The cutting edge in the healthcare industry is typically reserved for the operating room, not the IT department, but Erik Sargent is doctoring that thinking.
The Web applications architect for Providence Health System, a collection of hospitals, clinics and assisted-living complexes in the Northwest, has rolled out a Web service and plans a handful more as part of a project to create standards-based secure access to patients' personal data and medical records. Sargent is creating a unified patient profile without having to move or reformat any data in any of the nearly 200 systems Providence runs to support its operations.
"Generally what we're doing with Web services is trying to accomplish this gargantuan task of being able to easily access all of our different systems, which all store information about patients in different ways," Sargent says. "When we have a health plan and hospitals and laboratories and outpatient clinics, we should tie all that patient data together into a single patient profile."
Sargent says profile aggregation is not common in healthcare. "No one is really near where we are except possibly one or two other systems in the country. We're pretty excited about it," he says.
Sargent has deployed a Web service called Profile Manager that uses XML and Simple Object Access Protocol (SOAP) to extract data from Providence's disparate systems. The patient data is taken in its native format, mapped into an XML document and delivered via SOAP to Profile Manager, which presents the data to the requesting application.
To maintain security, applications never directly access the hospital's systems. The application authenticates the end user against a directory and Profile Manager acts as a broker.
Profile Manager and a Web services management system developed by software vendor Infravio orchestrate the entire exchange. Both sit on a pair of Compaq 700-MHz servers with 1G byte of RAM that run Microsoft's Windows 2000 Server and Internet Information Server and load-balanced by a Cisco Content Services Switch 11000, all of which sit on a 100M bit/sec Ethernet backbone.
"The idea is that we can take an XML-based profile of the information that is in each system and take that profile back to our apps and use it directly or merge it with other profiles," Sargent says.
The standard profiles let Sargent's Web developers easily pull patient data into their applications without, for instance, having to know how to program against MUMPS, a proprietary manipulation language with an embedded database used to store patient information.
It also lets other Providence developers, say those writing an internal billing application, use Profile Manager to pull patient data into their applications.
"We put all the access logic for each system into the profiles, so the developers just have to call the profile in Profile Manager," Sargent says. That model creates time- and cost-savings in developing applications that Sargent has yet to calculate fully.
It's a reuse scenario, he says, that was never fully realized in other component-based architectures such as the Common Object Request Broker Architecture, Component Object Model or Enterprise JavaBeans.
Before Web services, Sargent used enterprise application integration (EAI) software in an exhausting attempt to integrate patient data. That system now has 250 interfaces. Also, the performance is lackluster because EAI is not designed as a query/response system.
So far, Sargent has built two modules for Profile Manager - Web Site Profile and Health-Plan Member Profile. The Web Site Profile includes personal information such as name and address collected from users of Providence Web sites and stored on a Microsoft SQL Server 2000 database. The Health-Plan Member Profile is data from a user's insurance record, which is stored on a system called Amisys that runs on an HP-3000 server.
The profile modules, in essence, are XML documents that describe how to access data from the host system and what data to collect.
Currently, the profiles are used with Providence's Web-based application for registering participants in events the hospital sponsors, such as an upcoming community bicycle ride.
The Web Site Profile is used to automatically fill out registration forms with name, address and other information previously collected from users of Providence Web sites. It also can collect data from a new user's registration form to create a Web profile. The Health-Plan Profile gives the same service to Providence members, but also can be used to trigger membership benefits, such as registration discounts.
Profile Manager is written in Java and the business logic contained in the modules is written as Java servlets, which Infravio Web services software converts to XML and SOAP. The servlets run on an Apache Tomcat servlet engine installed on Win 2000.
Infravio serves as a security guard and gatekeeper, letting only authorized applications running on authorized servers request information through Profile Manager.
For example, the IP address of the server running the event registration Web site is authorized to connect to Infravio. That kind of configuration controls access to Profile Manager and meets current Health Insurance Portability and Accountability Act regulations, which requires securing access to patient information.
Profile Manager and Infravio software run behind the firewall so nothing goes out over the Internet except the nuggets of profile data that Profile Manager returns in the form of HTML pages.
The Infravio platform costs about $50,000 and consultants from the company set up Profile Manager in three weeks.
Sargent says he also had some idle server hardware that was used to run Profile Manager.
Sargent plans to roll out eight more profile modules in the coming months that he says will meet 90% of his needs for creating a unified patient profile.
One will be for his Logician system, which stores medical records for Providence's primary care clinics that record everything electronically.
"All the results, lab tests, doctor notes, prescriptions, it's all in there," Sargent says. "By creating a profile into Logician, that is where we can start doing the online medical record, online scheduling for people, the whole bit."
And when that rolls out, Providence's IT department will have secured its place on the cutting edge.
 |
|||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||
RELATED LINKS
