Architecture for eHealth (Sofia) - BG.ppt · Microsoft EMEA Public Sector Представяне – Иля Фъртунов •Над 28 години в информационната

5/15/2007 10:22 AM

© 2005 Microsoft Corporation. All rights reserved.This presentation is for informational purposes only. Microsoft makes no warranties, express or implied, in this summary. 1

Архитектура за Електронно Здравеопазване

Иля ФъртуновSenior ArchitectMicrosoft EMEA Public Sector

Представяне – Иля Фъртунов

• Над 28 години в информационната индустрия като консултант, разработчик и архитект в Европа, Северна Америка, Австралия и Азия

• В Microsoft от 1993 г. като консултант и водещ архитект на сложни разпределени системи (финанси, търговия, обществен сектор) – вкл. UK Government Gateway, NHS

• Автор на публикации на Microsoft по архитектура на информационни системи (MSDN Patterns & Practices Guides)

• Водещ автор на Connected Government Framework (CGF) и Connected Health Framework (CHF)

2Microsoft Connected Health Framework

Ролята на Microsoft в Здравеопазването

Трансформиране на предоставянето на здравни услуги чрез новаторско прилагане на информационни технологии и партньорства които подпомагат развитието накоито подпомагат развитието на здравеопазването чрез интеграция на грижите за гражданите, подобряване качеството и безопасността на услугите и намаляване на разходите за здравеопазване

3Connected Health Framework

Use

rs Clinical Records

Clinical Management

Outcomes Reporting

Disease Surveillance

Delivery Transformation

Seamless Health Delivery

Patient SafetyTimely Data

Reduce Transcription Errors

Increase Clinical Governance

Трансформиране на Здравеопазването чрез Технологии

По-добри Резултати за Пациентите, Медиците и Държавата

Electronic Medical Records

HealthcarePortals

Health I f i

HealthcareAnalytics

Compliance& Reporting

Financials

Bio-Surveillance

Vaccination &Immunization

Tracking

Diseaseя за

Здр

авеопазването

CaseManagement

ElectronicReferrals

Long Term C di i

PatientSelf-Service

Remote Care& Learning

Consumer

TimeIncrease AutomationReduce Input Burden

Negate Systems TrainingConnected Health Platform

Solution Platform INFORMATION, Business & Clinical Intelligence and Reporting

Organizational Productivity INTERACTION Collaboration, Mobility, Real-Time Data, CUIINTEGRATION Interoperability,

Core Infrastructure INFRASTRUCTURE, Systems Management ,DR, IDENTITY, Access Control,

InformationNetworks

PACsSystems

Clinical DecisionSupport

ConsumerEvidence

Tracking

EmergencyResponseNetworks

Polic

yИнф

раструктура

При

ложен

и я ConditionManagement

CaregiverCollaboration

Consumer Health Channels

HomeDevices

Contain CostsReduce DuplicationFund on OutcomesMinimize unneeded

admissions

BlueprintRoadmapReusable IPReferences

Privacy Accessibility

Usability Security Standards Interop

Архитектура за Електронно Здравеопазване (Connected Health Framework) VisionДефиниране на общоприложима архитектура за системи в здравеопазването– Съвети за изграждане на сервизно‐ориентирани системи за интегрирана здравна информация и

йвзаимодействие между участниците• Приложима на ниво звено (GP, клиника), регион и страна• Ефективно използване на ресурсите с по‐голям ефект• Основана на наложили се стандарти и протоколи

– Изграждане на екосистема от съвместими решения• Постигане на краен ефект по‐бързо и по‐евтино• Референтна рамка за решения от различни партньори• По‐лесно интегриране между отделните подсистеми


Екосистема на Здравеопазването

Медици

Достнвчици на

МедицинскаНаука

ГражданиПациенти

Услуги

СтратегияЗакониПравила

Спонсори и Застрахо‐ватели

Наука


5/15/2007 10:22 AM


Здравеопазването е Сложна Система

• Здравеопазването се различава от други сложни системи:– Работните процеси силно варират и често се променят– Множество резултати, трудни за предвиждане– Използването на системите зависи от предпочитанията

бна потребителите и съществуващата практика– Системите трябва да се адаптират към реалните условия и постоянно променящата се среда

• Connected Health Framework отчита тези проблеми и ги решава чрез:– Отделяне на по‐динамичната част от системата (работни процеси и начини за ползване) от стабилната част (основни функции и структура на данните)


