1. society
2. welfare
3. healthcare

CON8008 - Healthcare Modernization
with SOA Suite
Steve Schenks, Ascension Health
Kevin Mattingly, Ascension Health
Sean Keane, Oracle
Suresh Sharma, Oracle
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Safe Harbor Statement
The following is intended to outline our general product direction. It is intended for
information purposes only, and may not be incorporated into any contract. It is not a
commitment to deliver any material, code, or functionality, and should not be relied upon
in making purchasing decisions. The development, release, and timing of any features or
functionality described for Oracle’s products remains at the sole discretion of Oracle.
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
About the presenters
4
Steve Schenks
Kevin Mattingly
Integration Architect,
Ascension Health
Integration Architect,
Ascension Health
Sean Keane
Suresh Sharma
Director, Healthcare
Interoperability,
Oracle
Product Strategy Director,
Oracle
Copyright © 2013, Oracle and/or its affiliates. All rights reserved.
Oracle Public Information
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Oracle Healthcare Focus
Connected Health/
Operational Efficiency
Health Management
Platform
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Analytics
Oracle Healthcare: A Complete Portfolio
Business Performance
•Financials
•Supply Chain
•Human Resources
•Strategic Planning
•Talent Management
•Advanced Controls
•Value Chain Planning
•Grants Management
Infrastructure & Mobility
•Security
•Care Giver -Mobility
•Identity
•Exchange
•3CI
•Master Data Management
Healthcare Analytics
•Financial Performance
•Supply Chain Analytics
•Human Resources Analytics
•Cost Accounting
•Translational Research Analytics
•Molecular Medicine
•Clinical Performance
•Operating Room
Healthcare Management Platform
•Health & Disease
• Management
•Patient & Clinical Portal
•eCommerce
•Patient Discharge Mgt
•Healthcare Retail Solutions
•Translational Research Solutions
•Healthcare Cost Management
Care Management and
Partners
Interoperability
and Integration
•SOA Suite for Healthcare
•Master Patient Index
•Healthcare Data Model
•Collaboration
•HIE Solutions
•ACO Solutions- Coordinated Care
•NHIN Connect
•Medical Device Integration
•Epic
•Cerner
•McKesson
•Allscripts
•GE
•Orion
•Siemens
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Healthcare – tactical trends
 Securing data access and at rest
 Increased reporting of data breach
 Laptops, thumb drives, paper
 Data replicated to many unaudited destinations
 Meaningful Use Stage 2 is here
 Greater Patient Engagement, consumerism, retailization
 Increased data sharing
 Increased usage and demand for Analytics
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. | Oracle Confidential – Internal/Restricted/Highly Restricted
8
Healthcare – strategic trends
 ONC
 New focus on interoperabilty and data exchange
 Certification and Regulation role
 HL7 FHIR
 Fast Healthcare Interoperability Resource
 HL7 V4 (sshhh!), REST, JSON, XML
 Increased data sharing across care settings
 ACO
 Stop replicating data!
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. | Oracle Confidential – Internal/Restricted/Highly Restricted
9
Ascension Health
 Ascension (www.ascensionhealth.org) is transforming healthcare by
providing the highest quality care to all.
 Ascension is directed by the Church to care for those most in need. Our
Catholic philosophy permeates our national health ministries and our promise
to provide
Healthcare That Works
Healthcare That is Safe
Healthcare That Leaves No One Behind
Ascension Information Services Confidential and Proprietary
10
Program Agenda
 Oracle Healthcare Focus and Healthcare Trends
 Ascension Health Case Study
 Oracle SOA for Healthcare Overview
 Demo
Ascension Information Services Confidential and Proprietary
11
Current Environment – Scattered Deployments
 As Ascension Health added hospitals and related health facilities, siloed IT
departments were also added in some cases
 The majority of the clinical interfaces (2058) and all the PeopleSoft human
resources, finance, supply chain interfaces (1084) are supported by the
Ascension Shared Information Services ("SIS") integration team and run in a
centralized data center.
 Other interfaces (approximately 1000) are supported by Health Ministries
themselves and run locally at the Ministry.
