Enterprise Architecture Framework: In Proof and Practice€¦ · Public hospitals may also fax or...

Workshop Linking Individual Data to Improve National HIS – Phnom Penh, Cambodia | 6 – 7 December, 2012 1 |

Enterprise Architecture

Framework:

In Proof and Practice

Mr Mark Landry

Health Information Technical Officer

World Health Organization, Regional Office of the Western Pacific


What is Enterprise Architecture?

Driven by specific requirements

of an organization or sector

The Ministry of Health is the

“Enterprise” as a collection of

programs and functions

Promotes “good design” and a

“city planning” approach

Enables standards-based and

interoperable HIS and eHealth

solutions

Definition:

Enterprise

Architecture (EA) is a

comprehensive and

rigorous description of

the elements and

relationships of an

enterprise—such as

health.

Workshop Linking Individual Data to Improve National HIS – Phnom Penh, Cambodia | 6 – 7 December, 2012 3 | 12/12/2012 3

Common understanding 2

Workshop Linking Individual Data to Improve National HIS – Phnom Penh, Cambodia | 6 – 7 December, 2012 4 | December 12, 2012


HIS (or Enterprise) Architecture is a

Well Known and Described Discipline Four Layers Representative Questions Addressed

Business 1. Who are the key decision makers, what are their roles and behaviors insofar

as decision making is concerned?

2. What are the essential questions & requirements of users?

3. Who will be responsible for the managing the HIS?

Data 1. What are the essential core and common data necessary to support the

organization’s business architecture?

2. How will the sources of these data be extracted linked and transformed for

use from existing operational systems?

Applications &

Tools

1. What are the priority applications that a core HIS must deliver?

2. What applications are best included within a single platform design versus

those applications that are best maintained as separate operational systems?

3. How should the user interface work?

Technical 1. What are the requirements for information to be captured, data entered,

tagged, communicated and managed?

2. What is the minimum information and communication technology capacity

needed across the country to support access to the applications and

dissemination of information?


HIS Architecture Layers

Business /

Functional

Data /

Information

Application /

Integration

Technical /

Configuration

Principles Data Model Software Applications Servers / Devices

Vision / Mission Data Integration Integration Components Telecommunications

Objectives Master Data Management User Interfaces Operating Systems

Policies Data Dictionary Services Definitions Network Configurations

Use Cases Metadata Management Process Alignment Database Infrastructure

Data / Work Flows Data Delivery Information Exchange Storage

Requirements Classificaiton of Standards Middleware Security

Organizational Structure Business Intelligence Interoperability

Success Factors Data Quality

This is all health workers (users) need to know, care about,

or should care about… the rest is important to health

informatics or dedicated ICT professionals


Three Parts of the Architectural

Approach

1. Methodology Countries can Apply

– A step-by-step process for a country to develop a plan (architecture)

that is undertaken and owned by the country

2. Knowledge Countries can Re-Use

– A virtual repository of architectural building blocks and standards that

countries and developers can re-use

3. Resources Countries can Leverage

– A set of tools, templates, check lists, and techniques that countries

and developers can re-use

12/12/2012 7

2

3

1


HIS Architectural Methodology

adequate planning expected solutions

Environment Needs Users Processes Requirements

Specifications Standards Data model Hardware/software Interfaces

Iterative approach Development tools Network Databases Road maps

Testing Installation User training Budget and staff Maintenance

Analyze Design Develop Deploy

Ministry of Health Lead Solution Providers Lead

1


Development of

“Common” and

“Custom”

requirements and

solutions

ISO TR 14639

Capacity-based

eHealth architecture

roadmap

HIS Architecture

Framework


Architecture Continuum

Knowledge Captured in Reusable

Building Blocks

12/12/2012 10

Specific Common

Architecture Building Blocks Capture Rules, Requirements, Standards & Relationships

Represent Things You See and Read

Solution Building Blocks Capture Products, Systems, Capabilities & Services

Represent Things You Build, Buy and Use

2

Workshop Linking Individual Data to Improve National HIS – Phnom Penh, Cambodia | 6 – 7 December, 2012 11 | 12/12/2012 11

Global Health

Architecture

• Requirements

• Standards

• Guidelines

• etc.

Country Health

Architecture

Global Health

Solutions

Country Health

Solutions

• Software

• Hardware

• Services

• etc.

Global Health Local

1

2

1.No health impact until you

get into the green box.

2.Path #1 leverages global

standards & architecture.

