Overview/Tutorial Chairs William Ruh Chief Technology Officer The Advisory Board 600 New Hampshire Ave, NW Washington D.C. 20037 Phone 202 266 5815 Fax 202 672 5700 ruhb@advisory.com Thomas C. Culpepper Senior Architect 2AB, Inc. 1700 Highway 31 Calera, AL 35040 Phone 205 621 7455 ext 107 tculpepper@2ab.com Paris, France 2001 health/2001-04-04 http://www.omg.org http://www.omg.org/homepages/healthcare/index.htm
Mission & Goals Mission: To improve the quality of care and reduce costs through the use of interoperability technologies throughout the global healthcare community To utilize the OMG technology adoption process to standardize interfaces for healthcare objects To communicate the requirements of the healthcare industry to the Platform Technical Committee To assist and advise the Liaison Subcommittee regarding the relationship with healthcare standards organizations and consortia Goals: To educate both the system developers and the user community in the health care industry To issue RFIs and RFPs related to the healthcare community To evaluate RFI and RFP responses and RFCs for recommended adoption by the Domain Technical Committee
History Healthcare DTF 1996 PIDS & TQS adopted 1998 CIAS adopted 2000 1994 Healthcare Special Interest Group 1997 Liaison with HL7 & DICOM European Healthcare Chapter 1999 Roadmap published COAS & RAD adopted Liaison with X12 formed Latin America Healthcare Chapter
Stakeholders & Building Blocks Administrator Patient Clinician Educator Researcher Developers Chapters Education Specifications Liaisons Roadmap Recognition SDO
Stakeholders & Building Blocks Roadmap Administrator Patient Clinician Educator Researcher Developers SDO An understanding of the business (today & tomorrow) Logical semblance of components to meet business needs 1. Produce and maintain the Healthcare Component-based Reference Architecture. 2. The purpose of the Componentbased Reference Architecture is to delineate and describe the interfaces and interactions between the various logical components in health care systems. 3. The interactions and interfaces between the components will then serve as a reference against which the issuance of future health care related RFIs and RFPs can be considered.
Stakeholders & Building Blocks Liaison Administrator Patient Clinician Educator 1. To work collaboratively in moving Healthcare solutions forward. 2. Minimize redundancy. 3. Share experiences, ideas, and new perspectives. Researcher Developers SDO Expertise pertaining to Healthcare
Reference Model for Open Distributed Processing (RM-ODP) Relating to the Healthcare Domain & the OMG Healthcare Domain Task Force Purpose, scope, policies. Enterprise Viewpoint Registration Order Communications Scheduling Results Retrieval Business rules and content to be supported by the system. Information NCPDP X12 Viewpoint HL7 DICOM CEN TC251 ICO TC215 Lonic Snomed CPT ICD DRG Encapsulation of capability, separation of functionality, and interface definition. Distributed interactions & mechanisms between the components. Description of the implementation of the system. Computational Viewpoint Engineering DCE JavaBeans Viewpoint CORBA DCOM Technology Viewpoint ISO/OMG Unified Modeling Language (UML) PIDS ISO/OMG Definition Language (IDL) Standards TQS COAS RAD CIAS Conformance Java C++ SmallTalk COBOL Win32 Unix MVS Copyright 1999 Tom Culpepper, and Tim Brinson
Stakeholders & Building Blocks Education Administrator Patient Clinician Educator Researcher Developers SDO Present and be presented to. Educate and become educated. 1. Web site Executive summaries Toolkit 2. Technical Conferences OOPSLA Objects 6000 Open Forum on Metadata Repositories Applied Computer Security Associates Conference Workshop on Distributed Object Computing Security 3. Medical Conferences RSNA Role of Distributed Objects in Healthcare HIMSS 4. Publish articles Healthcare Informatics Publication 5. Lectures to Medical Informatics Students 6. Present to SDOs
Stakeholders & Building Blocks Chapters Administrator Patient Clinician Educator Researcher Developers SDO Work within the OMG Healthcare Domain Task Force Framework. 1. Work with the OMG Healthcare Domain Task Force in getting solutions incorporated into your specific environment. 2. Create unique solutions applicable only to your environment. 3. Work universally regardless of geographic boundaries.
