CON Healthcare Modernization with SOA Suite

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2 CON Healthcare Modernization with SOA Suite Steve Schenks, Ascension Health Kevin Mattingly, Ascension Health Sean Keane, Oracle Suresh Sharma, Oracle Copyright 2014, Oracle and/or its affiliates. All rights reserved.

3 Safe Harbor Statement The following is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle s products remains at the sole discretion of Oracle. Copyright 2014, Oracle and/or its affiliates. All rights reserved.

4 About the presenters Steve Schenks Kevin Mattingly Integration Architect, Ascension Health Integration Architect, Ascension Health Sean Keane Suresh Sharma Director, Healthcare Interoperability, Oracle Product Strategy Director, Oracle 4 Copyright 2013, Oracle and/or its affiliates. All rights reserved. Oracle Public Information

7 Oracle Healthcare: A Complete Portfolio Business Performance Financials Supply Chain Human Resources Strategic Planning Talent Management Advanced Controls Value Chain Planning Grants Management Healthcare Analytics Financial Performance Supply Chain Analytics Human Resources Analytics Cost Accounting Translational Research Analytics Molecular Medicine Clinical Performance Operating Room Healthcare Management Platform Health & Disease Management Patient & Clinical Portal ecommerce Patient Discharge Mgt Healthcare Retail Solutions Translational Research Solutions Healthcare Cost Management Infrastructure & Mobility Security Care Giver -Mobility Identity Exchange 3CI Master Data Management Interoperability and Integration SOA Suite for Healthcare Master Patient Index Healthcare Data Model Collaboration HIE Solutions ACO Solutions- Coordinated Care NHIN Connect Medical Device Integration Care Management and Partners Epic Cerner McKesson Allscripts GE Orion Siemens Copyright 2014 Oracle and/or its affiliates. All rights reserved.

8 Healthcare tactical trends Securing data access and at rest Increased reporting of data breach Laptops, thumb drives, paper Data replicated to many unaudited destinations Meaningful Use Stage 2 is here Greater Patient Engagement, consumerism, retailization Increased data sharing Increased usage and demand for Analytics Copyright 2014 Oracle and/or its affiliates. All rights reserved. Oracle Confidential Internal/Restricted/Highly Restricted 8

9 Healthcare strategic trends ONC New focus on interoperabilty and data exchange Certification and Regulation role HL7 FHIR Fast Healthcare Interoperability Resource HL7 V4 (sshhh!), REST, JSON, XML Increased data sharing across care settings ACO Stop replicating data! Copyright 2014 Oracle and/or its affiliates. All rights reserved. Oracle Confidential Internal/Restricted/Highly Restricted 9

10 Ascension Health Ascension ( is transforming healthcare by providing the highest quality care to all. Ascension is directed by the Church to care for those most in need. Our Catholic philosophy permeates our national health ministries and our promise to provide Healthcare That Works Healthcare That is Safe Healthcare That Leaves No One Behind Ascension Information Services Confidential and Proprietary 10

11 Program Agenda Oracle Healthcare Focus and Healthcare Trends Ascension Health Case Study Oracle SOA for Healthcare Overview Demo Ascension Information Services Confidential and Proprietary 11

12 Current Environment Scattered Deployments As Ascension Health added hospitals and related health facilities, siloed IT departments were also added in some cases The majority of the clinical interfaces (2058) and all the PeopleSoft human resources, finance, supply chain interfaces (1084) are supported by the Ascension Shared Information Services ("SIS") integration team and run in a centralized data center. Other interfaces (approximately 1000) are supported by Health Ministries themselves and run locally at the Ministry. Ascension Information Services Confidential and Proprietary 12

13 Moving to Standardization Stand-Alone Integration Shared Integration Sybase Impact TDM 4.1 / Ebiz Oracle Java CAPS (JCAPS 5.1.3) Sybase ebiz Orion Impact Rhapsody v Summit Express Connect 8 egate TRE (Clinical) egate SRE egate SRE (Symphony) Lawson Cloverleaf egate Shared Integration One Integrated Ministry Standardization Oracle Enterprise Manager 12c Oracle Database 12c Oracle SOA Suite Oracle SOA for Healthcare Governance & Optimization Oracle Managed File Transfer High-value Service Delivery Ascension Information Services Confidential and Proprietary 13

14 Schedule = Ascension Information Services Confidential and Proprietary 14

15 High Level Architecture Overview Ascension Information Services Confidential and Proprietary 15

16 IP Virtualization Strategy Ascension Information Services Confidential and Proprietary 16

17 Interfacing in SOA for Healthcare Comparison Testing Easing the transition to SOA for Healthcare Integration Flows Implementing Common Healthcare Message Patterns with SOA for Healthcare Exception Handling Framework Handling Exceptions with SOA for Healthcare Custom Operations Dashboard Managing an enterprise environment with SOA for Healthcare Ascension Information Services Confidential and Proprietary 17