3.Path #2 leverages global

standards, architecture and

others’ R&D.

4.Country solutions need to

work as part of a national

health information system.

From Architecture to Health Impact G

en

era

l

Arc

hit

ectu

res

Ge

nera

l

So

luti

on

s

Courtesy David Lubinski,

Gates Foundation


Example: Birth Notification System

Develop business

requirements

Develop functional

requirements

Courtesy Queensland Department of Justice and Attorney-General (2012)


Business Process Requirements

Develop

process flow

diagram

Develop

process

descriptions

BDM

Births

Hospital

JAG ITS

Qld Health

KE Software

Load bir th

notific ations to Bir th

Notic es module in

Vitalware

Enter bir th notific a tion

details into Bir th

Notic es module in

Vitalware

Return notific ation to

lis t for future matc hing

Matc h notific ation s

agains t av ailable

regis trations

Trans mit bir th

details from

hos pital s y s tem

(HBSCUS)

As s es s propos e d

potential matc h(e s )

on Vitalware s c re en

Link bir th

notific ation to bir th

regis tration in

Vitalware

Unmatc hed regis tration

and notific ation

Query hos pitalAdd to No

Matc h report

(automatic )

Email bir th

notific ation

details to BDM

Email bir th

notific ation

details to J AG

Fax /email bir th

details to BDM

Enter bir th

details into

hos pital s y s tem

To B irth Registra tion Process

(same sex parents)

'Check security code'

To B irth Registra tion Process

'Check security code'

From B irth Regis tration Process

(same sex parents)

'Check for errors '

From B irth Regis tration Process

'Upload registrat ion to Vitalware'

Nightly matc hing proc es s

Birth notific ations rec eiv ed

from J AG ITS

Birth notific ations rec eiv ed

from Qld Health

Bir th notific ations rec eiv ed

from hos pital

Within 2 day s of b ir th

(BDM-required timing)

Bir th notific ation d etails

rec eiv ed from ho s pital

Match birth registration and birth notification

Birth notifications entry and matching - links with Birth Registration Process (registration part) and Birth Registration Process (same sex parents) (registration part) - approved as current process 31/1/2011

unmatc hed

regis tration

unmatc hed notific ation

matc h rejec ted

matc h ac c epted

full matc h

c onfirmed

no regis tration

no notific ation

partial matc h

c onfirmationreques t for c onfir mation

of bir themail

emailed bir th deta ils

trans mitted bir th d etails

hos pital s et up

to s end

elec tronic ally

fax ed or emailed bir th details

hos pital s till

s ending manually

Business Process: Birth notification entry and matching (sub-process of Birth Registration process)

Lower Level Business Process: none

Description: A complete birth registration consists of information from two sources – the registration application from the parents, and the birth notification from the hospital where the child was born. This diagram depicts the process through which a birth notification is received from the hospitals, and matched with its corresponding birth registration. It forms a sub-process in both the Birth Registration, and Birth Registration (same sex parents) processes.

Actors: Hospital admin officer Qld Health admin officer JAG ITS support officer KE Software support officer BDM registry officer

Triggers: Initial processing of the birth registration has been completed, and the registration made available in Vitalware for matching with the birth notification.

Preconditions: A new birth has occurred, and the hospital has recorded the birth in their own system and sent a birth notification to BDM. The parent(s) have completed and submitted a birth registration application, and initial processing (data entry and compliance) has been completed.

Enter birth details into hospital system

Basic details about the birth (e.g. mother’s name, child’s date of birth) are entered into the hospital’s own record management system. Most public hospitals will then send this information electronically to Queensland Health. Private hospitals will fax or email lists of births directly to BDM, where they will need to be manually data entered into Vitalware. Public hospitals may also fax or email information on individual births as requested by BDM.

Fax/email birth details to BDM

Lists of births occurring at the hospital during a specified period of time (or any other births as requested by BDM) will be faxed or emailed to the Registrations area at BDM.

Transmit birth details from hospital system (HBCIS)

Details on births that occurred at the hospital during the specified period are transmitted electronically to Queensland Health.

Process Description:

Load or enter birth data into BDM Online Birth Notification System (new task)

For private hospitals who are set up to submit birth notification data electronically to BDM, the BDM Online Birth Notification System (web-based) is used. The user logs into the system, and either uploads a batch file of birth notifications (drawn from the hospital’s internal system), or manually enters the data for individual births.


