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AEGIS.net, Inc. - Powerful Results. Delivered. SM OSEHRA Summit Topic: “Why Interoperability Is So Damn Hard” Presenter: Mario Hyland Senior Vice President,

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Presentation on theme: "AEGIS.net, Inc. - Powerful Results. Delivered. SM OSEHRA Summit Topic: “Why Interoperability Is So Damn Hard” Presenter: Mario Hyland Senior Vice President,"— Presentation transcript:

1 AEGIS.net, Inc. - Powerful Results. Delivered. SM OSEHRA Summit Topic: “Why Interoperability Is So Damn Hard” Presenter: Mario Hyland Senior Vice President, AEGIS @Interopguy 1 Powerful Results. Delivered. Powerful Results. Delivered. September 5, 2014

2 How Important is Patient Safety? AEGIS.net, Inc. - Powerful Results. Delivered. SM 2

3  AEGIS has been supporting Interoperability Testing within the HealthIT space with VA/HHS (ONC).  HHS/ONC Nationwide Health Information Exchange (NwHIN) (IHE/HL7/OASIS-SAML)  Healtheway Compliance Testing Body (CTB) Certification process for the eHealth Exchange  OSEHRA Open Source Interoperability Work Group with a focus project of the DIL.  NIST HITECH Award HITTI  HL7 Conformance Testing Platform Introduction 3

4 AEGIS.net, Inc. - Powerful Results. Delivered. SM Definition of Interoperability (let’s agree to use IEEE).  Participants and Systems Not Ready for Certification or Accreditation ◦ Dependence on Self-Attestation  Understanding the Standards and Specifications ◦ Common (or Consensus based) Interpretation.  Conformance vs Interoperability  Syntactic vs Semantic Interoperability  Interoperability vs Continuous Interoperability Challenges facing Standards Adoption 4

5 AEGIS.net, Inc. - Powerful Results. Delivered. SM Topic: Open Source Development Objective: Adherence to a Standard can be demonstrated thru implementation & testing State of Maturity HealthIT Standards 5

6 Why Interoperability is Challenging  Systems Interoperability Challenges o Organizational exchange of information o Interruption thru Implementation o Common Testing Approach (Happy Path) o Limited Exception Negative Testing (due to dependence on Peer-to-Peer testing) o Change (yes, there will be change) Standards will be put under new intense pressure. 6 AEGIS.net, Inc. - Powerful Results. Delivered. SM

7 Robustness Principle "Be conservative in what you send, be liberal in what you accept" http://en.wikipedia.org/wiki/Robustness_principle Conservative – Happy Path Liberal – Negative and Exception Path 7 AEGIS.net, Inc. - Powerful Results. Delivered. SM

8 How to Mitigate Interoperability Risk  We offer a way to Mitigate Interoperability Risk o Because – you will face Interoperability Issues  Interoperability Strategies o Standards based Testing (feedback loop) o Test Early and Test Often o Infuse Interoperability into the Development Cycles thru TDD (Test Driven Development) o Embrace the goal of Continuous Interoperability thru process 8 AEGIS.net, Inc. - Powerful Results. Delivered. SM

9 How to Integrate TDD into Agile Process 9 AEGIS.net, Inc. - Powerful Results. Delivered. SM

10 Developers Integration Lab 10  Developers Integration Lab (DIL) o Self Service Bi-Direction message based test lab o Global accessibility 24x7/365 days o End-to-End Systems Testing o Beyond Happy Path o 70% Negative testing o Cloud Shared Service o Conformance & Interoperability

11 DIL Architecture AEGIS.net, Inc. - Powerful Results. Delivered. SM 11

12 Standards view thru Statistics  2013 - 1,387 Implemented Test Cases*:  522 Conformance Rules applying over 36,000 checkpoints.  Over 77,391 Test Case Executions starting in April 2013 ◦ By Healtheway's CTB candidate participants and vendors. NwHIN Specification20102011 Patient Discovery170177 Query for Documents178179 Retrieve Document2639 Totals537576 *ONC S&I Framework ARRA project The DIL is Actively Exercising Health IT Standards. 1,113 Test Cases for NwHIN specifications 12 AEGIS.net, Inc. - Powerful Results. Delivered. SM