18 Comparison Testing Testing with 1 month of input and output Production Data. Compare Results The scenarios that occur in 1 month of production data get tested * Legacy Output A = SOA Output A Typical technical scenarios captured and tested prior to comparison Ensures we are validating existing functionality. Typical end-to-end testing is not required because no new functionality is introduced. Migrated Interface functionality matches Legacy Interface functionality POTENTIAL DEFECT FIXING OPTIMAL USE OF END USER TIME SMOOTH DEPLOYMENT Potential defects proactively fixed to expedite testing and Cut-over validation. Code that has gone through output comparison against the scenarios that occur in 1 month of production data is deployed on UAT\Production servers enabling optimal UAT thus reducing test cycle durations. Typical scenarios which may create issues in Production Environment are mitigated by proactive planning. * NOTE: identical (same) production test data is processed in bulk through Legacy and SOA systems. Results are compared to match the legacy interface output against SOA interface output using same input data. Ascension Information Services Confidential and Proprietary 18

19 Comparison Testing - Architecture Ascension Information Services Confidential and Proprietary 19

20 Integration Flow High Level Routing Transformation Mediator A Source 1 1 Mediator Mediator Ba Destination A Mediator C Message Type 1 Mediator A Source 2 SSHI 2 Mediator SSHI Destination B Mediator C Message Type 2 Source 3 Message 3a Mediator Type 1 Message Type 2 3b Mediator Mediator Mediator Bb C Destination C Source Interface Leg Destination Interface Leg *Primary constraint is FIFO. Must be maintained by source. Ascension Information Services Confidential and Proprietary 20

21 Integration Flow - Scenarios Source with Single Message Format Source SSHI ADT 1 Mediator Mediator Mediator Mediator A B C ADT ADT ADT SSHI Destination A Destination B Destination C Source with Multiple Message Formats Source SSHI ADT ORU 1 2 Mediator Mediator Mediator Mediator A B C ADT ADT ORU SSHI Destination A Destination B Destination C Ascension Information Services Confidential and Proprietary 21

22 Integration Flow - Scenarios Destination with Single Message Format Source 1 ADT 1 Mediator Mediator A ADT SSHI SSHI Destination Source 2 ADT 2 Mediator Mediator A ADT Destination with Multiple Message Formats Source 1 ADT 1 Mediator Mediator A ADT SSHI SSHI Destination Source 2 ORU 2 Mediator Mediator A ORU Ascension Information Services Confidential and Proprietary 22

23 Integration Flow - Scenarios HL7 and Non-HL7 Batch File Non-HL7 Batch File Utilizes SOA Suite File Adapter HL7 Batch File Utilizes SOA Suite HealthCare Adapter and SSHI Endpoint MFT Solution Short-term: Accenture developed AFPO MFT solution Long-term: Oracle SOA Suite 12c MFT Ascension Information Services Confidential and Proprietary 23

24 Exception Handling Framework Consists of the following: Logging Exception Handling Notifications SISAI Event Handler Publisher Event Delivery Network Custom Operations Dashboard was developed for viewing errors and message data. SISAI Event Handler Subscriber ServiceNow Ticket Creation ADF DashBoard Logging Subscriber Notificatio n Sub scriber SISAI_ERROR_LOG (Table) B2B_INSTANCEMESSA GE (View) Ascension Information Services Confidential and Proprietary 24

25 Exception Handling Framework SSHI/B2B layer: Any exception in the SSHI layer like the unavailability of the End Points, TCP/MLLP/FTP protocol error, Document translation error etc. results in an exception thrown by the SSHI layer. SOA Composite layer: Any exception related to routing and transformations occurring in the Mediator component would be result in an exception thrown by the Composite layer. Ascension Information Services Confidential and Proprietary 25

26 Exception Handling Framework External Sender Inbound HL7 Processing Routing and Transformation (SOA Composite) Outbound HL7 Processing External Receiver Source System SSHI Adapter Routing Mediator Transformation Mediator Transformation Mediator SSHI Adapter SSHI Adapter Destination System Destination System B2B_EXCEPTION_QUEUE Fault Policy B2B Exception Handler Custom Component SOA Exception Handler Custom Component SISAI Exception Handling Framework SISAI Event Handler Publisher Event Delivery Network SISAI Event Handler Subscriber ServiceNow Ticket Creation SOA Infra DB Logger Notification Ascension Information Services Confidential and Proprietary 26

