Defining SOA?s increasing role in healthcare
ORLANDO—By 2010, service oriented architecture (SOA) will be used in 80 percent of mission-critical applications and business processes, including healthcare, according to a presentation from John Sharp, MSSA, PMP, and Robert Joe Turk, CPHIMSS, of the Cleveland Clinic in Ohio, during the 2008 HIMSS conference.

“The real purpose of this session is to cut through the hype and talk about real efforts in trying to implement this technology,” Sharp said. To this end, the presentation kicked off with Sharp offering attendees a definition of SOA, saying it was “a durable change in application architecture.”

He added that it encapsulates business processes as self-contained modular services; exposes platform-neutral interfaces; and keeps core business logic and database decoupled from the presentation layer.

The presentation also outlined the interoperability challenges in a complex IT systems environment of disparate applications, and discussed the planning requirements that organizations should consider when planning using a SOA for a specific use case.

“The real value of SOA, which is platform independent, is unlocking data from proprietary systems,” Sharp said. Normally, healthcare organizations store data in multiple systems which often do not talk with each other. The dilemma that Cleveland Clinic faced, as many organizations do, is how to pull data from those disparate systems and into once centralized EHR.

Turk provided attendees with two Cleveland Clinic case studies that illustrated to attendees what the particular business processes were, or pain points, and how they used SOA and web services to alleviate those pressures. One such case was hospital-to-hospital transfers and the other was to increase the number of pre-surgery patient registrations.
Using SOA in combination with HL7, Turk said the clinic found a few things as a solution to the registration problem. They implemented a self-service tool to update registration via the internet, capturing episode related information in real-time.

To solve the hospital-to-hospital transfer dilemma, they used a web service to pull data from the mainframe admission, discharge and transfer system into a web application in real time. “The goal of this solution was to assist in increasing our rate of acceptance of hospital-to-hospital transfers,” Turk said, “to ensure that we could easily place the right patient in the right bed.” Data was displayed by bed type and hospital, with dashboard indicators on bed availability.

Overall, both Sharp and Turk said that for a vended environment, SOA is the key enabler for in-house development focus, although initial implementation may be more difficult to build. Future changes and subsequent applications will be quicker, though, they added.

“Our model, which is opportunistic, was developed around a problem needing a solution, not a solution needing a problem,” Sharp said. Both presenters acknowledged that the next steps for SOA in healthcare are to educate and develop standards and to identify volume targets.