Ascension Information Services Confidential and Proprietary
12
Moving to Standardization
Shared Integration
Stand-Alone Integration
Oracle
Java
CAPS
(JCAPS
5.1.3)
Orion
Rhapsody
v 5.1.0
Sybase
Impact TDM
4.1 / Ebiz
5.5.4
Standardization
eGate
TRE 5.0.1
(Clinical)
eGate SRE
Summit
Express
Connect 8
Sybase eBiz
Impact
eGate
4.5.3
Lawson
Cloverleaf
eGate
SRE 5.0.5
(Symphony)
Ascension Information Services Confidential and Proprietary
Shared
Integration
One Integrated
Ministry
Oracle SOA
Suite
Oracle SOA for
Healthcare
Oracle
Enterprise
Manager 12c
Oracle
Database
12c
High-value
Service
Delivery
Oracle
Managed
File Transfer
Governance &
Optimization
13
Schedule
=
Ascension Information Services Confidential and Proprietary
14
High Level Architecture Overview
Ascension Information Services Confidential and Proprietary
15
IP Virtualization Strategy
Ascension Information Services Confidential and Proprietary
16
Interfacing in SOA for Healthcare
 Comparison Testing
 Easing the transition to SOA for Healthcare
 Integration Flows
 Implementing Common Healthcare Message Patterns with SOA for Healthcare
 Exception Handling Framework
 Handling Exceptions with SOA for Healthcare
 Custom Operations Dashboard
 Managing an enterprise environment with SOA for Healthcare
Ascension Information Services Confidential and Proprietary
17
Comparison Testing
Testing with 1 month of input and
output Production Data.
Compare Results
Legacy
Output
The scenarios that occur in 1 month
of production data get tested *
A
Typical technical scenarios captured
and tested prior to comparison
 Ensures we are validating existing functionality.
=
SOA Output
A’
Migrated Interface functionality
matches Legacy Interface functionality
 Typical end-to-end testing is not required because no new
functionality is introduced.
POTENTIAL
DEFECT FIXING
Potential defects proactively fixed to expedite
testing and Cut-over validation.
OPTIMAL USE
OF END USER TIME
Code that has gone through output
comparison against the scenarios that occur
in 1 month of production data is deployed on
UAT\Production servers enabling optimal
UAT thus reducing test cycle durations.
SMOOTH
DEPLOYMENT
Typical scenarios which may create issues in
Production Environment are mitigated by
proactive planning.
* NOTE: identical (same) production test data is processed in bulk through Legacy and SOA systems. Results are compared to match the legacy interface output against
SOA interface output using same input data.
Ascension Information Services Confidential and Proprietary
18
Comparison Testing - Architecture
Ascension Information Services Confidential and Proprietary
19
Integration Flow – High Level
Routing
1
Source 1
Mediator
Transformation
Mediator
A
Mediator
Ba
Mediator
C
Mediator
Source 2
2
SSHI
Destination A
Message
Ty pe
1
A
Mediator
SSHI
Mediator
Destination B
C
Message
Ty pe
2
Source 3
Message
Ty pe
1
Message
Ty pe
2
3a
Mediator
Mediator
Bb
Destination C
3b
Mediator
Source Interface Leg
Mediator
C
Destination Interface Leg
*Primary constraint is FIFO. Must be maintained by source.
