Architecture of eHealth Solutions Connected Healthcare Framework - A Stable Foundation for Agile Healthcare Dr Ilia Fortunov Senior Architect Microsoft

Architecture of eHealth Solutions

Connected Healthcare Framework - A Stable Foundation for Agile Healthcare

Architecture of eHealth Solutions

Connected Healthcare Framework - A Stable Foundation for Agile Healthcare

Dr Ilia FortunovDr Ilia FortunovSenior ArchitectSenior Architect

Microsoft Microsoft EMEAEMEA Public SectorPublic Sector

Connected Healthcare Framework 2

The Microsoft Vision for HealthcareThe Microsoft Vision for Healthcare

Enable the transformation of Enable the transformation of healthcare delivery through healthcare delivery through innovative technology & partnerships innovative technology & partnerships that advance public health programs that advance public health programs by enabling connected citizen care, by enabling connected citizen care, improving quality of care & safety, improving quality of care & safety, and reducing the healthcare cost and reducing the healthcare cost burdenburden


Healthcare is a Complex SystemHealthcare is a Complex System

Healthcare differs from other large scale Healthcare differs from other large scale systems because:systems because:

Healthcare business processes are highly variedHealthcare business processes are highly variedThey change constantlyThey change constantlyMultiple outcomes, often not predicableMultiple outcomes, often not predicableSystem usage is a function of user preference System usage is a function of user preference and practiceand practiceSystems adapt to real-world conditions and a Systems adapt to real-world conditions and a constantly changing environment constantly changing environment

The Connected Healthcare Framework The Connected Healthcare Framework recognises this by:recognises this by:

Separating the dynamic part of the system Separating the dynamic part of the system (business processes and system usage) from the (business processes and system usage) from the stable part (basic functionality and data stable part (basic functionality and data structure). structure).


CHF – Guiding PrinciplesCHF – Guiding PrinciplesAchieve Achieve Application IntegrationApplication Integration, through:, through:

A stable foundation and agile implementationsA stable foundation and agile implementationsManaged multiplicity of platform and locationManaged multiplicity of platform and locationFlexible application configuration and process engineeringFlexible application configuration and process engineeringConsistent, available, understandable Data Sources Consistent, available, understandable Data Sources Legacy rejuvenation and reuseLegacy rejuvenation and reuse

Expressed as:Expressed as:

A Business Pattern for HealthcareA Business Pattern for Healthcare

Achieve Achieve Technical InteroperabilityTechnical Interoperability, through:, through:Open standardsOpen standardsBest practice guidelinesBest practice guidelinesState of the art technical capabilities State of the art technical capabilities Secure, manageable, efficient infrastructuresSecure, manageable, efficient infrastructures

Expressed as:Expressed as:

A Reference Architecture for Connected HealthcareA Reference Architecture for Connected Healthcare


Connected Healthcare FrameworkConnected Healthcare Framework

Focused on major issues specific to Focused on major issues specific to connected healthcare solutionsconnected healthcare solutionsGoes far beyond conventional white papersGoes far beyond conventional white papersProvides:Provides:

A Business Pattern for HealthcareA Business Pattern for HealthcareA Reference Technical Architecture for A Reference Technical Architecture for HealthcareHealthcare

Based on real worldwide experienceBased on real worldwide experienceCreated, reviewed and approved byCreated, reviewed and approved by

Microsoft architects, engineering teams and Microsoft architects, engineering teams and consultants consultants

and and Microsoft partners and customersMicrosoft partners and customers


CHF – from Requirements to SolutionCHF – from Requirements to SolutionTop 10 issues to address:Top 10 issues to address:

How to create a Patient’s Health Record How to create a Patient’s Health Record

How to build a lifelong health history for a patient from How to build a lifelong health history for a patient from information held in multiple, diverse systems information held in multiple, diverse systems

How to mange Identity and AuthoritiesHow to mange Identity and Authorities

How to identify a patient (or a healthcare professional) How to identify a patient (or a healthcare professional) uniquely and reliably. uniquely and reliably.

