Singapore Healthcare s Journey towards Interoperability, Sharing and Reuse

Transcription

1 Singapore Healthcare s Journey towards Interoperability, Sharing and Reuse Tony Lam, Senior Consultant Wong Ming Fai, Senior Consultant Sari McKinnon, Director Enterprise Architecture Information Systems Division, MOHH 14 th Jan, 2011

2 Outline Introduction MOHH Plan & Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability & Integration Architecture (IIA) National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 2

3 Singapore: Small Country but Big City km million population This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 3

4 Diversified Providers for Full Spectrum of Healthcare Ecosystem Primary Care Acute & Intermediate Care Long-Term Care Community Hospital Polyclinics Nursing Home Screening & Preventation Restructured Hospital Palliative Care GPs Home Care Rehab & Support Services Public sector Private sector People sector This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 4

5 Supporting health landscape of the future One Patient, One Record This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 5

6 Electronic Records - EMR vs. EHR Electronic Medical Record (EMR) Specific to an facility (institution, private office); the equivalent of its paper predecessor and includes everything that is recorded by that organization about a given patient. It has depth but lacks breadth. Electronic Health Record (EHR) Specific to an individual; captures a key subset of health information from multiple point of service systems. It is available electronically to authorized healthcare providers and the individual anywhere, anytime in support of high quality care. This record is designed to facilitate the sharing of data across the continuum of care, across healthcare delivery organizations and across geographies. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 6

7 Outline Introduction MOHH Plan and Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability Architecture National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 7

8 About MOHH Singapore in2015 Goal for Healthcare and Biomedical Sciences This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 8

9 National Coordinator of Health IT Healthcare Innovations Communications, Education and Change Management Patient Care Provider Caregiver Industry Agencies Wellness && Prevention Prevention Personal Health Records Primary Care GP IT Enablement Prog* Primary Care Prog * Agency for Integrated Care (AIC) Acute Care Acute Care Regional Health Services (RHS) ILTC (Residential) ILTC (Residential) Comm Hospital Integration Care (CHIC) * National IT Initiatives across the healthcare sectors National Electronic Health Record (NEHR) Healthcare Informatics Summit 2010 * ILTC (Community) (Community) ILTC Prog & Mental Health Prog * NEHR Prog Joint Healthcare CFC * Telecare Prog * Data Standards Data Standards Nat l Standards Prog* Medical Product & Service Catalogue Nat l Data Dictionary Nat l Drug Dictionary NEH R EA CIC EA Enterprise Architecture Architecture Interop Arch, Services Catalogue Horizontal Functions NHSB Ref Arch, EA repository Privacy & Security Privacy & Security Healthcare Authentication & Access Mgmt Framework Nat l Privacy Framework Medical Informatics Medical Informatics Healthcare IT Summit & Medical Informatics Course EHR Clinical Taskforces This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 9

10 Our plan Healthcare Innovations Communications, Education and Change Management Patient Care Provider Caregiver Industry Agencies Wellness & Prevention Personal Health Records Primary Care GP IT Enablement Prog* Primary Care Prog * Agency for Integrated Care (AIC) Acute Care Regional Health Services (RHS) ILTC (Residential) Comm Hospital Integration Care (CHIC) * National Electronic Health Record (NEHR) Healthcare Informatics Summit 2010 * ILTC (Community) ILTC Prog & Mental Health Prog * NEHR Prog Joint Healthcare CFC * Telecare Prog * Data Standards Nat l Standards Prog* Medical Product & Service Catalogue Nat l Data Dictionary Nat l Drug Dictionary NEH R EA CIC EA Enterprise Architecture Service Catalogue, IIA, ESB Strategy, EA Repo Privacy & Security Healthcare Authentication & Access Mgmt Framework Nat l Privacy Framework Medical Informatics Healthcare IT Summit & Medical Informatics Course EHR Clinical Taskforces This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 10

11 General evolution pattern of Architecture Initiatives MOHH Architecture Initiatives Set the initial key architecture requirements NEHR Phase 1 Apply, validate, fine-tune and extend the architecture Other National Healthcare Initiatives Personal Health Mgmt Community & Integrated Care GP IT Enablement Community Hospital IT Enablement NEHR Subsequent Phases This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 11

