Federal Health Architecture NHIN Adaptor - Redwood MedNet
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[email protected] FHA NHIN ADAPTOR Simple Connector or SOA For Healthcare? Emory Fry, MD 10 July 2009
Transcript of Federal Health Architecture NHIN Adaptor - Redwood MedNet
FHA NHIN ADAPTORSimple Connector or SOA For Healthcare?
Emory Fry, MD
10 July 2009
The opinions of the presenter expressed hereindo not necessarily state or reflect those of theUnited States Government, the Federal HealthArchitecture group, or the Department of theNavy. They shall not be used for advertising orproduct endorsement purposes.
Office of the National Coordinator
NHINCCHIT
ONC
HITSP
HHS
Nationwide Health Information Network
AHIC FHA
NHIN
AdapterGatewayAgencySystems
NHIN
Decoupled standards-based common infrastructure
Data Transform
ServiceDiscovery
AuthorizationService
SubjectIdentity
DocumentQuery / Retrieval
Adaptor
AuditService
Agency EMR
Consumer Preferences
Gateway Centric ImplementationNHIN Gateway
DecouplingDecoupled system components helporganizations react and adapt torapidly changing operationalconditions
Standards AdoptionUse of standard based interfacesfacilitates interoperability
Legacy System ReuseReuse of legacy systems preservesprior capital investments and mayreduce future costs
The SOA Value Proposition
Data Access ServicesTechniques used to access enterprise data stores.
Proxy ServicesInsulates SOA core from “messy” implementation particulars.
Data ModelsDatabases and other information repositories.
ClientsApplication tier should support multiple “clients” to include traditional GUIs, otherinternal systems, B2B partners, etc.
SOA Approach
SOA Business ServicesCore functional services to support loosely coupled design, reusability, etc.
Enterprise Service BusCore infrastructure and integration component.
NHIN
Service OrganizationWhere should certain
components reside formaximum flexibility? Are
NHIN requirementsapplicable to other use
cases?
Document DeliveryImplied need for dynamic
assembly. What otherdocuments might be
exchanged in future? Whatother standards might need
to be supported?
Semantic SupportWhat translation servicesare available or needed to
ensure that requiredsemantic constraints are
supportable?
Clinical WorkflowHow best to integrate
NHIN documentexchange into provider /patient workflow? Can
service be hosted withinAHLTA?
Medical - LegalAre NHIN audit
requirements sufficient?Are they clinicallysufficient? Can we
persist NHIN documentsdirectly into the CDR?
ReusabilityCan we build reusable
SOA componentsapplicable to all Federal
partners? Can we build aFederal Adaptor as wellas a Federal Gateway?
NHIN Reconsidered
MHS CDR IHS RPMS VA VistA
DoD “Federal” Adaptor Approach
SOA Enterprise Bus
Orchestrator
Assembly Service
DocumentService
Audit Service Template ServiceTerminology Service
Common Access Layer Service
AHLTA Data Service RPMS Data Service VistA Data Service
ConsumerPreferences
AuthorizationService
MPI Service
ServiceDiscovery
DocumentQuery / Retrieval
SubjectIdentity
“Security”Services
Gateway
Adaptor
National Demonstration Outcomes
• Successful demonstration Dec 2008• Only three participants were dynamically
generating required C32 document• Only one NHIN participant was fully
compliant with all semantic requirements
Future SOA Components
MultipleGUI
Support
DeviceInterop
Clinical Metrics
Dashboard
ClinicalDecisionSupport
PatientEducation
SpecialtyApplicationIntegration
RIOSupport
MobileDeviceSupport
InpatientCharting
Tele-Medicine
Desirable Services
Future SOA servicescan be developed to
support non-NHIN usecases. The componentssimply plug into the busto rapidly provide new
functionality..
Leveraging Opportunities
Parsons
GUI Interface
SmartVentDeviceInterop
VCR Soft Clinical Metrics
Dashboard
KMRClinicalDecisionSupport
HealthwisePatient
Education
SpecialtyApplicationIntegration
CogonRIO
Support
MOCMobileDeviceSupport
SpartanburgRelayHealth
Tele-Medicine
Potential alignment ofCongressional set
asides to SOA services.
Desirable Services
InpatientCharting
Electronic Medical Record
DDSS / KMR System Overview
SOA Enterprise Bus
Distributed Decision SupportService
Common Access Layer Service
Enterprise Data Assessors
MedAlertUniversal Inbox Rule Workbench Patient Medical Record
Clients
PersonnelSystem
InventorySystem
CaseManagement
DiseaseRegistries
DDSS / KMR
Data Systems
Knowledge ManagementRepository
Weight Reduction Plan Nonlinear – Dr. Thomas Patient: Doe, John A.W
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Plan Evaluation Dates/Milestones vs. Actuals
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Begin End
Actuals
Planned
Careplan Runtime Engine
NHIN-Connect: Significance
• Reference infrastructure for seeding NHINstandards, policies, and objectives
• Platform for iterative refinement of thosestandards
• Birth of a multi-agency collaborative process• Creative of a new “vertical market” open
source collaboration
NHIN-Connect: Challenges• How to facilitate the dialog between vendors, OSS
projects, and Federal interests regardinggovernance, intellectual property, business modelsand philosophical (religious?) sensibilities?
• How to leverage this infrastructure for qualitymanagement, process improvement, and regulatorycompliance?
• How to engage patient, family and community intothe infrastructure discussion now?
• How can we use this reference architecture toexplore the possible rather than commoditize thecurrent?
