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Common Framework Implementation: The MA-SHARE Approach Vinod Muralidhar, CSC April 10, 2006. MA-SHARE Experiences with Health Information Networks. New England Healthcare EDI Network (NEHEN): HIPAA compliant administrative transaction routing - PowerPoint PPT Presentation
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Common Framework Implementation:
The MA-SHARE ApproachVinod Muralidhar, CSC
April 10, 2006
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MA-SHARE Experiences with Health Information Networks
• New England Healthcare EDI Network (NEHEN): HIPAA compliant administrative transaction routing
• MedsInfo-ED: Pilot medication history retrieval for emergency departments
• RxGateway e-Prescribing network conceptual architecture
• Connecting for Health Record Locator Service Prototype
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Federated SNO Network Architecture
• Member preference for Peer-to-Peer Clinical Data Exchange between clinical applications at provider (and other) locations
• Specification of both SNO ‘Network’ and ‘Edge’ connectivity services
• Federated model can support centralization of services such as – Data storage– Aggregation– …
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Gateways Provide Edge Services
• Gateways abstract differences between EHR application interfaces through standards based interfaces– HL7 and other clinical data
exchange standards– SOAP / WSDL and other
Web services standards
• Hosted Gateway Service– Enables direct (browser
based) client access to remote clinical systems
– Inter-SNO Bridge services
– Other centralized services
• EHR Registry• Standard Metadata, e.g.
Schema, WSDL, PolicyEHR-2
Gateway
Clinical Systems
HL7
EHR-1
Gateway
Clinical Systems
HIS API
CDX Viewer
RLS
Gateway
XML
EHR system registry
Patient Index
Community Master Patient Index
EHR-3
Clinical Systems
Browser UI
Secure Internet
Gateway
RLS Admin Viewer
1. Hosted Gateway service for standalone clients2. Front-end to RLS3. Inter-SNO Bridge
Gateway API ImplementationsServices embedded in the Clinical System, either1. Vendor implements API in COTS product, or2. Custom product extended to support HL7 over Web services etc.
Gateway in a BoxPreconfigured Gateway application hooked up to clinical systems in local network
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Service-Oriented Gateway Architecture
• Common infrastructural (plumbing) services – Systems management
• Logging, auditing, service management
– Security• Authentication, policy,
consent management
• Integration services• Messaging,
transformation, orchestration, adaptor
• Presentation/Business services
• Data management and storage– Clinical Systems Proxy– Caching
EHR-1
EHR-2
Record Locator Service
Ga
tew
ay
Integration Broker Services
Presentation Services
Business Application Services
Se
curity S
ervice
s
Syste
m M
gm
t Se
rvices
Data Storage Services
Data Management
Services
Thin Viewer
XHTML
Patient Index Service
RLS/CMPI Registry
Patient Record Linking/ Indexing
Patient Record Search
EHR Registry
xml
Community Patient Index
Enterprise Workstation
Ga
tew
ay
Integration Broker Services
Presentation Services
Business Application Services
Se
curity S
ervice
s
Syste
m M
gm
t Se
rvices
Data Storage Services
Data Management
Services
XHTML
EHR System
Hospital Information
System
Clinical Data Source /
EHR
EMPI
Ga
tew
ay
Integration Broker Services
Se
curity S
ervice
s
Syste
m M
gm
t Se
rvices
Data Storage Services
Data Management
Services
PIXSQLHL7 2.x
SOAPHTTPS
SOAPHTTPS
Presentation Services
Business Application Services
SOAPHTTPS
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Current NEHEN Network Model
Payer System (e.g Eligibility)
Secure Internet56K Frame Relay
Or VPN
RxGateway
Provider Registration Systeme.g. IDX
Firewall
eGatewayFirewall
Payer System(e.g. Claims)
Connections to other Providers
Connections to other Payers
Claims DB
Eligibility DB
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e-Prescribing Pilot Network Model
Payer System
Secure Internet
RxGateway
Point of Care Information System
Prescriber
Firewall
Connections to other Providers
Data Provider
Eligibility DB
Data Router
Dispenser
Pharmacy System(Retail or Mail-order)
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Planned Convergence of MA-SHARE Gateway Services
Clinical Data Exchange • Supports peer-to-peer clinical data
exchange through Web services• Federated data management requires
community RLS• EHR AdaptorsAdministrative Data Exchange• Compliance with HIPAA standards and
X12• Interfaces to ADT and billing systems• Revenue cycle tools to support
community needsE-Prescribing• Community business services• National standards compliance
(Medicare Part D)• Interface from order entry systems• Reduced complexity for participants in
leveraging eRx vendor offerings
Rx Gateway• Formulary Service• Pharmacy Directory• Pharmacy Benefit Eligibility• Medication History• eRx Adaptors
CDX Gateway• EHR Adaptors• Data Aggregation• Record Publishing
Service• Clinical Data
Access
NEHEN Gateway• ADT Adaptors• Billing Adaptors• Direct Data Entry
Core Gateway• Routing• Translation• Security• Logging• Validation• Guaranteed Delivery• Trading Partner
Registry
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MA-SHARE Roadmap
• Implementation of ‘nationwide’ standards within SNO enables flexible interoperability within and between sub-network
• Reduced implementation and maintenance cost through joint investment
• Unified network architecture maximizes reusability of infrastructure across use cases
• Common B2B framework leveraging transport and messaging standards from outside healthcare domain