12 Outline Introduction MOHH Plan Architecture Initiatives Highlight Service Catalogue Interoperability and Integration Architecture (IIA) National Health ESB Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 12

13 Two Key Dimensions This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 13

14 Two Key Dimensions Interoperability Architecture Service Catalogue National Health Service Bus Reference Architecture Enterprise Architecture Repository This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 14

15 Outline Introduction MOHH Plan Architecture Initiatives Highlight Service Catalogue Interoperability and Integration Architecture (IIA) National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 15

16 Service Catalogue Background: Early 2010, two-month effort Leverage on previous architecture work Objectives: Provide a baseline of NEHR services Take a step towards SOA-based NEHR architecture Deliverables: Approach for identifying services Template for documenting identified services A initial set of services required by the NEHR This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 16

17 Organisation 5 Domains: EHR, National Health Identification Service, Identify & Access Mgmt, Terminology, Integration x 5 x 24 x 82 x 461 This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 17

18 A Peek into the Service Catalogue Doma Functional in Area EHR EHR 1. Summary Care Record 1. Summary Care Record Service Name Patient Service Service Name Operation Description Manages the services to register patients. AddPatient DeletePatient Service Operation Description Registers a new patient with the EHR based on inputs from the source systems De Registers the patient from the EHR PID based on the source systems Service Input Patient Particulars; e.g. Last Name, First Name, etc Service Output Success or failure indicator Success or failure indicator This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 18

19 Service Catalogue Construction Approach Develop first-cut based on available information before vendor selection To be revised after finalisation of use cases and detailed requirements First Iteration NEHR Implementation Phase Current Business Requirements COTS Functions/Features Industry Practices Service Modeling Phase 0 SERVICE IDENTIFICATION Service Catalogue v1.0 Finalized NEHR Use Cases Current System Interfaces Service Modeling Phase 1 SERVICE IDENTIFICATION, SPECIFICATION, REALIZATION Service Catalogue v2.0 Existing Catalogue documents Non-Functional Requirements Others This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 19

20 Service Catalogue Next Step Review and update the catalogue after detailed design (completed) of NEHR phase 1, for example Subsume some operations into one another (e.g. add, update, delete) Further split some operations Inter-operations dependency to align with general business rule/architecture decision (e.g. patient registration shall exist done before medication orders) Reuse the NEHR services for new applications Stronger tie-up with Interoperability and Integration Architecture This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 20

21 Outline Introduction MOHH Plan & Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability and Integration Architecture (IIA) National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 21

22 Interoperability and Integration Architecture (IIA) Standards/Guidelines/Pattern Interoperability Specifications Administration Integration Services Infrastructure Security Key Questions Answered: Interoperability Specifications How can EHR information be understood in a consistent manner? Integration Services What capabilities does the EHR need to provide to support interoperability and integration? Security Administration How does interoperability impact administration and operations of EHR and EMR systems? Infrastructure This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 22

23 IIA Supporting Info Exchange Requirements of NEHR This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 23

24 Linkage to Standards S/ N 5 Doc Request EMRX Name Purpose Integration Standards Request source system for a specific document. Leverages on EMRX s GetDoc functionality. Web Service Semantic Standards EMRX XML This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 24

25 Linkage to Service Catalogue Domain Functional Area Service Name Service Operation EHR 1. Summary Care Record Medication UpdatePatientMedic ation Service Operation Description Update medication(s) on the patient medication list. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 25

26 Ultimately.. Interoperability Specifications Administration Integration Services Security Infrastructure Standards/best practices/existing implementation (e.g. services catalogue, NEHR ESB) for each areas List of profiles to cater to common implementation need for specific domain areas (SSO, lab results update, event summary retrieval, record reconcilation etc) This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 26

27 Outline Introduction MOHH Plan & Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability and Inttegration Architecture (IIA) National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 27

