04/21/23 07:20
Healthcare Services Specification Project The Business Case and Importance of Services
Healthcare Services Specification Project The Business Case and Importance of Services
HL7 Service-Oriented Architecture SIG
OMG Healthcare Domain Task Force
HL7 Service-Oriented Architecture SIG
OMG Healthcare Domain Task Force
January 2007January 2007
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BackgroundBackground
• This presentation represents the collective input and thinking from the collective participants involved in the Healthcare Services Specification Project.
• Contributions to this content have come from
– The Object Management Group (OMG) community
– The Health Level Seven (HL7) community
– The Integrating the Healthcare Enterprise (IHE) community
– The Eclipse Open Healthcare Framework community
• This presentation is intended to describe the purpose, role, and importance of industry-standard service interface specifications
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Why “common services” and not just “messages”?*Why “common services” and not just “messages”?*
• A common practice in healthcare, just not yet in healthcare IT
• Many key products use them but do not expose interfaces
• Ensures functional consistency across applications
• Accepted industry best practice
• Furthers authoritative sources of data
• Minimizes duplication across applications, reuse
• Messages can be either payloads in or infrastructure beneath services
• Service-oriented architecture is just automation of common services
*slide adapted from a Veterans Health Administration Presentation, used with permission
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What is the Healthcare Service Specification Project? What is the Healthcare Service Specification Project?
• An effort to create common “service interface specifications” tractable within Health IT
• A joint standards development project involving Health Level 7 (HL7) and the Object Management Group (OMG)
• Its objectives are:
– To create useful, usable healthcare standards that address functions, semantics and technologies
– To complement existing work and leverage existing standards
– To focus on practical needs and not perfection
– To capitalize on industry talent through open community participation
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What are threads of active work? What are threads of active work?
• SOA Functional Standards
– Scheduling Service, Order Entry/Management, Anonymization, Terminology Maintenance/Navigation, Workflow, etc, ….)
• Technical Specifications for balloted Functional Standards– Entity Identification, Record Location/Update/Retrieval,
Clinical Decision Support, Service Ontology Development
• Implementation Guidance & White Papers
– Service Registries, HL7 V2/V3 migration strategies, deploying SOA into Provider Organizations, etc.
• Methodology
– Service Specification Framework
– SOA4HL7 Messaging-to-SOA Transition Methodology
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2007 HSSP Project Schedule (planned, major milestones)2007 HSSP Project Schedule (planned, major milestones)
Jan: Baseline Functional Areas for 2007 cycle
HL7 San Diego (Jan 7-12)
Jul: Educ. Summit Boston (Jul 10-12)
Issue 2007 SFM Ballots
Feb: Aug: Ballot review
Mar: OMG San Diego (Mar 26-30)
EIS, RLUS “intent to submit” due Issue DSS RFP
Sep: HL7 Atlanta (Sep 16-21)
OMG Jacksonville (Sep 24-28)
EIS, RLUS Tech. Submissions Due
Apr: Oct:
May: HL7 Cologne
HSSP Information Day
Nov: HL7 Educational Summit
IHE Infrastructure Planning WG
Jun: Announce intention to ballot 2007 SFMs
Dec: OMG Burlingame (Dec 10-14)
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Where would these specifications be usedWhere would these specifications be used
• Inter-Enterprise (such as NHIN, RHIOs, LHINs)
– By functionally specifying behavior, roles between applications and products are clarified, and the technologies supporting them can be profiled and sharpened
• Intra-Enterprise
– Standardization on functionality allows for better integration of off-the-shelf and custom development environments, and promotes more of a “plug and play” environment
• Intra-Product
– Facilitates vendors ability to integrate third-party value-add components and speed design phase with higher confidence
• Custom-Implementation
– Affords organizations wishing to custom-develop the opportunity to later integrate off-the-shelf
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The ApproachThe Approach
• HL7 to lead in service selection, functional elaboration, and conformance criteria
• OMG to lead in technical specification
• Both organizations jointly participate in all activities
• Work products will be “owned” by only one organization but used collaboratively
• “Operate as one project” as a principle
• Actively seek vendor participation
• Engage IHE community
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The Value of Collaboration The Value of Collaboration
• HL7 brings…
– Healthcare semantic interoperability expertise
– Rich, extensive international community perspective
– Diverse membership base
• OMG brings
– distributed systems architecture and modeling excellence
– Effective, efficient, rapid process
– Premise that standards must be implemented
• Resulting in…
– Services will be identified by the community needing them
– Improved methodology resultant from functional and architectural merging of the two groups
– Facilitation of multi-platform implementation and broader implementation community
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Context of HSSP SpecificationsContext of HSSP Specifications
Ab
ilit
y to
Int
erop
erat
e
High
Low
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Two Dimensions of InteroperabilityTwo Dimensions of Interoperability
Sem
antics
Behavioral
UDDI v3
Web Services
Java RMI
HSSP RLUS (Profiled)
OWL-S
CORBA
Ideal Target
HSSP Reference Arch
HSSP EIS
• Behaviorally, there are a lot of solutions
• Need to marry Semantic Interoperability with Behavior
• The touchstone business case is the notion of automated discovery, composition, and delivery
• What can HSSP provide to get us to the goal?
