1. 9/17/2015 1:41 PM Healthcare Services Specification Project (HSSP): SOA standards in Healthcare Alan Honey Enterprise Architect (Kaiser Permanente) Co-chair HL7 SOA SIG Alan Honey Enterprise Architect (Kaiser Permanente) Co-chair HL7 SOA SIG October 2007

2. Page 2 Agenda HSSP Overview Background What is HSSP? Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

3. Page 3 Audience Assumptions Familiarity with SOA concepts and the basic value proposition of SOA –Business agility –Cost and efficiency (especially integration) –Simpler (at least it should be) Familiar with messaging standards (HL7, X.12 etc.) –HL7 V2.x: well established in US but has well publicized weaknesses –HL7 V3 (separates model from implementation, which is in all known cases based on XML) but heavy infrastructure and difficult to implement

4. Page 4 Refresher: Web Services v Services v SOA Web Services is technology (a platform in OMG-speak) Classic web services stack: XML, SOAP, WSDL, UDDI Usually HTTP based, but may use MQ (JMS, AMQP) or SMTP Can support SOA, but also can support messaging or document paradigms Services Well defined Functional Components, cohesive collections of business or infrastructure functionality, exposed through well-defined interfaces Separation of interface from implementation, service clients depend on the interface contract only, not internals of the implementation.

5. Page 5 Refresher: Web Services v Services v SOA Service Oriented Architecture Overall cohesive framework and approach for defining and using Services, with a focus on business perspective. Architecture focus: e.g. loose coupling, separation of concerns Focus on model driven solution delivery Common, standards-based infrastructure for distributed computing, providing the “…ilities” (availability, reliability, scalability, performance) Uses declarative policies / rules to drive decisions in processing Complements Business Process automation, separation of Process from Service SOA does NOT actually require Web Services, however web services is the technology that is being used to deliver it today by almost every organization doing SOA and this will continue for the foreseeable future.

6. Page 6 Evolution of SOA/Services in HL7 Web Services as Transport (Phase 1) –HL7 WS Profile Web Services as Enabling Technology (Phase 2) –SOA 4 HL7 –Provides some degree of durability Standard Services (Phase 3) – In Progress –HSSP Service Specifications –Services Interoperability Paradigm SOA (Phase 4) - Future –Compliant with Reference Architecture Metamodel Implementation Guides Profile Registry Template / Static Model Registry

7. Page 7 Healthcare Service Specifications Take good principles and practices learned from standardizing messaging and apply to Services, OR… Tie good SOA practices and patterns to the rich models of HL7, CEN, OpenEHR Create true Interoperability specifications, not just Integration specifications Provide architectural building blocks Helping to make SOA a reality for healthcare organizations that mainly buy vendor software, and providing direction for those that build.

8. Page 8 Agenda HSSP Overview Background What is HSSP? Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion

9. Page 9 What is HSSP? The Healthcare Services Specification Project (HSSP) is a joint venture between Health Level 7 (HL7) and The Object Management Group (OMG). HSSP relies on HL7’s national and international domain expertise and world-class information models to provide Functional requirements and specifications OMG brings the technology industry to the table by issuing a Request for Proposal (RFP). Submitting organizations create the Technical Specification HSSP is young – it has been around for around 2 years or so, and is growing

10. Page 10 What is HSSP? An effort to create common service interface specifications for Healthcare IT Its objectives are: –To create useful, usable healthcare standard services that address functions, semantics and technologies –To provide a framework for tying the specifications together into a coherent overall Service Oriented Architecture –To complement existing work and leverage existing standards where possible –To focus on practical needs and not perfection –To capitalize on industry talent through open community participation Participation (past and current) from many organizations, including: VA, DoD, NCI, HL7 Finland/SerAPI, HL7 Australia, Ocean Informatics, Kaiser Permanente, CSW (UK), Intel, IBM, Oracle, Software Partners, Northrop Grumman, Initiate Systems, many others

11. Page 11 OMG HL7 The HSSP Process HL7 SOA SIG HL7 DSTU Service Functional Model OMG RFP RFP Responders Technical Specification ANSI Standard OMG HDTF

12. Page 12 Agenda HSSP Overview Background What is HSSP Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

13. Page 13 What has HSSP delivered to date? Functional Specifications - HL7 DSTUs: –Decision Support Service (DSS) receives patient data as the input and returns patient-specific conclusions as the output –Retrieve, Location, and Update Service (RLUS) provides a set of interfaces for accessing and managing health information –Entity Identification Service (EIS) for identification of patient, providers and other entities participating in the care OMG-issued technical Requests for Proposal (RFPs) finalized or drafted for all DSTUs –Initial Submissions received for RLUS and EIS and LOIs from four organizations for DSS A Service Specification Framework (methodology) for developing the service specifications An informative HL7 ballot document on Messaging-to-SOA Transition Methodology (SOA4HL7)

