tools supporting iso tc215 – iso 19669 re-usable component strategy for use case development...
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Tools SupportingISO TC215 – ISO 19669Re-Usable Component Strategy for Use Case
Development
Presented to
HSPC DC Meeting, 17-19 June 2015
Presented by
June 17, 2015
Tools Supporting ISO 19669
Vision
Goals
– Interoperable Health IT systems– Maintaining health record authenticity and accountability
Objectives
– Semantic Interoperability– full development lifecycle support – Traceability among Requirements, Design, Test and certification
artifacts using tooling– Model Driven Architecture, design and testing support
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Tools Supporting ISO 19669
Key Collaborators
– Use Case Developers: Office of National Coordinator (ONC), Standards and Interoperability (S&) Framework, S&I Simplification Work Group; Canada Health Infoway (tentative); Health Services Platform Consortia (in discussion), Defense Health Agency, Veterans Administration
– Expertise and Guidance: National Institute for Standards and Technology (NIST)– Use Case Repository: Agency for Health Research and Quality (AHRQ)/US
Health Information Knowledgebase (USHIK)– Information Model: US Federal Health Information Model (FHIM), part of US
Federal Health Architecture (FHA)– Standards Developers: Health Level Seven (HL7) Electronic Health Record
(EHR) Work Group; ISO TC215 (Health Informatics) WG1 (Architecture, Frameworks and Models)
– Tool Developers: Prometheus Computing (Beacon); SPARX Systems (Enterprise Architect)
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Tools Supporting ISO 19669
Source Information (Traceability)
– HITSP Use Cases and S&I Framework Use Cases– ISO 19669 Methodology (Technical Report)– ISO/HL7 10781 EHR System Functional Model R2– ISO/HL7 16527 PHR System Functional Model R1– FHA FHIM – captures data requirements and maps to implementable
• HL7 V2, HL7 CDA, CCDA, HL7 FHIR• HIPAA X12 Transaction Set• NCPDP (Pharmacy)• SNOMED, LOINC, RXnorm vocabularies and code sets
– NIST Health IT Test and certification Framework Tools for • Implementation Guide Authoring and Management Tool (IGAMT)• Test Case Authoring and Management Tool (TCAMT)
– AHRQ USHIK-based repository: HITSP and S&I Use Cases
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Tools Supporting ISO 19669
Benefits
– agile aligned interoperable systems– Patient Privacy and Security
Authentication/Authorization/Audit/Accountability support within ACA compliance Rules
– Record Management Lifecycle & Provenance support– higher effectiveness and efficiency– Specification, Test Certification Framework for EHRs– Integrated Framework for End User Requirements traceability to
Health IT certification and implementations
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ISO TC215 – ISO 19669
Re-Usable Component Strategy for Use Case Development
Report to ISO TC215 WG1
21 April 2015
San Francisco, California, USA
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ISO 19669
Fundamentals
• Based on US Standards and Interoperability (S&I) Framework– Sponsored by the US Office of National Coordinator for Health
Information Technology (ONC)– Based on S&I Simplification Work Group analysis (2011 on)
• In Close Collaboration with– US National Institute for Standards and Technology (NIST)– US Agency for Health Quality and Research (AHRQ)
• Now: ISO 19669– Approved as New ISO Work Item - April 2014– Added to ISO TC215 WG1 Work Program– Draft in Development
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In General
Use Cases
• A Use Case has– One or more Scenario(s) with– One or more Event(s) with – One or more Action(s).
• Use Case Scenarios describe (resolve to):– A set and sequence of Actors taking Actions;– A progression of steps.
• Actors may be– Individuals, organizations or systems.
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In General
Use Cases
• Convey Uniform and Integrated Patterns of:– Patient Flow – with Patient as Actor– Provider (Work/Process) Flow – with Provider as Actor– Information Flow – including System as an Actor
• And Show:– Event Steps with Actions taken – by Actors in Roles – to
support individual health and provide healthcare– Often including health record entries resulting from
Actions taken
• With Commonalties, Patterns of Repetition/Re-Use– Both Current and Potential
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US Standards and Interoperability (S&I) Framework
S&I Simplification WG
• Reviewed S&I Initiative Use Cases• Identified Commonalties, Patterns of
Repetition/Re-Use– Both Current and Potential
• Compiled and Distilled Components from S&I Initiatives
Current Analysis:20 Use Cases with 44 Multi-Step Scenarios
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S&I Framework – Cross Initiative – S&I Simplification
Key Objectives
• To identify a set of Core Components broadly applicable to, and re-usable in subsequent specification of, Use Cases
– Core Components are Requirements, Events, Actions, Actors, Roles and Data Objects and Elements, that we:• Find in common across Use Cases, Scenarios and Events;• Might re-use in a new Use Case Scenario.
• To establish/maintain a Core Component Registry• To allow each Use Case Initiative to
– Select (re-use) Core Components applicable to their needs– Create anew: identify new Core Component candidates
• To identify Implementable Data and Software Constructs fulfilling Core Component requirements
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S&I Framework – Cross Initiative – S&I Simplification
Key Objectives, con’t
• To lay the foundation for a consistent infrastructure and build-out
• To lead to uniformity in requirement specification, standards and implementation guidance, software development, testing and certification, implementation
• To ensure requirements traceability, at each progression step, and end-to-end (use case to implementation)
• [NIST] To apply cross-industry: beyond S&I Framework, beyond the domain of health and healthcare– A generic approach
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S&I Framework – Cross Initiative – S&I Simplification
Considering…
• Which Components of a Use Case are:– Potentially computable?