From the RM-ODP Informational Viewpoint
HSSP RLUS
HL7 Messaging
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What Participants are Saying… What Participants are Saying…
• “Kaiser Permanente I.T. is currently transitioning to an SOA-based approach to business and systems integration. Availability of industry standard services will bring many benefits towards this goal in terms of speed of implementation, flexibility and reduced cost. I am very pleased that both HL7 and OMG are committed to this timely effort.”, Alan Honey, Enterprise Architect (Principal), Kaiser-Permanente
• “The creation of a health Informatics infrastructure based upon a service-based architecture grounded in comparable data has the potential to improve healthcare delivery and greatly enhance patient safety.”, Peter L. Elkin, MD, FACP, Professor of Medicine, Mayo Clinic College of Medicine
• “The MedicAlert mission – to protect and save lives – requires a repository of comprehensive medical information that comes from multiple sources for our members. Our SOA-based infrastructure demands the rich and flexible capabilities that are provided by these standard interoperable services.”, David Harrington, CTO, MedicAlert Foundation
• “The Eclipse Foundation is pleased to support an open source project dedicated to building frameworks, components, and exemplary tools to make it easy and cost-effective to build and deploy healthcare software solutions. This Eclipse Open Healthcare Framework project will leverage the Eclipse Platform developed by IBM, Intel, Wind River, Actuate, Borland, BEA, Computer Associates and others.” Mike Milinkovich, Executive Director, Eclipse Foundation
• “The time is now and the place is here in this joint OMG/HL7 project. Never before has the industry been closer to cogent, clear healthcare IT data model and service standards that can provide true interoperability in a short timeframe, with open-source implementations making availability abundant.”, Richard Mark Soley, Ph.D., Chairman and CEO, OMG
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HSSP – Moving in Internet Time (Globally)HSSP – Moving in Internet Time (Globally)
2005 January: Joint Project Chartered
2005 April: Project Kickoff
2006 May: EIS, RLUS, and DSS Ballots Issued
2007 Q1: Functional work begins for ‘07
2005 October: Interoperability Services Workshop & Conference
2006 January: HL7 Charters SOA Special Interest Group
2006 September: EIS, RLUS, and DSS Pass HL7 Ballot
2006 December: EIS, RLUS RFPs Issued
2006 Summer: HSSP Education held in Australia, Finland, Norway, US
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What has the HSSP delivered?What has the HSSP delivered?
• HL7 DSTUs:
– A Decision Support Service (DSS) receives patient data as the input and returns patient-specific conclusions as the output
– The Retrieve, Location, and Update Service (RLUS) provides a set of interfaces for accessing and managing health information
– The Entity Identification Service (EIS) for identification of patient, providers and other entities participating in the care
• OMG-issued technical Requests for Proposal (RFPs) finalized or drafted for all DSTUs
• A Service Development Framework (methodology) for developing the service specifications
• An informative HL7 ballot document on the SOA4HL7 Messaging-to-SOA Transition Methodology
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How is this project “different”? How is this project “different”?
• Active participation from three continents and 15+ organizations
• Significant cross-cutting community involvement• Providers & Payers (Blue Cross/Blue Shield, DoD Military Health
System, Intermountain Health, Kaiser-Permanente, Mayo Clinic, Veterans Health Administration)
• Vendors & Integrators (Accenture, CSW Group, EDS, IBM, Northrop-Grumman, PatientKeeper, Universata)
• Value-added Providers (MedicAlert, Ocean Informatics, Eclipse Foundation, etc.)
• Governments (Veterans Health Administration, DoD Military Health System (MHS), Canada Health Infoway, NeHTA Australia, SerAPI (Finland))
• Managing differences between SDOs in terms of membership, intellectual property, and cost models
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Approach is producing a Comprehensive SolutionApproach is producing a Comprehensive Solution
• HL7
– Story Boards
– Application Roles
– Payloads
– CIMs and LIMs
– Control Act and Transmission Wrappers
– HMD
• Services
– Interaction Payload
– Interaction Contracts
– Interactions
– [Compositions]
• HSSP SOA
– Conformance Profiles
• Semantic + Functional
• Model Pedigree
– Profile and Template Registries
– Conformance Testing (Governance)
– Functional Models for Core and Business services
– Methodology for HL7 to Service Mapping
– Support for Federation, Forwarding, and Orchestration
– Ontology for Service Description and Discovery
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Why should I participate? [One]Why should I participate? [One]
• This effort is focused on and driven by business-need
– It is not an “academic exercise” striving for perfection
– Acknowledgement that for standards to be useful they must be used
– Focused on the practical and achievable
– Short timelines
– Based upon business value and ROI
• Leveraging talent from two standards communities
• Up-front commitment ensures community engagement
• Being run like a “project” and not a committee
• Recognize participation as an investment and not an expense
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Why should I participate? [Two]Why should I participate? [Two]
• This is happening—the only way to influence the outcome is to engage
• Significant “networking” opportunities—you will gain access to the best and brightest in the industry and the world
• Prime opportunity to directly engage with complementing stakeholder groups (provider-to-vendor, vendor-to-payer, SDO-to-SDO, etc)
• Benefit from “lessons learned” from others
• Reduce design burden
• Establish market presence and mindshare as industry leader
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How do I Participate?How do I Participate?