How to “Join-up” different systems on different platformsHow to “Join-up” different systems on different platforms

How to interconnect diverse systems and how to make How to interconnect diverse systems and how to make them interoperatethem interoperate

How to communicate with remote systemsHow to communicate with remote systems

How to reuse legacy systems How to reuse legacy systems

How to achieve flexibility and agilityHow to achieve flexibility and agility

How to achieve performance and scalabilityHow to achieve performance and scalability

CHF – Aims & Objectives(Demand side = What the Customer wants….)

An Agile, Flexible ArchitectureAn Agile, Flexible Architecture““Plug and Play” application integrationPlug and Play” application integrationUse of open, international standardsUse of open, international standardsProcess orchestrationProcess orchestrationUse of clinical messaging – HL7v3, Use of clinical messaging – HL7v3, SNOMED - CT, IDC10SNOMED - CT, IDC10Module reusability and replacabilityModule reusability and replacability

Business CoverageBusiness CoverageComprehensive functionalityComprehensive functionalityConsistent support for common tasksConsistent support for common tasksSpeciality support on a common Speciality support on a common foundationfoundation

Legacy Integration, includingLegacy Integration, includingIntegration of existing applicationsIntegration of existing applicationsIntegration with legacy messagesIntegration with legacy messagesIntegration with terminology codingIntegration with terminology coding

Role-based User Interfaces Role-based User Interfaces and Processesand Processes

Across multi application, multi Across multi application, multi platform environments (medical error platform environments (medical error reduction)reduction)Preservation of context across appsPreservation of context across apps

Business-focused Processes, Business-focused Processes, local procedureslocal procedures

Consistent, reliable standard Consistent, reliable standard processes with local implementation processes with local implementation flexibilityflexibilityWorkflow support Workflow support

Privacy & ConfidentialityPrivacy & ConfidentialityPatient ConsentPatient ConsentSecurity of data (encryption, sealed Security of data (encryption, sealed envelopes)envelopes)Gatekeepers and guardiansGatekeepers and guardians

Healthcare Business Healthcare Business IntelligenceIntelligence

Data analysisData analysisIdentification of best practise (role of Identification of best practise (role of coding)coding)Forecasting future healthcare needs Forecasting future healthcare needs (could be based on Genomics based (could be based on Genomics based medicine)medicine)

Decision supportDecision supportKnowledge toolsKnowledge toolsDigital contentDigital contentMaterial on the webMaterial on the web


CHF – Needs(Supply side = What we must provide….)CHF – Needs(Supply side = What we must provide….)

Agility and FlexibilityAgility and Flexibility Standards-based, modular, reusable, interoperableStandards-based, modular, reusable, interoperable

ScalabilityScalability National, Regional, Local or Distributed application National, Regional, Local or Distributed application

““Focusability”Focusability”Patient-centric, Process-centric, Research-centric, Admin-Patient-centric, Process-centric, Research-centric, Admin-centric, Speciality-centriccentric, Speciality-centric

GranularityGranularity From high-level summary to the deepest detailFrom high-level summary to the deepest detail

Implementation independent designImplementation independent designCore Business and Data ServicesCore Business and Data ServicesBusiness focused Processes, local procedures Business focused Processes, local procedures User focused, Role-based Presentation and working User focused, Role-based Presentation and working practicepractice

Thorough engineering and testingThorough engineering and testing


CHF – Capabilities(Supply side = What we do provide……)

Agility and FlexibilityAgility and FlexibilityFlexible architectures Flexible architectures

Highly distributed to fully centralisedHighly distributed to fully centralised

Middleware Middleware Secure and Reliable MessagingSecure and Reliable MessagingAdapters and ConnectorsAdapters and ConnectorsBuses and Hubs (e-Health Service Hub) Buses and Hubs (e-Health Service Hub)

Identity and Access Control Identity and Access Control TechniquesTechniques

Directory ServicesDirectory ServicesSingle Sign OnSingle Sign OnFederated identity and authenticationFederated identity and authentication

Enterprise Application IntegrationEnterprise Application IntegrationPersistent to transient data stores and Persistent to transient data stores and recordsrecords

