Developing Enterprise Applications
A technology perspective
V. “Juggy” Jagannathan
Associate Professor of Computer Science
West Virginia University
VP of Research
MedQuist
1
Disclosure
MedQuist, Inc. sells and operates
enterprise dictation and transcription
software.
2
Tutorial Goals
 Provide
overview of the technologies
that are relevant for the
development and deployment of
enterprise solutions – in particular
ASP solutions
 Allow participants to evaluate where
the technology is headed
 Use transcription industry as the
main example
3
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

4
What is an ASP?
Application Service Provider (ASP) provides
applications to customers on a
subscription basis. ASPs provide for all
the infrastructure needs to host the
application and rely on Internet or
Intranets to deliver the applications to
customers.
ASPs are Enterprise Applications and need
to satisfy a wide range of stringent
requirements.
5
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

6
ASP Requirements










Flexibility
Security
Reliability
Availability
Scalability
Evolvability
Performance
Supportability
Maintainability
Interoperability




Platform Independence
Location Independence
Open Standards and Systems
Architectural Choices
7
Flexibility
 Ability
to configure solutions that
satisfies customer’s workflow
needs.
 For the transcription industry:
– Dictation workflow
– Transcription workflow
– Signature workflow
– Routing workflow
It is the process stupid! Not technology. – Mike Waldrum, UAB
8
Flexibility – Edge Computing
Off-Premise Computation
Internet
On-Premise Computation
Focus computation where it can be most
effective to meet the needs of the workflow
9
Security
Compliant with all HIPAA’s upcoming
regulations.
 Encryption of communication.
 Stringent access control.
 Audit trails.
 Physical security of premises
 Virus protection & Intrusion detection

Encryption...is a powerful defensive weapon for free people.
It offers a technical guarantee of privacy, regardless of who is
running the government... It's hard to think of a more
powerful, less dangerous tool for liberty.
Esther Dyson
10
Reliability
 No
work is ever lost.
 No document is ever lost and no
document ever gets corrupted.
 What backup and recovery
strategies are in place?
 How well is the physical
infrastructure (Data center)
protected? Fire protection?
There are only two kinds of computer users: those who have lost data in
a crash, and those who will lose data in a crash – Bob LeVitus
11
Availability








What guarantees is the ASP willing to
provide?
What down time are you willing to tolerate?
How can you find out?
What happens when a server goes down?
Is there a backup?
What happens when there is a power
blackout? Is there backup power source?
What happens if there is a network outage?
Is there a backup?
Is there a backup data center?
Is there a disaster recovery plan?
12
Availability
# of hours of Formula
downtime
Uptime
%age
5
(8760 –
minutes/year 5/60)/8760
99.999 %
[five 9s]
1 hour/year
8759/8760
99.99 %
52
hours/year
(1 hr/week)
8708/8760
99.4%
# of hours per year = 365*24 = 8760
13
Scalability
What happens when there are more
users? More volume? How easy is it to
upgrade infrastructure?
 Does the company have the financial
where with all to improve the
infrastructure? Sooner or later,
scalability means to add additional
hardware.

Just as we could have rode into the sunset, along came the
Internet, and it tripled the significance of the PC.
Andy Grove
14
Evolvability
How easy is it to upgrade? Can
one user be upgraded without
upgrading others?
 What are the technological
underpinnings?
 Are there automatic upgrades?
 Solutions must be engineered to
continuously evolve and leverage
the latest in internet
technologies.

Whoever desires constant success must change his conduct with the
times - Machiavelli
15
Performance
What benchmarks are available?
 Time to submit reports?
 Retrieve reports?
 Retrieve and sign?
 Performance under heavy load? No
load?
 What is the degradation?
 Is it acceptable to the user
community?
 Can you work off-line?

Technology is so much fun but we can drown in our technology.
The fog of information can drive out knowledge.
Daniel J. Boorstin
16
Supportability
Can the user manage their own support
needs? Is it web-based?
 What infrastructure support is
available?
 Is it 24x7, 365 days? How long does it
take to respond?
 Does it cause downtime to your work?