• Join appropriate standards organizations
– HL7 for functional work
– OMG for technical specification work
– Join both
• Allocate resources to actively engage in the project
– Engage existing, knowledgeable resources in the areas they are working already.
– Subgroups form based on industry need and priority
– Teleconferences are weekly; meetings approximately bimonthly
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Who should I involve?Who should I involve?
• Involve the staff that can best address your business needs:
– The benefits you receive will depend upon your investment
– Organizations that commit resources garner more influence and more mindshare
– Your business interests are being represented by your attendees
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ReferencesReferences
• HL7 Website:
• http://www.hl7.org
• OMG Website:
• http://www.omg.org
• Services Project Homepage
• http://hssp.wikispaces.com/
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Supplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and ImpactsSupplemental Slides: Supplemental Slides: HSSP Stakeholder Benefits and ImpactsHSSP Stakeholder Benefits and Impacts
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For Product Consumers and Users…The Impacts and Rationale of HSSP SpecificationsFor Product Consumers and Users…The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Promotes deployment ease and flexibility
Specifications will support multiple topologies
Consistency at the interface level assures asset protection
Standard interfaces means that conformant components are substitutable
Multiple vendor product use/ interoperability
Using compliant products means side-by-side interoperation of multiple product offerings
Increased buyer/product offerings Consumer demand will create increased marketplace competition
Facilitates integration Unity in purpose and consistency in interface eases integration burden
Time to market Availability of an industry-accepted component interface eases product development burden
Requirements definition – influence vendors in a direct way
Participation by provider and payer community is direct expression of business need
Lower cost = wider deployment = higher quality service
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Product Vendor …The Impacts and Rationale of HSSP SpecificationsProduct Vendor …The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Market opportunity – ability to grow business / “Grow the pie”
Standardization of interfaces eases cost-of-entry to markets
Conformance adds legitimacy to product offering
Consumers view conformance as a confidence metric
Reduced time and cost to market
• Use of 3rd party components
• Simplify / reuse of design
Ability to reuse design ideas, incorporate off-the-shelf components into value-add offerings
Participation provides the ability to influence the standard
You can shape the standard to be supportive of your product architecture
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Regulatory/Policy/Legislative …The Impacts and Rationale of HSSP SpecificationsRegulatory/Policy/Legislative …The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Establishing objective assessment criteria:
Measurement criteria for regulatory compliance
Inclusion of rigorous conformance assertions benefits compliance and verification
Allows for technology change within the regulation
Concurrent support of multiple technologies allows for technology evolution
Offering an easy/easier solution that is complete and actionable / ease the path to adoption:
How do we “Pick the winning horse”?
“Opportunity cost” of using the wrong standard has big implications
HSSP integrates function/ behavior, data, and protocol promoting an integrated solution set
Solution that complements existing standards
HSSP is using HL7 semantics, OMG processes, IHE testing, and established technology protocols
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Research …The Impacts and Rationale of HSSP SpecificationsResearch …The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Promotes accessibility to “raw” information
Strong emphasis on semantically rigorous data and query/retrieval
Enabler for collaborative studies, e.g. de-identification, retrieval, etc.
Leveraged use of identity service enables de-identification
Enlarges cell and sample sizes based on interoperability
Facilitates responsiveness to bio-surveillance requirements
Standard interfaces accommodate dynamic and emerging strategies and tools
Enables construction of higher-order service stacks with less investment
Composable nature of services promotes construction
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Implementer/Integrator …The Impacts and Rationale of HSSP SpecificationsImplementer/Integrator …The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Reduced integration time and cost resulting from the use of standard tooling
Use of standard in off-the-shelf tools facilitates their use
Risk mitigation (skill portability/ training advantage, vendor independence, substitutability)
By training staff in the standard, skills are portable across tools
Creates a value offering opportunity based on the ability to deliver using these service standards
Allows staff and solutions to build upon the use of the standard and not technologies
Improved ability to deliver and support interfaces that have been implemented
Using services speeds project design phases and promotes reuse
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SDOs …The Impacts and Rationale of HSSP SpecificationsSDOs …The Impacts and Rationale of HSSP Specifications
Impacts Rationale
Useable standards Emphasis on practicality
Market-focused standards based on commercial implementations
Shortens time required to develop specifications and encourages collaboration
Promotes harmonization, cooperation, cohesion among standards communities
Integration of function, data, and technology promotes leveraged reuse
More members/involvement = more revenue & better specs
Practical, market-focus and iterative timeline promotes participation and results