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Healthcare Services Specification Project The Business Case and Importance of Services October 2005 HL Healthcare Services Specification Project The Business Case and Importance of Services October 2005 HL 7 Services Specification Project Workgroup OMG Healthcare Domain Task Force 3/15/2018 12: 42 PM

Background • This presentation represents the collective input and thinking from the collective participants Background • This presentation represents the collective input and thinking from the collective participants involved in the Healthcare Services Specification Project. • Represented were members from – Object Management Group (OMG) – Health Level Seven (HL 7) – Integrating the Healthcare Enterprise (IHE) • This presentation is intended to describe the purpose, role, and importance of industry-standard service interface specifications Page 2

Why “common services” and not just “messages”? * • A common practice in healthcare, Why “common services” and not just “messages”? * • A common practice in healthcare, just not yet in healthcare IT • Many key products use them but do not expose interfaces • Ensures functional consistency across applications • Accepted industry best practice • Furthers authoritative sources of data • Minimizes duplication across applications, reuse • Messages can be either payloads in or infrastructure beneath services • Service-oriented architecture is just automation of common services *slide adapted from a Veterans Health Administration Presentation, used with permission Page 3

What is the Healthcare Service Specification Project? • An effort to create common “service What is the Healthcare Service Specification Project? • An effort to create common “service interface specifications” tractable within Health IT • A joint standards development project involving Health Level 7 (HL 7) 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 industry talent through open community participation Page 4

Where would these specifications be used • Inter-Enterprise (such as NHIN, RHIOs, LHINs) – Where would these specifications be used • Inter-Enterprise (such as NHIN, RHIOs, LHINs) – By functionally specifying behavior, roles between applications and products are clarified, and the technologies supporting them can be profiled and sharpened • Intra-Enterprise – Standardization on functionality allows for better integration of off-the-shelf and custom development environments, and promotes more of a “plug and play” environment • Intra-Product – Facilitates vendors ability to integrate third-party value-add components and speed design phase with higher confidence • Custom-Implementation – Affords organizations wishing to custom-develop the opportunity to later integrate off-the-shelf Page 5

The Approach • HL 7 to lead in service selection, functional elaboration, and conformance The Approach • HL 7 to lead in service selection, functional elaboration, and conformance criteria • OMG to lead in technical specification • Both organizations jointly participate in all activities • Work products will be “owned” by only one organization but used collaboratively • “Operate as one project” as a principle • Actively seek vendor participation • Engage IHE community Page 6

The Value of Collaboration • HL 7 brings… – Healthcare semantic interoperability expertise – The Value of Collaboration • HL 7 brings… – Healthcare semantic interoperability expertise – 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 7

High Ability to Interoperate Context of HSSP Specifications Low Page 8 High Ability to Interoperate Context of HSSP Specifications Low Page 8

HSSP Stakeholder Benefits and Impacts Page 9 HSSP Stakeholder Benefits and Impacts Page 9

For Product Consumers and Users… The Impacts and Rationale of HSSP Specifications Impacts Rationale For Product Consumers and Users… The Impacts and Rationale of HSSP Specifications Impacts Rationale Promotes deployment ease and flexibility Specifications will support multiple topologies Consistency at the interface level assures asset protection Standard interfaces means that conformant components are substitutable Multiple vendor product use/ interoperability Using compliant products means side-by-side interoperation of multiple product offerings Increased buyer/product offerings Consumer demand will create increased marketplace competition Facilitates integration Unity in purpose and consistency in interface eases integration burden Time to market Availability of an industry-accepted component interface eases product development burden Requirements definition – influence vendors in a direct way Participation by provider and payer community is direct expression of business need Lower cost = wider deployment = higher quality service Page 10

Product Vendor … The Impacts and Rationale of HSSP Specifications Impacts Rationale Market opportunity Product Vendor … The Impacts and Rationale of HSSP Specifications Impacts Rationale Market opportunity – ability to grow business / “Grow the pie” Standardization of interfaces eases cost-of-entry to markets Conformance adds legitimacy to product offering Consumers view conformance as a confidence metric Reduced time and cost to market Ability to reuse design ideas, incorporate off-theshelf components into value-add offerings • Use of 3 rd party components • Simplify / reuse of design Participation provides the ability to influence the standard You can shape the standard to be supportive of your product architecture Page 11

Regulatory/Policy/Legislative … The Impacts and Rationale of HSSP Specifications Impacts Rationale Establishing objective assessment Regulatory/Policy/Legislative … The Impacts and Rationale of HSSP Specifications Impacts Rationale Establishing objective assessment criteria: Inclusion of rigorous conformance assertions benefits compliance and verification Measurement criteria for regulatory compliance Allows for technology change within the regulation Concurrent support of multiple technologies allows for technology evolution Offering an easy/easier solution that is HSSP integrates function/ behavior, data, complete and actionable / ease the path and protocol promoting an integrated solution to adoption: set How do we “Pick the winning horse”? “Opportunity cost” of using the wrong standard has big implications Solution that complements existing standards HSSP is using HL 7 semantics, OMG processes, IHE testing, and established technology protocols Page 12

Research … The Impacts and Rationale of HSSP Specifications Impacts Rationale Promotes accessibility to Research … The Impacts and Rationale of HSSP Specifications Impacts Rationale Promotes accessibility to “raw” information Strong emphasis on semantically rigorous data and query/retrieval Enabler for collaborative studies, e. g. de-identification, retrieval, etc. Leveraged use of identity service enables deidentification Enlarges cell and sample sizes based on interoperability Facilitates responsiveness to biosurveillance requirements Standard interfaces accommodate dynamic and emerging strategies and tools Enables construction of higher-order service stacks with less investment Composable nature of services promotes construction Page 13