Connected Health FrameworkBusiness Framework

• Използва сервизно‐ориентиран подход за да:– Дефинира функционалните (бизнес) компоненти и основните обекти за даннитеПредлага набор от “услуги” (services) които могат– Предлага набор от услуги (services) които могат да се комплектоват в различни набори да поддържат променящите се работни процеси

– Използва максимално съществуващите източници на информация и функции

• Предлага Business Pattern for Health


Business Framework


Connected Health FrameworkTechnical Framework

• Анализира вариантите за решаване на общите архитектурни проблеми:– Множественост на услугите, източниците на данни и интегрирани системи

– Идентификация и управление на пациентите и медицинския персонал

– Интегриране на разнообразни системи и платформи– Гъвкавост и настройване към промените– Безопасност и сигурност– Мащабиране, капацитет и надеждност

• Предлага Reference Architecture for Health


Technical FrameworkCommunication

Operations Management

Security

Collaboration, Presentation and Point of Access, Identity Management, Privacy and

Security Services

11

Security Services

Service Publication and Location

Shared Services

System Management Services

Communication Services

Data Services

Connected Health Services HubIntegration Services

Connected Health Framework ArchitectureCommunication


Security

Collaboration Services

Presentation and Point of Access Services

Identity Management Services

Privacy and Security ServicesUser Processes AGILEAGILE


Shared Services



Data Services

Business Processes


Business Components

Service Component Interface

Data Access Logic ComponentsSTABLESTABLE

5/15/2007 10:22 AM


Основни Принципи на Архитектурата

• Сервизно‐Ориентирана (Service Oriented Architecture)– Позволява модулен подход и независимост– Използва стандартни интерфейси и протоколи– Фокус на основната рамка и функции, с последващо разширяване

• Мрежа за данни– Потребителските интерфейси като надстройкар рф р

• Федерация на данните– Първоначално фокус на минимален набор критични данни– Стопанисването на данните остава непроменено

• Федеративна идентификация– Оставя сложностите по идентифициране, управление на потребителите, ролите и правата им в периферните системи

• Надеждна– Безопасност, защита на личните данни, винаги достъпна…


Варианти за Съхранение на Здравни Данни

• Преди всичко въпрос на политика и закони• Централизиран модел

– Пълна здравна история в централна база данни– Clinical Data Exchange (CDX) Gateway публикува данните и управлява синхронизирането

• Федеративен моделЦ б– Централната база не съдържа лични данни – само индекси къде има данни за съответния пациент

– CDX Gateway публикува сигнали за различни епизоди и временно съхранява пълната история получена по заявка от различни източници

• Хибриден (смесен) модел– Централната база съдържа само извлечение– CDX Gateway публикува извлечението и временно съхранява пълната история

– Може да бъде на мното нива и бази данни


Проблеми на Интегрирането

• Варианти за интегриране– Директно, на база стандартни интерфейси

• Това е идеалният случай към който се стремим• Предполага съгласувани интерфейси• SOA поддържа директно интегриране• SOA поддържа директно интегриране

– Чрез адаптери• Централни• Разпределени


Интегриране Чрез Адаптери• Без промени в съществуващите системи• Различни протоколи• Трудно за реализиране през WAN• Сложно за растеж

A

B

• Включването на нови системи изисква промени в центъра

HubB

C

D


Интегриране Чрез Дистанционни Адаптери• Всяка система се интегрира до съгласувания стандартен интерфейс

• Промени във всеки възел ( x N ) • Един WAN протокол

A

B

X

X


HubB

C

D

X

X

X

• Използва обща база завсяко конкретно интегриране

• Разработват се само уникалните елементи

Authentication Challenges• Scale (e.g. >1M employed by NHS in UK)• Organisational structures and practices• Authentication and access for users outside of the organization– Other organisations (e g social services)

18

Other organisations (e.g. social services)– Citizens

• Non‐standard authorisation requirements – Role‐based– “Legitimate Relationship” aspect– Emergency override – “Sealed Envelopes” – explicit consent required

Microsoft Connected Health Framework

5/15/2007 10:22 AM


Pluggable Authentication Model


Authentication Challenges• Scale (e.g. >1M employed by NHS in UK)• Organisational structures and practices• Authentication and access for users outside of the organization– Other organisations (e g social services)

20

Other organisations (e.g. social services)– Citizens

• Non‐standard authorisation requirements – Role‐based– “Legitimate Relationship” aspect– Emergency override – “Sealed Envelopes” – explicit consent required