28 National Health Service Bus Reference Architecture Background Most systems integrations (EMR, LIS, RIS etc) in large healthcare settings are using traditional MLLP via integration engine minimal Enterprise Service Bus (ESB) investments to-date. However, ESB is being considered in a number of upcoming large scale healthcare IT initiatives (NEHR, NHIS, CLEO, Hospital Cluster wide Initiatives) Opportunity for early alignment!!! This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 28

29 National Health Service Bus Reference Architecture Process One month exercise Over 10 internal/external stakeholders engaged for interviews, major stakeholders participated in working group Deliverables and Outcome A Reference Architecture for ESB landscape Key directions identified for moving towards the reference architecture This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 29

30 Reference Architecture SCM NHG NHG Apps EHR-IX (NHG) Internal SHS EHR-IX (SHS) Internal SHS Apps Other NHG/SHS Cluster (1..n) EHR-IX (Cluster) Internal Cluster Apps MOHH EHR-IX (MOHH) Internal EHR-IX (NHG) EHR-IX (SHS) EHR-IX (Cluster) EHR-IX (MOHH) 1 National Healthcare ESB Medinet MOH Apps HPB Apps Characteristics 1. Federated Model. No one single ESB for everybody. Multiple ESB instances in the whole landscape 2. Each hospital cluster will have own physical instance of ESB, with dedicated ESB partition for external integration. 3. Planned initiatives that required ESB capability (e.g. National EHR) Key Considerations:- Org/structures, governance, operation performance, effort/cost 3 NEHR 3 NHIS CLEOS 3 CHIC 3 AIC 2 EHR-IX (AIC) Internal EHR-IX (AIC) 3 AIC Apps This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 30

31 Key Direction #1 A Shared ESB for MOHH driven initiatives Isolated Infrastructure Shared Infrastructure ESB NEHR & NHIS ESB NHG ESB CLEOS Hospital cluster(s) ESB NHG ESB NEHR, NHIS CLEOS, CHIC AIC MOHH driven initiatives ESB ESB AIC CHIC ESB SHS NHG ESB SHS Isolated 1. Investment in more sets of ESB platforms and implementation. 2. Investment in more physical network connections and data centre operations. Shared 1. Investment in less sets of ESB platforms and implementation. 2. Investment in less physical network connections and data centre operations. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 31

32 Key Direction #2 National EHR to extend the Info exchange platform to support other MOHH initiatives NHG NHG Apps EHR-IX (NHG) Internal EHR-IX (NHG) SHS Medinet EHR-IX (SHS) Internal EHR-IX (SHS) SCM SHS Apps MOH Apps HPB Apps Other NHG/SHS Cluster (1..n) EHR-IX (Cluster) Internal Cluster Apps EHR-IX (Cluster) National Healthcare ESB MOHH EHR-IX (MOHH) Internal EHR-IX (MOHH) NEHR CLEOS NHIS CHIC AIC EHR-IX (AIC) Internal EHR-IX (AIC) AIC Apps Considerations: Scale and project timeline dependency This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 32

33 Key Direction #3 Leverage on same products/technologies for other ESBs NHG NHG Apps Service Registry EHR-IX (NHG) Internal EHR-IX (NHG) SHS Medinet EHR-IX Registry EHR-IX (SHS) Internal EHR-IX (SHS) MOHH NHG SHS SCM SHS Apps MOH Apps HPB Apps NEHR (Int & Ext) NHIS (Int & Ext) CLEOS (Int & Ext) CHIC (Int & Ext) NHG Apps (Int & Ext) SHS Apps (Int & Ext) Other NHG/SHS Cluster (1..n) EHR-IX (Cluster) Internal Cluster Apps EHR-IX (Cluster) National Healthcare ESB AIC AIC Apps (Int & Ext) Medinet MOH & HPB Apps (Ext) MOHH EHR-IX (MOHH) Internal EHR-IX (MOHH) NEHR CLEOS NHIS CHIC EHR-IX Registry AIC EHR-IX (AIC) Internal AIC Apps EHR-IX (AIC) MOHH NEHR (Int & Ext) NHIS (Int & Ext) CLEOS (Int & Ext) CHIC (Int & Ext) AIC AIC Apps (Int & Ext) NHG NHG Apps (Int & Ext) Medinet MOH & HPB Apps (Ext) SHS SHS Apps (Int & Ext) Considerations Ease of Integration, establishing of logical SOA registry for all cross-org services to facilitate reuse This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 33

