CONNECT: SOA for Healthcare
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1 CONNECT: SOA for Healthcare
2 A Nation s Call to Action We ll be on our way to computerizing all of America s medical records, which won t just eliminate inefficiencies, save billions of dollars and create tens of thousands of jobs but will save lives by reducing deadly medical errors. President Barack Obama, February 4,
3 The Current State of Affairs: A Disjointed, Expensive Healthcare System U.S. spent approx. $2.2 trillion on health care in 2007 ($7,421/person). This comes to 16.2% of GDP, nearly twice the average of other developed nations. (Source: Only about 8% of the nation's 5,000 hospitals and 17% of its 800,000 physicians currently use the electronic health record (EHR) systems envisioned for the whole nation. Most of today s systems are still not interoperable. (Source: CNN) Due to lack of interoperable EHRs, tests are duplicated, information is unavailable at the point of care, public health information is difficult to track and health organizations carry a heavy administration burden. 3
4 The National Health IT Agenda The American Recovery and Reinvestment Act (ARRA) invests $19 billion in computerized medical records that will help to reduce costs and improve quality while ensuring patients privacy. ARRA promotes the national agenda by helping: Increase access to care Improve quality of care Decrease the costs of care Promote meaningful use of EHRs ARRA and the President s reform agenda focus on building open and transparent government. 4
5 Federal Health Architecture Advancing the Agenda FHA ensures federal participation in ONC-led initiatives such as the NHIN, NHIN Direct, EHR adoption, and CONNECT E-gov initiative managed by ONC within HHS 26+ federal agencies participate in FHA 5
6 CONNECT Meeting Multiple Objectives CONNECT promotes the widespread adoption of interoperable health IT. It uses nationally recognized standards, conventions and trust agreements, to address multiple complex objectives simultaneously. CONNECT is a federally funded, Open Source software solution that is a: Platform for Participation Platform for Innovation Reform Objectives Transparent Government Objectives Meaningful Use Objectives 6
7 NHIN/CONNECT Implementation Status Federal Adopters Centers for Disease Control & Prevention Centers for Medicare & Medicaid Services OFM (esmd) OCSQ (PQRI) OCSQ (C HIEP) CMSO (MITA Claims Submission) Department of Defense Department of Homeland Security Department of Veterans Affairs Food and Drug Administration Federal Communications Commission Indian Health Service National Cancer Institute National Disaster Medical System Social Security Administration Test/Demo * * Production CONNECT and NHIN * Planned
8 NHIN/CONNECT Implementation Status Non Federal Adopters Center for Healthy Communities, Wright State University, Healthlink Central Virginia Health Network/MedVirginia Community Health Information Collaborative (CHIC) Emdeon EPIC HealthBridge Indiana State Department of Health Iowa Department of Public Health Iowa Health Systems Kaiser Permanente MedVirginia MEDNET in Partnerships Community Health Information Collaborative (aka HIE Bridge) LACIE Lewis and Clark Information Exchange Emdeon Hielix Phase 1 Contract for the State of North Dakota Statewide HIE New York State Department of Health Orange County ER Connect Redwood MedNet Regenstrief Institute, Inc. Southeastern Michigan Health Association Thayer County Health Services Washington State Department of Health Test/Demo * 2009 Production * * * * * CONNECT CONNECT and NHIN * Planned
9 Vendors Solutions with CONNECT Reflection Technologies 9
10 CONNECT as SOA Scope: The focus has been on the secure interoperable exchange of health information between organizations Systems Inventory: EHRs, PHRs, Practice Management Systems, Lab Systems, Pharmacy Systems Services Inventory: The NHIN Service Specifications 10
11 NHIN Exchange Specifications and Operational Infrastructure Transaction Profiles Utilize exchange patterns for specific transactions CMS CARE Doc Submission CDC GIPSE HIEM MITA Eligibility Verification Patient Discovery Discovery and Information Exchange Services Rely on foundations to enable exchange patterns Discovery Pull Push Pub/Sub Services Registry Query & Retrieve Docs Eligibility Verification Doc Submission Messaging, Security, & Privacy Foundations Enable private, secure, and interoperable communication of health information HIEM Messaging Platform Authorization Framework Access Control Policy Operational Infrastructure Runtime systems that support the NHIN Limited Production Exchange Security Infrastructure (managed PKI) Web Services Registry
12 12 CONNECT Architecture Message from NHIN
13 13 CONNECT Architecture Message to NHIN
14 CONNECT Adapter: Organizational SOA Starter Kit Enterprise Service Components: Master Patient Index Policy Engine Redaction Engine Audit Services Document Registry/Document Repository Subscription Repository Re-identification Service Entity Integration Services SDK Services 14
15 What s cooking for CONNECT 3.1? CONNECT Core Gateway Refactoring Java Library Architecture Enhancements Separation of Web Services and Business Logic via component proxies in Spring Framework Enables CONNECT portability to many environments in the future Enables the use of other technologies in the future e.g. REST, XMPP, SMTP, etc Improves CONNECT performance when adapter and gateway reside on the same machine. Reduces the number of web service calls Deferred Document Retrieve and Query Services 15
16 What s cooking for CONNECT 3.1? Large Image and File Transfer (LiFT for Document Retrieve Large File Support for Document Retrieve Logging Enhancements Administrative Distribution Service Support for Secure and Unsecure connectivity between the Adapter and Gateway Performance Testing Enhancements Automate Performance Testing as part of testing suite 16
17 Work anticipated in CONNECT 3.2 Support for pluggable protocols and dynamic protocol negotiation Support for NHIN Direct Emerging Services for Resource Management/Logistics Emerging Services to support Meaningful Use and Health Care Reform Identity Management Services Semantic Services 17
18 18 CONNECT Community Portal connectopensource.org
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