How To Align With Common Ground And Shared In A Cloud Computing Environment

Transcription

1 Shared /Cloud Computing Ready for Key Linkages between Federal, State and Local Communities John C. Dodd, Fellow for Health and Human and Enterprise Architecture CSC CSC Copyright 7/23/2010 4:24 PM

2 Key Message: Alignment with Common Shared can Create Key Design Platforms for Change and Innovation Foster alignment between Federal-State-Local Communities is not needed Use UCore Concepts, Business Artifact Flows, and Semantic matching along with Adapt with Harmonization with MDMI and Semantic Data Patterns to define Key universal data elements and shared services that can be common ground elements Defined as Shared in a Cloud Computing environment. Many Federal, State agencies, and local communities are defining comprehensive sets of business capabilities and integration. Need Simple Core and Guidelines Some of those business areas e.g., in Medicaid are more outward facing areas like Provider Management, Client Management to be shared within the Cloud. The state of trusted shared services, standards and the readiness of cloud computing to address key aspects of an integrated environment. What are enablers and barriers to change? Is the technology ready? Are we ready? Roadmap to Align and Support Rapid Evolution CSC Copyright 7/23/2010 4:24 PM

3 CSC Copyright 7/23/2010 4:24 PM Key Message: The Healthcare Business Complexity Provider and Supplier Provider and Supplier Health Plans Health Plans Electronic Health Records Electronic Health Records Billing Billing Quality Data Reporting Quality Data Reporting Hospital/ Facility Affiliation Hospital/ Facility Affiliation Imaging Imaging Lab Lab erx erx CPOE CPOE Referrals Referrals Billing Service Billing Service Patient Contact And Mgmt Patient Contact And Mgmt Training Training Staffing Staffing COB COB Coordinate Care Coordinate Care Contract Mgmt. Contract Mgmt. Security Security Other Payers Other Payers Employers Employers CMS CMS Insurer Insurer Associations Associations Education Education Professional Qualification Professional Qualification Certification Certification Research Research Patient Safety Patient Safety Financial Mgmt. Financial Mgmt. Reviews And Audits Reviews And Audits Incentives Incentives Problem List Problem List Regulation And Compliance Regulation And Compliance Privacy Privacy Liability Liability Treat Prescribe Diagnose Treat Prescribe Diagnose Preventive Care Preventive Care Educating Patients Educating Patients Technology Mgmt. Technology Mgmt. Practice Management Practice Management Attending Attending Payer Mgmt. Payer Mgmt. Workflow Workflow

4 Complete Alignment- Business and Framework: Support Alignment Cross Boundaries To create a coordinated view of health and human services by linking information and creating meaningful information exchanges to better support the citizen. PRIVATE (Provider, Citizen) LOCAL-COMMUNITY Common Provider Common Provider Business Processes COMMON VIEW Common Local Common Local Business Processes STATE FEDERAL Common State Common State Business Processes Common State Information Model Common Federal Common Federal Human Processes CSC Copyright 7/23/2010 4:24 PM

5 ONC: NIEM/NHIN Alignment CSC Copyright 7/23/2010 4:24 PM

6 Aligning Shared with NIEM/NHIN and HL7/OMG: Strategic Harmonization and Transformation Planning 5. Service Registry: HSSP S-RAMP 1. Strategy-Standards Segment- Domain Guide: SAIF Plus 2. Use Case Prioritized: Business Process Artifact Flows & Semantic Data Patterns 4. UCore by Domain: Meta Data Management: Data : MDMI Design Starterkits 3.Automation Support Vocabularies & Ontologies: Semantic Mapping Database Tools: Modeling CSC Copyright 7/23/2010 4:24 PM

7 SAIF Value Proposition : Working Interoperability Interoperability Paradigm (Messages, Documents, ): specifications which enable two or more (HL7) trading partners to collaborate in the context of a specific business interaction No assumptions of size, character, or identify of parties Nations, Enterprises, Departments, Individual, Systems, etc. No assumptions of exchange details (What, Why, How, etc.) CSC Copyright 7/23/2010 4:24 PM

8 Common Ground elements Business Architecture: Service Framework, Common Capabilities, Adaptation, Extension Approaches 8 Current State: Many functions Many systems Many point-to-point interfaces CSC Copyright 7/23/2010 4:24 PM

9 Potential Shared Shared Foundational NHIN Shared System Management Enrollment Lab Provider Directory NHIN Gateway Subject Discovery Info. Exchange Eligibility Check HER Interfaces Record Locator Messaging Demographic s State Service- Msmt Registry Immunization Validation Analysis & Reporting Registry EMPI Event Log Claim Clinical Data Financial Documents CSC Copyright 7/23/2010 4:24 PM

10 SAIF Value Proposition : Working Interoperability C D E A -- F: trading partners A B Component Component Agree on Platform -Specific view Agree on Platform-Independent view Agree on Conceptual view F Agree on Reference view Interoperability: the deterministic exchange of data/information in a manner that preserves shared meaning Two trading partners interoperate based on a certified level of shared compliance to interoperability specifications/standards Certified level of conformance determine degree of automated interoperability that is possible and/or difficulty of the transformations that are required to enable interoperability CSC Copyright 7/23/2010 4:24 PM