Ascension Information Services Confidential and Proprietary
20
Integration Flow - Scenarios
Source with Single Message Format
ADT
Mediator
Source
SSHI
ADT
1
Mediator
A
Destination A
ADT
Mediator
B
Mediator
C
Mediator
A
SSHI
ADT
Destination B
Destination C
Source with Multiple Message Formats
ADT
Source
ADT
1
SSHI
Mediator
ORU
2
Ascension Information Services Confidential and Proprietary
Destination A
ADT
Mediator
Mediator
B
C
ORU
SSHI
Destination B
Destination C
21
Integration Flow - Scenarios
Destination with Single Message Format
Source 1
ADT
1
Mediator
Mediator
A
ADT
SSHI
Source 2
ADT
2
Mediator
Mediator
A
Mediator
Mediator
A
SSHI
Destination
SSHI
Destination
ADT
Destination with Multiple Message Formats
Source 1
ADT
1
ADT
SSHI
Source 2
ORU
2
Ascension Information Services Confidential and Proprietary
Mediator
Mediator
A
ORU
22
Integration Flow - Scenarios
HL7 and Non-HL7 Batch File
Non-HL7 Batch File – Utilizes SOA Suite File Adapter
HL7 Batch File – Utilizes SOA Suite HealthCare Adapter and SSHI Endpoint
MFT Solution – Short-term: Accenture developed AFPO MFT solution
– Long-term: Oracle SOA Suite 12c MFT
Ascension Information Services Confidential and Proprietary
23
Exception Handling Framework
Consists of the following:
• Logging
• Exception Handling
• Notifications
SISAI Event Handler
Publisher
Event Delivery Network
Custom Operations Dashboard was developed for
viewing errors and message data.
ADF
DashBoard
SISAI Event Handler
Sub scriber
Logging
Sub scriber
ServiceNow
Ticket
Creation
Notificatio n
Sub scriber
SISAI_ERROR_LOG
(Table)
B2B_INSTANCEMESSA GE
(View)
Ascension Information Services Confidential and Proprietary
24
Exception Handling Framework
SSHI/B2B layer: Any exception in the SSHI layer like the unavailability of the End Points, TCP/MLLP/FTP protocol
error, Document translation error etc. results in an exception thrown by the SSHI layer.
SOA Composite layer: Any exception
related to routing and transformations
occurring in the Mediator component
would be result in an exception thrown
by the Composite layer.
Ascension Information Services Confidential and Proprietary
25
Exception Handling Framework
External
Sender
Source System
Inbound HL7
Processing
SSHI Adapter
Routing and Transformation
(SOA Composite)
Routing
Mediator
Outbound HL7
Processing
Transformation
Mediator
Transformation
Mediator
B2B_EXCEP TION_QUEUE
External
Receiver
SSHI Adapter
Destinatio n
System
SSHI Adapter
Destinatio n
System
Fault
Policy
B2B Excep tio n
Handler
SOA Exceptio n Handler
Custom Compo nen t
Custom Compo nen t
SISAI Exception Handling
Framework
SISAI Event Handler
Publisher
Event Delivery Network
SISAI Event Handler
Sub scriber
Logger
ServiceNo w
Ticket
Creation
Notificatio n
SOA Infra
DB
Ascension Information Services Confidential and Proprietary
26
Custom Operations Dashboard
Problem
Ascension Health has approximately 2750 endpoints spread across 26 Health Ministries. The number of endpoints
dictates that multiple SOA for Healthcare domains must exist – current implementation plan includes 6 domains.
Solution
In order to effectively monitor and get a complete picture of the Healthcare transactions and endpoints across the
multiple domains, Ascension in partnership with Accenture is developing a Custom Operations Dashboard that will
provide the single view across all Healthcare endpoints. The Operations Dashboard will include the following
functionality:
•
•
•
Endpoint Dashboard: allows for a ‘rollup’ status by Ministry. This dashboard utilizes the B2B_InstanceMessage view as well
as a custom table used to store the errors / notifications produced by SOA and SOA for Healthcare.
Errors: allows for the searching and viewing of errors that occur in any of the domains.
Messages: allows for the searching and viewing of transactions that are received or sent via any of the domains
Ascension Information Services Confidential and Proprietary
27
Operations Dashboard – Endpoint Dashboard
Provides an status overview of all endpoints. Status is based on the last message processed. It is not used for
monitoring.
Ascension Information Services Confidential and Proprietary
28
Operations Dashboard – Errors
Allows for searching and displaying of error messages that occur across all domains
Ascension Information Services Confidential and Proprietary
29
Operations Dashboard – Errors - Detail
Displays detailed information for selected error.
Ascension Information Services Confidential and Proprietary
30
Operations Dashboard – Messages
Allows for searching of data
messages – both metadata
and payload.
Displays messages based on
search results.
Ascension Information Services Confidential and Proprietary
31
Operations Dashboard – Messages - Detail
Displays detailed information for selected message.