34 Outline Introduction MOHH Plan & Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability and Integration Architecture (IIA) National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 34

35 1.2.1 Access Screening Data in PHR Access Screening Data in PHR Manage Facility Information Manage Facility Information Extract EHR Data for Clinical Audit Extract EHR Data for Clinical Audit Enable EHR Access Manage Patient Enable EHR Access Demographics Capture Manage Care Patient Team Details Demographics Capture Care Team Details Review Summary Record Review Event Details Review Summary Record Review Investigation Details Review Event Details Review Procedure Details Review Investigation Details Review Referral Details Review Procedure Details Review Care Plans Review Referral Details Review Notifications Review Care Plans Review Notifications Manage Clinician Information Manage Clinician Information Create / Manage Care Plans Reconcile Medications Create / Manage Care Plans Reconcile Problem List Reconcile Medications Update Allergy / ADR Reconcile Problem List Update Allergy / ADR Manage EHR Operations Manage EHR Operations Extract EHR Data for Programme Evaluation Extract EHR Data for Programme Evaluation Create / Manage Referral Create Event Summary Create / Manage Referral Create Discharge Summary Create Event Summary Create Discharge Summary Legend Level One business capability Legend Level Two business capability Level EHR-related One business functionality capability Level Two business capability Not directly impacted by EHR EHR-related functionality Not directly impacted by EHR Data Source NHG R1 R R1 - - R R1 R1 - - R1 - - R1 R1 - - R1 - SHS R1 R R1 - - R R1 R1 - - R1 - - R1 R1 - - R1 - GP EMR R Com. Hosp EMR R1 R R R1 R1 R1 R1 R1 R AIC DOT CMIS R NIR R Mindef R R MOH AMD - - R Enterprise Architecture (EA) Repository Background Our IT initiatives involve a lot of integration > need intensive planning For planning purpose, we gather & generates vast amount of architecture artefacts in different formats, stored in different locations and captured from different perspective. Lack consistent way to maintain/update. Artefacts collected become obsolete overtime Difficult to cross harmonise and reuse. 1.0 Support & Educate Patient 1.0 Support & Educate Patient 1.1 Educate 1.1 Educate 1.2 Enable Self Management 1.2 Enable Self Management 1.3 Access Care 1.3 Access Care 3.0 Plan & Manage the Health System Plan Manage & Manage the Health 3.2 Manage System Logistics Finances 3.1 Manage 3.2 Manage Logistics Finances 2.0 Deliver Health Services 2.0 Deliver 2.1 Schedule Health Services / Register 2.2 Assess Patient 2.3 Deliver Care 2.4 Transfer of Care 2.1 Schedule / Register 2.2 Assess Patient 2.3 Deliver Care 2.4 Transfer of Care 2.5 Manage Patient Flow 2.5 Manage Patient Flow 3.3 Manage Legal & Commercial 3.3 Manage Legal & Commercial 3.4 Manage HR 3.5 Manage IT 3.4 Manage HR 3.5 Manage IT 4.0 Manage Population Health 4.0 Manage 4.1 Define Population & Manage Health 4.1 Design Programme 4.2 Execute Programme 4.3 Evaluate Programme Performance Targets 4.1 Define & Manage 4.1 Design Programme 4.2 Execute Programme 4.3 Evaluate Programme Performance Targets 3.7 Manage Quality 3.7 Manage Quality 3.8 Manage Policy 3.8 Manage Policy Data Type Patient Demographics Event AMD Care Team Screening Referral Record Inpatient Disch Sum (str) Com Hosp Disch Sum (str) Polyclinic Evt Sum (str) ED Evt Sum (str) Pvt GP Evt Sum (str) Referral Document Allergies Immunisation Medication Orders History Medications Dispensed History Medications Current Medications Reconciled Problem/Diagnosis History Problem/Diagnoses Reconciled Lab Orders Lab Reports Rad Report Rad Orders Rad Image Procedure Report Transfer of Care comp in docs. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 35

