F Model-centric approaches for HIS development 1 Model-Centric Approaches for the Development of Health Information Systems Medinfo 2007, Brisbane Tue

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1Model-centric approaches for HIS development

Model-Centric Approaches for the Development of Health Information Systems

Medinfo 2007, Brisbane

Tue 21 Aug, Session S090, 4 PM

Mika Tuomainena, Juha Mykkänena, Heli Luostarinena,

Assi Pöyhöläb, Esa Paakkanena

University of Kuopio, Finlanda Health Information Systems (HIS) R&D Unit

b Shiftec, Department of Health Policy and Management

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Overview of presentation

Analysis of three model-centric approaches in the context of health information systems development Model-Driven Architecture Process modeling with BPMN (Business Process Modeling

Notation) and BPEL (Business Process Execution Language)

Health Level Seven Development Framework

Motivation and introduction of the study Materials and methods

Analysis framework for modeling approaches Results of the analysis Conclusions and implications

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Motivation of the study

Modeling is used increasingly in healthcare to increase shared knowledge to document and improve the processes to document the requirements and solutions related to

health information systems (HIS) Numerous modeling approaches available Modeling approaches need to be selected and assessed

(strengths, deficiencies, support for specifics of healthcare)

In this study, we analyzed three model-centric approaches in the context of HIS development: Model-Driven Architecture (in general and MDA toolkit [7]) Business Process Modeling with BPMN and BPEL HL7 Development Framework

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Introduction of the study

The analysis was based on literature and the use of a conceptual framework our previous studies and experience of applying these

approaches in HIS development and integration (interoperability, service-oriented solution specification and standardization projects)

Results of previous research [4] stated that in the modeling of healthcare solutions traceability is crucial between development phases special emphasis should be paid to semantic elements illustration of solutions to the end users in early phases of

the development lifecycle is beneficial documentation of accurate, consistent, atomic and

unambiguous requirements should be supported

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Analysis approach

Conceptual comparison of model-centric approaches Analysis framework

Main purpose Phases of the information systems development value chain

(and traceability throughout the chain) Aspects of information systems [5]

structure, function, behavior

Semantic elements and entities (in different phases) Illustration of solutions to end users Quality of requirements (accuracy, consistency, atomicity,

unambiguity) Definitiveness of the approach for the modeler Visibility of end users and other health care stakeholders Automation of model transformations Dissemination, usage

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Model-centric approaches(main features briefly)

RIM

D-MIM

Instantiate

R-MIM

Restrict

HMD

Restrict

Message Type Restrict

I nteraction

Content

Application Role

Sender

Trigger event

Triggers

Receiver

Storyboard

References

Hoi

to-

pro

sess

iE

ndos

kopi

an

tutk

imus

palv

elu

2.2 Asiakkaanvalmistelu

tutkimukseen

1.1Lähetteenkäsittely

1.2 Hoidonsuunnittelu

1.3 Ajan-varaus

1.4Asiakkaankutsuminen

3.4 Jatkohoito-suunnitelma

2.3 Asiakkaanlääkitys

3.1 Tähystyslau-sunnon kirjoitusja kuvien valinta

2.4 Tähystysja koepalojen

otto

2.1Asiakkaanilmoittau-tuminen

1.6Lääkkeiden

tilaus 3.2 Jälki-tarkastus

3.4Hoitopalautetutkimuksen

pyytäjälle

Lähete endoskopiaan

Hoitopalaute

1.5Esitutki-mukset

3.3 Tulostenlisääminen

potilaskerto-mukseen

CIM PIM

PSM

PSM

PSM

Code

Code

Code

.

.

.

.

.

.

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Model Driven Architecture (MDA)

The Model-Driven Architecture (MDA) by the Object Management Group (OMG) supports software development through modeling techniques such as Unified Modeling Language (UML)

Main modeling and abstraction levels CIM: computation-independent model PIM: platform-independent model PSM: platform-specific model

Primary goals of the MDA are (through architectural separation of concerns) portability, separation of application logic from platforms interoperability, by mapping a higher level model to different lower

level models reusability of models, platforms and solutions

Transformation of system specifications between models (and platforms), including automated implementation (the transformations of PSM models to executable code by MDA tools)

models can be realized on many platforms (Web Services, .NET, CORBA, J2EE and others)

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Business process modeling with BPMN and BPEL

BPMN (Business Process Modeling Notation) A graphical notation for process modeling Aim: understandable by users, business analysts,

developers, managers Private, Public and Collaboration process models

BPEL (Business Process Execution Language for Web Services) an XML-based language for the specification and

automation of processes and interaction protocols BPMN specification contains a mapping to BPEL

BPMN and BPEL can be used together for the modeling and web services-based (WSDL) implementation of processes

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HL7 Development Framework (HDF)

Model-driven framework for the analysis and design of processes, actors, rules for the HL7 version 3 standards development

All information models in the HL7 version 3 standards are based on the Reference Information Model (RIM) Domain information models (DIM / D-MIM) Constrained information models (CIM / R-MIM) serialized constrained information models (HMD) message specifications supported by structured vocabulary and glossaries

Dynamic and user-level documentation: storyboards, use cases, triggers, constraints, UML activity and state diagrams

Out of seven phases, requirements analysis and documentation, specification modeling and standard profiling are especially within the scope of this work

HDF uses and extends UML class diagrams and other diagram types, extensions to UML meta-model in the HDF UML profile

