Guest Columnist
Service Oriented Architectures and the Healthcare Ecosystems
By
Apr 27, 2008 - 9:55:05 AM

(HealthNewsDigest.com) - American adults, on average, receive only a little more than half of the health care measures recommended for their conditions. Nearly 1/3 of adults and children with asthma do not receive effective Rx. Iatrogenic injuries (adverse events being the most common) are up to 180,000 US deaths each year. Medical errors cause between 44,000-98,000 annual deaths, and incur an annual cost of $17-29 billion. These are staggering statistics that drive the need for efficiency and transformation in the overall “healthcare ecosystem”. This transformation will be enabled efficiently through the effective and intelligent use of Service Oriented Architectures (SOA).

SOA Defined

There are numerous interpretations and definitions in the industry,, but consider Service-Oriented Architecture (SOA) to be a set of business-driven architectural design principles that represent business functionality as implementation-neutral, standards-based, distributed, loosely-coupled, and re-usable services. These enable the healthcare ecosystem to be more agile and to respond more quickly to changing business needs.

The “Healthcare Ecosystem”

The “healthcare ecosystem” includes the various segments that have an impact on global patient safety issues - from pharmaceutical companies and laboratories developing the drug including FDA reviews, to Post marketing safety surveillance of these drugs, translating the effects and benefits of these drugs to the appropriate consumers and finally the transactional issues dealing with payers, providers and the consumers. This is a vast arena, but what is common amongst all of these areas is that they all have an impact, in their own way, on patient safety. All of these elements in the ecosystem are moving towards modernization of their business processes, architecture and technology stacks. This is where SOA is already making a positive impact by delivering quality medical services that require solutions to be well aligned with an organization's business goals, and flexible to dynamic business changes. SOA, when planned for properly, can positively change the statistics mentioned above and shape future healthcare policies. This article will discuss the potential impact of SOA on the different elements of the “healthcare ecosystem” using SOA principles.

SOA implications in the Pharmaceutical Segment (Premarket, Clinical Trials)

The average cost of moving a new drug through the development process is $800 million to $1 billion and takes between 12 to 15 years on average. Over the years, a tremendous volume in the terabytes of data has been accumulated in numerous databases. Adopting an incremental SOA design infrastructure will make this data more accessible and will translate it into knowledge. By re-using these critical data assets, decoupling legacy systems and sharing accurate and complete information across multiple disparate systems, SOA will reduce expenses and decrease the time clinical trials are conducted; from drug discovery and development to review and approval of Investigational New Drugs (IND) and Biologics License Applications (BLA) among others, and distribution to the market. Additionally, through better access to disparate sources of data and establishment of authoritative data sources leveraged as data services and the use of the semantic web (web 3.0), several major diseases could be understood at the molecular level during clinical trials reducing the overall risk to patient health right at the beginning of the healthcare “supply chain”.

SOA implications in the Regulatory and Post Marketing Safety Surveillance (PMSS)–

Currently, adverse event (AE) data across the healthcare ecosystem is not being disseminated in a timely and efficient manner. The translation of this data into knowledge for patients is critical. SOA design principles and the use of standard enabling technologies (e.g. Web Services, Web 2.0/ 3.0) can have a positive impact on patient safety providing real-time access to knowledge, accurate patient data on time and as needed and reduced manual data entry errors. Improvements are realized in the implementation of PMSS programs including the tracking, reporting and dissemination of AE data. Another major benefit is that subpopulations at risk for adverse drug events will be identified for many therapeutics more efficiently through the seamless exchange of data across multiple systems. Regional SOA implementations in the future could be a start to a broader federated SOA strategy focusing on the entire PMSS program both for federal agencies and commercial organizations and impact key healthcare information exchange initiatives.

SOA implications in the Healthcare Payer, Provider Segment–

Many healthcare organizations have multiple disparate systems. Patient data in the inpatient system cannot be accessed by doctors in ambulatory care. Typically a nurse’s station is not linked to outpatient clinics to receive updated patient information. Additionally, problems with disparate patient payment and tracking systems, and health insurance claims stored in several legacy systems cannot be accessed and shared easily. This type of environment severely hinders the productivity and efficiency of payers and providers to deliver quality services to patients. SOA design of loosely coupled, standards-based, distributed architectures and modern integration and transformation engines such as Enterprise Service Bus (ESB) will establish a common platform for integration of disparate systems, provide real-time knowledge for patient care, and enable re-usable business services within the organizations. The value of SOA will be realized when payers and providers can access knowledge from segments in the overall healthcare ecosystem and vice versa in a real-time setting. This will lead to an increase in efficiencies in business to consumer (B2C) transactions and Employer driven Healthcare easing access to knowledge to a broader population.

Future Value for the Healthcare Ecosystem

The full value of SOA will be realized when SOA spans the entire healthcare ecosystem of locally managed globally aware systems. The adoption of SOA in the next few years will increase at a fast pace and organizations within the Healthcare Ecosystem will be beyond optimization of their SOA strategy, and focusing on institutionalization of SOA. The push for intelligent electronic health records, real-time access to health data and complex sets of functions needed to enable electronic quality monitoring will drive the transformation of medicine. This transformation will be accelerated by a combination of revolutionary technologies and evolutionary practices.

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