Stakeholders & Building Blocks Recognition Administrator Patient Clinician Educator Researcher Developers SDO Nominate. Be nominated. Market yourself. 1. OMG Homer R. Warner Healthcare Interoperability Award. 2. Distinguish yourself as a leader in Healthcare Informatics. 3. Provide interoperable solutions to assist others in the Healthcare profession.
Stakeholders & Building Blocks Specifications Administrator Patient Clinician Educator Researcher Developers SDO Provide use-cases and scenarios about the business. Turn functional requirements into standard interfaces. Provide informational views for the business requirements. 1. Provide interoperability solutions to help individuals perform optimally. 2. Reduce software lifecycle and provide extensibility mechanisms to increase future growth. 3. Utilize the OMG OMA that maintains existence with every new sliver bullet that comes along. Minimizing complete rewrites. 4. Utilize existing standards within our specifications.
Specifications Specification Person Identification Service (PIDS) Terminology Query Service (TQS) Clinical Observation Access Service (COAS) Resource Access Decision (RAD) Clinical Image Access Service (CIAS) Heterogeneous Information Locator Service (HILS) Order Entry/Tracking Service (OETS) Milestones RFI RFP Submission Adopted Available FTF RTF ISO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! As of November, 2000
PIDS Name SS # Birth Date Age Sex Person Identification Service http://cgi.omg.org/cgi-bin/doc?corbamed/98-01-09 Brief Summary: Service for uniquely identifying a person in an enterprise. Design Considerations: 1. Support both the assignment of IDs within a particular ID Domain and the correlation of IDs among multiple ID Domains. 2. Support searching and matching of people in both synchronous and asynchronous modes, independent of matching algorithm. 3. Permit PIDS implementations to protect person confidentiality under the broadest variety of confidentiality policies and security mechanisms. 4. Enable plug-and-play interoperability via a "core" set of profile elements, yet still support site-specific and implementation-specific extensions and customization of profile elements. 5. Support federation of PIDS services in a topology-independent fashion.
TQS Terminology Query Service http://cgi.omg.org/cgi-bin/doc?corbamed/98-03-22 Brief Summary: Service for accessing terminological information for use in mediation, presentation and dynamic discovery. Design Considerations: 1. Specify a set of common, read-only methods for the purpose of accessing the content of medical terminology systems. 2. The two major areas of focus: High volume on-line services. These services are used by an on-line production system. The services include translation, inference, presentation and the like. Perusal and browsing services. These services are used as a means of understanding the content and structure of the specific terminology.
COAS Clinical Observation Access Service http://cgi.omg.org/cgi-bin/doc?dtc/00-01-01 Brief Summary Service used to retrieve content information about a subject of care, such as a person. Design Considerations: 1. The Clinical Observations Access Service (COAS) is a set of interfaces and data structures with which a server can supply content information about a subject of care. 2. The information can be quantitative, qualitative, or recordings. For example: Vital signs Clinical laboratory results Trends in measured values Impressions from a clinical exam Correlation of several qualitative impressions 3. The information includes any related item that has the necessary context information to enable it to be queried from a COAS server.
