Enablement through SOMA: Moving from Strategy to Implementation

1. National Emergency Management Summit: March 5, 2007 Building a Statewide Emergency Services Information Exchange Network Enablement through SOMA: Moving from Strategy to Implementation Donald George, CEO PRISM Communication Systems, Inc.

2. Emergency Response Challenges Today Why does Emergency Response need transformation? -Fragmented infrastructure -Insufficient planning -Insufficient policy -Fragmented operational linkages Disasters

3. Emergency Response Challenges Today Why does Emergency Response need transformation? -Fragmented infrastructure -Insufficient planning -Insufficient policy -Fragmented operational linkages Diseases

4. Emergency Response Challenges Today Why does Emergency Response need transformation? -Fragmented infrastructure -Insufficient planning -Insufficient policy -Fragmented operational linkages Terrorism

5. Emergency Response Challenges Today • How can our healthcare system respond most effectively to a major health emergency that could overwhelm the system’s routine capacity and resources?

6. How do we transform Emergency Response? Why does Emergency Response need transformation? Business Needs Emergency Preparedness: California's Administration of Federal Grants for Homeland Security and Bioterrorism Preparedness Is Hampered by Inefficiencies and Ambiguity California State Auditor/Bureau of State Audits September 2006 • Integrated communication • Decision support • Alerting systems • Surveillance • Countermeasures • Geospatial services

7. How do we transform Emergency Response? Connect the Information Systems • Build an Integrated Health and Emergency Services Framework • Transform the public health business model across multiple functional health and emergency systems The business needs will be met by using the Service Oriented Modeling and Architecture (SOMA) to:

8. How do we transform Emergency Response? Service-oriented Modeling and Architecture (SOMA) CBM Business Vision SOMA combines Business Vision with Modern and Legacy assetsto achieve an enterprise services architecture. Model driven development is key. Top-down: business-driven Process, event and variation analysis 1 Specify IT Components, their services and flow Business Services linked To Business Goals Map components & Services to best technology, 3 4 5 Service-oriented Architecture Bottom-up: Leverage Legacy thru understanding and transformation 2 Legacy

9. Process integration Emergency Operations Center Dispatch Public Health First Responders Federal Agency How do we transform Emergency Response? Integrated Business Services Connect the Information Systems Reusable, integrated services

10. HL7 ICD-9-CM CPT-4 SNOMED CT LOINC NDC DSM IV HL7 IEEE NCPDP DICOM ANSI ASC X12N SOA CAP EDXL NIMS How do we transform Emergency Response? Integrated Health Framework Connect the Information Systems Intro to Health and Emergency Standards Standardized Data Structures Standardized Architecture Standardized Emergency Services Standardized collaboration processes help bring about interoperability.

11. Public Health Directory • Standards-based communications • Open Architecture • Web services enabled Public Health Information Network Preparedness & Emergency Response Emergency Management Fire, Rescue EMS Transportation Law Enforcement 911 Federal, State, Local, Tribal Govt. NGOs Industry Utilities Schools, Education EPAD Public Health and PHIN Alignment

12. How do we transform Emergency Response? Integrated Health Framework Connect the Information Systems Intro to Service Oriented Architecture Modeling • Business Decomposition • Identification of Services • and Classification • Subsystem Analysis • and Interface • Software Service • Realization Service-architecture modeling is a method for developing software components as services using a service-oriented analysis and design process for modeling, analyzing, designing, and producing an SOA alignment with the business analysis. It allows development of an integrated business service model.

13. Service Oriented Analysis How do you understand the business as services? How do you enable business agility? Service Oriented Design What is the precise behavior of services? How do you ensure scalability, reliability, etc? How do you enable technical agility? Service Oriented Provisioning How do you determine which Services to use? How do you choose Service Providers? Service Oriented Programming How do you reduce effort to code Web Services? How do we transform Emergency Response? Intro to Service Oriented Architecture Modeling The best practices of service orientation which is the process and practices that guide the delivery of a SOA is in the early stages of adoption for many organizations Service Requirements Service Design Service Build Service Development

14. Atomic Service Composite Service Registry How do we transform Emergency Response? SOMA Processes Integrated Services Architecture First Responders Health Workers Consumers Service Consumer Business Process Composition; choreography; business state machines Data Architecture (meta-data) & Business Intelligence QoS Layer (Security, Management & Monitoring Infrastructure Services) Governance Integration (Enterprise Service Bus) Services atomic and composite Service Components Service Provider OO Application Custom Application Packaged Application Operational Systems

15. Roadmaps Enable Alignment

16. Get DI Report Get OutbreakCase Data List CD ReportEvents List DI Results Get Client IDResolution List LaboratoryResults List EncounterEvents Stream DI Image Get ProviderInformation List Laboratory Orders Get Laboratory Result List ServiceDeliveryLocations List Medications Get EncounterSummary Get ClinicalDashboard Get ClientDemographic Get Prescription How do we transform Emergency Response? Longitudinal Record Services Common Services Integrated Health Framework Connect the Information Systems Communication Bus Case Study: Public Health Information Network Health Services Ancillary Data& Services EHR Data& Services DataWarehouse Registries Data& Services OutbreakManagement PHSReporting SharedHealth Record DrugInformation DiagnosticImaging Laboratory HealthInformation ClientRegistry ProviderRegistry BusinessRules EHRIndex MessageStructures NormalizationRules LocationRegistry TerminologyRegistry Security MgmtData Privacy Data Configuration HIAL Public HealthServices PharmacySystem EMS Systems Lab System(LIS) Hospital, LTC,CCC, EPR PhysicianOffice EMR Public Health Provider Pharmacist Radiologist Lab Clinician Physician/Provider Physician/Provider POINT OF SERVICE

