Connected Health Framework

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Connected Health Framework

• Roberto Ruggeri
• Sr. Technical Strategist - Healthcare
• Worldwide Public Sector
• Microsoft Corporation

One Health _at_ Microsoft
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Health Plans
Collaboration Care Mgnt, Case Mgnt Self
Serve, HSAs Call Center Solutions Disease
Management Modernizing Claims Processing
Life Sciences
Provider
Clinical Administrative Portals Real-time
Communications Physician Office MS Dynamics
Partner Solutions HIS Clinical
Systems Connected Healthcare HL7 HIPAA
Clinical Research, Collaboration
Knowledge Mgnt Discovery Collaboration Clinical
Trials Enablement Improved Sales Marketing
E-detailing Mobile CRM solutions Agility in
Manufacturing
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The Need for Health Information Networks

• Healthcare spending up to 1.7T in 2003 ()
• Between 44,000 and 98,000 Americans die each year
  from inpatient medical errors ()
• Over 770,000 people are injured or die each year
  in hospitals from adverse drug events ()
• But also consider day-to-day scenarios
• Filling the immunization records for school
  enrollment
• Filling the same clipboard with the same data
  over and over and over
• Getting to your specialist for a visit before
  your health records
• Having access to the health records for your
  dependents
• And many others

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Health Information Networks
Data W/H
HIPAA
HIPAA
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Opportunities in Health Information Integration

• Health information integration and collaboration
  projects are everywhere
• Integration within the hospital and across
  hospital networks
• Large national integration projects
• US NHIN/RHIOs, Canada InfoWay, UK NHS
• Drivers
• Health Plans-Healthcare Provider-Pharmaceutical
  companies collaboration
• Consumerism
• Need for comprehensive and unified message and
  guidance for partners and customers

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Key Microsoft Activities

• Develop architectural guidance
• Federated, trustworthy, distributed system for
  health information exchange based on
  open-standards
• Develop partner ecosystem
• ISV partners make customer experience reliable,
  cost-predictable interoperable.
• SI partners for business consulting, deployment,
  integration
• Develop and profile the use of standards
• Working closely with SDO to define infrastructure
  standards
• Working with customers and partners to refine use
  of standards
• Engage early adopters
• Thought leadership
• Interoperability Consortium, Connecting for
  Health (Markle), DHHS RFP, policy-making
  activities, AHIC, HITSP

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Connected Health Framework

• A Foundation for Service Oriented Health Industry
  Architecture

One Health _at_ Microsoft
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Vision

• Define an overarching framework for Health
  Industry Architecture
• Best practices for service oriented health
  information integration and collaboration
  architectures
• Enterprise-, state-, province- and country-wide
  projects
• Faster ROI
• Based on open standards and protocols
• Develop ecosystem of CHF-enabled solutions
• Faster ROI for customers
• Frame of reference for partners solutions
• Easier integration across multiple solution areas

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Guiding Principles

• Achieve Application Integration, through
• A Stable Foundation and Agile Implementations
• Managed Multiplicity of Platform and Location
• Flexible Application Configuration and Process
  Engineering
• Consistent, available, understandable Data
  Sources
• Legacy Modernization and Reuse
• A Business Pattern for Healthcare
• Achieve Technical Interoperability, through
• Open Standards
• Best Practice Guidelines
• State of the Art technical capabilities
• Secure, manageable, efficient infrastructures
• A Reference Architecture for Healthcare

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CHF Business Framework

• The CHF Business Framework uses a service
  oriented approach to
• Define business components and major subject
  areas
• Offer a range of services that can be
  orchestrated to enable and support business
  processes
• Leverage existing sources of functionality and
  information
• It provides a Business Pattern for Healthcare

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CHF Business Framework
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CHF Technical Framework

• The CHF Technical Framework addresses
• Multiplicity of services, sources of data and
  systems
• Management of patient and clinician identity
• Integration across multiple systems
• Flexibility and agility
• Security
• Scalability, Performance and Availability
• It provides a Reference Architecture for e-Health
  

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CHF Technical Framework
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Connecting Business Technical Frameworks
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CHF Unified Architecture
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Technical Architecture
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Key Architectural Principles

• Service Oriented Architecture
• Allows for modular approach
• Open standards-based
• Focus on the basics, add additional services
  later
• Data Network
• UI is an additional service
• Federated data
• Focus on subset of Critical Care Information
• Data ownership is preserved
• Federated security
• Centralized security management extremely complex
• Trustworthy
• Reliable, fault tolerant

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Options For Clinical Data

• Mostly a matter of ownership and policy
• Centralized model
• Central repository holds replica of full health
  record
• CDX Gateway published full health record and
  managed data sync
• Federated model
• Central repository holds no PHI, just demographic
  data
• CDX Gateway publishes registration events and
  caches full record
• Hybrid model
• Central repository holds record summary
• CDX Gateway published record summary and caches
  full record

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Flexibility in Deployment
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Core Services

• High-performance Record Locator Service
• DNS-like operation, totally replicable and
  redundant
• No Protected Health Information (PHI)
• Clinical Repository
• Depending on data federation policies
• Patient Registry and Identity
• Master Patient Index
• Security and Trust services
• Manage federation of applications
• Accreditation process
• Authorization, logging and access control

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Value-add Services

• Hosting
• Physician practices, vendor-led communities,
  rural and underserved areas
• Provide appropriate service levels
• Data pre-aggregation
• Mediation and terminology services
• Translation services
• Publish and Subscribe
• De-identified data for surveillance, research
• Mostly orthogonal to clinical data exchange
• Patient or population Intelligence
• Decision support, outcome-based care

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Interoperability

• Service Oriented Architecture
• Detailed business collaboration specifications
• Core messaging and connectivity Web Services
• Based on broadly accepted and adopted standards
  such as SOAP, WSDL
• Protocol or message security based on HTTPS,
  tunneling protocol or WS-Security 1.0/1.1
• Security federation
• WS-Trust family of specification
• Agnostic to message payload
• Clinical Data Exchange based on limited,
  normalized set of standards HL7 v2.x, HL7 CDA,
  ASTM CCR, NCPDP SCRIPT, DICOM (?), HIPAA TS

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Microsofts CHF Platform
Office System
Office System, LiveMeeting, Exchange, Windows
Server System
BizTalk Server, .NET Framework
Visual Studio, .NET Framework
Operations Manager, System Center
SQL Server
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Next Steps

• CHF content is now being finalized
• Verification with selected customers and partners
  in several countries
• Business and Technical Architecture papers and
  guidance will be published in Q4 CY2006
• Contact your local Microsoft subsidiary or
  health_at_microsoft.com to engage
• Think service oriented business and technical
  architectures
• Leverage Microsofts platform for security,
  collaboration, management, integration

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Thank You!

• Roberto Ruggeri
• Roberto.Ruggeri_at_Microsoft.com
• http//blogs.msdn.com/rruggeri