Healthcare Services Specification Project The Business Case and Importance of Services

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Healthcare Services Specification Project
The Business Case and Importance of Services
June 2005

• HL7 Services Specification Project Workgroup
• OMG Healthcare Domain Task Force

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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 RHIOs)
• 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
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
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Functional Organization
OMG Service
INFRASTRUCTURE
Service
Service
API
API
TOOLS
HL7
HL7
HL7
HL7
OMG Service
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• HSSP Stakeholder Benefits and Impacts

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For Product Consumers and UsersThe Impacts and
Rationale of HSSP Specifications

• Promotes deployment ease and flexibility
• Consistency at the interface level assures asset
  protection
• Multiple vendor product use/ interoperability
• Increased buyer/product offerings
• Facilitates integration
• Time to market
• Requirements definition influence vendors in a
  direct way
• Lower cost wider deployment higher quality
  service

• Specifications will support multiple topologies
• Standard interfaces means that conformant
  components are substitutable
• Using compliant products means side-by-side
  interoperation of multiple product offerings
• Consumer demand will create increased marketplace
  competition
• Unity in purpose and consistency in interface
  eases integration burden
• Availability of an industry-accepted component
  interface eases product development burden
• Participation by provider and payer community is
  direct expression of business need

Impacts
Rationale
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Product Vendor The Impacts and Rationale of
HSSP Specifications

• Market opportunity ability to grow business /
  Grow the pie
• Conformance adds legitimacy to product offering
• Reduced time and cost to market
• Use of 3rd party components
• Simplify / reuse of design
• Participation provides the ability to influence
  the standard

• Standardization of interfaces eases cost-of-entry
  to markets
• Consumers view conformance as a confidence metric
• Ability to reuse design ideas, incorporate
  off-the-shelf components into value-add offerings
• You can shape the standard to be supportive of
  your product architecture

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

• Establishing objective assessment criteria
• Measurement criteria for regulatory compliance
• Allows for technology change within the
  regulation
• Offering an easy/easier solution that is complete
  and actionable / ease the path to adoption
• How do we Pick the winning horse
• Opportunity cost of using the wrong standard
  has big implications
• Solution that complements existing standards

• Inclusion of rigorous conformance assertions
  benefits compliance and verification
• Concurrent support of multiple technologies
  allows for technology evolution
• HSSP integrates function/ behavior, data, and
  protocol promoting an integrated solution set
• HSSP is using HL7 semantics, OMG processes, IHE
  testing, and established technology protocols

Impacts
Rationale
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Research The Impacts and Rationale of HSSP
Specifications

• Strong emphasis on semantically rigorous data and
  query/retrieval
• Leveraged use of identity service enables
  de-identification
• Standard interfaces accommodate dynamic and
  emerging strategies and tools
• Composable nature of services promotes
  construction

• Promotes accessibility to raw information
• Enabler for collaborative studies, e.g.
  de-identification, retrieval, etc.
• Enlarges cell and sample sizes based on
  interoperability
• Facilitates responsiveness to bio-surveillance
  requirements
• Enables construction of higher-order service
  stacks with less investment

Impacts
Rationale
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Implementer/Integrator The Impacts and
Rationale of HSSP Specifications

• Reduced integration time and cost resulting from
  the use of standard tooling
• Risk mitigation (skill portability/ training
  advantage, vendor independence, substitutability)
• Creates a value offering opportunity based on the
  ability to deliver using these service standards
• Improved ability to deliver and support
  interfaces that have been implemented

• Use of standard in off-the-shelf tools
  facilitates their use
• By training staff in the standard, skills are
  portable across tools
• Allows staff and solutions to build upon the use
  of the standard and not technologies
• Using services speeds project design phases and
  promotes reuse

Impacts
Rationale
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SDOs The Impacts and Rationale of HSSP
Specifications

• Useable standards
• Market-focused standards based on commercial
  implementations
• Promotes harmonization, cooperation, cohesion
  among standards communities
• More members/involvement more revenue better
  specs

• Emphasis on practicality
• Shortens time required to develop specifications
  and encourages collaboration
• Integration of function, data, and technology
  promotes leveraged reuse
• Practical, market-focus and iterative timeline
  promotes participation and results

Impacts
Rationale
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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 (IBM, PatientKeeper, Universata)
• Value-added Providers (MedicAlert, Ocean
  Informatics, Eclipse Foundation, etc.)
• 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 happeningthe only way to influence the
  outcome is to engage
• Significant networking opportunitiesyou 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/hssp
• Services Project Homepage
• http//groups.yahoo.com/group/ServicesSpec