Computers shouldn't be unusable. You don't need to know
how to work a telephone switch to make a phone call, or how
to use the Hoover Dam to take a shower, or how to work a
nuclear-power plant to turn on the lights.
Scott McNealy
17
Maintainability
 Who
is maintaining the software?
 How is maintenance and software
evolution managed?
 What is the technology basis that
facilitates maintenance?
 Use of advanced component and
object-oriented technologies
facilitates software maintenance
and evolution.
Correct me if I'm wrong - the gizmo is connected to the flingflang
connected to the watzis, watzis connected to the doo-dad connected
to the ding dong.
18
Patrick B. Oliphant
Interoperability
 How
easy is it interface to the
system?
 Does it provide open APIs?
 Does it support XML-based data
exchange? Document
interchange?
 Does it support HL7 standards?
19
Platform
 What
is the platform used?
 Is it Windows or Unix platform?
 Does it support both leveraging
the strengths of both
platforms?
20
Location Independence
 Can
users work from home?
 Over low speed modem lines?
 Work in LAN, WAN
environments over secure
lines?
 Can they be mobile workers
using their PDAs?
21
Open Standards
 What
standards are supported?
 Internet standards: HTTP, XML,
Web services etc.
 Object Standards: CORBA,
DCOM
 Healthcare standards: HL7
 Security Standards: PKI, SSL
22
Architecture Choices
Platform Choices – Microsoft, OMG,
Java, Web services
 Off-premise, on-premise, edge
computing trade-offs
 Thin vs. Thick clients. Trade-offs in
functionality, performance and
supportability.

The first rule of any technology used in a business is that
automation applied to an efficient operation will magnify the
efficiency. The second is that automation applied to an
inefficient operation will magnify the inefficiency.
Bill Gates
23
Broad Requirements for
Transcription Industry
Need to support the dictation and
document authoring process
 Need to support transcribing and
document creation process
 Need to support the physician
review and sign-off process
 Need to support the document
distribution process

24
Broad Requirements for
Transcription Industry
 Hosting
of Enterprise
Transcription Solution for the
following types of customers:
– Hospitals
– Physician groups
– Transcription Service Providers
– Independent Contractors
25
Typical ASP Use Case Scenario
S1
TSP1
S2
TSP2
S3
TSP3
S4
Transcriptionists
Transcription
Service Providers
S5
Hospitals/
Clinics
Clinicians
26
Implementation Alternatives
 Off-premise
- hosted solution
– typically viewed as the ASP
model
 Edge Computing Model – a
hybrid model combining ASP
and on-premise solution
 On-premise solution
Choice of solution depends on organization’s goals and objectives
27
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

28
Platform Choices
Platform Standards
– Object Management Group (OMG)
CORBA Infrastructure and approach
– Web services – the new kid on the
block
Other Popular Platforms
– Sun J2EE Platform
– Windows .NET

Host of other vendor platforms
– Oracle
– IBM
– Iona
29
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

30
CORBA Technology
Overview
Distributed Object
Infrastructure
31
Heterogeneity is Permanent

Programming languages
– ~3 million COBOL programmers
– ~1.6 million VB programmers
– ~1.1 million C/C++ programmers

Operating systems
– Unix, MVS, VMS, MacOS, Windows (all 8!),
PalmOS…
– Windows 3.1: it’s still out there!
– Embedded devices (mobile, set-top, etc.)

Networks
– Ethernet, ATM, IP, SS7, Firewire, USB
– Bluetooth, 802.11b, HomeRF
Courtesy: Richard Mark Soley, CEO & Chairman of OMG
32
Where Can We Agree?





