1/16/2016 6:56 PM Healthcare Services Specification Project An Overview of HSSP April 2006 Ken Rubin EDS Co-Chair, OMG Healthcare Domain Task Force Co-Chair, HL7 Services-oriented Architecture SIG Ken Rubin EDS Co-Chair, OMG Healthcare Domain Task Force Co-Chair, HL7 Services-oriented Architecture SIG

Page 2 © 2006 HSSP Project, Reuse with attribution permitted Organization of Today’s Program Background / Rationale behind HSSP HSSP Objectives The Impetus for Collaboration OMG, HL7, and Operational Concerns Project Artifacts Dialog: The Value of Participating

Page 3 © 2006 HSSP Project, Reuse with attribution permitted Project context: Why was HSSP created? Several large provider organizations were each facing challenges in integrating current and emerging systems –Veterans Health Administration –Kaiser-Permanente –SerAPI Project (Finland) There were a number of shared beliefs among the founding partners…

Page 4 © 2006 HSSP Project, Reuse with attribution permitted Project context: Why was HSSP created? (2) In each case… –There was active integration and development work –There was a shared belief that messaging alone was not the optimal solution –A services-oriented architecture was the target environment –It was recognized that developing “stovepipe” services would not address business challenges –There was strong commitment to standards –There was recognition standard services would further interoperability with partners and products

Page 5 © 2006 HSSP Project, Reuse with attribution permitted So, what is HSSP? An project to create common “service interface specification” standards that are tractable within healthcare IT A joint initiative co-sponsored by Health Level 7 (HL7) and the Object Management Group (OMG) Its objectives are: –To create useful, usable healthcare standards that address functions, semantics and technologies –To complement existing work and leverage existing standards –To focus on practical needs and not perfection –To capitalize on the best industry talent through open community participation and maximizing each community for its strengths

Page 6 © 2006 HSSP Project, Reuse with attribution permitted HSSP Builds Upon Existing Work Ability to Interoperate High Low

Page 7 © 2006 HSSP Project, Reuse with attribution permitted Current HSSP Priority Areas AreaScope and Rationale for Priority Terminology ServicesTo develop a comprehensive terminology specification (versioning, maintenance, query, etc.) built upon the current CTS specification. Selected based upon past precedence, ongoing work interest, and ability to validate the emerging methodology. Entity IdentificationTo manage and maintain identities within and across domains, localities, or products. Anticipated to be critical path dependency for other services; foundational work was available from HL7 and OMG. Record Location and Retrieval To discover, retrieve, and update records in distributed environments. Seen as core foundational service to support EHR and healthcare delivery with interest from many national and regional programmes. Location & Retrieval merged upon recognition that location was effective retrieval of metadata. Decision SupportTo assess data (such as patient data) and returns specific conclusions as the output. Seen as a way to significantly reduce effort required and to promote wider adoption of CDSS implementations. Selected based upon strong business need and interests and additional volunteer community.

Page 8 © 2006 HSSP Project, Reuse with attribution permitted OMG, HL7, and the Collaboration

Page 9 © 2006 HSSP Project, Reuse with attribution permitted Collaboration Rationale – Initial Thoughts… HL7 has a world-class functional community …but HL7’s strength is not service architecture HSSP project needed to leverage talent of a strong architectural community OMG has history and demonstrated leadership in service definition and SOA OMG provided the ability to interact with multiple vertical domains (pharma, manufacturing, etc.)

Page 10 © 2006 HSSP Project, Reuse with attribution permitted The Challenges Prior negative history between the two organizations HL7 and OMG had very different membership composition Drastically different processes Differing intellectual property models between HL7 and OMG Potential for added complexity by involving additional organizational dependency

Page 11 © 2006 HSSP Project, Reuse with attribution permitted Attractions about the Collaboration Allowed project to leverage each group to its core strength “Whole” better than the sum of the parts: better specs! Opportunity to broaden marketplace impact Core tenets of OMG process ensure technical viability and marketplace availability (e.g., remove the shelfware stigma) Rapid adoption model: 18 months from concept to standard Methodology embraces multi-platform standards specifications

Page 12 © 2006 HSSP Project, Reuse with attribution permitted The Result… HL7 brings… –Healthcare semantic interoperability expertise and credibility –Rich, extensive international community perspective –Diverse membership base OMG brings –distributed systems architecture and modeling excellence –Effective, efficient, rapid process –Premise that standards must be implemented Resulting in… –Services will be identified by the community needing them –Improved methodology resultant from functional and architectural merging of the two groups –Facilitation of multi-platform implementation and broader implementation community