Ascension Information Services Confidential and Proprietary
32
Operations Dashboard – Messages - Detail
Displays selected message payload.
Ascension Information Services Confidential and Proprietary
33
Milestones Timeline
FY14-Q4
FY15-Q1
FY15-Q2
FY15-Q3
FY15-Q4
FY16-Q1
FY16-Q2
FY16-Q3
FY16-Q4
FY17-Q1
FY17-Q2
(Apr-Jun 2014)
(Jul-Sep 2014)
(Oct-Dec 2014)
(Jan-Mar 2015)
(Apr-Jun 2015)
(Jul-Sep 2015)
(Oct-Dec 2015)
(Jan-Mar 2016)
(Apr-Jun 2016)
(Jul-Sep 2016)
(Oct-Dec 2016)
PLATFORM DEVELOPMENT
1
2
3
4
1. Development (DEV) Run Time Environment available (6/20/14)
2. System Integration Test (SIT) Run Time Environment available (7/11/14)
3. User Acceptance Test (UAT) Run Time Environment available (9/5/14)
5
4. Production (PRD) Run Time Environment available (10/24/14)
5. Monitoring Dashboard is operational (11/14/14)
6. Oracle to advise on 12c version upgrade (TBD)
INTERFACE DEVELOPMENT & CUT-OVER (BY MINISTRY)
Alpha: MDBAL (11/14/14)
Note: Durations/dates for Groups 6 (AZTUC & NYNIA), 7 (ILARL), 8 (MOKAN)
and 9 (Marian Health Ministries) are to be determined.
A
Beta: FLJAC (1/27/15)
B
1a
1b 1c
1d
Group 1:
1a. IDLEW (2/9/15), 1b. TXWAC (3/20/15), 1c. WIMIL (3/31/15), 1d. MIGRA (5/28/15), 1e. TXAUS (12/23/15)
1e
2a
Group 2:
2a. INEVA (1/29/16), 2b. ININD (6/30/16)
2b
Group 3: SY-SR (12/23/16)
3
4a 4b
Group 4:
4a. DCWAS (5/18/16), 4b. ALMOB (5/31/16), 4c. NYBIN (10/24/16), 4d. MIDET (10/31/16),
4e. ALBIR (12/23/16)
4c
4d
4e
5a
Group 5:
5a. CTBRI (11/30/16), MIKAL (11/30/16), MITAW (11/30/16)
5b. WAPAS (12/23/16), TNNAS (12/23/16), FLPEN (12/23/16),
MISAG (12/23/16)
SIS-AI ORGANIZATIONAL DESIGN & OPERATING MODEL
1
2
3
5
4
6
1. Functional Model complete (5/16/14)
2. Org Structure and Capacity Planning detailed (7/2/14)
3. Roles and Responsibilities finalized (7/16/14)
4. Resource Transition Plan complete (8/1/14)
5. Operating Model complete (9/12/14)
6. Org Blueprint complete (10/1/14), Operations Manual complete (10/1/14)
& Performance Metrics Deliverable complete (10/1/14)
SIS-AI TRAINING & TRANSITION
A
1
B
C
2
1. Training materials developed (9/12/14)
2. Trainers (4) equipped to conduct training (12/24/14)
Ascension Information Services Confidential and Proprietary
D
A. Ready to Support Alpha Go-Live (9/4/14)
B. Ready to Support Beta Go-Live (11/6/14)
C. Ready to Support Group 1 Go-Live (12/4/14)
F
E
G
D. Ready to Support Group 2 Go-Live (11/2/15)
E. Ready to Support Group 3 Go-Live (8/4/16)
F. Ready to Support Group 4 Go-Live (3/3/16)
G. Ready to Support Group 5 Go-Live (9/2/16)
34
5b
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Oracle SOA Suite
Unified Integration Across Cloud, Mobile, and On-premise
• Simplifies development and
management
• Standards-based, open
infrastructure interoperates
with your existing IT
Analytics
Business Activity Monitoring
Event Processing
Orchestration
BPEL Process Manager
Business Rules
Service Virtualization & Mediation
Service Bus
• Consistent tooling - Single
development, deployment and
management platform
Connectivity
Apps
Services
Business to Business
On-premises
Cloud
Platform
Apps
Mainframe
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
DB
EDI
XML
Industry
SOA Suite 12c
Key Features
• 30 % memory footprint reduction
• First class support for mobile-
friendly standards (REST, JSON, …)
• Startup acceleration
Web Scale
• Pre-tuned database profiles
Mobile
• Automated conversions REST/SOAP
• Active-active support
• One-click install
• Cloud adapters to simplify on-prem