Core Models for Authentication

Single Realmfor users and resources

Separate Realms

ResourceResourceUserUser

DirectoryDirectory

Acct. Info

21

Account info replicated between realms

FederationNo shared account infoUser presents federation claims with the request

UserUser

FSFS--AA

ResourceResource

FSFS--RR

Fed. Trust

UserUser ResourceResource


Federated Web SSO with a Portal

ActiveActiveDirectoryDirectory

FederationFederationSTSSTS


SIDsSIDsFederationFederationClaimsClaims

ApplicationApplicationClaimsClaims

Health ApplicationHealth Application

Medical Medical InformationInformationPortalPortal

1. User accesses VZP Medical Information Portal to request some medical info

Healthcare SystemHealthcare SystemVZP InsuranceVZP Insurance

2. User redirected to VZP STS• Seamlessly authenticated using Active Directory & Windows integrated

authentication (Kerberos security token)3. User obtains SAML security token from VZP STS for Healtcare STS

• Federation claims per VZP and Healthcare business agreement 4. User obtains SAML security token from Health STS for the Health application

• Claims in the token (role, etc.) are specific to VZP5. User accesses seamlessly the Health application in the Healthcare system

Federation and Distributed Authorization

SIDs/AttribsSIDs/Attribs

Federation RealmFederation RealmFederationFederationClaimsClaims

ApplicationApplicationClaimsClaims

FederationFederationFederationFederation

Roles-based Access Control with Federated Web SSO

23

AzMan (RBAC)AzMan (RBAC)RolesRoles

Resource RealmAccount Realm

Web ServerWeb Server

FederationFederationSTSSTSActiveActive

DirectoryDirectory



Advantages of the Federated SSO Model

• Superset incorporating other models• Allows more flexibility long‐term• Maps easier to existing org. structures• Distributed user management

24

Distributed user management • Easier to scale• Aligned with broader eGovernment services strategy (e.g. Government Gateway in the UK and other countries)


5/15/2007 10:22 AM


Federated Authentication Model

• Federated Authentication– Supports existing identity models from independent trust domains

– Authentication occurs in “home” domain

25

– Resources/Services accessed in “target” domains– Trust established between participating domains– Supported by industry web service standards:

• WS‐Federation, WS‐Trust, WS‐Security• Active Directory Federation Services (ADFS) implements WS‐Federation in Windows Server 2003 R2


An e‐Health Services Hub

• Common infrastructure that addresses the common architecture challenges identified earlier

• The Hub logically provides the required set of services – May be physically realized through a federation of hubs,

h idi b t f th i d ieach providing some subset of the required services• The Hub plays two roles:

– Provider of services to various types of consumers across a number of access channels

– Consumer of services provided by other systems or hubs


An e‐Health Services Hub –Client and Provider Interactions


Основни Услуги

• Високопроизводителен Индекс на Здравните Данни (Record Locator Service)– Подобно на DNS – може да е разпределен и дублеран– Не съдържа защитени лични данни

• Архив с медицински данни В зависимост от съответните закони правила и– В зависимост от съответните закони, правила и избраната архитектура

• Регистър на пациентите и идентифициране– Главен индекс при системи на много нива

• Услуги за сигурност и защита– Управление на федеративни данни и функции– Процедури за акредитиране на участниците (хора, системи, приложения, методи за идентификация,...)

– Права за достъп, контролни записи (logging), проверки28Microsoft Connected Health Framework

Допълнителни Услуги

• Предлагане на услуги от общ център (Hosting)– За малки и отдалечени участници с ограничени ресурси– Може да осигури висока надежност с малко разходи

• Обобщаване на данните за отчети и изследвания• Справочници и регистри за термини, к ас ф ка а оз екарс е сре с акласификации, диагнози, лекарствени средства

• Публикуване и получаване на информация по зададени критерии (“абонамент”)– Очистени от лични данни, за епидемиологични и други изследвания и мониторинг

– Независимо от обмена на на медицински данни• Информация за подпомагане на клиничните решения, лечение на база резултати


Варианти на Топологии

• Generic hub as described can be deployed across a number of topologies:– Едно централно ядро– Слой за външно интегриране– Равностойни партньори– Йерархия


5/15/2007 10:22 AM


Централно ядро

• Services published by providers and consumed by clients from a single physical d l tdeployment