Implementer/Integrator … The Impacts and Rationale of HSSP Specifications Impacts Rationale Reduced integration time Implementer/Integrator … The Impacts and Rationale of HSSP Specifications Impacts Rationale Reduced integration time and cost resulting from the use of standard tooling Use of standard in off-the-shelf tools facilitates their use Risk mitigation (skill portability/ training advantage, vendor independence, substitutability) By training staff in the standard, skills are portable across tools Creates a value offering opportunity based on the ability to deliver using these service standards Allows staff and solutions to build upon the use of the standard and not technologies Improved ability to deliver and support interfaces that have been implemented Using services speeds project design phases and promotes reuse Page 14

SDOs … The Impacts and Rationale of HSSP Specifications Impacts Rationale Useable standards Emphasis SDOs … The Impacts and Rationale of HSSP Specifications Impacts Rationale Useable standards Emphasis 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 15

Reference Examples • Mass Clinical Data Exchange (CDX) • RHIO • Merger/acquisition • Public Reference Examples • Mass Clinical Data Exchange (CDX) • RHIO • Merger/acquisition • Public health / disease reporting Page 16

What Participants are Saying… • • “Kaiser Permanente I. T. is currently transitioning to What Participants are Saying… • • “Kaiser Permanente I. T. is currently transitioning to an SOA-based approach to business and systems integration. Availability of industry standard services will bring many benefits towards this goal in terms of speed of implementation, flexibility and reduced cost. I am very pleased that both HL 7 and OMG are committed to this timely effort. ”, Alan Honey, Enterprise Architect (Principal), Kaiser-Permanente “The creation of a health Informatics infrastructure based upon a service-based architecture grounded in comparable data has the potential to improve healthcare delivery and greatly enhance patient safety. ”, Peter L. Elkin, MD, FACP, Professor of Medicine, Mayo Clinic College of Medicine • “The Medic. Alert mission – to protect and save lives – requires a repository of comprehensive medical information that comes from multiple sources for our members. Our SOA-based infrastructure demands the rich and flexible capabilities that are provided by these standard interoperable services. ”, David Harrington, CTO, Medic. Alert Foundation • “The Eclipse Foundation is pleased to support an open source project dedicated to building frameworks, components, and exemplary tools to make it easy and costeffective to build and deploy healthcare software solutions. This Eclipse Open Healthcare Framework project will leverage the Eclipse Platform developed by IBM, Intel, Wind River, Actuate, Borland, BEA, Computer Associates and others. ” Mike Milinkovich, Executive Director, Eclipse Foundation “The time is now and the place is here in this joint OMG/HL 7 project. Never before has the industry been closer to cogent, clear healthcare IT data model and service standards that can provide true interoperability in a short timeframe, with opensource implementations making availability abundant. ”, Richard Mark Soley, Ph. D. , Chairman and CEO, OMG • Page 17

Project Timeline and Roadmap 1996: First OMG Healthcare Service Spec Adopted (PIDS? ) 2003: Project Timeline and Roadmap 1996: First OMG Healthcare Service Spec Adopted (PIDS? ) 2003: HL 7 Services. BOF formed 2005 September: HL 7, OMG Collaboration MOU 2005 January: Joint Project Chartered 2005 April: Project Kickoff 2005 September: Methodology and Meta. Specs Baselined (planned) 2005 October: Interoperability Services Workshop & Conference 2006 January: Functional Specs Ballot (planned) 2006 Q 4: Technical Specs RFP (planned) Page 18

How is this project “different”? • Active participation from three continents and 15+ organizations How is this project “different”? • Active participation from three continents and 15+ organizations • Significant cross-cutting community involvement • Providers (Kaiser, VHA, Intermountain Health, Mayo) • Vendors (CSW Group, IBM, Patient. Keeper, Universata) • Value-added Providers (Medic. Alert, Ocean Informatics, Eclipse Foundation, etc. ) • Payers (Blue Cross/Blue Shield, Kaiser) • Integrators (IBM, EDS) • Governments (Veterans Health Administration, Canada Health Infoway, Health. Connect (Australia), Ser. API (Finland)) • Managing differences between SDOs in terms of membership, intellectual property, and cost models Page 19

Why should I participate? [One] • This effort is focused on and driven by Why should I participate? [One] • This effort is focused on and driven by business-need – It is not an “academic exercise” striving for perfection – Acknowledgement that for standards to be useful they must be used – Focused on the practical and achievable – Short timelines – Based upon business value and ROI • Leveraging talent from two standards communities • Up-front commitment ensures community engagement • Being run like a “project” and not a committee • Recognize participation as an investment and not an expense Page 20

Why should I participate? [Two] • This is happening—the only way to influence the Why should I participate? [Two] • This is happening—the only way to influence the outcome is to engage • Significant “networking” opportunities—you will gain access to the best and brightest in the industry and the world • 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 • Establish market presence and mindshare as industry leader Page 21

How do I Participate? • Join appropriate standards organizations – HL 7 for functional How do I Participate? • Join appropriate standards organizations – HL 7 for functional work – OMG for technical specification work – Join both • Allocate resources to actively engage in the project – Engage existing, knowledgeable resources in the areas they are working already. – Subgroups form based on industry need and priority – Teleconferences are weekly; meetings approximately bimonthly Page 22

Who should I involve? • Involve the staff that can best address your business Who should I involve? • Involve the staff that can best address your business needs: – The benefits you receive will depend upon your investment – Organizations that commit resources garner more influence and more mindshare – Your business interests are being represented by your attendees Page 23

References • HL 7 Website: • http: //www. hl 7. org • OMG Website: References • HL 7 Website: • http: //www. hl 7. org • OMG Website: • http: //www. omg. org • Services Project Homepage • http: //groups. yahoo. com/group/Services. Spec Page 24