13 DIL Statistics  More than 200+ Organizations Registered on the DIL to test  45 active Healtheway 2014 onboarding candidates (through Sept.) Healtheway 2013 Onboarding Candidates Product Vendors8 HIE Participants34 Federal Agencies3 Key Findings: 1. Neither vendors or participants are ready when they started certification testing. 2. 2-4+ month learning curve to demonstrate compliance to baseline specifications and required message conformance/interoperability expectations. 13 AEGIS.net, Inc. - Powerful Results. Delivered. SM

14  The DIL provides objective analysis of health information standards implementation and exchange problem areas: DIL Statistics DIL execution data record the root cause(s) of conformance/interoperability failures: System/product failures Test case definition defect Specification lacks sufficient implementation guidance 14

15 Industry Approach to Interoperability ONC Roadmap to Interoperability (10 Years)  Patient Privacy (Consent Policy & DS4P) o Unstructured vs Structured Data o Granularity o Data Providence  Leverage Existing HIT Infrastructure  FDASIA Report (Risk Management)  Jason Report (API Architecture) 15 AEGIS.net, Inc. - Powerful Results. Delivered. SM

16 OSEHRA Interoperability Work Group GOALS:  Publish thought leadership pieces  Participate in speaking engagements  Contribute content to the OSEHRA public comment platform  Captures User Experiences and Technical Challenges  Support Rapid Integration of Standards  Influence technology, public policy, laws and regulations  Develop resources, tools and test labs 16 AEGIS.net, Inc. - Powerful Results. Delivered. SM

17 Mario Hyland Senior Vice President mario.hyland@aegis.net (703) 893-6020 x707 (301) 529-5466 (c) Contact Us - AEGIS.net, Inc. 2275 Research Boulevard, Suite 500 Rockville, MD 20850 www.aegis.net DUNS: 152858358 CAGE Code: 3YHD9 17

18 AEGIS.net, Inc. - Powerful Results. Delivered. SM  HIE participant learning curves vary widely. One example: DIL Statistics 18 Early failures -> Learning - > Refinement -> Success

19 AEGIS.net, Inc. - Powerful Results. Delivered. SM  HIE participant learning curves vary widely. BEST CASE: DIL Statistics 19 2 calendar months from DIL registration to CTB test case results submission for CCHIT review/Healtheway CC onboarding approval.

20 AEGIS.net, Inc. - Powerful Results. Delivered. SM  Once past the system configuration learning curve, DIL Test Execution is FAST: DIL Statistics 20 12 MINUTES to actually execute the test cases required for Healtheway’s 2013 onboarding program.

21 AEGIS.net, Inc. - Powerful Results. Delivered. SM  Product Vendor learning curve example: DIL Statistics 21 Early failures -> Learning - > Refinement -> Success Vendors should take more time—and make use of the DIL more extensively—than individual participants.

22 AEGIS.net, Inc. - Powerful Results. Delivered. SM State HIE - SUT 22

23 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test Account 23

24 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test Scenario/Case 24

25 AEGIS.net, Inc. - Powerful Results. Delivered. SM State HIE Patient Info (SUT) 25

26 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test Results 26

27 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Exception Reporting 27

28 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Message Debugging 28

29 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Message Analyzer 29

30 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test History 30

31 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Role Based Features 31  Developers Integration Lab (DIL) ◦ Test Users / Participants ◦ Test Case Developers ◦ Test Rules Engine ◦ Community Representatives ◦ Certification / Test Validation ◦ DIL Administrator

32 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test Case Developer 32

33 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Test Rules Engine 33

34 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Community Rep 34

35 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Certification / Validation 35

36 AEGIS.net, Inc. - Powerful Results. Delivered. SM DIL Administration 36

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