HL7 Roadshow 2009 Connected Healthcare

HL7 Roadshow 2009Connected Healthcare Jose Sueiras, March 2009

Integration solutions using Ensemble HealthShare. Building an EHR CSC - TIE Trust Integration Engine Implementing Spine Compliance i.e. TrakCare

InterSystems Integration Technology • HL7 Features • Schemas. Virtual documents. Message Router (Rules). • Integration platform. • Adapters, BPM, Data transformation. • Management, Monitoring.. • Database / Application Server OO. • SOAP,XML,EJB,COM… • ODBC, JDBC HL7 Ensemble Cache

Healthshare Gateway Healthshare Gateway Healthshare Gateway ECR ECR ECR HealthShare. Architecture Hospital/CHC CIS RIS HIS Etc. Healthshare Hub EMPI EMR LIS Physician's Practice Laboratory

Regional & National EHR GP 1 Viewer RAD EMPI Point of Care LAB GP 2 EMPI HUB Hospital PAS Edge Gateway GP 3 Gateway OPR Edge Gateway Clinic A & E Repository I C U Edge Gateway Edge Gateway Clinical Repository

HealthShare – The Components • One shared resource for the exchange. • Primarily responsible for managing identifiers (EMPI) Many distributed resources across the exchange Provider portal for querying the exchange and viewing results Hub • Many distributed resources across the exchange • Primarily responsible for managing data collection & caching Edge Gateway Access Gateway

Main Features • Patient Identity Management • Identity Hub as clinical record locator • Identity Policy and Service most commonly centralised. Fuzzy logic algorithms. • Use of (existing) national numbers (Social Security Number / NHS number) • User Provisioning & Consent • User Access and Consent policy and service is typically centralised • Access/Consent policy not typically defined / controlled by those who need to use the systems • Clinicians may perform different roles at different times in different facilities. • Time-based nature of “legitimate user relationship” & “consent” • Integration of Smartcards and biometrics • Requirement for tamper-proof audit and governance databases / message archives • Data aggregation / normalization • Variable quality of data source systems • Data Capture – push/pull • Structured & Unstructured data • Coded / Non-Coded data – differing coding regimes & purposes • Numerous (converging) Standards for Normalisation • CCR, CDA, CCD

InterSystems Ensemble Trust Integration Engine (TIE) • Connecting applications in the Trust with the applications supplied by CSC • Integrate applications within the Trust. (Upgrade)

CSC Data Message Architecture TIE TIE TIE TIE TIE TIE TIE Spine Messages Data Message Hub Central Trust DB

CSC Data Message Architecture Ensemble Ensemble Ensemble Ensemble Ensemble Ensemble Ensemble TIE TIE TIE TIE TIE TIE TIE Spine Messages Data Message Hub Central Trust DB Ensemble

TIE. Ensemble Production Client Applications HL7 Business Operations HL7 Outbound Adapter External Applications HL7 Inbound Adapter HL7 Business Services HL7 Business Processes HL7 Message

Plymouth Hospitals NHS Trust Ensemble

“Spine Compliant”. CFH Definition Patient Demographics Service (PDS) Access/Update “PDS Compliance” patient demographics NHS Number Access Control Framework (SDS, SSB) “IG Compliance” Authentication. Authorization EBXML/HL7V3/MIM Transaction Messaging (TMS) Basic Connectivity (N3) NPfIT services. Firewalls/routers

“Spine Compliant” CFH Definition. NHS Acute/ Community/ Mental Health or ISTC EPR/PAS Community Pharmacy Urgent Care Choose and Book (CAB) NPFIT-FNT-TO-TIN-1032 Electronic Prescriptions NPFIT-FNT-TO-TIN-1050 Summary Record NPFIT-FNT-TO-TIN-0830 GP System Summary Record NPFIT-FNT-TO-TIN-0830 GP2GP Transfer NPFIT-FNT-TO-TIN-0402 Electronic Prescriptions NPFIT-FNT-TO-TIN-1050 Choose and Book (CAB) NPFIT-FNT-TO-TIN-1032 PDS/IG Compliance (PDS = NPFIT-FNT-TO-TIN-1023, IG = NPFIT-FNT-TO-TIN-1031)

“Spine Compliant”. CFH facts • It takes about 9 – 12 months to “become compliant” from scratch • “Compliance” is specific to a functionality, spine version and supplier software version – not a general status • Spine Compliance must be maintained – it is not static

Ensemble. Spine FW • Web services and ebXML toolkit. • XML – Object mapping • BPM capabilities • Message patterns • Alert generation. Error handling workflow • Data transformation. • HL7 2.x schemas. Hl7 v3 • Storage • Guarantee message delivery. • SDS Cache • Monitoring. Management

Ensemble based solution for TrakCare PDS and C&B compliance. Authentication and authorization process integrated in a single sign on architecture. Smart cards TrakCare is easily configurable to interact with other systems using HL7 v2.x messages Use Ensemble to implement a MHS that will talk to TRAK using HL7 v2.4

Ensemble based solution for TrakCare Spine Ensemble. MHS Routing DTL ebXML W.S. TCP TRAKCare BPM WF Errors HL72.4 HL7 Version 3 SDS Cache

Spine. Iteration example Intermediary MHS Ensemble MHS TRAK Request Available Slots PRSC_IN080000UK07 / ebXML Persist MCCI_IN010000UK13 / ebXML ACK 2.4 SQM_S25 / TCP 2.4 SQR_S25 / TCP Persist Respond Available Slots PRSC_IN090000UK09/ ebXML Persist MCCI_IN010000UK13 / ebXML ACK Message Processing

Conclusions • Ensemble is a versatile integration platform • Unified development environment that promotes rapid development • Especially suited for healthcare • HL7 and other standards • High performance solutions at different scales

Questions? Questions?? • jose.sueiras@interSystems.com • www.intersystems.co.uk/TIE

HL7 Roadshow 2009 Connected Healthcare