Page 13 © 2006 HSSP Project, Reuse with attribution permitted The Opportunity Created... HSSP is open to any type of participant: –National, Federal, State, Local Governments –Payers, Providers, Consultants –Individual stakeholders The process facilitates each party participating to their maximum advantage –Discussions are “community of interest” focused Healthcare discussions in healthcare venue Technical discussions in technical venues Processes and results are open and available –All proceedings are published on web and listserv –Consistent multinational/multicultural participation “Guiding Principles” ensure we don’t lose sight of our objectives

Page 14 © 2006 HSSP Project, Reuse with attribution permitted Project Operational Concerns

Page 15 © 2006 HSSP Project, Reuse with attribution permitted The Approach HL7 is leading in service selection, functional elaboration, and conformance criteria OMG is leading the technical specification Both organizations jointly participating in all activities Work products are “owned” by only one organization but used collaboratively (e.g., any product is “hosted” by HL7 or OMG) “Operate as one project” is a core principle Actively seeking vendor participation Eclipse has committed to providing open source implementations IHE discussions are underway to profile and demonstrate viability of the implemented solutions

Page 16 © 2006 HSSP Project, Reuse with attribution permitted Project Organisation One overarching project with five subproject efforts Overall project –Meets at HL7 and OMG meetings –Status teleconferences biweekly –Owns responsibility for planning, marketing, etc. “Infrastructure” Subgroup –Developed and maintains methodology Subprojects –Determine their own deadlines, meeting schedules, etc. –May be hosted by other committees –Leverage project infrastructure and methodology

Page 17 © 2006 HSSP Project, Reuse with attribution permitted Timeline of Key Events 1996: First OMG Healthcare Service Spec Adopted (PIDS?) 2003: HL7 ServicesBOF formed 2004 September: HL7, OMG Collaboration MOU 2005 January: Joint Project Chartered 2005 April: Project Kickoff 2006 March: Issue Ballot for Functional Specs 2006 Q4: Technical Specs RFP (planned) 2005 September: Methodology and MetaSpecs Baselined (planned) 2005 October: Interoperability Services Workshop & Conference

Page 18 © 2006 HSSP Project, Reuse with attribution permitted 2006 HSSP Project Schedule (major milestones) Jan: Charter HL7 SOA SIG HL7UK Information Day Jul: HL7 Educational Summit Issue 4 ballots (3 + 1) Feb: Announce intention to ballot Aug: Ballot review Mar: Issue ballots for RLUS Sep: HL7 Boca Raton (Reconciliation); RLUS DSTU’s Adopted! OMG Anaheim (Issue RFPs) Apr: OMG Meeting St. Louis (RLUS RFP prep) Oct: Intent to ballot DSS, EIS, CTS2 May: HL7 San Antonio (RLUS ballot reconciliation) Nov: Issue DSS, CTS2 Ballots Jun: Announce intention to ballot (3 committee, 1 membership) OMG Boston (Issue Draft RFPs) Dec: OMG Washington (Review Initial RFP Submissions)

Page 19 © 2006 HSSP Project, Reuse with attribution permitted HSSP Project Differentiators Active participation from three continents and 15+ organizations Significant cross-cutting community involvement Providers (Kaiser, VHA, Intermountain Health, Mayo) Vendors (CSW Group, IBM, PatientKeeper, Universata) Value-added Providers (MedicAlert, Ocean Informatics, Eclipse Foundation, etc.) Payers (Blue Cross/Blue Shield, Kaiser) Integrators (IBM, EDS) Governments (Veterans Health Administration, Canada Health Infoway, HealthConnect (Australia), SerAPI (Finland)) Managing differences between SDOs in terms of membership, intellectual property, and cost models

Page 20 © 2006 HSSP Project, Reuse with attribution permitted Where should I engage? Interest Area (including representative communities-of-interest) Venue Setting functional priorities; selecting priority services (Consumers, Providers, Vendors, Integrators) HL7 Defining behaviour; service capabilities (Consumers, Providers, Vendors) HL7 Defining functional conformance/compliance criteria (Consumers, Regulatory) HL7 Technical specification, interface specification, evaluation criteria (Consumers, Regulatory, Integrators) OMG Technical conformance/compliance criteria (Consumers, Regulatory, Integrators) OMG Architectural considerations; service interdependencies, SOA (Integrators, Vendors, Implementers) OMG Product development; technical standard creation; API definition (Vendors, Implementors) OMG