There will not
There will not
There will not
There will not
languages
be
be
be
be
consensus
consensus
consensus
consensus
on
on
on
on
hardware platforms
operating systems
network protocols
programming
There must be consensus on interfaces
and interoperability!
Courtesy: Richard Mark Soley, CEO & Chairman of OMG
33
Who Are OMG?
2AB
Alcatel
BEA
Borland
Boeing
CA
Citigroup
Ericsson
Ford
Fujitsu
Glaxo
SmithKline
John Deere
Rational
Microsoft
SAP
MITRE
SAS Institute
Siemens
Hyperion
MSC.Softwar
e
IBM
NASA
IONA
NEC
io Software
NIST
Kabira
NTT
Kennedy Carter
OASIS
LION Bioscience
Oracle
Hewlett Packard
Hitachi
Sony
Softeam
Sprint
Sun
Unisys
W3C
Courtesy: Richard Mark Soley, CEO & Chairman of OMG
34
Integration Technology - CORBA
– The Common Object Request
Broker Architecture is the standard
adopted by OMG as a framework
to provide common ORB services
and interfaces to support portable
clients and services.
– The Object Request Broker (ORB)
provides the mechanisms by which
clients transparently make
requests and receive responses.
35
CORBA (continued)

Advantages offered by CORBA:
– architecture independence (hardware
and operating system independence)
– language independence
– location independence

The standard specifies the Interface
Definition Language (IDL) language used to describe the
interfaces that client objects call and
object implementations provide.
36
CORBA Architecture –
Simple view
Servers
Server
Clients
C++ Java Ada C
other
C++ Java Ada C
Client Requests
IDL-based
other
Service
IDL-based
ORB
37
UML and Model Driven Architecture



UML provides higher level abstraction to
software design
By focusing on models, higher levels of
interoperability can be achieved.
OMG’s MDA operationalizes this approach –
where models can be defined in UML but
implemented using EJB, DCOM or
Webservices.
38
OMG Platform and Approach
 An
approach that can be
combined with any
implementation considered.
 Based on evolving technologies,
standards and approaches.
 Provides an approach to integrate
with CORBA, EJB (JAVA
platform), .NET and Web
services.
39
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

40
Web Services - Jargon
Basis – XML Technology
 Web Services Description Language
(WSDL)
 Simple Object Access Protocol
(SOAP)
 Universal Description, Discovery,
and Integration (UDDI)
 Other elements – ebXML, SAML,
XKMS, X-KISS and a host of other
efforts

41
XML Technology
Overview
42
Emerging Importance of XML


HTML-tagging is display oriented.
XML-based content tagging has important
uses:
–
–
–

Wide spread industry support for this new
open standard
–
–
–

data mining
role-oriented display customization
intelligent searching and other value added
elements
Microsoft
Netscape
W3C is pushing the standardization efforts
Complementary technology to HTML-based
web browsers
43
Requirements best addressed by XML
Customizing front-end applications easy presentation of what users want
to see
 Data mining
 Synthesis type applications combining multiple information
sources
 Electronic commerce-type
applications
 Structured Data Exchange

44
XML Markup
 Elements
and attributes
 Entity References
 Comments
 Processing Instructions
 Marked Sections
 Document Type Definitions
(DTDs)
 Now, XML Schemas
45
Elements
 Bounded
by start and end tags
 Sample markup
<Patient>
<FirstName> Frank</FirstName>
<LastName> Foster</LastName>
</Patient>
 Patient,
LastName, FirstName
are all entity tags.
46
Attributes
Name-value pairs included as part of
start tags.
 Sample markup

<APatient patientID=“123” FirstName=“Frank”
LastName=“Foster”>
<Insurance> Blue Cross </Insurance>
<Insurance> HMO </Insurance>
</APatient>

FirstName and LastName in the
example above are attribute
declarations.
47
Document Type Definitions
 Allows
the expression of
constraints on tags
 Defines sequencing and nesting
of tags
 Defines attributes and values
and defaults
 Allows specification of external
file references
48
XML Schemas
 Replaces
DTDs
 Is in XML format (DTD’s are
not)
 Supports data typing (DTD’s
didn't)
 Schemas are extensible
 XML Schemas – next
generation of DTDs.
 Wide industry support
49
XML’s evolving family of standards
XML Linking Specification (XLL)
 Resource Directory Framework (RDF)
 Style sheets