Middleware Middleware

Secure and Reliable MessagingSecure and Reliable Messaging

Adapters and ConnectorsAdapters and Connectors

User Interface and Process DesignUser Interface and Process DesignDevice sensitive interfaces and processesDevice sensitive interfaces and processesLocal and user group specific processesLocal and user group specific processesClinical speciality customisationClinical speciality customisation

Business ProcessBusiness Process OrchestrationOrchestrationReliable and secure message delivery, Reliable and secure message delivery, routing, transformationrouting, transformation

Development MethodsDevelopment MethodsComponent Based Development and Object Component Based Development and Object OrientationOrientation

Service Oriented Architecture and Web Service Oriented Architecture and Web Services TechnologyServices Technology

Software ArchitectureSoftware Architecture..Net FrameworkNet Framework

Relational databases Relational databases

Data ManagementData ManagementClustering and failoverClustering and failover

Disaster recovery – data mirroringDisaster recovery – data mirroring

ScalabilityScalabilityScale-up and scale-out capabilityScale-up and scale-out capability

PerformancePerformanceTuning servicesTuning services

Dialogue OptimisationDialogue Optimisation

SecuritySecurityAuthentication and Authorisation Authentication and Authorisation MechanismsMechanisms

Encryption and secure messaging Encryption and secure messaging

System ManagementSystem ManagementSystem monitoringSystem monitoring

Software distributionSoftware distribution


CHF Business FrameworkCHF Business Framework

The The CHF Business FrameworkCHF Business Framework addresses application integration and is addresses application integration and is based on a service oriented approach based on a service oriented approach focused on defining a set of business focused on defining a set of business components, each addressing a major components, each addressing a major subject area and offering a range of subject area and offering a range of services that can be “orchestrated” to services that can be “orchestrated” to enable and support the wide range of enable and support the wide range of healthcare business processes. Wherever healthcare business processes. Wherever possible, existing sources of functionality possible, existing sources of functionality and data are used. and data are used.

It provides a It provides a Business Pattern for Business Pattern for HealthcareHealthcare


CHF Business FrameworkA Business Pattern for HealthcareCHF Business FrameworkA Business Pattern for Healthcare


CHF Technical FrameworkCHF Technical Framework

The The CHF Technical FrameworkCHF Technical Framework is is concerned with interoperability and concerned with interoperability and addresses the following key architectural addresses the following key architectural challenges:challenges:

MultiplicityMultiplicityIdentity ManagementIdentity ManagementIntegration ChallengesIntegration ChallengesFlexibility and AgilityFlexibility and AgilitySecuring the SolutionSecuring the SolutionScalability, Performance and AvailabilityScalability, Performance and AvailabilityAchieving the Common HubAchieving the Common Hub

It provides a It provides a Reference Architecture for e-HealthReference Architecture for e-Health


CHF Technical FrameworkA Reference Architecture for HealthcareCHF Technical FrameworkA Reference Architecture for Healthcare


Support for Both Centralized and Federated Deployment ModelsSupport for Both Centralized and Federated Deployment Models


Connecting the CHF Business & Technical FrameworksConnecting the CHF Business & Technical Frameworks


CHF – Consolidated FrameworkCHF – Consolidated Framework


CHF – A Stable Foundation for Agile HealthcareCHF – A Stable Foundation for Agile Healthcare

S T A B L E

A G I L E


CHF – Who does what?CHF – Who does what?

Customer Specific(MS provides Guidelines,

Platform Products, Assistance)

ISV Provided (MS provides Business Pattern – Component and Service Definitions)

MS or SI Partner Provided

SI Partner Provided(MS provides Reference Architecture

and SDKs)

SI Partner Provided(MS provides Reference Architecture and SDKs)


Building Solutions using the CHFBuilding Solutions using the CHF

Key scenarios depending on the role:Key scenarios depending on the role:CustomerCustomer - Formulating Requirements (RFP) - Formulating Requirements (RFP)

Vendor/Systems IntegratorVendor/Systems Integrator - Meeting - Meeting Requirements (Responding to an RFP) Requirements (Responding to an RFP)

Software VendorSoftware Vendor - Aligning an ISV Application - Aligning an ISV Application with the CHFwith the CHF

Infrastructure providerInfrastructure provider - Establishing the - Establishing the EnvironmentEnvironment

