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Healthcare Services Specification Project

The Business Case and Importance of Services

October 2005

HL7 Services Specification Project Workgroup


OMG Healthcare Domain Task Force

10/11/10 09:15
Background

• This presentation represents the collective input and thinking


from the collective participants involved in the Healthcare
Services Specification Project.
• Represented were members from
– Object Management Group (OMG)
– Health Level Seven (HL7)
– Integrating the Healthcare Enterprise (IHE)
• 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”?*

• 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?

• 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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Where 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 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

• 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 Specifications High

Ability to Interoperate
Low

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HSSP Stakeholder Benefits and Impacts

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For Product Consumers and Users…
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Promotes deployment ease and Specifications will support multiple topologies
flexibility
Consistency at the interface level Standard interfaces means that conformant
assures asset protection components are substitutable
Multiple vendor product use/ Using compliant products means side-by-side
interoperability 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 Participation by provider and payer community is
vendors in a direct way direct expression of business need
Lower cost = wider deployment =
higher quality service

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Product Vendor …
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Market opportunity – ability to grow Standardization of interfaces eases cost-of-entry to
business / “Grow the pie” markets
Conformance adds legitimacy to Consumers view conformance as a confidence metric
product offering
Reduced time and cost to market Ability to reuse design ideas, incorporate off-the-shelf
components into value-add offerings
• Use of 3rd party components
• Simplify / reuse of design
Participation provides the ability to You can shape the standard to be supportive of your
influence the standard product architecture

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Regulatory/Policy/Legislative …
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Establishing objective assessment Inclusion of rigorous conformance assertions
criteria: benefits compliance and verification
Measurement criteria for regulatory
compliance
Allows for technology change within the Concurrent support of multiple technologies
regulation allows for technology evolution
Offering an easy/easier solution that is HSSP integrates function/ behavior, data, and
complete and actionable / ease the path protocol promoting an integrated solution set
to adoption:
How do we “Pick the winning
horse”?
“Opportunity cost” of using the wrong
standard has big implications

Solution that complements existing HSSP is using HL7 semantics, OMG


standards processes, IHE testing, and established
technology protocols
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Research …
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Promotes accessibility to “raw” Strong emphasis on semantically rigorous data
information and query/retrieval
Enabler for collaborative studies, e.g. Leveraged use of identity service enables de-
de-identification, retrieval, etc. identification
Enlarges cell and sample sizes based
on interoperability
Facilitates responsiveness to bio- Standard interfaces accommodate dynamic and
surveillance requirements emerging strategies and tools
Enables construction of higher-order Composable nature of services promotes
service stacks with less investment construction

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Implementer/Integrator …
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Reduced integration time and cost Use of standard in off-the-shelf tools facilitates
resulting from the use of standard tooling their use

Risk mitigation (skill portability/ training By training staff in the standard, skills are
advantage, vendor independence, portable across tools
substitutability)
Creates a value offering opportunity based Allows staff and solutions to build upon the use
on the ability to deliver using these service of the standard and not technologies
standards
Improved ability to deliver and support Using services speeds project design phases
interfaces that have been implemented and promotes reuse

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SDOs …
The Impacts and Rationale of HSSP Specifications

Impacts Rationale
Useable standards Emphasis on practicality

Market-focused standards based on Shortens time required to develop specifications


commercial implementations and encourages collaboration
Promotes harmonization, cooperation, Integration of function, data, and technology
cohesion among standards promotes leveraged reuse
communities
More members/involvement = Practical, market-focus and iterative timeline
more revenue & better specs promotes participation and results

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Reference Examples

• Mass Clinical Data Exchange (CDX)


• RHIO
• Merger/acquisition
• Public health / disease reporting

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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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Project Timeline and Roadmap

1996: First OMG Healthcare Service Spec Adopted (PIDS?)

2003: HL7 ServicesBOF formed

2005 September: HL7, OMG Collaboration MOU

2005 January: Joint Project Chartered

2005 April: Project Kickoff

2005 September: Methodology and MetaSpecs Baselined (planned)

2005 October: Interoperability Services Workshop & Conference

2006 January: Functional Specs Ballot (planned)

2006 Q4: Technical Specs RFP (planned)


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How is this project “different”?

• Active participation from three continents and 15+


organizations
• Significant cross-cutting community involvement
• Providers (Kaiser, VHA, Intermountain Health, Mayo)
• Vendors (CSW Group, IBM, PatientKeeper, Universata)
• Value-added Providers (MedicAlert, Ocean Informatics, Eclipse
Foundation, etc.)
• Payers (Blue Cross/Blue Shield, Kaiser)
• Integrators (IBM, EDS)
• Governments (Veterans Health Administration, Canada Health
Infoway, HealthConnect (Australia), SerAPI (Finland))
• Managing differences between SDOs in terms of
membership, intellectual property, and cost models

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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]

• 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?

• 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?

• 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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References

• HL7 Website:
• http://www.hl7.org
• OMG Website:
• http://www.omg.org
• Services Project Homepage
• http://groups.yahoo.com/group/ServicesSpec

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