– CSS Cascading Style sheets
– XSL - XML Style sheet Specification
Language
Document Object Model (DOM)
 XML Schemas
 Provides the basis for Web Services
and Simple Object Access Protocol
(SOAP)

50
Web Services
Definition
Language
WSDL
51
What is WSDL






Web Services Definition Language
It is equivalent of IDL for Web Services
It is in XML Schema format
It defines an EXTENSIBLE framework for
specifying web services interfaces
Developed originally by Microsoft and IBM
and now being put through its paces in
W3C.
W3C working on Version 1.2 of WSDL right
now (Fall 2003).
52
WSDL: What does it support?
Data type definitions
 Messages supported
 Operations supported
 Port type (an aggregation of
messages and operations)
 Binding (what protocol supports the
service – ala SOAP)
 Port – target address where service
is available
 Service – aggregation of port types

53
WSDL Service
Web Service

Port Type
Port TypePort Type
Operation
OperationOperation
Operation
OperationOperation
Operation
OperationOperation
Binding
Binding
Binding
BindingBinding
Binding
Binding
Binding Binding

WSDL
specifications are
published in a
URL.
Clients download
this specification,
pick a particular
protocol to
communicate
with the service
(binding) and use
that protocol.
54
SOAP...
It is a Simple Protocol that allows
you to Access an Object through
the net.
Courtesy: Yan Liu, my student.
55
SOAP Motivations
Heterogeneous systems must be able
to communicate
 Binary protocols don’t always work

– CORBA, DCOM, etc. don’t work well through
firewalls
– Nobody can agree on a standard binary format
(usually due to platform-related issues)
– We’re dealing with many heterogeneous
environments (MVS, Unix, Windows NT, Linux,
PalmOS, etc.)
– Component runtimes differ
– Security models differ (Kerberos, NTLM, OSF-DCE)
Courtesy: Yan Liu, my student.
56
What SOAP is...

SOAP is a specification for defining...
– an encoding style that uses XML to
represent information graphs
– a standard way to move XML with HTTP
– rules for passing messages
– error (fault) definition
– a medium for performing Remote
Procedure Calls (RPC)
– one layer in a multi-layer architecture
Courtesy: Yan Liu, my student.
57
SOAP Contains Four Parts:

An extensible envelope expressing (mandatory)
– what features and services are represented in a
message;
– who should deal with them,
– whether they are optional or mandatory.

A set of encoding rules for data (optional)
– Exchange instances of application-defined data types
and directed graphs
– Uniform model for serializing abstract data models
that can not directly be expressed in XML schema

A Convention for representation RPC (optional)
– How to make calls and responses

A protocol binding to HTTP and HTTP-EF (optional)
Courtesy: Yan Liu, my student.
58
SOAP - Simple Example
<Envelope>
<Header>
<transId>1234</transId>
</Header>
<Body>
<Add>
c = Add(a, b)
<a>3</a>
<b>4</b>
</Add>
</Body>
</Envelope>
Courtesy: Yan Liu, my student.
59
System Flow (HTTP)
<Envelope>
<Header>
<transId>1234</transId>
</Header>
<Body>
<Add>
<a>3</a>
<b>4</b>
</Add>
</Body>
</Envelope>
<Envelope>
<Header>
Courtesy: Yan Liu, my student.
<transId>1234</transId>
</Header>
<Body>
<AddResponse>
<c>7</c>
</AddResponse>
</Body>
</Envelope>
60
SOAP – Example from
healthcare
Example Request
<soap:Envelope>
<header> …. </header>
<soap:Body>
<GetName>
<MR#>123456</MR#>
</GetName>
</soap:Body>
</soap:Envelope>
Example
Response
<soap:Envelope>
<header> …. </header>
<soap:Body>
<GetNameResponse>
<Name>John
Doe</Name>
</GetNameResponse>
</soap:Body>
</soap:Envelope>
61
SOAP Execution
Application
Web Service
Interface Semantics
Interface Semantics
Envelope/Header/Body
Envelope/Header/Body
Message Encoding
Message Encoding
Transport (e.g. HTTP)
TCP/IP
Transport (e.g. HTTP)
TCP/IP
Courtesy: Yan Liu, my student.
62
SOAP – Conclusions
 Basis
for Web services
 Significant component of
Microsoft’s .NET platform
 Supported by everyone
 Has a strong future
63
Universal
Description,
Discovery and
Integration
(UDDI)
64
UDDI – What is it?
A
vehicle to locate operational
web services
 Similar to Domain Name
Service (DNS) lookup
 Embodies the concepts of
“White Pages and Yellow
Pages”.
65
UDDI Elements
 White
Pages: Business Name,
Contact Info, DUNS etc
 Yellow Pages: Business
categories, key-value pairs of
relevant information
 Green Pages: Technical
information on how to connect
to web services
66
UDDI Process Supported
Business registers its web service
(information that put in white,
yellow and green pages).
 The information gets propagated to
all UDDI servers (replicated)
 Customers contact known registries
 Locate appropriate service and
invoke them.
 Main protocol supported is SOAP.