11 Many Aspects of Quality Measurement, Payment Reform, and Health IT Must Work Together to Improve Care Measurement and Data Collection Meaningful Use of Health IT Increasingly sophisticated, patient-centered information about quality, costs, and care experience Payment Reforms/Incentives Health IT and Interoperability Standards Availability of Electronic Clinical Health IT Systems CSC Copyright 7/23/2010 4:24 PM

12 Systemic Reform: Innovation Prescription Isolated Best Practices General Hospital Systemic Reform Physician Practices Affordable Care Act (2010) Your Transform Plan- Aligned. Personal Health Business Model Innovation Population Health To-Be new Health Business Models Intuitive Medicine: Empirical Medicine: Precision Medicine: Outside and Inside Innovation: Focused Models CSC Copyright 7/23/2010 4:24 PM

13 Schools Family Courts Substance Abuse Treatment Centers Healthcare Providers SAC WIS State Department of Vital Statistics Juvenile Courts Immunization Registry Medicaid Alignment can link Health & Human Working to improve health and human services to citizens through an information-driven enterprise Business Process Improvement Areas Enrollment and Coordination of Benefits Improving to Children Population Health Reporting Local/State/Federal/Private Information Exchanges SSA CHIP IRS School Breakfast Program Newborn Metabolic Screening TANF PRIVATE (Provider, Citizen) LOCAL-COMMUNITY Common Local Common Local Business Processes Social Workers Local Child Welfare WIC Common Provider Common Provider Business Processes COMMON VIEW SNAP Head Start Labs Newborn Hearing Screening Child Child Care Support Enforcement Foster Care School Lunch Program STATE Common State Common State Business Processes Common State Information Model FEDERAL Common Federal Common Federal Human Processes Provide the Foundation to Support Business Priorities Business and Framework Federal Health Information Model Performance Management CSC Copyright 7/23/2010 4:24 PM

14 Moving the Needle within 30 months: Agile Architecture and Rapid Development Improved Quality & Efficiency Care Delivery System Payment Provider Reform Feedback & Measurement HIT Foundation: Meaningful Use of EHR & HIE s Communities- Grants and Pilots.Looking for Innovations aligned to Goals CSC Copyright 7/23/2010 4:24 PM

15 Key aspects of an integrated environment: Capabilities with Coordinated Views of each Business Challenge with a 360 Citizen-Client-Caseworker at the Center Provider View Business Challenges Common View Local- Community View Citizen-Client & Family State View Citizen View Federal View CSC Copyright 7/23/2010 4:24 PM

16 Strawman Health and Human Business Capability Categories: Human Health and Human Business Service Categories Eligibility and Enrollment Health Human Common Ground, and Shared Policy, Reporting, Oversight and Research Aging and Disabilities Behaviorial Health and Crisis Management Children, Youth, and Family Public Health Special Needs Housing Provider Management Common Ground Business Member-Client Management Care and Service Mgmt Program-Integrity Accountability Management CSC Copyright 7/23/2010 4:24 PM

17 Business Areas Alignment defining Cross Boundary Business Operations Models: Finding Common Ground Process 1. Strategy and Concern Maps: Priorities State & Local Communities: State Architecture NASCIO MITA Self Assessment & HHS Business Architecture Common Ground: Common State HHS Aligned with Fed NIEM NHIN MITA FHA Transform CONNECT Federal: FEA HHS EA NIEM NHIN MITA FHA Transform CONNECT 2. Business Process Artifacts-Entity-Access Policies and Process Alignment CSC Copyright 7/23/2010 4:24 PM

18 Starter Kit: Support the Range of Organizations with a Family of Health Enterprise Transformation: Tailored EA-SOA Shared in Cloud Enterprise Transformation for Health Care Reform: From Fragmented to Loosely Coupled Big Org Change COTS partners Shared Light Linking Key Shared Provider Mgmt Data Mgmt Msmt Mgmt Assurance: Service Factory HIE Node in Cloud Small Org Changes IdM-Security- Consent-Compliance CSC Copyright 7/23/2010 4:24 PM

19 Strawman Health and Human Business Capability Categories: Human Health and Human Business Service Categories Eligibility and Enrollment Health Human Common Ground and Shared : Policy, Reporting, Oversight and Research Aging and Disabilities Behavioral Health and Crisis Management Children, Youth, and Family Public Health Special Needs Housing Training Programs Fed Business Capabilities State Business Capabilities Local- Community Business Capabilities Feds lead Alignment with Stakeholders Provider Business Capabilities Series of Capability Templates Created CSC Copyright 7/23/2010 4:24 PM