17. Major Components of PHIN Early detection, alerting, and counter measures

18. Start with a “hot” component area – product identification How do we transform Emergency Response? Move from Strategy to Implementation PHIN and Emergency Services Model Building an Emergency Services Information Exchange Network • Define a model (e.g. with WBI Modeler) of the component to be transformed • Understand the underlying applications infrastructure and how it needs to change • Identify and design the required supporting infrastructure

19. Government Line of Business to Citizens (G2C): Health Illness Prevention Consumer Health & Safety Immunization Management PH Monitoring Health Care Services Services Mode of Delivery -Physicians’ Alert -Women, Infant, Children services -Web based interface to allow entry of environmental data (Environmental Health) Georgia Immunization Registry (GRITS) Vital Records, Vital Events, NSTS Supporting Applications Technology OIT will develop/align Service Reference Model (SRM), Data Reference Model (DRM), and Technical Reference Model (TRM) for each line of business Core: e-mail, network availability, IT maintenance, enterprise architecture & strategy Support Functions -WIC Branch -Family Health Br. -Bioterrorism/ Emergency Rsp. -Laboratory Br. -Epidemiology Br. -V. Records Br. Family Health Br. -Prevention Services Branch -Chronic Disease Prv. & Health Promotin. Br. Resources -Environmental Health and Injury Prevention Branch -Prevention Services Branch -Director, Deputy, CFO -Grants Development Division -Legal Services and Policy Division -Governmental Relations Division -PH Districts -Advisory Boards & Councils -State Pharmacy -Office of Nursing -Office of Health Information & Policy -IT Liaison Policy/Planning Procedure Administration Resource Mgt. • The Division of Public Health (DPH) is responsible for disease control and prevention, the reduction of avoidable injury-related deaths and disabilities, and the promotion of healthy lifestyles.  Mission Completing the Framework: Public Health Sample Analysis Phase: Sample Result

20. Tier 2 Tier 3 Tier 1 Resource Functions Existing Systems Presentation Functions Service Control Functions Persistence & Connectivity Devices External Services Web Services P P P 7 A T T L WEB EOC T T O H Clinical H H S Manage OID LOINC Systems Track Lab Lab Pharmacy HL 7 v 2 . x NCPDP P P Sample Result Order Order I A A HL 7 v 3 . 0 X 12 N M O O HL 7 CDA Other R GEO Mapping S S SNOMED PHINMS CAP 1 . 0 CAP NEDSS Patient Diagnosis Investigation Complaint Alert Encounter P O Validate I I Vocabulary Exposure Treatment Reporter Application Info 7 Q Internal Services P Countermeasure L M T H Response GHIN XML M S Adverse CMR CMR Substance Environmental Event Admin Referral Follow Up Health Information L M System X Outbreak Management System . V Notifiable Outbreak Org Specimen Case Management Condition Notification System GIS Incident Command System Web / Gateways Integration Server Message Service Directory Server Server Choreography CICS Connection Multi-device UDDI Management Transformation UNIX IVR Adaptor ToolKit Multi-device RDBMS Windows Custom Adaptors GIS Server Fax IMS Vocabulary Server Infrastructure DBMS Application Server Portal Server Transaction Business Rules SAS Application Mgt Manager State Persistence Analysis & Search System Monitor Visualization PHIN Portal Application Enterprise Application Server SSO Supply Chain Business Intelligence Enterprise ResourcePlanning Management Demand Planning Service Enterprise Asset Management Utilities Functional Architecture

21. VAN Homeland Security Governor Wireless/ Radio Network Virtual Private Network Authent. Reverse Proxy Incident Management Command Control System Alert Communication System EMA ENOC FEMA MMRS Law Enforcement Hospitals Wireless/ Internet VPN Network Secure Connection EMS Offices Enterprise Service Bus Intranet Firewall Wireless Secure Gateway Public Health Labs Authentication Services Intranet/ Internet VITAL RECORDS NEDSS SNS Fire/ Rescue Enterprise Directory CDC Public Health Offices GIS Voice Gateway Text-Voice Gateway IMMUNIZATION Public Health Offices Multi Partner Complex: Bioterrorism Preparedness Supported by Appropriate Public Health Infrastructure

22. Benefits of Integrated Services • Integrated services improve emergency response and reduces costs • Provides an integrated view across the continuum of responses • Creates an integrated process framework that connects health and emergency services to improve operational response efficiency • Builds common, reusable services

23. Summary • Without an Enterprise Services Vision and Roadmap for emergency response, today’s response services will remain siloed • An Enterprise Services Vision and Roadmap is essential to move toward an SOA enabled emergency preparedness • Make SOA real by tackling cross-enterprise processes • Service oriented modeling is essential to effective architecture design

24. More Information http://www.prismsolution.com Donald George Chief Executive Officer PRISM Communications System, Inc. 1701 Barrett Parkway - Marietta, Georgia 30061 dgeorge@prismsolution.com

25. National Emergency Management Summit: March 5, 2007 Building a Statewide Emergency Services Information Exchange Network Enablement through SOMA: Moving from Strategy to Implementation Donald George, CEO PRISM Communications Systems, Inc.