1. Oklahoma State Department of Health (OSDH) August, 2008

2. OSDH Messaging Group  Messaging Project Director  Peter Lemmon (50%)  Email peterl@health.ok.gov  Message Coordinator /DBA  Allen A. Badgett Ph.D. (100%)  Email allenb@health.ok.gov  Message Developer  Wendy Zhou (100%)  Email wendyz@health.ok.gov

3. Original Production  Messages from two sites.  LabCor and DLO (Quest)  Transmission  Sending PHINMS 2.1  Receiving PHINMS 2.1  Translators  eWebIT 3.0.5 two for LabCorp (CDC)  eWebIT 3.0.5 two for DLO (OSDH)  Database  SQL 2000 database

4. LabCorp Message Characteristics  LabCor  HL7 2.3.1 message sent using PHINMS 2.6  Message received using PHINMS 2.1 (OSDH)  Message sent as batch file usually in the evening  Message is translated using eWebIT 3.0.5  Two Translators created by CDC  Data inserted into SQL 2000 database

5. DLO Message Characteristics  DLO (Quest)  ASCII file inserted into directory by DLO  ASCII file translated to HL7 2.3z then HL7 2.3.1 eWebIT 3.05  Two translators created by OSDH  HL7 2.3.1 message sent using PHINMS 2.1  Batch file morning  Message received using PHINMS 2.1 (OSDH)  Message is translated eWebIT 3.0.5  Data inserted into SQL 2000 database

6. Original OSDH Production

7. Problems with Existing Messaging structure Messaging platform is fragile, requiring numerous reboots. Problems handling simultaneous messaging PHINMS/eWebIT components were no longer supported System had become “black box” Server contention with other large jobs, like EDI billing

8. Reasons to Update Existing Messaging Structure To move toward standard PHIN v2.5.1 ELR message To direct program-specific messages to individual programs instead of main surveillance system To move toward sending standard PHIN v2 messages Needed to move to at least PHINMS 2.6 to add messaging partners:  Receive Cancer Registry messaging  Exchange immunization messaging  Regional Oklahoma labs.

9. Messaging Project (1)  Develop overall messaging architecture for OSDH  Review domain structures involved in messaging  Upgrade all existing messaging software  PHINMS 2.1 to PHINMS 2.8  eWebIT 3.0.5 to eLink 4.6  Migrate to new messaging servers  Test

10. Messaging Project (2)  Migrate from using eLink Translators  Move to MSS (NBT & Rhapsody)  Review existing routes for Rhapsody (ARUP)  Develop mapping expertise  Move to production

11. Messaging Architecture for OSDH  Transmission  PHINMS (depends on sending facility)  Reception  PHINMS 2.8  Translation  eLink 4.6  Data Storage  SQL 2000 (moving to SQL 2005)

12. ELR Sending

13. OSDH Proposed Messaging Architecture

14. Message types  Immunization  Asynchronous batch file now, move to synchronous  In development (OK route)  Cancer Registry  Receive pathology reports  ARUP  HIV, STD, Hepatitis  Regional and Specialty Medical labs  In development  Current ELR messages (LabCorp and DLO) *HL7 2.3.1

15. OSDH Proposed Messaging Architecture

16. Software Upgrade  PHINMS 2.1 to 2.7 - Complete  PHIMS 2.7 to 2.8 - Complete  Install and configure Rhapsody 2.4.5 -Complete  Install and configure MSS 2.1 - Complete  Upgrade eWebIT 3.05 to eLink 4.6 -Complete

17. PHINMS Upgrade  PHINMS 2.1 to 2.7 - Complete  Personnel change from 2.1 installation  Poor documentation  Multiple copies of old files  PHIMS 2.7 to 2.8 - Complete  Relatively easy  PHINMS 2.8 fine tuning  Confusion with Database drivers

18. Rhapsody (ARUP)  Install Rhapsody 2.4.4  Successful  Database drivers and permissions  Upgrade to Rhapsody 2.4.5  Some port issues  Successful  Review and modify ARUP  Initial development complete  Modification for Oklahoma needs  A thank you to Rob Byers from Idaho

19. eLink 4.6 Upgrade  Upgrade eWebIT 3.05 to eLink 4.6 -Complete  Issue of backing up existing translators on eWebIT  Solved problems with source code  Installed eLink 4.6 on new production server  Used backup files to restore translators in 4.6  Modifications needed for new environment  Some directory confusion from eWebIT

20. MSS 2.1  Install and configure MSS 2.1  Some issues with ports and Permissions  Completed  Analyze Idaho route  Completed  Modify Idaho route to OK route  Thanks to Robbin, Trico, Sydney and Fred  Rhapsody OK route  ELR to PHINMS to MSS(NBT Rhapsody) to eLink to PHIDDO  Development  Use OK route for immunization information from IHS  Development

21. Current Challenges  Completion of OK route  Pass message to eLink translators  Pass message to local component  Minor adjustments to PHINMS/MSS/SQL  This is a moving target but we are making progress  Mapping local vocabulary  Next major challenge  Complete move of remaining elements to production

22. Thank You  OSDH and Keith Lindsay for ongoing support  The MSS support group of Robbin, Fred, Sydney, Liz and Gong  The PHINMS support group of Lawrence and others  Rob Byers of Idaho who saved us months of work we hope to reciprocate.  CDC for continued support  The messaging group at OSDH is willing to share what we have learned in the hopes it will save other states time and money.