36 1.2.1 Access Screening Data in PHR Access Screening Data in PHR Manage Facility Information Manage Facility Information Extract EHR Data for Clinical Audit Extract EHR Data for Clinical Audit Enable EHR Access Manage Patient Enable EHR Access Demographics Capture Manage Care Patient Team Details Demographics Capture Care Team Details Review Summary Record Review Event Details Review Summary Record Review Investigation Details Review Event Details Review Procedure Details Review Investigation Details Review Referral Details Review Procedure Details Review Care Plans Review Referral Details Review Notifications Review Care Plans Review Notifications Manage Clinician Information Manage Clinician Information Create / Manage Care Plans Reconcile Medications Create / Manage Care Plans Reconcile Problem List Reconcile Medications Update Allergy / ADR Reconcile Problem List Update Allergy / ADR Manage EHR Operations Manage EHR Operations Extract EHR Data for Programme Evaluation Extract EHR Data for Programme Evaluation Create / Manage Referral Create Event Summary Create / Manage Referral Create Discharge Summary Create Event Summary Create Discharge Summary Legend Level One business capability Legend Level Two business capability Level EHR-related One business functionality capability Level Two business capability Not directly impacted by EHR EHR-related functionality Not directly impacted by EHR Data Source NHG R1 R R1 - - R R1 R1 - - R1 - - R1 R1 - - R1 - SHS R1 R R1 - - R R1 R1 - - R1 - - R1 R1 - - R1 - GP EMR R Com. Hosp EMR R1 R R R1 R1 R1 R1 R1 R AIC DOT CMIS R NIR R Mindef R R MOH AMD - - R Need for EA Repository Key Challenge: How to maintain, align, exploit and reuse these architecture information for ongoing planning purpose? 1.0 Support & Educate Patient 1.0 Support & Educate Patient 1.1 Educate 1.1 Educate 1.2 Enable Self Management 1.2 Enable Self Management 1.3 Access Care 2.5 Manage Patient Flow 1.3 Access Care 2.5 Manage Patient Flow 3.0 Plan & Manage the Health System Plan Manage & Manage the Health 3.2 Manage System Logistics Finances 3.1 Manage 3.2 Manage Logistics Finances 4.0 Manage Population Health 4.0 Manage 4.1 Define Population & Manage Health Performance Targets 4.1 Define & Manage Performance Targets Data Type Patient Demographics Event AMD 2.0 Deliver Health Services 2.0 Deliver 2.1 Schedule Health Services / Register 2.2 Assess Patient 2.3 Deliver Care 2.4 Transfer of Care Care Team 2.1 Schedule / Register 2.2 Assess Patient 2.3 Deliver Care 2.4 Transfer of Care 3.3 Manage Legal & Commercial 3.3 Manage Legal & Commercial 3.4 Manage HR 3.5 Manage IT 3.4 Manage HR 3.5 Manage IT 4.1 Design Programme 4.2 Execute Programme 4.3 Evaluate Programme 4.1 Design Programme 4.2 Execute Programme 4.3 Evaluate Programme Screening Referral Record Inpatient Disch Sum (str) Com Hosp Disch Sum (str) Polyclinic Evt Sum (str) ED Evt Sum (str) Pvt GP Evt Sum (str) Referral Document Allergies Immunisation Medication Orders History Medications Dispensed History Medications Current Medications Reconciled Problem/Diagnosis History 3.7 Manage 3.8 Manage Policy Quality 3.7 Manage 3.8 Manage Policy Quality Problem/Diagnoses Reconciled Lab Orders Lab Reports Rad Report Rad Orders Rad Image Procedure Report Transfer of Care comp in docs Distilled Info A repository is required to capture & manage the gist of the architecture information in a structured manner as a single source of info (though may not be the truth) to facilitate ongoing analysis and planning This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 36

