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SPECIAL REPORT: Service Oriented Architecture

SOA: Health Care Enabler
SOA is at the heart of the health information exchange movement.
*Architecture: A 12 Letter Word For Having A Plan
*Establishing Common Ground
*SOA: Health Care Enabler
*SOA: Evolving Challenges
*Governing Principles
*SOA Improves Services [Online bonus material]

*SOA: Service-Oriented Architecture [PDF]
Having the right patient information in the right hands at the right time does make a difference. The drive to electronic health records and the seamless sharing of patient information is on ongoing movement within the American healthcare community. But it has not been easy, nor or we ready to declare victory.

That’s why we should be cheering the efforts of dedicated professionals such as Vish Sankaran, the program director for Federal Health Architecture at HHS.


During a recent appearance on the Federal Executive Forum on SOA, Sankaran spoke about his role in Federal Health Architecture. “It is made up of over 20 federal agencies. And the role here is to build tools and solutions for federal agencies, to have cross agency collaboration and also to implement interoperable health information solutions across the federal government.”


That collaboration was demonstrated at HHS headquarters in Washington, DC in front of two cabinet level secretaries on September 23. “I’m happy to report that we were able to demonstrate live exchange of health data,” proclaimed Sankaran. “These were tests with live data across the country around 15 different health information exchanges. That is something we can all be proud of. It’s a new chapter in the ongoing effort to improve quality of health care for the citizens of this country.” Sankaran is working within a SOA model to enable health IT collaboration and firmly believes that the architecture must be business driven. “We have learned that the hard way with the Federal Health Architecture Initiative, where it was initially focused on just architecture work,” explained Sankaran.


“But over the years the way we have brought agencies together is by looking at the business priorities of these agencies. Every agency has their own set of requirements that they need to meet and the mission goals that they need to meet. What we did is look at the business drivers and then try to use architecture to achieve that particular goal and build solutions along with it.” How do you build a SOA for this kind of activity? “It was very interesting when we started but as we started looking at business priorities and giving more emphasis on business needs, and then using architecture to support it, there was a lot more buy in from the agencies,” Sankaran noted.


Exchanging Private Information

“We walk into hospital and we all have to fill out those 8 or 9 page clipboards. Or someone like me who is a cancer survivor has to go through multiple specialties and information is critical there. I need to make sure the  information is all connected,” explained Sankaran. “Think of a wounded soldier who comes back who needs, who lacks cognitive skills. And who becomes the health information exchange for all these people? How do you make sure the information flows from different specialties within the hospital? It is their families. So these are challenges that we have in health care today,” Sankaran said. “We will never have a large data base holding all the medical records of patients.”


But we have to connect all these existing networks around the country said Sankaran. “We have made some great strides towards agreeing on common principles on how you identify a patient across different systems.” “The secretary of HHS will be releasing a privacy and security framework by the end of this year, for health information. Along with that we are also looking at the FISMA and HIPPA kind of security controls that are required by the federal agencies compared to the private sector,” Sankaran continued.


Even though the benefits are obvious, major challenges
exist to make health information available online at the
different stages of patient care.


But questions remain. “How do you make sure there is some kind of a baseline that all the agencies can agree upon when we start moving into this production world of moving health information?” queried Sankaran.


Down The Road

Sankaran is confident that we are moving in the right direction and a few years down the road, we are going to be able to point back and say that came from this. “Think of a world where it’s more of a consumer centric health care system; where we have control of our health and we know where we can get the best services at a cheaper cost and a higher quality,” he pondered. Sankaran is optimistic because he sees a lot more collaboration going on right now, because now agencies are focusing more on the citizens’ needs.  “Because if you take a wounded soldier, it doesn’t stop with the DOD,” said Sankaran. “From DOD it moves over to VA and then there are interactions with Social Security, and interactions with CMS.”