SOA applied to Healthcare
Of all the public or private services, probably the most needed and valued by everybody is Healthcare. It is undoubtedly one of the most important and critical sectors. Everyone, throughout our lives, needs to make use of these services, either for us or for our loved ones. In this issue, an error can have very serious consequences, so the management of information in the health sector is of vital importance (literally). Join me in this new post of the series that we are dedicating to SOA case studies. This time it is the turn of SOA applied to Healthcare.
Fortunately, in the course of the century, more and more governments and healthcare organizations have seen the importance of interoperability in health. An important economic and human effort is being made to try to optimize this aspect in health information ecosystems.
However, most attempts have ended, or are on the way, to spaghetti-type architectures, or at least, architectures that present many of their most characteristic problems. This translates into a growing difficulty and an increase in the cost of maintaining the ecosystem, as well as a burden for the evolution of the health business itself to respond to the needs that society and laws are demanding.
Let us think about the importance of this subject. The simple absence of a data such as an allergy, in the planning of a surgical intervention, means for the patient to risk his life, although the intervention itself does not present such a high risk. This example is by no means an exaggeration.
In a health information ecosystem where the availability of information is not immediate, nor precise, nor semantically standard, the risk is very high. It is a risk that simply can not be admitted. In these scenarios, it is crucial to re-focus the issue of interoperability from scratch.
People’s health and the quality of their health care can not depend on whether a system is available or not, or that a data is coded equally in two systems of different technology providers, or that a data is not properly updated when it is consulted. Obviously there are health professionals, last and authentic responsible for patient care. But they are not infallible. And of course they are not soothsayers: without the complete and accurate information of the patient, they can not guarantee much. And when our health professionals search for a patient’s data in their medical records through their information system, if the data they are seeing is not correct or not updated, they can not know.
What can SOA apply to Healthcare contribute?
The answer is brief: with proper Governance, everything.
And I have added that premise about proper Governance because it is, without a doubt, the most difficult factor to achieve. More complex than even hitting the technological infrastructure, or analyzing business processes, or planning a viable roadmap and keeping it up to date, or anticipating and managing risks throughout the deployment of the strategy.
Achieving effective governance is tremendously complicated, because a multitude of actors, variables, interests and constraints come into play. It is a daunting task to combine all these factors so that they align with an interoperability strategy, which in its basic objectives includes things like improving business processes (changing them if necessary), standardizing messaging and semantics (overriding possible dominant positions of third parties), homogenize the coordination and planning of multiple projects, different functional areas, with different groups of experts who usually lack a global vision of the business, etc, etc ….
With an SOA strategy, a healthcare ecosystem can aspire to optimize the information workflow in all the areas it covers: from health care, to financial, logistics, human resources, etc., etc.
It can achieve semantic interoperability thanks to the standardization of its messaging, having also in this sector the luck of having a mature standard in the market such as HL7.
And it can aim to more efficiently manage its ICT budgets, by quickly finding a group of services not very large but with a huge reuse rate. Not surprisingly, one of the characteristics of healthcare that best suits the use of an SOA strategy is that, throughout the world, health business processes are essentially identical. Only when we reach very low levels of abstraction do we begin to see differences, or in very specific areas such as finance. Thanks to this, the ICT projects in Health are fast accelerated, and in a few years a high capacity of scalability and adaptation to new requirements is reached.
But it is imperative that all participating stakeholders be aligned with the overall objectives of the business processes, assuming the need to codify health information following the ontologies and standards dictated by Governance, and that the fundamental role of information exchange throughout the information ecosystem should be granted, forever forgetting the still widespread tendency to consider the issue of integrations as merely technical and minor. When in fact it is what makes the value chain of any business work.
To close this entry, I’ll share with you an example of SOA applied to healthcare that I know well, because I had the pleasure of leading this project: the case of the Andalusian Health Service, pages 16 and 17 of HL7 International magazine, published on May 2012.