Legacy Integration Hub

• Wraps, consolidates and publishes legacy services to e‐Health Hub

• Custom integration built on a common base

Hub

A

B

C

D

X

X

X

X


Равностойни Партньори

• Federation of hubs based on separation of service

ibilitresponsibility, geographic, or performance constraints


Йерархия

• Further federation of hubs based on the specific requirements and

t i tconstraints


Interoperability

• Service Oriented Architecture– Detailed business collaboration specifications

• Core messaging and connectivity ‐ Web Services– Based on broadly accepted and adopted standards such as SOAP, WSDL

– Protocol or message security based on HTTPS tunnelingProtocol or message security based on HTTPS, tunneling protocol or WS‐Security 1.0/1.1

• Security federation– WS‐Trust family of specifications

• Agnostic to message payload– Clinical Data Exchange based on limited, normalized set of standards: HL7 v2.x, HL7 CDA, ASTM CCR, NCPDP SCRIPT, DICOM (?), HIPAA TS…


Communication


Security




Privacy and Security Services


User Processes

B i P

CHF Ecosystem – Who does what?

Customer Specific(MS provides Guidelines,

Platform Products, Assistance)

SI Partner Provided(MS provides Reference Architecture

and SDKs)

Shared Services



Data Services

Business Processes


Business Components


Data Access Logic Components


ISV Provided(MS provides Business Pattern – Component and Service Definitions)

MS or SI Partner Provided

SI Partner Provided(MS provides Reference Architecture and SDKs)

ISV or SI Partner Provided(MS provides platform and guidance)

5/15/2007 10:22 AM


Communication


Security




Privacy and Security ServicesUser Processes

Microsoft’s Connected Health Platform

Office System

Office System, LiveMeeting,Exchange,

Windows Server System

Windows Mobile


Shared Services



Data Services

Business Processes


Business Components



Visual Studio, .NET Framework

BizTalk Server, .NET Framework

Operations Manager, System Center

SQL Server

CHF in Context


Building Solutions using the CHF

• Key scenarios depending on the role:– Customer ‐ Formulating Requirements (RFP)– Vendor/Systems Integrator ‐ Meeting Requirements (Responding to an RFP)

– Software Vendor ‐ Aligning an ISV Application with the g g ppCHF

– Infrastructure provider ‐ Establishing the Environment• CHF (Part 4) provides guidance for each, e.g.:

– Understanding Scope & Boundaries– Understanding the Required Features– Deriving the Architecture – Defining the Solution


MSDN Health Industry Center

• Намира се на http://msdn.microsoft.com/health• Стартова страница, води до всички материали за разработчици и софтуерни архитекти в областта на здравеопазването

Връзки до всички други ресурси– Връзки до всички други ресурси• Полезна информация за:

– Доставчици на здравни услуги– Правителствени органи на различни нива, отговорни за здравето и социалните грижи

– Национални инициативи за електронно здравеопазване

Next Steps

• Connected Health Framework Architecture and Design Blueprint е публикуван и достъпен– Кратко обобщение http://www.microsoft.com/industry/healthcare/businessvalue/chframework.mspx

– Пълна документация на http://solshare.net , форуми иПълна документация на http://solshare.net , форуми и дискусии

– Контакт с местното представителство на Microsoft или [email protected]

• Think service oriented business and technical architectures– Използвайте богатите функции на платформата на Microsoft за сигурност, съвместна работа и обмен на данни, управление и интеграция…


© 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries. The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and

Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

5/15/2007 10:22 AM


CHF – from Requirements to Solution• Top 10 issues to address:

– How to create a Patient Health Record – How to build a lifelong health history for a patient from information held in multiple, diverse systems

– How to manage Identity and Authorities– How to identify a patient (or a healthcare professional) uniquely and reliablyuniquely and reliably.

– How to enable the creation of composite applications from different systems on different platforms

– How to interconnect diverse systems and how to make them interoperate

– How to communicate with remote systems– How to reuse legacy systems and applications– How to achieve organizational flexibility and agility– How to achieve performance and scalability

43Connected Health Framework - Part 1

Microsoft Healthcare Standards Strategy

Standards and Policy Strategy

• Microsoft’s engagement is driven (mostly) by:– Intent to implement the standard– Impact on industry, customer and partner’s ability to adopt key technologies

– Strategic engagement and thought leadership opportunity• Objective: drive the adoption of horizontal standards by profiling their use for health scenarios

• Approach– Improve Microsoft’s platform support for the standard or policy

– Help the organization leverage horizontal standards such as XML and Web Services


Levels of Engagement

None Monitoring Engaging Driving• No engagement other than knowing the organization exists

g• Scanning newsletters and distribution lists

• Gauging customer’s interest on the activities of the organization.

g g g• Actively participating in discussions and the decision making process by exercising voting rights.

g• Writing specifications or policies and seeing them through the development process.