67
Web Services Current Status
Evolving rapidly – strong support for
SOAP and WSDL has decent
support.
 UDDI is little further away.
 All vendors are incorporating various
components of Web services
 Web services is the future – right
now people have to deal with other
component technologies

68
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

69
Java and J2EE
Platform
Overview
70
J2EE Architecture
XHTML
XML
Mail Server
RDBMS
HTTP(S)
Java App.
CORBA Server
Web Container
Applet
Servlets
JSPs
JAF
JavaMail
JMS
JDBC
JTA
JNDI
RMI/IIOP
J2EE
Application
Server
EJB Container
Session
Entity
Beans
Beans
Directory
Service
Message Queue
JAF
JavaMail
JMS
JDBC
JTA
JNDI
RMI/IIOP
Client
App.
Tag
Library
71
Reproduced with Permission from Java Server Programming J2EE Edition – Wrox Press, Ltd, 2000
J2EE Platform Components






JAXP 1.0 – Java API
for XML Processing
JDBC 3.0 – Java Data
Base Connectivity
RMI over IIOP
EJB 2.1 – Enterprise
Java Beans
Java Servlets 2.4
Java Server Pages 2.0





Java Message Service
1.0
Java Naming and
Directory Interface
(JNDI) 1.2
Java Transaction API
1.0
JavaMail 1.1 J2EE
Connector
Architecture 1.0
Java Authentication
and Authorization
Service 1.0
72
J2EE Platform
 Strong
and proven platform
 Evolving constantly
 Already supports various APIs
to develop and deploy web
services
73
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

74
.NET Platform
Client App.
Users
.NET Framework
Web
Services
.NET
DCOM
ODBC
UDDI
SOAP
HTTP
Web
servers
Web
Webservers
servers
Web
Forms
Web
servers
Web
servers
.NET
servers
75
.NET Components

.NET framework
– Common Language Runtime (CLR)
library
– ActiveX Data Objects - (ADO.NET)
– Active Server Pages – (ASP.NET) and
supports Web Services (UDDI, WSDL &
SOAP)
– .NET Compact framework for PDAs
– .NET Remoting (RPC support)

Visual Studio .NET
– VB, C++, C#, Jscript… all compile to
MSIL (Microsoft Intermediate
Language) and utilize CLR.
76
.NET Framework
Microsoft’s big push to open
standards and support for XMLbased solutions
 Fully supports web services
approach
 Microsoft is an active participant in
W3C efforts and is a strong
proponent of standardization of web
services and related technologies.

77
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

78
Security Concerns
Authentication
 Authorization and access control
 Data Integrity
 Data Confidentiality
 Signing and non-repudiation
 Audit trails
 Virus protection and intrusion
detection

79
Security Technologies
Hashing/digest creations – SHA,
MD5
 Encryption – Symmetric - DES
 Encryption – Asymmetric - PKI
 Digital Signatures
 Trust and Public Key Certificates
 Secure Socket Layer (SSL)
 Smartcards, Biometrics (Thumb
prints, retinal prints, voice prints)