Page 21 © 2006 HSSP Project, Reuse with attribution permitted References HL7 Website: OMG Website: Services Project Homepage

Page 22 © 2006 HSSP Project, Reuse with attribution permitted Thank you! Ken Rubin, EDS desk mobile

Page 23 © 2006 HSSP Project, Reuse with attribution permitted Supplemental Slides

Page 24 © 2006 HSSP Project, Reuse with attribution permitted How the priorities were determined… Based on an open selection process Brainstorming gave way to successive refinement and downselect Priorities determined by business need and resources Initial list included Terminology, Entity ID, Record Location, Record Retrieval Record Location and Retrieval activities subsequently merged Decision Support added later based upon community interest and resources

Page 25 © 2006 HSSP Project, Reuse with attribution permitted SDOs … The Impacts and Rationale of HSSP Specifications ImpactsRationale Useable standardsEmphasis on practicality Market-focused standards based on commercial implementations Shortens time required to develop specifications and encourages collaboration Promotes harmonization, cooperation, cohesion among standards communities Integration of function, data, and technology promotes leveraged reuse More members/involvement = more revenue & better specs Practical, market-focus and iterative timeline promotes participation and results

Page 26 © 2006 HSSP Project, Reuse with attribution permitted Why “services” and not “messages”?* Accepted industry best practice –A common practice in healthcare but not yet healthcare IT –Commonplace usage across “IT” outside of healthcare –Many key products use them but do not expose interfaces Services define behavior explicitly and data transport implicitly –Ensures functional consistency across applications –Furthers authoritative sources of data –Minimizes duplication across applications, reuse Services do not preclude the use of messages –Services rely upon underlying transport protocols –Messages can be used as payloads for service calls –Messaging infrastructure may be used as underlying transport *slide adapted from a Veterans Health Administration Presentation, used with permission

Page 27 © 2006 HSSP Project, Reuse with attribution permitted So, what about web services? Web services alone (e.g., SOAP/WSDL, etc) do not solve the problem: –What behaviours do we expect of an MPI? –What behaviours are not expected or should remain unspecified? –What confidence do we have that two MPIs can interoperate in an SOA intra- or inter-organization? –What about information semantics? –How will business exceptions be managed across instances? These issues are not addressed via selection of SOAP/WSDL as a platform These issues are not entirely addressed via Web Services as an ITS

Page 28 © 2006 HSSP Project, Reuse with attribution permitted Overview of Key HSSP Artefacts Service Development Framework (SDF) –Methodology describing the services specification process –Integrates life cycle across HL7 and OMG with callouts to existing processes (such as ballots) –Version 1.0 Baselined in January 2006 (HL7 Phoenix) Service Functional Model (SFM) –Describes in business terms the behaviour of the service –Identifies relevant information content (e.g., RIM-derived artefacts, terminologies, etc.) –Technology independent –Includes conformance profiles RFPs Submissions

Page 29 © 2006 HSSP Project, Reuse with attribution permitted The SFM and Leveraged HL7 Content The SFM: –identifies relevant semantics (including HL7 RIM-derived content, terminologies, constraints, etc) Note: HSSP does not expect to be adding RIM content. When shortcomings exist, the work will be directed to the appropriate existing HL7 Committees. –includes a section to cite existing external work and explain its relevance –has a traceability matrix to the EHR Functional Model and Standard –expressed behaviours are intended to be explicit representations considering HL7 Application Roles, Interactions, etc. –conformance profiles are one mechanism of addressing localization concerns and implementation variations

Page 30 © 2006 HSSP Project, Reuse with attribution permitted Why Participate in HSSP? Relentless focus on added business value for healthcare and project participants –focused on and driven by business-need –not an “academic exercise” striving for perfection –Acknowledgement that standards must be used to be useful –Emphasis on practical, achievable, & marketplace-relevant Without these standards, we’re building “service stovepipes” Aggressive timelines encourage progress Assembled community of top industry talent Project structure promotes targeted participation

Page 31 © 2006 HSSP Project, Reuse with attribution permitted Why participate in Standards? This is happening—the only way to influence the outcome is to engage Prime opportunity to directly engage with complementing stakeholder groups (provider-to- vendor, vendor-to-payer, SDO-to-SDO, etc) Benefit from “lessons learned” from others Reduce design burden Significant networking opportunities Establish/maintain market presence as thought-leader