20 Enablers and Barriers Enablers It makes sense. The technology-standards are there- (privacy still being worked but much better than last year) NIEM/NHIN converging and many other related standards Many excellent examples of small to medium interoperability Some models for Cancer Research, Public Health.. Lots of financial transactions. Barriers But means you have to talk across boundaries fragmentation is strong Not well known and Health has often been isolated from the many other interoperability- we are different. Distribution of knowledge- some real leaders but huge gap - Crossing the Chasm and becoming mainstream CSC Copyright 7/23/2010 4:24 PM

21 Is the technology ready? Are we ready? Good libraries of basic services and push for more open source for health issues.adapters that can be shared Interoperability- HL7 and OMG others working together Office of National Coordinator don t need to solve everything attitude and phased approach..niem/nhin and Health Interoperability Model Business Architecture and tie in Performance Architecture- Dashboards Business Artifacts/ BEDL..IBM and others SOA- SOAML, Model Driven Message Interoperability (MDMI) Patterns and Architecture need to be shared and leveraged CSC Copyright 7/23/2010 4:24 PM

22 Cloud Computing Partnership Trusted Cloud CSC Enterprise Cloud Management (Orchestration) Integration Fault Tolerance Disaster Recovery Master Data Management SLA Management Security Administration Transaction Logging Service-Oriented Architecture (SOA) Business Process as a Service Software as a Service Platform as a Service Infrastructure as a Service Provisioning Auditing Billing Monitoring ITIL Compliance Identity Authorization Federation Single Sign-On Policy Administration Policy-Based Access Mgmt. Directory will require orchestration, integration, monitoring, SLA management, security, monitoring, master data management, auditing, metering, billing, and so much more CSC Copyright 7/23/2010 4:24 PM

23 Cloud Computing Partnership Power of Choice: Software + SERVICES Many Choices: Some Standards CSC Copyright 7/23/2010 4:24 PM

24 Information Assurance is Cloud-Complicated, CSC TRUSTED Clouds CLOUD are cloudy VISION Requirements As visibility is lost Where is the data? Who can see the data? Who has seen the data? Is data untampered? Where is processing performed? How is processing configured? Does backup happen? How? Where? Security, compliance, and value are lost as well CSC Copyright 7/23/2010 4:24 PM

25 A Cloud That A TRUSTED CLOUD harmonizes the security for transactions and data with comprehensive transparency of control and result such that conveys evidence-based confidence that systems within its environment operate as advertised, and that no unadvertised functions are occurring Is A Trusted Cloud rendered via a Trusted Cloud are Trusted Cloud The generation of new enterprise value with Trusted Cloud is an application of Digital Trust CSC Copyright 7/23/2010 4:24 PM

26 ORCHESTRATION Translation CORE of Business Needs to Trusted Cloud Service Delivery 1. Trusted Cloud Service decision support Trusted cloud services business needs analysis and recommendations (CloudAssist) 2. Orchestrator of Orchestrators The automated arrangement, coordination, connection, and accountability for individual cloud service contributions Business and technical needs integration knowledge CloudTrust Protocol Trusted Cloud Private Cloud... CSC Copyright 7/23/2010 4:24 PM

27 Information Centric Security Solutions Content INFORMATION RIGHTS MANAGEMENT Centralized Document Access Control Revocation (Digital Shredding) Document Activity Monitoring and Audit Applications IDENTITY AND ACCESS MANAGEMENT Identity Administration Directory Access Management DATABASE SECURITY Activity Monitoring Access Control and Authorization Encryption and Data Masking Databases CSC Copyright 7/23/2010 4:24 PM

28 Defining a Transparency-Msmt Shared Cloud Technology Roadmap: Boundaries and Policies for Sharing Consumer Information- Insurance Exchange in Cloud Comparative Data-Effectiveness in Cloud OR & Performance Improvement Tools in Cloud HIE in Cloud Partner-Policy Hybrid Profiles Registry-Data Collection-Msmt In Cloud CSC Copyright 7/23/2010 4:24 PM

29 Defining a Common Ground Shared Cloud Technology Roadmap: Boundaries and Policies for Sharing Consumer-Client Benefit Recommender Enroller- Tracking in Cloud Care and Service Management in Cloud Decision Options For Consumer in Cloud HIE with Service Registry in Cloud Partner-Policy Hybrid Profiles Provide Management Registry- Support In Cloud CSC Copyright 7/23/2010 4:24 PM

30 Leveraging Standards and Open : Strategic Roadmaps to Citizen- Population Group Coordinated and Integrated Across Views: Addressing Aligned Concerns Review Many pilots: Look for Integrated Results Foster Integrated Pilots and Demo Experience Gather-Select Early Results Legislative Reform Vision Focused Concerns Payment Changes: Mega Outcomes Adopting EHR s and Meaningful Use Changes Information Commonality and Quality Improvement HSSP Align with Current Fed Health Strategy & FHA Population Focused and Practice Changes Target Vision: Open Innovation Roadmap Engage State-Local- Provider Communities Gather Concerns: Continuing to Engage Community- Filling Gaps CSC Copyright 7/23/2010 4:24 PM

31 Contact Information: John Dodd Thanks CSC Copyright 7/23/2010 4:24 PM