HL7 and Service-oriented Architecture (SOA) Ambassador Briefing

1. HL7 and Service-oriented Architecture (SOA) Ambassador Briefing January 2008

2. HL7 Ambassador As an HL7 Ambassador, I personally participate and contribute to the activities and standards being discussed. I attend meetings, teleconference calls, and actively engage in the standards development process. Note that all HL7 Ambassador presentations are presented by authorized speakers of HL7, called “HL7 Ambassadors”.

3. Topics • HL7 Vision and Mission • Understanding Service-oriented Architecture (SOA) • The case for Healthcare SOA Standards • Introducing HSSP • Status of Standards Work • Summary

4. First, A Few Terms… • DSTU = Draft Standard for Trial Use • HL7 = Health Level Seven • HSSP = Healthcare Services Specification Project • OMG = Object Management Group • OHT = Open Health Tools • SOA = Service-oriented Architecture

5. Understanding SOA

6. A Twenty-Second Interoperability Quiz… Are you interoperable… • … if you and your business partners “speak” different languages • … if gender = “01” means “male” in your business and “female” for your business partner? • …if the primary context for information sharing is e-mail or fax? • …if electronic data is exchanged via CD-ROM, or DVD-ROM? • …if you use XML? • …if you use Web Services?

7. The 20 Second Agility Quiz How well does your organization’s IT adapt to… • … address the new business rules that resulted from a legislated policy? • … deployment changes resulting from adding a data center? • … integrating clinical information with a new business partner? • … integrating with “the new <place clinical specialty here> system” • … emerging public interest in personal health records?

8. Wouldn’t it be nice if… • …your organization could use any MPI you chose without re-integrating? • …you could painlessly integrate data from new clinical systems into a patient’s health summary / cover sheet? • …heterogeneous systems could be accessed consistently from your installed application base • …standards supported your ability to redeploy or distribute hardware and software without breaking things

9. SOA ≠ Web Services

10. How isSOA different from messaging? • 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, provides reuse • Messages can be either payloads in or infrastructure beneath services • Service-oriented architecture provides the framework for automation of common services • Still, SOA has to be done well. It is cheaper and easier than ever to create badly designed applications and spaghetti integration

11. Why SOA Healthcare Standards?

12. Why develop healthcare SOA standards? • Healthcare organizations are being driven to interoperate • “Messaging” is not the ideal approach for every interoperability challenge • SOA has demonstrated viability and benefits for many organizations and in many vertical-markets

13. High Ability to Interoperate Low Information Design and Technology & Semantics Interoperability Understanding Interoperability Platform Bindings Model-based Platform-independent component Specifications Model Fragment Computationally- Independent Specification Reference Information Model HL7 Application Roles Data Types and Terminology Bindings Middleware Frameworks Standard Terminologies and Vocabularies Messaging Specifications (HL7, others) HL7 Community and Open Participation Physical/Software Infrastructure

14. Scenarios SOA In Action…An Identity Management Example 1. Query local domain: entity found locally Local/Regional Domain 2 2. Query local domain: entity not found locally, retrieve from master domain 3. Query master domain: retrieve linked entities from master domain Regional Identity Service (EIS) 4. External System Query: Retrieve from master domain Implementation External organization’s system Interface National/Master Domain 4.1 service client National Identity Service 4.2 Local/Regional Domain 1 3.4 2.6 Implementation “Local” Identity Service 2.5 3.3 2.4 1.4 Implementation Interface 1.3 2.3 3.2 Interface 1.2 2.2 service client service client 1.1 3.1 2.1

15. Introducing HSSP

16. The Healthcare Services Specification Project (HSSP) • 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

17. The Benefits of HSSP Standards… • Define industry standard behaviors for healthcare-oriented service functions • Eliminate “different flavors” of web services from occurring in different organizations • Rapid-pace stds development: ~18-24 months • Methodology embracing cross-group standards development

18. HSSP is part the bigger HIT landscape…

19. Cross-Organizational Standards Development HL7 HL7 SOA SIG Service Functional Model OMG OMG HDTF OMG Request for Proposal (RFP) HL7 Draft Stds for Trial Use ANSI Standard RFP Responders Technical Specification

20. Status of HSSP Standards Work (Jan 2008) • Functional Standards Adopted as DSTU • Entity Identification Service (EIS)* • Retrieve Locate Update Service (RLUS)* • Decision Support Service (DSS)* • Clinical Research Filtered Query (CRFQ)* • Functional Standards Under Development • Human Services Directory (HSD) • Privacy Authentication Security Services (PASS) • Common Terminology Services 2 (CTS2) • Implementation Guidance • Services Interoperability Profile • HSSP Reference Architecture *Technical Specifications Under Development **Ballot reconciled; pending official organizational adoption

21. Status of Standards Work

22. SOA in Health Care: Realizing Quality of Care, Business Value, and Delivery on I.T.’s Promise Chicago, IL April 15-17, 2008 • Three-day event featuring lessons-learned, best-practices, and experience sharing • Event features an “Executive Summit” followed by business & technical tracks • Representation from provider, payer, and public health communities • Featured speakers and panelists include • Jonathan White, M.D. Health IT Portfolio DirectorAHRQ • Vish SankaranProgram Director, Federal Health Architecture, ONCHIT • Ken LunnDirector of Data Stds and ProductsNational Programme for Health IT (UK) • Marion Ball, Ed.D.Fellow, IBM ResearchProfessor Emerita, Johns Hopkins • Steve FlamminiChief Technology OfficerPartners Health Care • Dennis GiokasChief Technology OfficerCanada Health Infoway • Don MonVice PresidentAHIMA • Stanley Huff, M.D.Chief Medical Informatics OfficerInterMountain Health Care

23. For More Information…. • Contact us! • ken.rubin@eds.com • alan.p.honey@kp.org • koisch_john@bah.com • Visit our project wiki…. • http://healthinterop.org

24. Summary “How do you know that the [web-] services you’re building are not just the next generation of stovepipes?” Janet Martino, LTC, USAF (Retired) to a panel of Healthcare IT Leaders