Unlocking Business Processesin the Health Industry

From the Health Consumer to the WSDLDan Russler, M.D.

12Oct2012

Agenda1. Introduction – who am I?2. Starting from Wednesday3. Standards in Business IT4. Standards in Development & Implementation5. Nation-wide Health Information Network6. WS-Addressing & Asynchronous Web Services

Who Am I?

Meeting at the Software Contract Level (WSDL)Top-Down and Bottom-Up

Dr. Russler

Dr. Blough

(Component of WS-Coordination)

(Component of WS-Addressing)

(2009)

Multi-Data-CenterCloud

US

Australia

Europe

China

Retail “Front-Door”

Wholesale “Front-Door”

Standards in Business IT

AdaptiveBusiness ProcessManagement

Business Process Management IT SolutionsOracle, IBM, and many others--Business Process Model Notation (BPMN)--Business Process Execution Language (BEPL)--Web Service Orchestration and SOA

The Growth of Business Viewpoints--from Object Management Group (OMG)

PolicyBusiness ManagementIndustrial Engineering

Interactive ComputingIT Systems (SOA)IT Manufacturing

IT Process Standards -- BPMN♦ Business Process Modeling Notation (BPMN) is currently

maintained by the Object Management Group♦ BPMN is a standard for business process modeling, and provides a

graphical notation for specifying business processes in a BusinessProcess Diagram (BPD), very similar to activity diagrams fromUnified Modeling Language (UML)

♦ BPMN Objectives– Provide a notation that is intuitive to business users yet able to

represent complex process semantics– Provide a mapping between the graphics of the notation to the

underlying constructs of Business Process Execution Language(BEPL)

♦ BPMN Stakeholders– Business analysts who create and refine the processes– Technical developers responsible for implementing the processes– Business managers who monitor and manage the processes.

IT Process Standards – BPMNExample without BPMN Swimlanes

IT Process Standards -- BPEL♦ Business Process Execution Language (BPEL), short for Web

Services Business Process Execution Language (WS-BPEL) is anOASIS standard executable language for specifying actions withinbusiness processes with web services. Processes in Business ProcessExecution Language export and import information by using webservice interfaces exclusively.

♦ Web service interactions in BPEL– Executable business processes model actual behavior of a

participant in a business interaction– Abstract business processes are partially specified processes, often

in BPMN, that serve a descriptive role (hiding some operationaldetail) and are not intended to be executed

– Experience is needed in order to decide when to use BPEL andwhen to use Java or some other programming language to executeweb services

IT Process Standards – BPELA Snippet of BPEL code<partnerLinks><!--The 'client' role represents the requester of this service. It is used for callback.

The location and correlation information associated with the client role areautomatically set using WS-Addressing.-->

<partnerLink name="client" partnerLinkType="client:CFP1_sequence"myRole="CFP1_sequenceProvider"/></partnerLinks><!--================================================================= --><!-- VARIABLES --><!-- List of messages and XML documents used within this BPEL process --><!--================================================================= --><variables><!-- Reference to the message passed as input during initiation --><variable name="inputVariable"messageType="client:CFP1_sequenceRequestMessage"/><!-- Reference to the message that

will be returned to the requester --><variable name="outputVariable"messageType="client:CFP1_sequenceResponseMessage"/></variables><!--================================================================= --><!-- ORCHESTRATION LOGIC --><!-- Set of activities coordinating the flow of messages across the--><!-- services integrated within this business process--><!--================================================================= --><sequence name="main"><!-- Receive input from requestor. Note: This maps to

operation defined in CFP1_sequence.wsdl --><receive name="receiveInput" partnerLink="client“…. </sequence>

IT Process Standards -- UML♦ Unified Modeling Language (UML) is a standardized general-

purpose modeling language in the field of software engineering. Thestandard is managed, and was created by, the Object ManagementGroup.