to cloud integration
• Everything in JDeveloper
Developer
Productivity
• Debugger & tester
• Templates
Cloud
• Managed File Transfer (MFT) for
file-based integration
• Certifications on Oracle Public Cloud
Copyright © 2014, Oracle and/or its affiliates. All rights reserved. |
Oracle SOA Suite for healthcare integration
Healthcare
Console
Enterprise
Manager
Document
Editor
Interface Configuration,
Dashboards, Monitor
Healthcare Message creation,
customization, testing
Systems
Management
HealthCare Runtime Engine
Translation
HL7 v2.X
Validation
MLLP
HLLP
WS-HTTP
FILE
ACK FTP
Handling
SFTP
JMS
MFT
Sequencing
Healthcare Runtime
Engine
Translation
HL7 v3.0
Custom
Sequencing
Mapsets
ACK
Handling
Resubmission
Validation
Batching
Callout
TRANSPORT
Route, Transfer,
Integrate
BACK END
INTERFACE
SOA
Composite
Document
Handling
Database
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
External
System
IOT in Healthcare
Scenario : Correlating a Patients Diagnosis with Devices Reading for More Accurate Alarm
Evaluation and Enhanced Patient Care
Correlation scenario:
Scale: 3 lb weight gain
 BP cuff: Slight elevation in BP
Pulse: Slight increase in pulse
–Alone, each data point may not
be reason for concern
– Together they may indicate a
potential emergency
– Local analytics triggers a query
to the patient, and sends data
along with patient feedback in a
single alert to the care provider or
hospital
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. | Oracle Confidential – Internal/Restricted/Highly Restricted
39
Mobile Health
Scenario : Collect Member healthcare info via mobile channels
 push to EHR, proactively increase patient engagement
Biometric Devices
RESTful API
Oracle Service
Bus
Integration Infrastructure
Healthcare Adapter
Update EHR
Analytics View, Alerts
Driver: Move to ACO, Value based Payments,
Population Health Management require Providers
to provide proactive care delivery
Solution : Leverage mHealth /mobile apps ,
biometric devices to increase Patient engagement
Flow:
Mobile Application : Collecting Patient Data from
devices
REST API to send data to backend application
(EHR) ;convert JSON msg to HL7 format
Sync up data with back end (EHR) using SOA for
Healthcare
capture and analyze large amounts data and
generate appropriate alerts / data flows into the
EHR workflows to proactively engage with patients.
Platform/Devices:
iOS/iPhone, FitBit, Withings Pulse O2
EHR
BAM Dashboards
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Program Agenda
Oracle Healthcare Focus and Healthcare Trends
Ascension Health Case Study
Oracle SOA for Healthcare Overview
Demo
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Healthcare 2 Home IOT Flow
4
3
Sends Temperature,
Breathing and SPO2
results to REST Service
Sensors Installed
on Healthcare IOT
Device and sends
captured results
SOA Healthcare sends
data to endpoints
6
Cloud Services
Oracle SOA
Healthcare
Send to EMR System
EMR
Raspberry Pi with OEP
Server and Web Server
DB
Breathing
Sensor
1
5
Oracle SOA
Temperature
Sensor
SPO2 Sensor
Receives JSON data and
converts into HL7 and
invokes SOA Healthcare
Adapter and stores the
information into tables
2
Gateway becomes SMART
with OEP Embedded.
JSF/ADF
Mobile
It analyzes temperature data
to identify temperature
fluctuations
8
7
ADF /ADF Mobile
UI (Oracle Portal)
To present the captured
data
Copyright © 2014 Oracle and/or its affiliates. All rights reserved. |
Portal to observe the
result and analyze