14. Page 14 Current Service Specifications

15. Page 15 Other Current HSSP Activities Reference Architecture - Taxonomies - Business Rules - Choreographies - Service Meta-model - Implementation guide Profiles Methodologies Template Registry Evangelizing SOA within the Healthcare community Technical Specifications (EIS, RLUS, DSS)

16. Page 16 Agenda HSSP Overview Background What is HSSP Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

17. Page 17 Roadmap and Reference Architecture Roadmap: High level summary of HSSP Services work and direction – v1.0 complete and published on HSSP Wiki. Reference Architecture: Detailed framework relating services wihin an overall Service Oriented Architecture (work in progress). Includes: –SOA Principles –SOA Reference Model –Service Taxonomy –Service Portfolio –Governance –Methodologies Also, other important components are: –Profile and Template / Static Model Registries –Tooling Support

18. Page 18 SOA Services Taxonomy (example) Business Functional Business Information Infrastrucutre Information Infrastructure Functional Business Process HSSP Service TaxonomyLayer InfrastructureBusiness Focus InformationInfrastructure Information: (e.g. RLUS Update Security Key Service) Business Information: (e.g. RLUS Retrieve CCD Service) FunctionalInfrastructure Functional: (e.g. Choreography Engine, Logging) Business Functional: (e.g. Lab Order Management Service)

19. Page 19 Service Portfolio (example)

20. Page 20 Services Metamodel

21. Page 21 Service Profiles Service definition defines consistent overall functionality based on business requirements Profiles provide means to specialize and test conformance (for function and information) Service Instance (e.g. EIS) Service Instance (e.g. EIS) Semantic Signifiers Business Drivers Business Service Realizes Functional Profile Semantic Profile

22. Page 22 Governance Principles and Policies: The foundation of SOA Governance Business Principles / Objectives IT Principles SOA Principles IT Architecture (SOA, Service Interfaces) Methodology and Standards HSSP Policies Service Instances Conformance?

23. Page 23 Service Design - The Semantic Spectrum Why does this matter? Affect the way that your governance model will work Affect the way you will structure your services Affect how you will (or won’t) maintain architectural integrity Development and Design Reusability Contracts QoS Not necessarily good or bad …. Just different InformationFunction

24. Page 24 Spectrum of Semantics (Function and Information) Operation SignaturePotential InterfaceNotes 1Ack:Do(message message)MessageHandlerBehavior is enclosed in the message and is not expressed in the operation 2HTTP GET, PUTREST styleInformation is explicit in the object through early binding, while the functionality is fixed 3Stuff: Retrieve (stuffTraits traits)RLUS (without a profile) Functionally simplistic, but bound to variable Information. Business semantics are not explicit 4Order:Retrieve (orderTraits traits)RLUS with an Order Management Profile Functionally simplistic, but reasonably mapped to business semantics because of the constrained information semantics and a manageable DAM 5LabOrder:Retrieve(labOrderTraits traits) RLUS with a LabOrderManagement Profile As above with more tightly constrained information semantics, as well as a more constrained DAM 6Ack:CreateLabOrder(order order) Order:LabOrderNotification() Lab Order Management Service A constrained and functionally complete DAM, neatly mapped to both information and functional semanitcs 7Ack:ChangeAge(person person, age age) Demographic ServiceFunctional semantics are reasonably explicit, information supports functionality implicitly. Classic OOD 8Ack:ChangeKenAge(age age)Demographic ServiceFunctional semantics are very explicit, information supports functionality implicitly. Classic OOP without any design or reuse. Inappropriate functional granularity. 9Ack:ChangeKenAgeTo25()Demographic ServiceFunctional semantics encompass informational semantics. Zero reusability. Silly.

25. Page 25 Agenda HSSP Overview Background What is HSSP Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

26. Page 26 HSSP Methodology Work SSF –HSSP Process for producing Service Specifications. Covers both Functional (HL7) and Technical (OMG) processes SOA4HL7 –Interim methodology (Balloted HL7 Informative document) for producing Service definitions in advance of Standards being availabe Dynamic Model –Ongoing work with other HL7 committees (InM, MnM, ITS SIG) on new approaches to dynamic modeling Interoperability Paradigms –Part of the Dynamic Model work to consider similarities and differences between Services, Messaging and Document based methodologies and looking for commonality where possible.

