Kevin Miller

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The Oracle HTB Designed for Healthcare
Baltic ITT 2005 Riga, April 8 Thomas M Jones,
MD Vice President and Chief Medical Officer
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Healthcare challenges
Challenge Requirement
Manage across the continuum of care Comprehensive patient centric record
Assure data re-use for multiple purposes Standards-based data management
Protect patient privacy and adhere to legislative mandates Access control, de-identification, reverse notification
Leverage existing investments Transform and integrate data from any source
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Healthcare activity
Costs
Economic Outcomes
Is a part of
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The importance of infrastructure

• It is important to note that the provision of
  infrastructure services is an enabling mechanism.
  
• The infrastructure itself will deliver some
  benefits, but the main outcomes will be achieved
  by the provision of additional applications and
  services.
• As with any infrastructure, information
  technology infrastructure enables other systems
  that do yield business benefits.

Implementing Information for Health - Denis Protti
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A lifetime of care
Hospital
GP
Pathology
Dental
Physiotherapy
Birth
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Current IT practice
Building silos
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A standards based platform
Healthcare Transaction Base
A Standard Information Model Health Level 7 RIM
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One place to store everything and to retrieve
it for re-use
Healthcare Transaction Base
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Creating a single person record
GP 32561 F
HOSP 2345
PHY 4562 LG
DEN9001
Person Services
Healthcare Transaction Base
A10001
12324
Single Identifier Patient 123456
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Integrating information
HL7 version 2.X
Delaminated File
HL7 Version 3
Person Services
Message Services
XML
Healthcare Transaction Base
Flat File
Bespoke Standard
Single Record Patient 123456
HL7 Version 3.0
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Integration is more than just data exchange

• HL7 Mission StatementDevelop specifications
  that support interoperability in healthcare,
  i.e. computer systems exchanging information in
  the healthcare space will predictably compute on
  the exchanged information based on an agreed upon
  set of specifications defining the structure and
  meaning of the exchanged information.

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More on interoperability

• Syntactic interoperability
• Structures are exchangeable but there is no
  guarantee that meaning will be consistent across
  system boundaries
• Semantic interoperability
• The exchange of meaning between systems
• Computable semantic interoperability
• The exchange of consistent and unambiguous
  meaning between two or more machines

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HL 7 affiliates

• Members include Argentina, Australia, Brazil,
  Canada, China, Croatia, Czech Republic, Denmark,
  Finland, Germany, Greece, India, Ireland, Italy,
  Japan, Lithuania, Mexico, Netherlands, New
  Zealand, Poland, South Africa, South Korea,
  Spain, Switzerland, Taiwan, United Kingdom, and
  USA

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Why HL 7 works many brains
RIM Harmonization Meeting
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Allergy RMIM
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Adding to and reading the EHR
Person Services
Message Services
Healthcare Transaction Base
Single Record Patient 123456
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The ability to unify terminologies
Dental Code
SNOMED Code
ICD 10 Code
Local Code
LOINC
Person Services
Message Services
Terminology Services
Healthcare Transaction Base
ICD 9 Code
Normalised Data SNOMED 123456789
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Incorporating rules
Rule Processing
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Protecting patient privacy
Support for evolving technologies

Security Service
Auditing Service
Healthcare Transaction Base
Single Source of Truth
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Enhancing decision support
Star Schema
Analytic Workspace

Business Intelligence
Healthcare Transaction Base
Single Source of Truth
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Rapid application development

Healthcare Transaction Base
Single Source of Truth
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Supporting new healthcare applications and
processes
Remote Monitoring
New Applications
Application Programming Interface

Healthcare Transaction Base
Single Source of Truth
Existing Applications
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Healthcare Transaction Base Interoperability
Framework
Interoperability Platform

• Data Repository
• Messaging Services
• Terminology Services
• Configuration Services

• Security Services
• Auditing Services
• Person Services
• Business Process API

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Current HTB projects - USA

• District of Columbia Department of Health
• Los Angeles County Public Health System
• National Cancer Institute
• US Military Health Service
• RITPO
• Madigan Army
• CMS
• Louisiana Department of Health and Hospitals

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Municipal Public Health
Data CaptureApplications
Data Mining
Alert Notifications
IncidentReports
EncounterSummary
ResultsAccess
Data Warehouse
Facility ADT Clinical Systems
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National Disease Surveillance
Clinical and Public Health Systems
Messaging Services

• OracleAS
• Integration

HL7 V3 Reference Information Model
Enterprise Data Model
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EHR Public Health Interoperability System
Scenario
Public Health Surveillance
Clinical Care
Hospital of Birth
Newborn Screening Registry
ADT Birth Record
HL7 2.4
HL7 3.0
Newborn Screening
Hearing Screening Registry
HL7 3.0
OracleAS Integration
HL7 3.0
HL7 3.0
Hearing Screening
HL7 2.4
Immunization Registry
HL7 3.0
Immunization Administration
HL7 2.4
HL7 3.0
Communicable Disease Registry
HTB
J2EE
External Laboratory
API
API
J2EE
Healthcare Transaction Viewer
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Metropolitan integrationCentralized decision
support Los Angeles County
Internet
EncounterLifecycle Monitoring
ClinicalOutcomes
ExecutiveInformation System
OperationalDay-to-Day Reports
Cost AnalysisReports
Historical Trending
Data Warehouse
BusinessProcess DataWarehouse
Financial Systems
ADT Clinical Systems
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Metropolitan integration
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Results Review- Metropolitan
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National Network
Internet
Scheduling
StaffManagement
Organization Management
ADT Clinical Systems
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Staff Management
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Current HTB projects - Europe

• Groupe Hospitalier du Havre
• Creteil et Montreuil
• Finsiel (Modena, Busto, Careggi)
• CSC Scandihealth
• Son Llatzer
• Stockholm County
• Cronos (Antwerp)
• Biobank

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Integrated healthcare informationGroupe Hospital
du Havre
New Applications
Analysis and Reporting
Legacy Applications
J2EE
External DataWarehouse
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Summary

• The Healthcare Transaction Base is a standards
  based solution that
• is based on proven scalable technology
• integrates healthcare data across single or
  multiple enterprises
• provides a rapid application development
  environment for healthcare solutions
• protects the IT investments of purchasers,
  partners, and end users
• offers a unique service for citizens/patients
  world wide

Application Programming Interface
Healthcare Transaction Base
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Thank you tom.jones_at_oracle.com