Gabe RijpmaHealthcare Industry DirectorMicrosoft Asia Pacificgabery@microsoft.com

Challenges

Agenda

Universal Data Issues

The Importance of XML

Application Architecture and SOA

Summary : Q&A

Typical Integration

Healthcare Integration

Best Practices

Finding The Right Data

How clinicians spend time

Student Study: Washington Medical Center – Study tracking Doctor and Nurses Time

Universal Data Issues

• Lots and lots of data scattered around• Very diverse data types• Legacy systems everywhere• No standards• Too many standards• Traditional business practices work against

integration & sharing

Universal Data Problems

• Completeness problem– Hard to know whether you have all the known

data• Correctness problem

– Hard to resolve conflicting or incorrect data• Access problem

– Hard to get at data even when you know some information exists in a particular place

• Organization problem– Hard to put it all together

• Time problems– Time resources, delays, response speed

“XML as a common way of describing data is important to deliver true interoperability”

Why Does Microsoft Care About XML

• Work started in 1997

• Microsoft bet the company on this with .NET in 2000

• Had a major impact on all software systems: OS, database, Office, services

• Industry-wide adoption

• Competition on implementation

Simple adaptors allow connection to any power outlet in Europe

Industry standards for interoperability• Software that talks to other software

over the network • Based on Internet standards• Works with any operating system• Loosely coupled programming• Preserve and connect existing systems• Integrate inside and outside the firewall• Broad industry support

So why is this important?

The Power Of Reuse

Software Reuse

Highest

Low

Higher

Low

Application Silo “Architecture”

ClientB

ClientA

ClientC

ApplicationB

ApplicationA

ApplicationC

API BAPI A API C

Services Oriented Architecture

ClientB

ClientA

ClientC

ApplicationB

ApplicationA

ApplicationC

API BAPI A API CCommon Services LayerXML Web Services

Open Standards Progress

Tuxedo, MQ Series, COM, CORBA, etc.

Tuxedo, MQ Series, COM, CORBA, etc.

SNA, DecNet, SPX/IPX,TCP/IP, etc.

SNA, DecNet, SPX/IPX,TCP/IP, etc.

TCP/IP

XML Web Services

Network

Middleware/Plumbing

BusinessLogicFocus Expertise Here

Raise the bar…Open Standards

OrdersOrders

RadiologyRadiology

How does Healthcare Integration Work?

ADTADT

ADTADT

ADTADT

ORMORM

ORUORUDFTDFT

DFT

DFT

PharmacyPharmacy

OtherOther

OR

MO

RM

BillingBilling

LaboratoryLaboratory RegistrationRegistration

Patients may be “registered” via a patient Patients may be “registered” via a patient registration system or HIS (Hospital registration system or HIS (Hospital Information System)Information System)Orders may be created and results Orders may be created and results reportedreportedMay maintain the Electronic Medical May maintain the Electronic Medical Record (EMR)Record (EMR)

Patients may be “registered” via a patient Patients may be “registered” via a patient registration system or HIS (Hospital registration system or HIS (Hospital Information System)Information System)Orders may be created and results Orders may be created and results reportedreportedMay maintain the Electronic Medical May maintain the Electronic Medical Record (EMR)Record (EMR)

OrdersOrders

RadiologyRadiology

How does Healthcare Integration Work?

ADTADT

ADTADT

ORUORU

DFT

DFT

PharmacyPharmacy

OtherOther

OR

MO

RM

BillingBilling

LaboratoryLaboratory RegistrationRegistration

HL7 was created to help standardize the messaging communication between healthcare applications

HL7 was created to help standardize the messaging communication between healthcare applications

The Reality of Integration

FinancialSystem

PatientData

Lab Data

Data Warehousing

Billing

Membership

Claims

Capitation

Utilization

Billing Membership

Human Resources

Source: Deloitte & Touche Consulting Group

OrdersOrders

RadiologyRadiology

Delivering XML and HL7 Integration

PharmacyPharmacy

OtherOther

BillingBilling

CPRCPR

LaboratoryLaboratory

RegistrationRegistration

AD

TA

DT

ADTADT

ORUORU ??

ORMORM

ORUORU

DF

TD

FTORU

ORU

BizTalkServer

Best Practices XML/HL7 in Action

• New Zealand Health Connection Engine (HCE)– Brings together primary care, pharmacy, lab and tertiary

care integration regardless of existing systems by using XML, Web Services and HL7

• Singapore EMRX (Electronic Medical Record Exchange)– Integrates tertiary care patient record with lab results and

more to create a single patient record that can be shared amongst hospitals

• Korea Yonsei University Medical Centre– integrating and interconnecting, OCS, EMR, PACS (Picture

Archiving and CommunicationsSystems) and ERP (Enterprise Resources Planning) systems

– Taking this further through the creation of an HER and extending building the base for CDSS (Clinical Decision Support Systems)

Thinking About the Opportunities Ahead

Integrated and Interoperable V

iew of H

ealth

Q&A