Task Analysis and Interoperable Application Services for Service Event Management

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Computing, Healthcare Information Systems Research and Development, Kuopio, Finland b Medbit Oy, Turku,

1 Task Analysis and Interoperable Application Services for Service Event Management Juha MYKKÄNEN a, Hannu VIRKANEN a, Pirkko KORTEKANGAS b, Saara SAVOLAINEN a, Timo ITÄLÄ c a University of Eastern Finland, School of Computing, Healthcare Information Systems Research and Development, Kuopio, Finland b Medbit Oy, Turku, Finland b c Aalto University School of Science and Technology, SoberIT, Espoo, Finland juha.mykkanen@uef.fi MIE 2011 Oslo 1

2 Outline Background The national health IT infrastructure development in Finland The SOLEA project Materials and methods Results: the analysis model Discussion and conclusions 2

Speaker background Juha Mykkänen, PhD, research director University of Eastern Finland, Health Information Systems R&D Board member in Finnish Social and Health Informatics Association, IMIA

3 Speaker background Juha Mykkänen, PhD, research director University of Eastern Finland, Health Information Systems R&D Board member in Finnish Social and Health Informatics Association, IMIA representative of Finland, HL7 Finland chair (co-chair common services SIG), HL7 SOA Ambassador Projects developing and applying SOA and integration approaches, national-level and citizen-centred ehealth and wellbeing projects SOLEA: Agile Enterprise Architecture using SOA and BPM Mind and Body programme, SalWe SHOK, OmaHyvinvointi (MyWellbeing): personal wellness management SerAPI: SOA and integration of healthcare applications PlugIT: healthcare application integration ekat / guidelines for national ebooking of health services 2008 Healthcare services specification project (HSSP) / HL7 and OMG, Integrating the Healthcare Enterprise - IHE.fi National project for social services IT - Tikesos China/Finland ehealth partnership + other projects in Shanghai Various HL7 Finland and web services standards specifications Juha Mykkänen, MIE

4 Background: national health IT initiatives in Finland National-level centralized services for eprescription and earchive National-level information sharing through earchive service and local / regional systems which connect to it Structured patient information, agreed-upon document specifications, messaging and security solutions eprescription spreading nationally (currently more than 100 k eprescriptions made) earchive and sharing of patient documents in testing phase Many different specifications from various projects guiding the implementation work of national information sharing Difficulties in providing uniform and comprehensive composition rules for patient information from various systems and sources and from disparate local workflows Irmeli Luukkonen, MIE

5 Context: SOLEA project national R&D project focusing on the use of service-oriented enterprise architecture to support the management and interoperability of complex information systems in healthcare and other industries one of many working packages: refinements required to support service events in relation to the national EPR specifications was selected as one of the main working items of the project in late 2009 Juha Mykkänen, MIE

6 Service event concept Encounters are used for organizing and structuring healthcare acts which pertain to patient's health history and guidelines related to multistep clinical processes Collecting and sharing service encounter data is the foundation of an electronic health record Challenge: multiple sources, different syntaxes and semantics In Finnish national solutions, service events are used to group documentation entries of one visit or episode: "organizing or performing one healthcare service a central concept in patient consent management, reporting and billing, as well as in achieving clarity and integrity of EPR use for professionals

7 Goals, materials and methods Challenge: requirements and specifications stating the concepts and functionality related to the management of EPR information in clinical and administrative activities were inconsistent and dispersed Goals: clarification of definitions and interpretations of service events coherent specification of lifecycle of service events and communication of this lifecycle in various information systems related to the care process refinements to the interoperability specifications between various applications or services related rules and information and concept models reusable services to support the management of care process documentation and consent management basis for open interface specifications Materials: existing national specifications, eight expert workshops Methods of this paper: task analysis and identification of SOA application services based on this analysis (constructive conceptual development)

8 Tasks of service event management 1 Service event management tasks Provid er Patient EHR Archi ve Make a referral P P P Receive and process a referral P P a Insert a patient in the queue P P a Schedule an encounter based on a referral P a P a Schedule an encounter without a referral P a P a Cancel a scheduled encounter P a P a Unanticipated registration and admission P P a Define information needs P a a a Define justification of information transfer across organizations P a P a Pr = provider Pa = patient EHR = local EHR application EAr = national EPR archive service P = always participating, a = potential participant for improved automation or efficiency 8

9 Tasks of service event management 2 Service event management tasks Provid er Patient EHR Archi ve Document query P P P Document retrieval P P P Assess and use information in care P a Make a new information entry P P P Make an information delivery consent or denial a P a P Transfer patient to another ward / unit P P a Discharge patient / conclude a visit P P P Make a study or consultation request P P a Receive and fulfill a study or consultation request P P a Pr = provider Pa = patient EHR = local EHR application EAr = national EPR archive service P = always participating, a = potential participant for improved automation or efficiency 9

10 After identification of tasks... Based on the above business-level tasks, 22 lower level information processing functions were identified Each function was analyzed for specifying the logical architecture and implementation guidance identification of application roles and services which handle all necessary tasks and functions for each function: location in systems and application services specification of inputs, outputs, participants (as SOA / system roles), exceptions, automation potential, interoperability needs 10

11 Application roles and services SOA service / application role Centralized EPR archive Document composition service Document transmission service Entry composition service Event information repository Document retrieval service Other outputs: user storyboards and example scenarios, conceptual and ontological analysis models specifications of shared information models architectural diagrams for migration phases 11 SOA service / application role Information query service Content producer Content consumer Controller of the patient administrative process Integration infrastructure for service events Context manager

12 Location of application roles and services SOA service / application role Centralized EPR archive L R C D Document composition service * I I Document transmission service * I * Entry composition service * I * Event information repository * * I Document retrieval service I * I I I Implementation scope: N = national service R = regional or local shared service C = included in local core EHR or patient administration applications D = included in departmental / specialized systems I = will be implemented on this level at least in one of the involved organizations or projects * = is potentially implemented on this level depending on local requirements Other outputs: user storyboards and example scenarios, conceptual and ontological analysis models specifications of shared information models architectural diagrams for migration phases 12 SOA service / application role L R C D Information query service I * I * Content producer I I Content consumer * I * Controller of the patient administrative process Integration infrastructure for service events * I Context manager I * I

13 Use and evaluation of results results have been quickly taken up by various other national projects HL7 interface specification project for service event integration specification project for the architecture of lab and imaging integration harmonization project of national specifications resulting specifications of the service event work of SOLEA were evaluated using a survey for the participants of the work and users of the results in the related projects 8 respondents in evaluation questions results summaries such as location of application roles and services and detailed task specifications were seen very useful for system integrations and implementations task analysis and documentation method validation continues: requirements and services for identity and access management + consent and care relationship management for social services

14 Clear and flexible orchestration of care processes and documentation! Tusen takk / Kiitos additional information juha.mykkanen@uef.fi 14

"We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro

"We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro systems " -George Halvorson, borrowed from opening speech by Marion Ball 1 HIS architectures