27 Custom Operations Dashboard Problem Ascension Health has approximately 2750 endpoints spread across 26 Health Ministries. The number of endpoints dictates that multiple SOA for Healthcare domains must exist current implementation plan includes 6 domains. Solution In order to effectively monitor and get a complete picture of the Healthcare transactions and endpoints across the multiple domains, Ascension in partnership with Accenture is developing a Custom Operations Dashboard that will provide the single view across all Healthcare endpoints. The Operations Dashboard will include the following functionality: Endpoint Dashboard: allows for a rollup status by Ministry. This dashboard utilizes the B2B_InstanceMessage view as well as a custom table used to store the errors / notifications produced by SOA and SOA for Healthcare. Errors: allows for the searching and viewing of errors that occur in any of the domains. Messages: allows for the searching and viewing of transactions that are received or sent via any of the domains Ascension Information Services Confidential and Proprietary 27

28 Operations Dashboard Endpoint Dashboard Provides an status overview of all endpoints. Status is based on the last message processed. It is not used for monitoring. Ascension Information Services Confidential and Proprietary 28

29 Operations Dashboard Errors Allows for searching and displaying of error messages that occur across all domains Ascension Information Services Confidential and Proprietary 29

30 Operations Dashboard Errors - Detail Displays detailed information for selected error. Ascension Information Services Confidential and Proprietary 30

31 Operations Dashboard Messages Allows for searching of data messages both metadata and payload. Displays messages based on search results. Ascension Information Services Confidential and Proprietary 31

32 Operations Dashboard Messages - Detail Displays detailed information for selected message. Ascension Information Services Confidential and Proprietary 32

33 Operations Dashboard Messages - Detail Displays selected message payload. Ascension Information Services Confidential and Proprietary 33

34 Milestones Timeline FY14-Q4 (Apr-Jun 2014) FY15-Q1 (Jul-Sep 2014) FY15-Q2 (Oct-Dec 2014) FY15-Q3 (Jan-Mar 2015) FY15-Q4 (Apr-Jun 2015) FY16-Q1 (Jul-Sep 2015) FY16-Q2 (Oct-Dec 2015) FY16-Q3 (Jan-Mar 2016) FY16-Q4 (Apr-Jun 2016) FY17-Q1 (Jul-Sep 2016) FY17-Q2 (Oct-Dec 2016) PLATFORM DEVELOPMENT Development (DEV) Run Time Environment available (6/20/14) 2. System Integration Test (SIT) Run Time Environment available (7/11/14) 3. User Acceptance Test (UAT) Run Time Environment available (9/5/14) 4. Production (PRD) Run Time Environment available (10/24/14) 5. Monitoring Dashboard is operational (11/14/14) 6. Oracle to advise on 12c version upgrade (TBD) INTERFACE DEVELOPMENT & CUT-OVER (BY MINISTRY) Alpha: MDBAL (11/14/14) A Beta: FLJAC (1/27/15) B Note: Durations/dates for Groups 6 (AZTUC & NYNIA), 7 (ILARL), 8 (MOKAN) and 9 (Marian Health Ministries) are to be determined. Group 1: 1a 1b 1c 1d 1e 1a. IDLEW (2/9/15), 1b. TXWAC (3/20/15), 1c. WIMIL (3/31/15), 1d. MIGRA (5/28/15), 1e. TXAUS (12/23/15) Group 2: 2a. INEVA (1/29/16), 2b. ININD (6/30/16) 2a 2b Group 3: SY-SR (12/23/16) 3 Group 4: 4a 4b 4c 4d 4e 4a. DCWAS (5/18/16), 4b. ALMOB (5/31/16), 4c. NYBIN (10/24/16), 4d. MIDET (10/31/16), 4e. ALBIR (12/23/16) Group 5: 5a. CTBRI (11/30/16), MIKAL (11/30/16), MITAW (11/30/16) 5b. WAPAS (12/23/16), TNNAS (12/23/16), FLPEN (12/23/16), MISAG (12/23/16) 5a 5b SIS-AI ORGANIZATIONAL DESIGN & OPERATING MODEL SIS-AI TRAINING & TRANSITION 1. Functional Model complete (5/16/14) 2. Org Structure and Capacity Planning detailed (7/2/14) 3. Roles and Responsibilities finalized (7/16/14) 4. Resource Transition Plan complete (8/1/14) 5. Operating Model complete (9/12/14) 6. Org Blueprint complete (10/1/14), Operations Manual complete (10/1/14) & Performance Metrics Deliverable complete (10/1/14) A 1 B C 2 D F E G 1. Training materials developed (9/12/14) 2. Trainers (4) equipped to conduct training (12/24/14) A. Ready to Support Alpha Go-Live (9/4/14) B. Ready to Support Beta Go-Live (11/6/14) C. Ready to Support Group 1 Go-Live (12/4/14) D. Ready to Support Group 2 Go-Live (11/2/15) E. Ready to Support Group 3 Go-Live (8/4/16) F. Ready to Support Group 4 Go-Live (3/3/16) G. Ready to Support Group 5 Go-Live (9/2/16) Ascension Information Services Confidential and Proprietary 34

