Improving medical system performance with service-oriented architecture

SOA in the medical field

The rapid development of technology and its application in the medical field have led to the accumulation of many systems in the medical organization that cannot interact with one another. However, from a business standpoint, these systems require not only collaborative work within the organization but also external access. In this situation, the burden of integration often falls on the users who have to access multiple systems to accomplish a task. However, the use of service-oriented architecture (SOA) can improve delivery of critical information and allow data to be shared across the healthcare community in conditions where costs, security, and deployment risks are acceptable.

Managing an ever-growing collection of systems is a challenge for today's healthcare organizations. The costs of creating, integrating, and maintaining these systems are increasing, as are requirements for system users. The organization must address the evolving clinical needs while supporting the revenue cycle and managing business functions. In addition, in order to support the transfer of regional medical services, the need for interoperability with other medical organizations is increasing. Service-Oriented architecture provides the system design and management principles for the reuse and sharing of the system resources of the whole medical organization. SOA does not require the reengineering of existing systems. With SOA, existing processes can build a service library in conjunction with new functionality, each of which is part of the solution. Using shared services that are consistent with business processes, SOA enhances interoperability while reducing the need for synchronized data between orphaned systems. Wherever the services are located, they can be used to create solutions that go beyond desktops, departments, and healthcare organizations.

Introduction to SOA usage in medical information technology

If a medical organization relies solely on a single system to support the work of organizations and provide medical services, they often have a solution for sharing and reusing system resources. However, it is more typical of this organization: it relies on one or more enterprise internal systems, supporting additional systems for departmental-specific requirements, devices with their own systems, and interoperability using complex data interface networks. It is easier to apply SOA to organizations with a large collection of systems than to show its advantages. An SOA environment enables system assets to be accessed across the organization and provides the possibility of sharing existing orphaned system functionality. For example, SOA can help meet unmet process requirements without acquiring additional systems and provides opportunities for standardized processes and data management. This means that existing system features will appreciate as they are packaged into shareable services. Figure 1 shows examples of medical system features and related applications. Although the chart does not contain a complete list of features or systems, it shows the redundancy of system functionality in a typical medical environment.

Figure 1. Medical Systems and functions

SOA defines a service as an independent unit of work that is self-contained, well defined, and understandable. A unit of work can be a whole process, a function that supports a process, or a step in a business process. Through SOA, services can directly support business processes because they are "discovered" and compiled as a system solution. The functionality that is used across systems, departments, and organizations is most likely to improve reuse and standardization through SOA. If system functionality is redundant between systems, the corresponding business process may be associated and may well indicate that the process needs to be shared as a service. In Figure 1, a large number of redundant features are:

Patient Registration

Admission, Discharge and referral

Record illness and diagnose

Payment and recording fees

Create a clinical record

Each system work can be divided into tasks to further improve the reusability of the service. For example, the "Patient Registration" feature may be divided into "finding and browsing patient records", "Creating and updating Patient records", "Verifying Insurance Qualifications", "Historical archives" (new or updated), and other business activities completed during the registration process. This division allows other services and applications to use the "patient registration" part of the function. The task of "finding and browsing patient records" may be used by most organizations, and the task of "Creating and updating patient records" may only be used by the admissions and reception staff. In some cases, other systems may provide better functionality than is currently used in the current process. For example, the "Verify Insurance qualification" feature used by another system may provide more functionality than the corresponding functionality in the system that handles "patient registration." In an SOA environment, functionality can be standardized and used by different systems and processes.

Figure 2 shows the conceptual view of the "Patient Registration" service feature:

Figure 2. "Patient Registration" system function

As SOA is further promoted in the healthcare industry, service sets and other special services are expected to be used, and consumers may be the Service procurement organization function of a medical organization (see chap. II). Because the services provided by the system are location-transparent, these purchased services may be hosted outside the organization. For example, a diagnosis-related group (diagnostic Related Group, or DRG) or other services such as the word encoding for controlled drugs can be integrated into an organization's solution. This service may be located in an external agent system that is used by different medical organizations. An added benefit of SOA is the ease with which you can maintain a separate, up-to-date set of DRG code for the entire organization and for all medical organizations using the service. Figure 3 shows an example of a medical industry service classification.

Figure 3. Examples of service classification in medical industry