RAD Resource AccessDecision http://cgi.omg.org/cgi-bin/doc?corbamed/99-04-04 Brief Summary Service used to obtain authorization decisions and administrating access decision policies for information. Design Considerations: 1. The ability to leverage existing security standards, such as Kerberos, SSL, PKI 2. Secure interoperability across distributed technology environments (OSF/DCE, CORBA, LDAP) 3. Use for the identification of caregivers privileges 4. Commercial vendor support by companies specializing in security solutions 5. To maintain security policy without the need to modify healthcare applications. Allows the security administrators to dynamically maintain and enforce security policies as they evolve 6. Leverage the power of componentization : the separation of security policy from the healthcare applications 7. A simple, standardized interface that product vendors use to request access control decisions
CIAS ClinicalImage Access Service http://cgi.omg.org/cgi-bin/doc?corbamed/00-02-01 Brief Summary The Clinical Image Access Service (CIAS) is a set of interfaces and data structures with which a server can provide clinical images. It also provides a means to transforming images from non- Internet formats such as DICOM to standard Internet formats such as GIF and JPEG. Design Considerations: 1. Clinical images are sets of two-dimensional arrays of picture elements (pixels) which may be related by anatomy or time series, or both. From the image format point of view, it can be divided into two categories: DICOM images and non-dicom images 2. CIAS is used only for clinical image access. Real-time or broadcast streaming video information is specifically excluded from this specification 3. To provide clear, unambiguous mechanisms to access medical image information and related metadata in a manner which is useful to general practitioners and clinical specialists where diagnostic image quality is not a consideration 4. CIAS is the first specification to specialize based on COAS
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: Medical Record #: F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs
Scenario Locate a given patient s unit and medical record number given a set of identifying traits. Master Patient Index Persistent Store Common Services PIDS CORBA PIDS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs
Radiology Clinic Persistent Store Common Services HILS Trader Primary Care Facility Persistent Store Common Services HILS Trader Scenario Keep track of locations where a given patient has had medical care given. HILS Trader CORBA Scenario Attain the locations where a particular patient has had medical care given. HILS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria Filter: All Date/Time: 01/01/00 01/12/00
Scenario Determine the access privileges of a given user for a given patients medical information. Resource Access Decision Persistent Store Common Services RAD CORBA RAD Clinican Workdesk Application
Primary Care Facility Persistent Store Scenario Attain the particular type of medical information at the specified location where a given patient has had medical care given. Common Services COAS CORBA COAS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria Filter: All Date/Time: 01/01/00 01/12/00 Date 02/07/2000 08/08/2000 09/10/2000 23/10/2000 16/10/2000 Report Chem19B Hemogram Blood Culture Chem 24 Glucose serum Status Complete Pending
Primary Care Facility Persistent Store Scenario Attain the detailed medical information at the specified location where a given patient has had medical care given. Common Services COAS CORBA COAS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria CHEM24 - NAS K CL BICARB BUN GLU-SER PLAS Filter: All 23/10/00 09:00 138 4.3 101 27 30 189 H Date/Time: 01/01/00 01/12/00 22/10/00 09:00 139 4.0 105 27 32 209 H 21/10/00 09:00 136 4.2 104 22 39 219 H Date Report Status 19/10/00 09:00 141 4.6 104 22 36 219 H 02/07/2000 Chem19B! " 08/08/2000 Hemogram Complete 09/10/2000 Blood Culture Pending 23/10/2000 Chem 24 16/10/2000 Glucose serum
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria CHEM24 - NAS K CL BICARB BUN GLU-SER PLAS Filter: Chest2 View 23/10/00 09:00 138 4.3 101 27 30 189 H Date/Time: 01/10/00 01/11/00 22/10/00 09:00 139 4.0 105 27 32 209 H 21/10/00 09:00 136 4.2 104 22 39 219 H Date Report Status 19/10/00 09:00 141 4.6 104 22 36 219 H 02/07/2000 Chem19B! " 08/08/2000 Hemogram Complete 09/10/2000 Blood Culture Pending 23/10/2000 Chem 24 16/10/2000 Glucose serum
Scenario Determine the access privileges of a given user for a given patients medical information. Resource Access Decision Persistent Store Common Services RAD CORBA RAD Clinican Workdesk Application
Primary Care Facility Persistent Store Scenario Attain the particular type of medical information at the specified location where a given patient has had medical care given. Common Services CIAS CORBA CIAS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria Filter: Chest2 View Date/Time: 01/10/00 01/11/00 Date 05/10/00 06/10/000 09/10/2000 16/10/2000 23/10/2000 Report Chest2 View Chest2 View Chest2 View Chest2 View Chest2 View Status
Primary Care Facility Persistent Store Scenario Attain the detailed medical information at the specified location where a given patient has had medical care given. Common Services CIAS CORBA CIAS Clinican Workdesk Application
File Edit Patient Clinical Modules Tools View Window Help Patient: Marianna, Mang Unit#: 169 Medical Record #: 984753 69Y F 25/06/1931 Find Patient Find Data Laboratory Pharmacy Allergies Radiology Vital Signs Search Criteria Chest2 View 09/10/00 Read by: Dr. X Ray Filter: Chest2 View Date/Time: 01/10/00 01/11/00 Date 05/10/00 06/10/000 09/10/2000 16/10/2000 23/10/2000 Report Chest2 View Chest2 View Chest2 View Chest2 View Chest2 View Status