80
XML and Security
XML Signature
 XML Encryption
 Security Assertion Markup
Language (SAML)
 XKMS – XML Key Management
Specifications
 X-KISS – XML – Key Information
Service Specification
 X-KRSS - XML Key Registration
Service Specification

81
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

82
Communication Technologies
 Ethernet
 Wireless
– GSM
– CDMA/TDMA
 Broadband
– DSL
– Cable
83
Broadband technologies
 High
bandwidth internet
connection
 Always on – no need to
explicitly establish connection
 Supports audio, video in
addition to data connectivity
 Typically downstream
bandwidth is a lot higher than
upstream bandwidth.
84
Bandwidth
 Options
– DSL
– Cable Modem
 Check
out how much bandwidth
you have from your broadband
provider!
http://www.toast.net/performance/
http://www.dslreports.com/stest
85
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

86
Storage Requirements
A
microcosm of ASP
requirements
 Storage technologies has to
address these issues:
– Availability
– Reliability
– Scalability
– Performance
– Security
87
Storage Technologies




RAID technology – primarily to address
reliability and performance issues
Storage Area Networks (SAN) and
Network Attached Storage (NAS) –
primarily to address scalability and
availability issues
SAN – to increase the storage capacity
of a server (say a database server)
NAS – to increase the storage capacity
of file servers on the network.
88
What is RAID?
 Redundant
Array of
Inexpensive/Independent Disks
 Can be implemented in software
or hardware
89
RAID configurations

RAID0 striping  Simple striping of
data across all the disks in an array.
Improves load balancing and
performance. Does not provide
redundancy.
Total capacity = Individual Disk capacity * number
of disks in array

RAID1 mirroring  Mirroring of data in
multiple disks. Provides redundancy.
Total capacity = Individual Disk capacity *
(number of disks in array/2)

RAID0+1  Where RAID0 and 1
strategies are combined to provide high
performance and reliability.
90
RAID configurations

RAID 5  Use of Error Correction
Codes to increase capacity in RAID
arrays.
Total capacity = Individual Disk capacity *
(n-1) where n is number of disks in array
Higher disk capacity. Good for small reads
and bad for writes.
Can recover from any one disk failure.

RAID 6  same as RAID 5 but can
tolerate two disk failures.
91
Storage Area Networks (SAN)
RAID
RAID
Switches
Bridges
Hubs
RAID
92
Storage Technology Highlights
 Rapidly
evolving field
 Major players for enterprise
storage include: EMC,
Network Appliance, Inc.
 Microsoft a recent entry to the
market place with their
Windows Storage Server 2003
93
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

94
Introduction to
Healthcare Standards
Standards, standards everywhere and not one of any use - Anonymous
95
Messaging & Object Standards
 HL7
 OMG
Healthcare Task Force
96
HL7 Standard
97
HL7 Messaging
 Established
Standards Body
(1987)
 ANSI accredited (1994)
 Over 1700 members
 Key efforts
– HL7 CDA (XML documents) Effort
– HL7 CCOW
– HL7 EHR Effort
98
HL7 Philosophy
 Designed
as a protocol for
exchange of healthcare and
related information
 Based on an event-based
transactional model that
mirrors real-life use-case
scenarios
99
HL7 Version Evolution
Produced Version 1.0 late in 1987
 Produced Version 2.0 late in 1988
 Version 3.0 effort underway for a
while
 Clinical Document Architecture
(CDA) effort – release 1 Nov
2000 & CDA release 2 passed in
committee ballot – Sept 2003
 Clinical Context Effort (CCOW)
 Electronic Health Record (EHR)
Functional Model (NHII initiative)

100
HL7 Message Structure
 Messages
by:
in HL7 are defined
– A message ID (a 3 letter code e.g.. ADT for Admit, Discharge,
Transfer related messages)
– One or more segments (logical
grouping - e.g. PID segment to
represent patient identifying
information)
– Nesting and repetition of
segments as appropriate
– “Z” segments for custom use
101
Sample CDA Document
102
103
HL7 Clinical
Context Object
Working Group
(CCOW)
104
Clinical Context Object Working
Group (CCOW)
 Focus
is the visual
integration of diverse
applications in the users
desktop.
105
CCOW
Technology neutral
specifications for healthcare
applications to switch contexts
seamlessly - oriented towards
making multiple Graphical User
Interface clients to work
together
 Already have interoperable
specifications and
implementations
 Currently working on an
interoperable single-sign-on
specification