• As implementable software and/or data objects?
– Uniquely identifiable? Catalogue-able?• In an established repository?
– Candidates for re-use?• In another Use Case scenario?
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Components selected from S&I Initiative Use Cases
Is it… Potentially Computable for…
In Common?
Re-Usable?
Computable?
Identity
Accountability
Permission, Consent
Access,Data Use
Performance/ Fulfillment
Capture, Provenance
Content:Struct/Unstruct
Coding,Classification
Completeness
Signature
Audit
Requirements Y Y Y • •Actors, Roles Y Y Y • • • • • • • •
Scenarios, Events, Actions
Y Y Y• • • • • • • • As standards-based software services
Data Objects, Elements
Y Y Y• • • • • • • • •
As standards-based data objects, messages, documents…
S&I Framework – Cross Initiative – S&I Simplification
Component Candidates
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S&I Framework – Cross Initiative – S&I Simplification
Analysis Focus
• Requirements• Actors and Roles
– Individuals, Organizations, Systems
• Scenarios• Events and Actions• Data Objects and Elements
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• S&I Simplification Work Group has:– Analyzed 20 S&I Use Cases with 44 Scenarios– Specified Actions (examples) for each Scenario and
Event Step
• Next Slide– Shows Repetition Counts for Action Examples
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S&I Simplification
Analysis
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S&I Simplification Analysis Examples
Potential Re-Use – Actions
RepetitionCount
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Source: Rob Snelick, NIST
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Traceability – Anchored by Use Case Authoring Tool (UCAT)
From Sketch to ImplementationUse Case Software
Requirements SpecificationHarmonization Development Testing/Cert
Implementation Traceability
WHO
Non-IT Business/Clinical Expert Expert User
Developer/Vendor
TestingBody
Business/Clinical User
HOW
Sketches Maps to Selectsfrom
Develops using Tests
Implements using
WHAT
Use Case Scenarios, Events
Actions, System
FunctionsImplementable Standards-Based Software Modules/Services
Use CaseData Req’ts
FHIM Data Objects
Implementable Standards-Based Data Artifacts(e.g., HL7 FHIR resources, messages, documents)
Tool
Use Case AuthoringTool (UCAT)
UCAT[Vendor]
NIST TCAMT
[Enterprise]NIST IGAMT
Feedback at each Stage
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S&I Simplification
Leveraging Opportunities
• S&I Use Cases – Buildout• ISO and CEN National Members (via ISO 19669)
– Often tied to National HIT Programs
• Federal Health Architecture– DoD, VA, IHS, FDA, CMS, HHS, ONC, also CDC, NLM,
NIH
• NIST: Cross Industry• Canada Health Infoway• West Health Institute• Health Services Platform Consortium (HSPC)• Model Driven Health Tools (MDHT)21 April 2015
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S&I Simplification
Use Case Template Examples
• Seeking– Blank Use Case Requirements Template– Template with example Use Case filled in– For comparison with S&I Use Case Requirements
Template
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Seeking Requests to Status• Blank Use Case
Requirements Template
• Template with one or more example Use Case(s) filled in
Nancy Orvis, US DOD MHS Requested
David Bass, US VHA Received
Other US FHA Agencies, via FHA HIM Requested
ISO TC215 National Member Bodies- Beatriz Leao (Brazil) Received
CEN TC215 WG1 – Stephen Kay (UK) Anticipated
Canada Health Infoway – Ron Parker Requested
Health Services Platform Consortia (HSPC)- Craig Parker, MD, Laura Heerman
Discussed
West Health Institute – Todd Cooper Discussed
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S&I Simplification
Use Case Template Examples
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S&I Framework – Cross Initiative – S&I Simplification
UCAT Tool Developers
• Prometheus Use Case Editor– Art Griesser, Lead
– https://prometheuscomputing.com/beacon
• Sparx Enterprise Architect Extensions– J.D. Baker, Lead
– http://www.sparxsystems.com
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S&I Framework – Cross Initiative – S&I Simplification
Links
• US Office of National Coordinator (ONC)Standards and Interoperability (S&I) Framework Wiki
– http://wiki.siframework.org
• S&I Simplification Wiki– http://wiki.siframework.org/Cross+Initiative+-+S%26I+Simplification+WG
– http://wiki.siframework.org/Use+Case+Simplification+Reference+Materials
• Federal Health Information Model (FHIM)– http://www.fhims.org
• AHRQ/USHIK S&I Pilot Site– http://ushik-stg.dcgroupinc.com/mdr/portals/si?system=si&enableAsynchronous
Loading=true
• HL7 EHR Interoperability Wiki– http://wiki.hl7.org/index.php?title=EHR_Interoperability_WG21 April 2015
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ISO 19669
Contact
• Gary L. Dickinson– Director, Healthcare Standards, CentriHealth
– Lead, S&I Framework, S&I Simplification Work Group
– Co-Chair, HL7 EHR Work Group
– +1-951-536-7010
21 April 2015