27. Page 27 Towards an HL7 Design Methodology Orchestration, Choreography, and Interaction Patterns Contents: Domain & Document Models Trading Partner Agreements: Binding Services and Content Models Made by HL7, IHE, Realms, Projects Messaging: Binding the Services and Contents to a transportation Platform (HL7 Wrappers & ATS) Services Interoperability Paradigm

28. Page 28 Agenda HSSP Overview Background What is HSSP? Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

29. Page 29 Technical Specifications and RFPs Coordinated by OMG Healthcare Domain Task Force (DTF) HL7 SFM used as basis for Request for Proposal (RFP) –Request for specification of a platform-independent model (PIM) and at least one platform-specific model (PSM) (e.g. SOAP/XML) conforming to SFM requirements Letters of intent to specify and implement within 12 mo.  initial specifications  single revised specification based on merged efforts Approval by Healthcare DTF  Architectural Board  Technology Committee  Board of Directors Specification not adopted unless at least one implementation available commercially

30. Page 30 OMG Technology Adoption Process Any interested vendor with OMG membership may submit No submissions pass on initial submission Vendors choose to partner to form joint submissions 95% of the time All OMG standards are reviewed by OMG Architecture Board The speed of the adoption is driven by marketplace pressure, not the process The standards committee may either accept or reject submissions – nothing more The approach assures business relevance and promotes rapid timelines and quality The OMG Standard is published when software is available

31. Page 31 Feedback loop to HL7 DSTU is ideally suited to this process –Allows two years for “practical experience” –OMG Technology adoptions are typically 18 months Throughout the process we will collect ‘lessons learned’ Outcomes of the technology adoption will be incorporated and balloted into the SFM

32. Page 32 Current RFP Progress EIS –Submission Team: Intel, Software Partners, Ocean Informatics, Initiate, NG, Satyam (also Oracle, Care Data). –Initial submission discussed in Jacksonville in September. Working on revised submission, including profiles for V3, V2 and OpenEHR. RLUS –Submission Team: Intel, Software Partners, Ocean Informatics, NG, Satyam (also Oracle). –Initial submission discussed in Jacksonville in September. Working on revised submission, including profiles for V3, V2 and OpenEHR DSS –Submission Team (forming): Software Partners, Religent, 88Solutions (also EDS, CDC, MHS) –Work just starting on technical specification. –Discussions with IHE progressing

33. Page 33 Agenda HSSP Overview Background What is HSSP Deliverables and Status Roadmap and Reference Architecture Methodology Technical Specification - RFP Process and submissions Value Proposition and Getting Engaged Questions / Discussion: (Open)

34. Page 34 Value for Kaiser Permanente Integration is very expensive, mainly COTS vendor packages (HL7 for clinical, also X.12, DICOM, others) mainly batch or messaging, and changes slow and difficult Turned to SOA to address this problem, however no standard service interfaces, and each vendors services very variable, semantically and technically. Good lessons learned from messaging standards not being applied to Services Part of initial HSSP kick-off and have been promoting the development of Service standards ever since. Return is long term but perceived to be very significant Apply pressure on software vendors to produce standard interfaces

35. Page 35 More value … ValueRationale Promotes deployment ease and flexibility Specifications will support multiple topologies and technologies 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 offeringsConsumer demand will create increased marketplace competition Facilitates integrationUnity in purpose and consistency in interface eases integration burden Time to marketAvailability 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

36. Page 36 Why participate? This effort is focused on and driven by business-need –It is not an “academic exercise” striving for perfection –For standards to be useful they must be used –Focused on the practical and achievable –Based upon business value and ROI Being run like a “project” and not a committee Recognize participation as an investment and not an expense 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 Establish market presence and mindshare as industry leader This is happening—the only way to influence the outcome is to engage

37. Page 37 How do I Participate? Determine areas of interest and priorities –Involvement in current specification work? –New Profiles for existing services (any time) ? –Propose New Service needs (any time) ? –Reference Architecture? Allocate resources to actively engage in the project –Engage knowledgeable resources in the areas they are working already in day job –Involve the staff that can best address your business needs –Organizations that commit resources garner more influence and more mindshare –Your business interests are being represented by your attendees

38. Page 38 2008 HSSP Schedule (planned, major milestones) Jan: SFM Ballots (CRFQ, Security) Publish Reference Architecture v1? HL7 San Antonio (Jan 13-18) Jul: Feb:Aug: Mar: OMG Washington (Mar 10-14) EIS, RLUS RFP Final submissions DSS RFP Initial Submission Sep: HL7 Vancouver (Sep 14-19) OMG Orlando (Sep 22-26) Apr: SOA in Healthcare conference (Chicago) Organized by HSSP Oct: May: HL7 Phoenix (May 4-9) (possible CTS II, Provider/Services Directory SFM Ballots) Nov: Jun: OMG Ontario (CA) (Jun 23-27) EIS, RLUS RFP Finalization? Dec: OMG Santa Clara (Dec 8-12)

39. Page 39 References HL7 Website: http://www.hl7.org OMG Website: http://www.omg.org Services Project Homepage http://www.healthinterop.org QUESTIONS ?