CHF (Part 4) provides guidance for each, CHF (Part 4) provides guidance for each, e.g.:e.g.:

Understanding Scope & BoundariesUnderstanding Scope & Boundaries

Understanding the Required FeaturesUnderstanding the Required Features

Deriving the Architecture Deriving the Architecture

Defining the SolutionDefining the Solution


CHF – How To Engage ?CHF – How To Engage ?Content is now being finalisedContent is now being finalised

Verification with selected customers Verification with selected customers and partners in several countriesand partners in several countries

Will be published on a SSN (Solution Will be published on a SSN (Solution Sharing Network) collaboration web Sharing Network) collaboration web sitesite

Workshops across the EMEA region Workshops across the EMEA region and beyond to spread the knowledgeand beyond to spread the knowledge

Contact your local Microsoft subsidiary Contact your local Microsoft subsidiary to engageto engage

© 2006 Microsoft Corporation. All rights reserved.This presentation is for informational purposes only. Microsoft makes no warranties, express or implied, in

this summary.


Improved Outcomes for Patients, Clinicians and GovernmentsImproved Outcomes for Patients, Clinicians and Governments

InfrastructureInfrastructure Systems Management, Directory, Security, Disaster Recovery, Business Continuity

Lifetime Clinical Record

Long Term Condition

Management

Outcome Based

Funding

IndependenceIndependence Mobility, Remote Access, Inclusion

EMR/E Prescribing

InformationInformation Messaging, Portals, Real-Time collaboration, Business Intelligence, ERP

Community EMR

MPI

Nati

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Sta

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Loca

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Pati

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Nati

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Information Hub

IdentityIdentity Single Sign On, Role Based Access, Privacy, Federated Identity

Develo

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DR

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LCR

MicrosoftMicrosoftValueValue

ConnectedConnected

ProductiveProductive

Best Best EconomicsEconomics

DependableDependable

ClinicalDecision Support

Healthcare Transformation through Healthcare Transformation through TechnologyTechnology

Service Delivery Reform

Integration Integration Interoperability and Orchestration

Industry Industry StandardsStandards

Respect for Respect for PrivacyPrivacy

Improve Improve adoptionadoption

Leverage Leverage legacy appslegacy apps

Scalable Scalable and robustand robust

Data Aggregato

r

BI Engine

Visualization and

Analysis

Disease Surveillanc

e

Real Time Data

Consolidation

Deployment System

MappingClinical Messaging

PACSClinical Coding

CommunityData

Collection

Electronic Referrals

TeleMedicine

Genomic Medicine

Health ID Cards

Call centre & online Triage


Microsoft’s value propositionMicrosoft’s value proposition

Connected – Interoperable by designConnected – Interoperable by designOpen architectures built on industry standards that facilitate the Open architectures built on industry standards that facilitate the flow of patient information and clinical knowledge seamlessly flow of patient information and clinical knowledge seamlessly through the healthcare continuum and across agenciesthrough the healthcare continuum and across agenciesLeverage legacy application and infrastructure investmentLeverage legacy application and infrastructure investment

Productive – Familiar tools to automate the way you workProductive – Familiar tools to automate the way you workLet clinicians be clinicians: improve adoptionLet clinicians be clinicians: improve adoptionEnable delivery of public health services in a standardized, Enable delivery of public health services in a standardized, replicable mannerreplicable manner

Best Economics – Driving down the cost of healthcare Best Economics – Driving down the cost of healthcare technologytechnology

Create ROI faster than traditional investmentsCreate ROI faster than traditional investmentsAn integrated platform that lowers TCO overallAn integrated platform that lowers TCO overallLocal delivery modelLocal delivery modelScalable from single providers to county wide programsScalable from single providers to county wide programs

Dependable – Proven and RobustDependable – Proven and RobustApplications that support 24x7x365 healthcare operationsApplications that support 24x7x365 healthcare operationsFinancially stableFinancially stableExtensive partner ecosystem gives decision-makers choiceExtensive partner ecosystem gives decision-makers choice

Documents

Architecture of eHealth Solutions Connected Healthcare Framework - A Stable Foundation for Agile Healthcare Dr Ilia Fortunov Senior Architect Microsoft