Example: U.S. SDO and Policy Microsoft Engagement (CY06)

Solid Border: SDO; Dashed Border: Policy


Health Level Seven (HL7)

• Healthcare SDO founded in 1987• 3,000+ members representing 1,000+ organizations from around the world– Providers, health plans, pharma companies, vendors, government agencies…

– 90% of largest healthcare ISVs WW• 30+ international affiliates

– Many have adopted HL7 as a government standard• Many liaisons with other healthcare SDO

– DICOM, CDISC, OMG, SNOMED, X12N (HIPAA)…


5/15/2007 10:22 AM


Microsoft and HL7

• Microsoft is Benefactor member of HL7 since 2000– Highest level of membership

• Participated to the HL7 Interoperability Demo in 2002‐2004– Showcase of HL7 standards

• Submitted Web Services proposal in Sept 2003– Now an official HL7 standard

• Submitted Web Services profiles for security and reliable messaging in Sept 2004

• Sponsor many projects and activities– Business Collaboration Framework (BCF) POC– HL7/CDISC Single Source Data Capture POC

• Released BizTalk Accelerator for HL7 in Feb 2004• Demonstrated Office support for HL7 standards

– InfoPath, Word, SharePoint


HL7 Web Services Profiles


Support for XML standards

• .NET Framework: developers’ framework• Office System 2003/2007

– Create and consume standard XML using familiar Office tools: InfoPath, Word, Excel

– Manage document repositories and document life cycle• BizTalk Server 2004/2006

– Messaging, Business Process Management, Business Activity Monitoring, Rules Engine

• SQL Server 2005– Store raw XML with schema support


Conclusion on Standards

• Microsoft is committed to standards in healthcare and across the industry

• Microsoft unique approach– Ease of implementation– Better integration among platform components– Achieve better results faster (ROI)– Developed Partner Ecosystem

• BizTalk is the cornerstone of our Business Process Integration and Workflow strategy


Connected Health Platform Accelerators

• MSDN Health Industry Center• Health Connection Engine• Common UI Effort

MSDN Health Industry Center

• Reach it at http://msdn.microsoft.com/health• One‐stop‐shop for all content for developers and software architects– Additional links to other resources

• Relevant to– Healthcare provider organizations– State and local government, federal Health and Human Services agencies

– National healthcare initiatives

5/15/2007 10:22 AM


Health Connection EngineCommunication


Security





HCE Services and Service Publication and Location

Shared Services



Data Services

Business Processes


Business Components



HCE Services and Registries

Messaging Management Services

Adapters

Messaging Management Services

Health Connection Engine (HCE)

• Open source project on http://www.CodePlex.com/hce

• Accelerates the development and deployment of connected solutions– Adapters SDKStandard set of Web Services– Standard set of Web Services

• Based on BizTalk, SQL Server and the .NET Framework

• First reference implementation in line with the Connected Health Framework – Architecture and Design Blueprint

• Developed in partnership with the New Zealand Health Cluster

Connected Health AcceleratorCommon User Interface

Common User InterfaceCommunication


Security





User Interface Components

User Interface Components


Shared Services



Data Services

Business Processes


Business Components



Medical Research and Reference Services

Medical Research Services

5/15/2007 10:22 AM


Clinical Application ‐ Demonstrator

Clinical Application ‐ Design Guidance Medications Overview – Top Patient Safety Risks

• Clear, consistent display of medication information

• Unambiguous dose information• Clear distinction between items to be administered and items that are still clinicallyadministered and items that are still clinically relevant

• Clear indication of alerts associated with medication items

• Clear indication of ALL medications in the active medications list

• Provision of appropriate ‘summary’ indicators

Medications Overview ‐ Summary GuidanceThe same rules apply regardless of the form of the display

Medications Overview ‐ Summary Guidance

• Prioritise the display of drug or item name –spatially and stylistically

• Use dm+d term

• Use generic name (all lowercase) unless there is a specific requirement otherwise

• DO NOT use frequency abbreviations

• Separate dose from item name with at least 2 spaces

• DO NOT abbreviate the item name

• DO NOT truncate the item name

• Avoid wrapping the item name

abbreviations

• Always use labels where the value could be associated with more than one attribute

• Use useful forms of data (today) to increase clarity

Documents

Architecture for eHealth (Sofia) - BG.ppt · Microsoft EMEA Public Sector Представяне – Иля Фъртунов •Над 28 години в информационната