Executive Summary

Health care providers across the world are finding that the issue of interoperability between heterogeneous information systems is adversely impacting their delivery of health care. Information systems that do not interoperate fail to provide information to address business needs. Inefficiencies in information management can effect organizations in many ways.

Do you have any of these issues in your organization?

  1. Are you capturing encounter data at the point of service in an electronic form?
  2. Can electronic data captured in one clinical system be used by another?
  3. Can your information systems provide timely good quality information for clinical decision support?
  4. Can your information systems provide timely good quality information for managerial decision support?
  5. Can your clinical system interoperate with your financial systems?
  6. Do your computer systems allow for shared care between multiple caregivers within and across organizations?
  7. Can you communicate with external organizations, for example government agencies?
  8. Do you have adequate information to support appropriate disease or medical management?
  9. Is your maintenance and interfacing costs shrinking?
  10. Do you have flexibility, not locked into current information systems and applications?

If the answer is NO to any of these, you have an interoperability problem!

Here are the Information Management Information Technology "facts of life"that you should be aware of:
  1. There will not be consensus on hardware platforms
  2. There will not be consensus on operating systems
  3. There will not be consensus on programming languages
  4. There will not be consensus on graphical user interfaces
  5. There will not be consensus on domain boundaries
  6. There will not even be consensus on data standards
Therefore, there MUST be consensus on a
Common Interface Architecture

A common interface architecture consensus is now emerging on a global scale. Solutions to interoperability challenges are being defined and adopted by International Standards Organizations.

SOLUTIONS ARE BEING BUILT INTO INFORMATION SYSTEMS TODAY!

Who is helping to create these solutions?
The OMG

What is the OMG? The Object Management Group (OMG) is a consortium of over 800 companies formed in 1989. Their mission is to promote the theory and practice of object technology for the development of distributed computing systems. The goal is to provide a common architectural framework for object-oriented applications based on widely available interface specifications.

The model of the OMG infrastructure is similar to the model of the technology that the majority of information technology is working on – a distributed “object” technology. The companies forming the OMG work together to produce an infrastructure and set of standardized interfaces that make distributed, object oriented computing possible on a global scale. Each company participates, contributes and profits within their area of expertise.  This doesn’t mean that competition doesn’t exist.  In any given domain, several of the 800 companies will compete for a particular portion of the business, whether it be transaction processing, naming and trader services, object request brokers, security or perhaps one of the vertical domains such as finance, manufacturing, telecommunications or healthcare.

The infrastructure developed by the OMG is referred to as the Object Management Architecture (OMA). It has grown into a powerful toolkit of tools and services, including a set of lower layer interoperability tools known as the Common Object Request Broker Architecture (CORBA). It also includes a rich set of services and facilities, which serve as the infrastructure and glue to make distributed computing possible.

The Healthcare Domain Task Force (DTF) was chartered in 1996 by the OMG Domain Technical Committee (DTC) to produce a standard set of object interface specifications applicable to the healthcare domain. They have developed a number of standards:
 

  • Person Identification Service (PIDS)
  • Terminology Query Service (TQS)
  • Clinical Observation Access Service (COAS)
  • Resource Access Decision (RAD)
  • Clinical Image Access Service (CIAS)


    • Today, the Healthcare DTF is embarking on new specifications to meet the challenges of the healthcare domain.

    How can the OMG and the Healthcare DTF help with the past The basic tenants of object technology turn out to serve us very well when we are working with existing systems.  The beauty of an interface is that we don’t have any idea how software is actually carrying out the public operations of the interface.  This means that one organization may implement an interface using the hottest new OO database, while another may implement it by performing a set of function calls on a system that has been in production for 20 years. Yet, another organization may fill out an HL7 message and route it to a server that is capable of accomplishing the task.  It doesn’t matter!

    Additionally, existing systems may begin to utilize the additional capabilities and functionality made available by CORBA and the OMA.  Because CORBA clients and servers are language independent, it is possible for a COBOL “client” running on an IBM AIX system to utilize the services of a JAVA services running on a Sun Workstation.  Existing systems may be enhanced and extended via the OMA.  This capability allows these systems to evolve into the next generation of computing rather than having to be discarded and written from scratch.

