Slide 0 EHR SD RM - EHR Way Forward … Future State Reference Architecture HSSP Practitioners Guide...

EHR 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 [email protected], Editor

GovProjects, EHR, PHER, HSSP co-sponsors


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


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.


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


The Practical Guide for SOA in Health Care


Agenda




Services Aware Interoperability Framework (SAIF) 10 min




Wrap Up 2 min


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 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


HL7 SAIF ResponsibilitiesConformance and Compliance Framework (ECCF)

Consistency

Tra

ceab

le

Implementation“Where”

Behavior“How”

Content“What”

Policy“Why”


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 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


HL7, HITSP, FHIMS 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 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


Agenda





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



Wrap Up 2 min


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.


Functional Analysis Object Analysis

Requirements Analysis

Interface Design Analysis Service Analysis

EHR 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).


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

16


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.


HITSP Harmonization Framework

AddressingBusiness

Needs

ProvidingInfrastructure,

Security,Privacy

Data Architecture

Available for Independent Implementation

DefiningInformation

Content

IS = Interoperability Specification

Base and Composite Standards


Agenda






Candidate HSSP Services for use in HSSP Practitioners Guide Volume II


Wrap Up 2 min


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.


Agenda







DRAFT Table of Contents for HSSP Practitioners Guide Volume II

Wrap Up 2 min


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








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 March 26, 2010 at 12:30 Eastern Time

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

– WEB: http://my.dimdim.com/hssp

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