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Considera-tion

Model-Driven Architecture

Business Process Modeling with BPMN and BPEL

HL7 Development Framework

Main purpose

model-based software develop-ment, insulation of business from the changing technology

process modeling notation and process execution

model-based production and man-agement of interoperability stan-dards

Structure & information

class and other UML diagrams on CIM, PIM and PSM levels

BPMN: little description, BPEL: through XML/WSDL interfaces

RIM, domain analysis and information models, constrained models, XML schemas for messages

Functionality use case, class and other UML diagrams

on process level only, internal functionality in private BPMN

interaction names, receiver respon-sibilities for messages

Interaction sequence, activity and other UML diagrams

abstract and collaboration BPMN: generic, BPEL: specific

triggers, application roles, interactions, UML diagrams

Analysis (1): purpose and IS viewpoints

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Analysis (2): approaches in relation to the phases of the ISD value chain

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Analysis (3)

Consideration Model-Driven Architecture



Main users of the method

CIM: domain practitioners, PIM, PSM: IT experts

business analysts, business process owners and designers

accurate user roles specified for different phases

Semantic specification details

CIM focuses on information viewpoint, including vocabulary, more specific in PIM and PSM

little emphasis on information or semantics other than parameters of interfaces

glossaries, data types and vocabularies specified for more rigorous information support

Illustration to end users

CIM: vocabulary, environment, functionality

BPMN: visualized processes can be examined

storyboards, use cases and activity diagrams

Requirements quality

documentation identified but not specified for the requirements

many requirements are implicit in the process descriptions

on generalized level (for all standards), but traceable due to definitive phases

Definitiveness very loosely defined, accurate methods and tools needed

not in notations and languages but in tools and methods

accurate phases and outcomes specified, messaging presumed

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Consideration Model-Driven Architecture



Abstraction levels CIM, PIM and PSM, lots of freedom within levels

BPMN: private, public and abstract; BPEL: execution level

models and tools defined for all specification phases and steps

Visibility of users / health professionals

evident in use case models, CIM and PIM emphasize communication with users

BPMN: user interactions, lanes, pools, activities; BPEL: no distinction between user and system steps

storyboards, use cases, activity diagrams, indirectly through application roles and triggers

Automated implementation

transformations of models to executable code emphasized, various different possibilities

BPEL can be generated from private BPMN; BPEL is executed in workflow engines

implementation based on the specifications, little automation due to local variability

Dissemination promoted widely, solutions mostly tool-specific

promoted for business process man-agement, increasing support

healthcare-specific, mostly used for standardization only

Other relevant aspects

requires more detailed methods, has been interpreted varyingly in different tools and methods

focuses on process modeling and management, relationships to other aspects remain undefined

currently under revision, new dynamic and static model approaches being refined

Analysis (4)

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Conclusions: different model-centric approaches

The studied approaches support the documentation and communication purposes and shared understanding in the development of HIS

MDA: a generic and overarching approach, isolates technology changes from the logical solutions; no unified application or requirements to include MDA meta-level foundations in tools or projects; no "one MDA" but situation- and tool-specific application, other approaches could be MDA subsets

BPMN + BPEL: valuable for process abstraction and automation but requires many additional considerations for holistic modeling (excludes organizational resources, functional breakdowns, data and information models and business rules, no consideration of users except "tasks")

HDF: Definitive, support for different phases especially for information aspects and healthcare specifics, functionality implicit to some extent, applied differently in different (HL7 v3) domains, method evolution hinders learnability and implementation tools

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Conclusions: implications for the modeling of health information systems in general

The selection of a modeling approach (according to the main purpose and definitiveness) must be locally complemented to compensate the definiciencies

Generic needs for improvement Illustration of solutions to the end users Supportive notations for missing aspects Traceability and atomicity of requirements

Requirements dilemma of model-centric approaches: model "is" the solution, justifications and rationale easily

remain ambiguous and implicit to the modeler generic models and standards are a result of

generalization and negotiation which risks traceability to accurate requirements and health care activities

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other results from the SerAPI project in Medinfo'07

Conformance Testing of Interoperability in Health Information Systems in Finland (Toroi et al.)

A National Study of eHealth Standardization in Finland - Goals and Recommendations (Mykkänen et al.)

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Thank you

The SerAPI project participants: National Technology Agency TEKES (grants no 40437/04, 40353/05, 40251/06), Medici Data Oy, Datawell Oy, Fujitsu Services Oy, Hospital district of Northern Savo, WM-data Oy, Commit; Oy, Intersystems B.V. Finland, Mediconsult Oy, Microsoft Oy, Oracle Finland Oy, Hospital District of Satakunta, Bea Systems Oy, Hospital District of Helsinki and Uusimaa, City of Kuopio, The Finnish Medical Society Duodecim, Mawell Oy, Oy Prowellness Ltd.

www.serapi.fi/english/

first author: Mika Tuomainenpresenter: Dr. Juha Mykkänen

University of KuopioHIS R&D Unit

[email protected]@uku.fi

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Main efforts which the analysis is based on (in addition to the literature and tool trials)

various activities in SerAPI and PlugIT projects in 2001-2007 MDA:

development of integration specification methodology, utilization of this methodology in 10+ interface specification (sub)projects

Healthcare Services Specification Project (HSSP) in HL7 and OMG, whose methodology is MDA-based

BPMN + BPEL: specification and assessment of processes (e.g. endoscopy) and

generic integration solutions for departmental information systems in a Finnish hospital district (in SerAPI project), a study and examples of BPMN and BPEL

HDF: specification of scheduling services and interfaces for regional

scheduling using HL7 version 3, application of HL7 version 3 messaging standards for scheduling and medical records (in SerAPI project and HL7 Finland)

Documents

F Model-centric approaches for HIS development 1 Model-Centric Approaches for the Development of Health Information Systems Medinfo 2007, Brisbane Tue