    The OMA and CORBA provide the potential that we may now build on the work that we have accomplished in the past rather than having to discard it and start anew.  You might note that this ability to retain existing hardware, software and operating systems is not in the best interest of all of the large corporations in the world today, some of whom are betting their own future on the fact that you will have to do exactly that.

    The key, however, to achieving this interoperability is to begin to agree on a common way to communicate.  Vendors and providers together must together agree on what the points of interface are between the various objects within the healthcare domain.

    How can the OMG and the Healthcare DTF help with the future The OMG is continuing to advance and develop the tools and technology necessary to make distributed object computing a reality.  The OMG has also become a central forum for discussion between and across various groups within the domains.  The Healthcare DTF participants are actively involved in the specification of workflow processes, publish and subscribe interfaces, security packages, metadata specification and access just to mention a few. The Healthcare DTF also serves as a central forum for discussion between those in the dictation, transcription, imaging, data repository, decision support, coding and terminology, instrumentation and many other arenas.  These discussions are leading to the discovery of common patterns and interest that will continue to serve to reduce the cost while increasing the quality of computerized medicine.

    What should I be doing to help and participate in that future
    1. Become an active participant in the OMG and participate in the Healthcare DTF.  This is especially true if you are a healthcare provider and/or customer of healthcare software vendors.  The OMG process needs to become consumer driven. The customer needs to spearhead the drive for distributed object computing. See: http://www.omg.org for more information about joining.
    2. Investigate the benefits and ramifications of distributed object technology within your own organization.  Educate yourselves and discover what is best for you and your organization.
    3. Actively require that healthcare vendors provide standard distributed object interfaces to their software.  Many medical software vendors are still “sitting on the fence”, hesitant to expend the effort until they are certain that there are customers for their effort.  Encourage them to become participants in the distributed object revolution!  We all stand to win.

    Wrapping it up Thank you for your interest in The OMG Healthcare DTF.

    We look forward to your participation in the Healthcare DTF in allowing us (we) to serve as your resource for healthcare interoperability standards.

    Please take a moment to peruse the Healthcare DTF Roadmap Document and the associated Healthcare DTF Toolkit 1.0, which we hope you will find helpful.
     

    Healthcare DTF Roadmap Document

    Included in the Healthcare DTF Roadmap is an introduction to Healthcare DTF and the business case highlighting the importance of distributed object computing in healthcare:
    1. Requirements Elaboration

      2. The activities that increase the Task Force's level of awareness for contemporary industry requirements. The OMG standardization process includes issuance of a Request for Information (RFI) and attendant response evaluations.
    2. Specification Development

      3. The core of Healthcare DTF activity that results in standard specifications and adoption of object interfaces for healthcare domain components. The OMG standardization process includes issuance a Request for Proposal (RFP) and attendant response valuations.
    3. Healthcare Domain Architecture Development

      4. The activity that defines a framework to support and guide activities. A logical representation of a Healthcare DTF Healthcare System Template provides the basis for this guidance. This logical representation is based on the ISO Reference Model for Open Distributed Processing (RM-ODP). The RM-ODP representation is then represented in UML based models to provide both a high level representation of Healthcare DTF services, the inter-dependencies and relationships between CORBA services.
    4. OMG Support

      5. Provides policies and procedures for standardization activities. Ensuring consistency with, and support of, healthcare domain requirements with current OMG specifications provides viable solutions for healthcare and leverages solutions from other domains, such as Electronic Commerce, Finance, Telecommunications, Transportation and more.

    The OMG Healthcare DTF Toolkit 1.0

    The Healthcare DTF Toolkit 1.0 has been published for your convenience. The Healthcare DTF Toolkit includes the following items and much more to set you on the path to healthcare solutions:
    1. Standard Specifications
    2. Trial products and demonstrations
    3. White papers and presentations
    4. Available products
    5. Companies contributing to the task force

    Success The success of the Healthcare DTF to provide solutions that will allow the healthcare domain stakeholders to perform true tasks with optimum efficiency at reasonable costs truly relies on the priceless input from the healthcare industry.

    Together we will strive to design compelling standard object services that meet your needs and the needs of your organization.

    It is our goal to provide you with the most value for your investment in the Healthcare DTF.

    Technology will not stand still while business systems catch up.

    An integrated architecture must be adopted that enables continuous managed migration of technology, infrastructure and business services.