1. Business Functions • Referral • Outcomes • Outcome Definitions • Patient • Population • Outcome application – Which could include: • Clinical Trial Eligibility

2. General caEHR Service Architecture Clinical Systems Clinical Service Layer Virtual EHR Business Service Layer Choreography Complete Patient Profile Analytics Service Requirements Define Business Services Define Specific Services Define Abstract Services Business Function Definition 1. Core Business Function Description

3. Referral Service Architecture and Service Dependencies Clinical Systems Clinical Service Layer Virtual EHR Business Service Layer Referral Generation Choreography Referral Acceptance Complete Patient Profile Referral Clinical Service Dependencies Allergies Imaging Demographic Service History Social History Master Problem List Encounter Substance Administration Treatments Lab Analytics Business Function: Referral 1. Referral Generation 2. Referral Acceptance

4. Referral Service Architecture and Service Dependencies and Trading Partner Business Service Layer Partner EHR Clinical Systems Clinical Service Layer Business Service Layer Virtual EHR Referral Generation Referral Generation Choreography Referral Acceptance Referral Acceptance Complete Patient Profile Referral Clinical Service Dependencies Allergies Imaging Demographic Service History Social History Master Problem List Encounter Substance Administration Treatments Lab Analytics Business Function: Referral 1. Referral Generation 2. Referral Acceptance

5. Referral Service Architecture Using Tolven Business Service Layer Tolven 2 Tolven 1 Clinical Service Layer Virtual EHR Referral Generation Referral Generation Referral Acceptance Referral Acceptance Tolven can be the platform that houses the “clients” and the some of the services. Having two instances of Tolven running allows us to test interoperability strategies and behavioral patterns. Business Function: Referral 1. Referral Generation 2. Referral Acceptance

6. Referral Service Architecture Security Business Service Layer Partner EHR Clinical Systems Clinical Service Layer∂ Business Service Layer Virtual EHR Referral Generation Referral Generation Choreography Referral Acceptance Referral Acceptance Complete Patient Profile Our service architecture has two security zones. The yellow zone provides for authorization and authentication, where the red zone is authentication only. This allows for clinical services to communicate with a minimum of security overhead. Analytics Business Function: Referral 1. Referral Generation 2. Referral Acceptance

7. Outcome Service Architecture and Service Dependencies Clinical Systems Clinical Service Layer Virtual EHR Business Service Layer Comparative Effectiveness Population Choreography Comparative Effectiveness Individual Clinical Trial Eligibility Cohort Profile Referral Clinical Service Dependencies Outcome (Definition, Query) Allergies Imaging Demographic Service History Social History Master Problem List Encounter Substance Administration Treatments Lab Analytics Business Function: Outcomes 1. Comparative Effectiveness 2. Clinical Trial Eligibility