e-health is the way via SOA

Healthcare Financial Management, March, 2007 by J. Peter Melrose

Looking beyond the medical breakthroughs and the personal approach and bedside manner required for clinical success at the point of care, we mustn't lose sight of the fact that the global healthcare delivery system is, at its core, a business. And unfortunately, today it is a business in crisis. Service-oriented architecture has the potential to increase the flexibility of business processes while enhancing clinical efficiency and patient safety.

Most healthcare systems are poised to "hit the wall" and may face immediate restructuring. To help turn this situation around, healthcare providers must aggressively embrace e-health standards and practices as an integral part of business best practices. The term e-health refers not just to health- and life-sciences-related digital information, but, more specifically, to the use of Internet/web-based information technologies, many of which are referred to by most other vertical industries as "e-business."

When it comes to fiscal health, having access to customized information that provides insights regarding the efficiency and effectiveness of a healthcare system is essential. This is equivalent to having personalized medical information to successfully manage the care of patients. In today's Internet age, adequately controlled accounting and management practices require the level of accuracy and timeliness that only e-health methods and tools can achieve.

However, even though there are numerous federal organizations pushing for electronic health records and interoperability to reduce costs and improve quality, the barrier to interoperability is exacerbated by at least three factors:

* Healthcare providers' failure to recognize and react to the fact that e-health represents a fundamental shift in consumer expectations based on experiences outside of health care and must be considered an operational imperative requiring near-term action

* The product development decisions of healthcare IT vendors that prioritize the good of the vendor over collective/industrywide IT advancement

* Traditional healthcare IT vendor implementations that frequently automate existing processes rather than transforming clinical workflow and operations

However, a new approach called service-oriented architecture has the potential to mitigate the effects of these obstacles.

A Breakthrough in Healthcare IT

SOA represents an evolution that is radically changing the IT landscape across industries as a result of the significant benefits it brings from a business perspective. By enabling IT leaders to more closely align the use of technology with business processes, we are now able to use and, more important, "reuse" applications in ways that their original creators may never had envisioned, which saves both time and money.

The SOA phenomenon is fundamentally not about new technologies, but rather about new ways to create, manage, share, and secure applications. SOA allows a company to break services down into reusable components, which can reduce overall development efforts and facilitate innovation by ensuring IT systems can adapt quickly, easily, and economically to support rapidly changing business needs.

SOA for health care is designed to give healthcare providers, healthcare benefit organizations, public health, and pharmaceutical companies the flexibility to leverage clinical and administrative business applications independently of the underlying computing platform.

By creating connections among disparate applications not previously possible due to their inherent incompatibility, the SOA approach can help companies increase the flexibility of their business processes, strengthen their underlying IT infrastructure, and retain and reuse the IT services they've already deployed. These connections allow a complete business process to be linked to the exact IT components needed to execute the processes. These connections can be mixed, matched, and reused to address problems unique to individual businesses, and since they are based on industry standards, services connected in this way can also be shared with partners, suppliers, and customers.

Using SOA to connect information from disparate medical systems can give caregivers secure, single sign-on to access multiple applications, including lab reports, medical imaging, patient phone call information, scheduling, health maintenance and disease prevention modules, and electronic signature and referring provider communication. Since it integrates and synchronizes all patient information from disparate applications, patient safety and clinical efficiency increase dramatically.

Ready, Set, SOA ...

Because SOA is a software architecture that drives the integration of business and management systems with enterprise IT strategic planning, a good first step is to start with "C-level" education regarding the SOA administrative and technical basics. SOA education is best achieved with the aid of an independent organization that demonstrates SOA experience and that offers both consulting services and SOA-related hardware and software products. Such an organization can serve as an authoritative and neutral third party to facilitate a common understanding of SOA among IT and non-IT C-level and other participating enterprise staff.