36 Oracle SOA Suite Unified Integration Across Cloud, Mobile, and On-premise Simplifies development and management Business Activity Monitoring Analytics Event Processing Standards-based, open infrastructure interoperates with your existing IT Consistent tooling - Single development, deployment and management platform BPEL Process Manager Orchestration Service Virtualization & Mediation Service Bus Connectivity Business Rules Cloud On-premises Business to Business Apps Services Platform Apps Mainframe DB EDI XML Industry Copyright 2014, Oracle and/or its affiliates. All rights reserved.

37 SOA Suite 12c Key Features 30 % memory footprint reduction Startup acceleration First class support for mobilefriendly standards (REST, JSON, ) Web Scale Pre-tuned database profiles Active-active support Mobile Automated conversions REST/SOAP Developer Productivity One-click install Everything in JDeveloper Debugger & tester Cloud Cloud adapters to simplify on-prem to cloud integration Managed File Transfer (MFT) for file-based integration Templates Certifications on Oracle Public Cloud Copyright 2014, Oracle and/or its affiliates. All rights reserved.

38 Oracle SOA Suite for healthcare integration Healthcare Console Document Editor Enterprise Manager SOA Composite Route, Transfer, Integrate Interface Configuration, Dashboards, Monitor HealthCare Runtime Engine BACK END INTERFACE Document Translation Sequencing Handling Healthcare Runtime Engine Translation HL7 v2.x HL7 v3.0 Custom Healthcare Message creation, customization, testing Validation Sequencing Mapsets ACK Handling Resubmission Validation Batching Callout TRANSPORT MLLP HLLP WS-HTTP FILE FTP SFTP JMS MFT ACK Handling Systems Management External System Database Copyright 2014 Oracle and/or its affiliates. All rights reserved.

39 IOT in Healthcare Scenario : Correlating a Patients Diagnosis with Devices Reading for More Accurate Alarm Evaluation and Enhanced Patient Care Correlation scenario: Scale: 3 lb weight gain BP cuff: Slight elevation in BP Pulse: Slight increase in pulse Alone, each data point may not be reason for concern Together they may indicate a potential emergency Local analytics triggers a query to the patient, and sends data along with patient feedback in a single alert to the care provider or hospital Copyright 2014 Oracle and/or its affiliates. All rights reserved. Oracle Confidential Internal/Restricted/Highly Restricted 39

40 Mobile Health Scenario : Collect Member healthcare info via mobile channels push to EHR, proactively increase patient engagement Biometric Devices Oracle Service Bus Healthcare Adapter Update EHR EHR RESTful API Integration Infrastructure Analytics View, Alerts Driver: Move to ACO, Value based Payments, Population Health Management require Providers to provide proactive care delivery Solution : Leverage mhealth /mobile apps, biometric devices to increase Patient engagement Flow: Mobile Application : Collecting Patient Data from devices REST API to send data to backend application (EHR) ;convert JSON msg to HL7 format Sync up data with back end (EHR) using SOA for Healthcare capture and analyze large amounts data and generate appropriate alerts / data flows into the EHR workflows to proactively engage with patients. Platform/Devices: ios/iphone, FitBit, Withings Pulse O2 BAM Dashboards Copyright 2014 Oracle and/or its affiliates. All rights reserved.

42 Healthcare 2 Home IOT Flow Temperature Sensor 3 Sends Temperature, Breathing and SPO2 results to REST Service 4 Receives JSON data and converts into HL7 and invokes SOA Healthcare Adapter and stores the information into tables Oracle SOA Cloud Services 5 SOA Healthcare sends data to endpoints Oracle SOA Healthcare EMR 6 Send to EMR System SPO2 Sensor Raspberry Pi with OEP Server and Web Server Breathing Sensor DB 1 Sensors Installed on Healthcare IOT Device and sends captured results 2 Gateway becomes SMART with OEP Embedded. It analyzes temperature data to identify temperature fluctuations 8 JSF/ADF Mobile UI (Oracle Portal) To present the captured data ADF /ADF Mobile 7 Portal to observe the result and analyze Copyright 2014 Oracle and/or its affiliates. All rights reserved.

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