Functional Requirements

Develop

use cases – Actors

– Triggers

– Pre-conditions

– Post-

conditions

– Normal flow

UC-05 Validate Birth

Details (batched

notifications)

UC-04 Validate Birth

Details (single entry

notifications)

UC-15 Transmit

Births through Firewall

UC-17 Match New

Notifications to

Registrations

UC-18 Match New

Registrations to

Notifications

UC-06 Correct

Single Entry BirthUC-20 Access No

Match Report

UC-10 Search

Submitted Records

UC-08 Submit Births

UC-12 Change

Password

UC-13 Display

Terms & Conditions

UC-16 Load

Received Data

UC-07 Retrieve birth

UC-09 View

Notification Report

UC-14 Display

Contact Details

UC-03 Upload

Batch

UC-19 Assess

Potential Match

UC-01 Log into

System

UC-02 Enter Birth

Details

UC-11 Resupply

Password

BDM Vitalware

<<system actor>>

JAG ITS firewall

<<system actor>>

BDM Births officer

Hospital staff

member

BDM Vitalware

temporary order store

<<system actor>>

TIM <<system actor>>

BDM Vitalware SystemOnline Birth Notification System

Requirement Identifier

Requirement Question / Comment Priority

FR-BN005 The Online Birth Notification System gives the option to directly enter a single birth notification record.

Already delivered in stage 1 Highly desirable

FR-BN006 The Online Birth Notification System captures the birth details for a single birth notification record through a data entry screen, with fields as listed in the ‘Enter Birth Details’ use case.


FR-BN007 The Online Birth Notification System indicates which fields in the data entry screen are mandatory.



Resources Available: Common Tools

Access and knowledge of health

informatics global standards for

developers and users

– ISO 215 Technical Committee on

Health Informatics

– Health Informatics Standards

Knowledge Resource (HIS-KR)

(www.hiwiki.org)

– Standards Knowledge Management

Toolkit (SKMT)

(www.skmtglossary.org)

3

http://www.hiwiki.org/

http://www.skmtglossary.org/


Health Ingenuity Exchange (HingX)

New online technical resource registry and repository:

– http://www.hingx.org

– http://aehin.hingx.org

Close to 1000 artefacts already:

– Use cases, requirements, guidelines, frameworks, strategies,

plans, computer source code, etc.

Powerful query and indexing tools

http://www.hingx.org/

http://aehin.hingx.org/


ICT-enhanced HIS Solution:

Acquisition Support

View technology as an integral part of a larger system, supported by adequate policies, funding, communication, and skilled leaders and staff

Create a long-term strategic plan for HIS and technology

Maintain control of the purchasing process – demand good customer service

Understand the true and Total Cost of Ownership – not just the cost of computers or software

Carefully match existing resources with the pace of implementation to allow for a sustained, incremental approach

Build local capacity to fully utilize the technology


Philippines eHealth Framework

Workshop Linking Individual Data to Improve National HIS – Phnom Penh, Cambodia | 6 – 7 December, 2012 19 | 19

VISION FOR HEALTH, BLUEPRINT AND TELEHEALTH POLICY

INFORMATION TECHNOLOGY STRATEGIC PLAN

ICT ROAD MAP

Pro

gra

m/F

un

ctio

n

ba

sed

init

iati

ves •Nationwide

(HMIS)

•Statewide (TPC)

•Public/Client

•Access (HOL)

Faci

lity

ba

sed

Init

iati

ves

• THIS/HIS

• Nat’l Blood Bank

• Public Health Lab

• Training Colleges

Healt

h R

ela

ted

MSC Flagship initiatives

• Telehealth

• MyKAD

• HRMIS

• E-Perolehan

• E-SPKB

• PMS

Malaysia ICT for Ministry of Health


Malaysia Scenario Of Integrated Health Services

MyKad

Step 1: Access health portal & perform HRA

Step 2, choice 1: Contact call centre

Step 2, Choice 2: Appointment to see doctor

Step 3: Consultation, EMR created

Seeking advice at point of care CME for decision

support

Step 4: LHR repository Step 5: Data Warehousing-

Support Health &

Financial Planning.

PLHP created

Individual

Step 1

Step 2: Choice 1

Step 2: Choice 2 Step 3

Step 4 Step 5


Hong Kong eHealth Consortium


Rwanda Health Enterprise Architecture

Framework

Adapted from presentation by Carl

Flourie, Jembi Health Systems


Thank You

Mr Mark Landry

Health Information Technical Officer

World Health Organization, Regional Office of the Western Pacific

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