♦ UML is used to specify, visualize, modify, construct and document theartifacts of an object-oriented software-intensive system underdevelopment. UML offers a standard way to visualize a system'sarchitectural blueprints, including elements such as:– Activities– Actors– Business processes– Information models (including mapping to various database

schemas)– Logical components– Programming language statements– Reusable software components

IT Process Standards -- UML

Health Level 7 Standards♦ The Health Level 7 standard was developed in the early 1990s by the

HL7 Standards Development Organization, a consortium of academic,government, healthcare provider, and vendor that assembled todevelop a specification for what is now known as Health InformationExchange

♦ HL7 standards replaced a small amount of the proprietary healthinformation exchange in January, 2010, with a limited productionNationwide Health Information Network in the US. Earlier, HL7standards replaced a portion of the proprietary health informationexchange in the UK and Canada.

♦ Communication Standards require a long lead time to market♦ Now, many large and small vendors create electronic health records at

the provider level and create personal health records at the consumerlevel

International Standards >>>>> US Standards

IT Process Standards -- Web Services

Standards in Developmentand Implementation

Process and Modeling Toolsfor Business Analystsand Engineers

IT Process Standards -- CMMI

IT Process Standards -- Agile♦ Agile software development is a group of

software development methodologies based oniterative and incremental development, whererequirements and solutions evolve throughcollaboration between self-organizing, cross-functional teams. The Agile Manifesto introducedthe term in 2001.♦ Agile Manifesto “Values”

♦ Individuals and interactions over processes and tools♦ Working software over comprehensive documentation♦ Customer collaboration over contract negotiation♦ Responding to change over following a plan

♦ While there is value in the items on the right, the itemson the left are valued more.

IT Process Standards -- Agile• No Documentation inAgile Development?

• What if a patientdies?• Softwaredocumentation mightbe needed fordiscovering root causeof the death or evencontribute to cause ofdeath

• Adapting Health Industryto Agile Documentation

• Initiate parallelCMMI documentationprocesses• Complete softwaredocumentation aftersoftware working

Technical Interoperability--HL7 2.5 Messaging (structural interoperability)

Unified Modeling Language (UML) Sequence Diagrams:describe transport sequences including message wrapper names

Nation-wide HealthInformation Network(NwHIN or NHIN)

Health Information Exchange (HIE)for the communication of medicalrecords between organizations(including competitive entities)

!!!!!!News Flash!!!!!!

♦Nationwide exchange stands on its own– October 11, 2012 | Tom Sullivan, Government

Health IT– WASHINGTON – Marking a bridge’s

beginning, ONC on Thursday made it official:eHealth Exchange is standing on its own as anon-federal, non-profit entity.

– The mammoth project formerly known asNwHIN-Exchange created enough buzzthroughout the year…

NwHIN Definition

♦NwHIN is a set of comprehensivestandards, services and policies that enablehealthcare organizations to shareinformation securely through the Internet.

♦NwHIN goal is that information follows thepatient where and when it is needed, acrossorganizational, vendor, and geographicboundaries.

Governance and Trust—the use case

Business Goals:

Privacy

Security

Trust

Business Goal:

Select the“thinnest”

technologyrequired

for the jobat the

Federal level

© 2009 Oracle Corporation – Proprietary and Confidential

NHIN High Level Architecture

* HIO = “Health Information Organization”

IHE Document Management

Finding Data across the NHIN

Meeting at the Software Contract Level (WSDL)Top-Down and Bottom-Up

Dr. Russler

Dr. Blough

(Component of WS-Coordination)

(Component of WS-Addressing)

(2009)

WS-Addressing &Asynchronous Web Services

Adapted from anIntegrating the Healthcare Enterprise (IHE)presentation:

WS* Standards Support forIHE Asynchronous Web Services

What is an Asynchronous Web Service?

Why not just useSynchronous Web Service Exchange?

IHE Document Management

Changes in the SOAP HeaderChanging the Synchronous Model to an Asynchronous Model

IHE Asynchronous Request and Response***Note that both “URI” sub-types, “URL” and “URN,” are used in thenew web service for request and response messages

Meeting at the Software Contract Level (WSDL)Top-Down and Bottom-Up

Dr. Russler

Dr. Blough

(Component of WS-Coordination)

(Component of WS-Addressing)

(2009)