Analysis
Requirements Analysis
Interface Design Analysis Service Analysis
EHR Future State Reference Architecture
Slide 15EHR SD RM - EHR Way Forward … Future State Reference Architecture
HL7 EHR System Functional Model (EHR-S)> 160 System Functions in 4 level categorization
(separate spreadsheet available for full enumeration)
NOTE: “Other” Category - The EHR-S model does NOT include Electronic Resource Planning (ERP) / Logistics and Financial components, which are needed for completeness of a Health IT Enterprise.
Other O-1 Electronic Resource Planning (ERP)
O-2 Finances
O-3 Other
Sys
tem
Fu
nct
ion
s
EHR-S FM functions can be grouped into Service Components … aka Capabilities
(e.g., Lab Order Capability, which
does eligibility and authorization
function as well as lab order function).
Slide 16EHR SD RM - EHR Way Forward … Future State Reference Architecture
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
Functional Areas + Focal Classes
Functional Areas + Focal Classes
Functional Areas + Focal Classes
EntityServices
Information Management
Information Management
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
16
Slide 17EHR SD RM - EHR Way Forward … Future State Reference Architecture
HL7 RIM (Reference Information Model)Six Core Classes Defining a Semantic Framework which
Maintains Clinical Data Context
The HL7 RIM expresses the data content needed in a specific clinical or administrative context and provides an explicit
representation of the semantic and lexical connections that exist between the information carried in the fields of HL7 messages.
Role link
Act relationship
Participation
The HL7 RIM supports EHR interoperability; an EHR may needs additional foundation classes (e.g., Responsibility)
Language /
communication
ACT (aka ACTION)ROLEENTITY
ACT – something that has happened or may happenEntity – a person, animal, organization, or thingRole – a responsibility of, or part played by, an EntityParticipation – the involvement of a Role in an ActAct Relationship – a relationship between two ActsRole Link – a relationship between two Roles.
Slide 18EHR SD RM - EHR Way Forward … Future State Reference Architecture
HITSP Harmonization Framework
AddressingBusiness
Needs
ProvidingInfrastructure,
Security,Privacy
Data Architecture
Available for Independent Implementation
DefiningInformation
Content
IS = Interoperability Specification
Base and Composite Standards
Slide 19EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Roll Call and Introductions 3 min
Overview Agenda 2 min
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
Candidate HSSP Services for use in HSSP Practitioners Guide Volume II
Overview of DRAFT Table of Contents for HSSP Practitioners Guide Volume II 13 min
Wrap Up 2 min
Slide 20EHR SD RM - EHR Way Forward … Future State Reference Architecture
Candidate HSSP Services for use in HSSP Practitioners Guide Volume II
CTS2 (Common Terminology Services 2)CTS 2 will be a commonly accepted standard for terminology services that enhances the capabilities of the initial CTS specification for sub-setting and mapping, and extends the specification into domains such as terminology distribution, versioning, and classification.
DSS (Decision Support Service) A commonly accepted standard for the DSS would make it more attractive for service consumers to invest in the infrastructure required for using the DSS to meet its patient evaluation needs, as they would be able to use the same interface to interact with multiple service vendors.
HCPDS (Healthcare Provider and Services Directory Service)HCPDS is required to provide an online facility that will enable Practitioners, via a set of parameters, to locate other practitioners, to assist in the continuum of care.
IXS (Identity Cross-Reference Service, formerly known as Entity Identification Service) NormativeIn balloting to become a full HL7 standard.
PASS (Privacy, Access and Security Services)The goal of PASS is to define a suite of services that will provide a simple interface for all privacy, access control, consent, identity management and other security services that are needed in a service-oriented health information architecture.
RLUS (Retrieve, Locate and Update Service) and EIS (Entity Identification Service)The HL7 SFM has been approved by the HL7 Board as an official DSTU.
Slide 21EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Roll Call and Introductions 3 min
Overview Agenda 2 min
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
DRAFT Table of Contents for HSSP Practitioners Guide Volume II
Wrap Up 2 min
Slide 22EHR SD RM - EHR Way Forward … Future State Reference Architecture
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”
Slide 23EHR SD RM - EHR Way Forward … Future State Reference Architecture
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, (fportila@gmail.com)
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
Slide 24EHR SD RM - EHR Way Forward … Future State Reference Architecture
Agenda
Roll Call and Introductions 3 min
Overview Agenda 2 min
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
Slide 25EHR SD RM - EHR Way Forward … Future State Reference Architecture
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 March 26, 2010 at 12:30 Eastern Time
– PHONE: +1 770-657-9270 Pass code 071582#
– WEB: http://my.dimdim.com/hssp