Ensemble or HealthShare as an Integration Platform - InterSystems ...
Ensemble or HealthShare as an Integration Platform - InterSystems ...
Ensemble or HealthShare as an Integration Platform - InterSystems ...
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<strong>Ensemble</strong> <strong>or</strong><strong>HealthShare</strong> <strong>as</strong> <strong>an</strong><strong>Integration</strong> Platf<strong>or</strong>mDavid Loveluck 5 th June 2013
Integrating a Suite of Applications• <strong>Ensemble</strong> <strong>or</strong> <strong>HealthShare</strong> <strong>as</strong> <strong>an</strong> <strong>Integration</strong>Platf<strong>or</strong>mIn this era of connected healthcare, a hospital <strong>or</strong> IDNwill simply not buy <strong>an</strong>y solution that c<strong>an</strong>'t be e<strong>as</strong>ilyintegrated into their existing environment. This sessionshows how embedding <strong>HealthShare</strong> into a suite ofapplications c<strong>an</strong> simplify the t<strong>as</strong>k of connecting to ahospital environment <strong>an</strong>d reduce the time required tobuild <strong>an</strong>d deploy applications.Dave Loveluck, Product M<strong>an</strong>ager <strong>InterSystems</strong> C<strong>or</strong>p.
Technology <strong>an</strong>d Domain Adapters• General Technology Adapters <strong>an</strong>d protocols• http:• FTP,• Files,• TCP/IP• JSON, SOAP, XML• Email etc..• Java <strong>an</strong>d .NET GATEWAYS3
Technology <strong>an</strong>d Domain Adapters• Healthcare specific Adapters <strong>an</strong>d structures• HL7 v2• DICOM• ASTM• X12• IHE profiles• CDA, CCD4
St<strong>an</strong>dards Localize●●●●●●HL7 v2 UKA.3– Implementation guide (in discussion)ITK (Engl<strong>an</strong>d)UK Spine HL7 v3, ebXMLNEHTA (Australia)HITSPDMP (Fr<strong>an</strong>ce)
Healthcare Message Processing• M<strong>an</strong>y deployments• V<strong>as</strong>t maj<strong>or</strong>ity of messages are HL7 v2• Others include X12, SOAP, XML, DICOM• Largest hospital sites are processing 6 millionmessages per day• Applications embed <strong>Ensemble</strong> to minimizeinterface supp<strong>or</strong>t costs
Two Very Different Use C<strong>as</strong>es• Hospital Wide Interface Engine• Application suite integration engine
Hospital HL7 Interface Engine• ‘One off’ solution• Hundreds of interfaces• Dedicated supp<strong>or</strong>t team• Evolves over years• Very frequent updates• M<strong>an</strong>y message types HL7, X12, files, FTP,
Typical <strong>Ensemble</strong> ‘Interface Engine’
Application Suite <strong>Integration</strong> Platf<strong>or</strong>m• Replicated to hundreds of sites• Typically very few interfaces• No local supp<strong>or</strong>t• Installed <strong>as</strong> a product• Updated infrequently• Fewer message types• M<strong>or</strong>e likely to use custom protocols
Application Connectivity in Healthcare• Interface technology built into the application• Embedded legacy Interface EngineApp1App 1App 2App1 App2App1nHL7 HL7 HL7Hospital HL7 Netw<strong>or</strong>k11
Typical SolutionApp 1 App 2 App 3SQL Java HL7<strong>Ensemble</strong> <strong>or</strong> <strong>HealthShare</strong>HL7, CCD, etcHospitalSystems
Typical Solution
Requirements• Flexible development• E<strong>as</strong>y to replicate <strong>an</strong>d modify solution• Absolute Minimum of site specific code• E<strong>as</strong>e of deployment• E<strong>as</strong>e of upgrade• E<strong>as</strong>e of m<strong>an</strong>agement
Processing Messages from Hospital• St<strong>an</strong>dard HL7 BS• BP• Provide customers with single message specification• Make custom schema available f<strong>or</strong> <strong>Ensemble</strong> users• Recognize what the message is• Use site specific tr<strong>an</strong>sf<strong>or</strong>m• Use library tr<strong>an</strong>sf<strong>or</strong>m to generate c<strong>an</strong>onical f<strong>or</strong>m• Route to appropriate BO• BO h<strong>an</strong>dles c<strong>an</strong>onical f<strong>or</strong>m
What does the hospital send you?• C<strong>an</strong> you specify a complete HL7 f<strong>or</strong>mat?• Strict specification makes it e<strong>as</strong>ier f<strong>or</strong> you• Flexibility makes it e<strong>as</strong>ier f<strong>or</strong> the hospital
IHE Profiles <strong>an</strong>d <strong>HealthShare</strong>• Connects your application to:• Document registries <strong>an</strong>d reposit<strong>or</strong>ies• Patient Index• ATNA reposit<strong>or</strong>ies• Health Inf<strong>or</strong>mation Exch<strong>an</strong>ge• Clinical applications17
Examples of IHE Profiles• XDS.bAct<strong>or</strong>sDocument ConsumerDocument SourceTr<strong>an</strong>sactionsRegistry St<strong>or</strong>ed Query[ITI-18]Retrieve Document Set[ITI-43]Provide <strong>an</strong>d RegisterDocument Set-b [ITI-41]18
Examples of IHE Profiles• PIX V3Act<strong>or</strong>sTr<strong>an</strong>sactionsPatient Identity Source Patient Identity Feed[ITI-8]Patient Identifier PIX Query [ITI-9] PIXCross-referenceConsumer19
Examples of IHE Profiles• PDQ V3Act<strong>or</strong>sPatient DemographicsConsumerTr<strong>an</strong>sactionsPatient DemographicsQuery[ITI-21]20
Document F<strong>or</strong>matsDocument Type HL7 HITSP IHEPatient Summary CCD C32 XPHRReferral Summary C48.1 MSDischarge Summary C48.2 MSLab<strong>or</strong>at<strong>or</strong>y Rep<strong>or</strong>t C37 XD-LAB• Bidirectional conversion to <strong>an</strong>d from the <strong>HealthShare</strong> SDA objectrepresentation, <strong>an</strong>d• Conversion from HL7v2 message segments to the equivalent CDAdocument sections• These conversions are carried out in a “message in, document out”b<strong>as</strong>is without <strong>an</strong>y data aggregation <strong>or</strong> terminology processing.21
HL7 v2 to XDS.b Reposit<strong>or</strong>y• Convert message to 2.5 with all necessaryfields• Prebuilt XSLT converts to SDA• Prebuilt XSLT converts SDA to CDA• Prebuilt BO to communicate with PIX m<strong>an</strong>ager<strong>an</strong>d XDS.b registry <strong>an</strong>d reposit<strong>or</strong>y
Deployment• Silent, Scripted Install• Use of %Installer• Deployed <strong>as</strong> part of <strong>an</strong> application upgrade
M<strong>an</strong>agement <strong>an</strong>d Monit<strong>or</strong>ing• Preconfigured m<strong>an</strong>agement t<strong>as</strong>ks• Prepared usage rep<strong>or</strong>ts• Remote Monit<strong>or</strong>ing?• VPN ?• https:?
Alerts• Who in the hospital gets alerted withproblems?• C<strong>an</strong> you route alerts back to your supp<strong>or</strong>tcenter?• By generating SOAP requests over https:??
An integrationplatf<strong>or</strong>m f<strong>or</strong>application suites
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