106
“Visual” Integration
“Data”
Integration
Server
Server
Visual
Integration
Server
The Clinical
Applications
The
Provider's
Workstation
The Provider
* Acknowledgement: Slide provided by Wes Rishel, Gartner Group
107
Context Manager
O'Donnell
Context
Manage
r
Patient
ID
Mapper
Master Patient Index
General
Hospital
O'Donnell
Furlow
Crane
University
Physicians
3222111 2344444
-- 6731123
582233
--
* Acknowledgement: Slide provided by Wes Rishel
University
Physicians
O’Donnell 2234444
Furlow
6731123
2234444
O'Donnell
3222111
General Hospital
O’Donnell 3222111
Crane
58233
108
CCOW Current Work

Single sign-on:
– users do not have to memorize many
user names and passwords
– authentication via password, badge
swipe, biometrics

Web-based applications
* Acknowledgement: Slide provided by Wes Rishel
109
HL7 Summary





Version 3.0 Reference Information Model effort underway to specify it in XML
Interoperability Demonstration using XML
and HL7 RIM models have happened since
HIMSS 99.
HL7 CDA effort has taken root and will
impact the transcription industry.
HL7 CCOW has made significant inroads.
EHR effort is ground breaking and is lead
by the Dept. of Health and Human Services
as part of the NHII
110
HL7 References
–HL7: Health Level 7:
http://www.hl7.org/
111
OMG Healthcare
Taskforce
112
CORBAmed
 The
Healthcare Domain Task
Force (DTF) of the Object
Management Group (OMG)
Acknowledgement: Courtesy Tim Brinson, 2AB Inc. & CORBAmed
113
114
Acknowledgement: Courtesy Dave Forslund of Los Alamos National Labs
Financial
Objects
Manufctring
Objects
Telecom
Objects
Healthcare
Objects
E-Commerce Transprtation
Objects
Objects
Horizontal CORBAfacilities
CORBAservices
CORBA
Acknowledgement: Courtesy Tim Brinson, 2AB Inc. & CORBAmed
Intermodal
Marine
Rail
EC Services
Offer Loc/Trade
E-Payment
COAS
LQS
PIDS
Tele Services
Stream Control
Tele Netwk Mgmt
Shop Floor Auto
ERP
PDM
Accounting
Insurance
Banking
DOMAIN FRAMEWORKS
CORBAmed within the OMA
115
Syllabus
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage
Advances
 Healthcare
Standards
 Sample
Systems

116
ASP Examples in Transcription
Industry
Company
Reference
MedQuist
Medquist.com
TotaleMed
Totalemed.com
MDinTouch
Mdintouch.com
Vianetta
Vianetta.com
Medremote
Medremote.com
Disclosure: TotaleMed is a customer of MedQuist’s
Careflow product solution
117
Conclusion
What is an ASP
 ASP Requirements
 Platform Choices

–
–
–
–
OMG Approach
Web Services
Java Platform
.Net Platform
Security
Technologies
 Communication
Technologies
 Storage Advances
 Healthcare
Standards
 Sample Systems

118
Glossary







MD5 - Message Digest 5
SHA - Secure Hashing
Algorithm
NTLM Authentication protocol
DES - Data Encryption
Standard
HTTP-EF - HTTP Extension
Framework
XKMS - XML Key Management
Services
X-KISS - XML - Key
Information Service
Specification






SAML - Security Access
Markup Language
WSDL - Web Services
Description Language
IDL - Interface Definition
Language
UML - Unified Modelling
Language
SOAP - Simple Object
Access Protocol
UDDI - Universal
Description, Discovery and
Integration
119
Questions?
Slides will be posted at: www.medquist.com
after the show.
You can contact me at:
[email protected]
120
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