37 Example of pain points We need clarity and visibility for the operating environment It is just too complex (over 150 applications, 300 known interfaces in clinical area etc). Everybody have a piece of puzzle that if we put together will likely have a clear picture. We want to mitigate ambiguity and standardise vocabulary e.g. is it episode or encounter or event or visit etc? We want to facilitate Architecture Information Reuse and Sharing e.g. I would like to know roughly which systems process this type of data and who are the project managers that I should talk to for more info. I do not want to start from zero!!! It is a like Knowledge Management!!! This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 37

38 How it is used D Architecture Principles D Architecture Requirements Repository Requirements Constraints Assumptions Gaps Architecture Principles, Vision & Requirements D Architecture Vision Business strategy Business Principles Objectives & Drivers Stakeholders Technology Strategy Business Architecture Application Architecture Data Architecture Technology Architecture A A IT Master Plan(current and to-be view ) supported Business Domains/Organizations (Business Support) - which IT systems provides which Capabilities to which Organizations. A Organization A Capability A Process* (Attachment) Program Plan Planned programs with view of affected Architecture, dependencies and program overlap A Application A A Application Releases A A Component Module Services Information Flow A Business Object (LIM) A Business Data (Physical) A Components A Standard Components A Standard Platform A Glossary Other References D Architecture Decision Log D Staff Contact list D Architecture Position Statement D Deliverable's PARCI D Processes D Toolkits D Specifications? A Typically structured Info that is crucial for architecture planning managed by the EA repository D Typically unstructured info, (e.g docs) generated for purpose like general communications, consumption by mgmt This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 38

39 Service Catalogue in the EA Repository Service Catalogue Data in the service Applications providing the service This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 39

40 Interoperability Architecture the in EA Repository Interfaces view for a application Interfaces view for a application This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 40

41 EA Repository Supporting Architecture Assurance & Governance Senior Management Stewardship 3 Inner Governance (Internal Operation & Control) Architecture Office Principal Architecture Enterprise Change Architect Management Guidance 4 Architects (Enterprise & Domain) Business Capability 5 Application Status Senior Management 6 EA Project Engagement (Interaction Points) Simplified Interaction 2 1 EA Repository Information Flow Technology Roadmap Implementation Projects (NEHR, CLEO, NHIS) Stage 3 (Delivery) Inception Elaboration Realization 7 New projects to tap on for initial planning Others architecture artefacts 1. EA team member assigned as project architect support a particular project, 2. Identify architecture gaps & opportunities as a natural part of the project execution. E.g.: Shared infra (e.g. ESB) need Reuse existing services 3. Architecture office review gaps and opportunities.. 4. The outcome of review will serve as input for on-going architecture development/ refresh. E.g.: Change in technical standards direction 5. Architecture decision that has cross project/ program impact (e.g. NEHR to extend its ESB to cover others need) will escalate SMM support and endorsement. 6. Project architecture info will be refreshed into the EA repository 7. Subsequently, other projects can make use of artifacts in the EA repository (e.g. Current state of applications, IT roadmap etc) for initial planning => avoid starting from zero. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 41

42 Outline Introduction MOHH Plan & Key Initiatives Architecture Initiatives Highlight Service Catalogue Interoperability & Integration Architecture National Health Service Bus Reference Architecture Enterprise Architecture Repository Conclusion This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 42

43 Two Key Dimensions Interoperability Architecture Service Catalogue National Health Service Bus Reference Architecture Enterprise Architecture Repository This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 43

44 Conclusion Singapore is embarking on multiple large-scale, and multi-years initiatives across its healthcare settings, taking an SOA-based approach to facilitate interoperability, sharing and reuse. As of now, key learning points are: Pragmatic how does it help for investment, project planning and implementation? Just-enough & just-in-time effort to show progress and value Continuously to re-visit, re-validate, extend and re-align the architecture to ensure the relevancy Key Challenges are: Delivery Perspective: Diversity of current systems capability/data Architecture Perspective: Optimal detail and level of architecture. Just-enough assurance process. Ensure our architecture reusable, maintainable and extensible across projects. This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 44

45 Conclusion If this whole journey is a soccer league, then we are in the midst of the opening match (NEHR Phase 1). This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission. 45

46 Thank You MOH Holdings