Healthcare organizations face challenges in sharing data across geographically distributed healthcare systems and non-healthcare systems due to regulations, compliance and complex distributed platforms. Hence the demand of modern technology solution is vital to establish seamlessly data flow among the healthcare systems across intranet, internet and cloud. Traditional data integration methodologies may be suitable to resolve all of these problems. However bus architecture based Enterprise Service Bus (ESB) middleware platform would help to simplify the healthcare integration complexities.

Challenges of modern Healthcare Systems

Clinicians face challenges in sharing patient information, lab data and images across departments (e.g. outpatient, inpatient, surgery and lab) due to lack of data integrations and data security restrictions.  Also, sharing insurance and claim data between healthcare organizations is complexes enough which further impacts patient’s experience. Seamless information exchange between various entities in healthcare industry is necessary to empower and engage patients, delivers visibility, and improved health outcomes.

Interoperability is the process of ensuring applications, software, systems, and services are able to exchange data and run business functions, so as to provide the user with a seamless experience. Technical benefits include:

• Speed up development which increases operations productivity
• Reduce IT costs
• Compatibility across the enterprise
• Flexibility and Scalability
• Simplified flow of information
• Loose coupling
• Easy access to patients record and reduction of medical errors

Healthcare systems must deliver and process data to manage patient’s data effectively. The data format and delivery protocols used by different healthcare systems may be different. To overcome these challenges healthcare organizations require a mechanism to understand various data formats, HIPAA standards and different protocols before transferring to other external systems.

ESB solution for Healthcare challenges

ESB offers an integration patterns and components to support interoperability across the enterprise.The ESB also supports healthcare domain specific standards such as HL7, MLLP, DICOM and EDI.  Fundamentally ESB solutions come with flexible infrastructure to share and process the data with a variety of entities.

Following are the important features of ESB to address healthcare challenges:

• Transformation: ESB supports various data formats and healthcare standards, transforming data from one format to another system specific format can be accomplish much simpler by make use of transformation components.  Most of the ESB based middleware product supports common formats listed below:
  • XML
  • Binary
  • Text
  • CSV
  • Swift
  • HL7 v2.x & v3
  • CDA
  • DICOM
  • EDI

• Protocol Conversion: There are various cases where integration interfaces or systems may support different technology protocol to interact with. This is another technology changes which can be resolved by make use of plug-play transportation components. The below are most common protocols supported by ESB middleware products.
  • TCP/IP
  • HTTP
  • MLLP
  • Web service (SOAP/REST)
  • Database
  • FTP/SFTP
  • Email
  • File System
  • Message Queue (JMS, MSMQ, Websphere MQ and etc.)
  • DICOM

• Routing: The ability to determine the appropriate end consumer or consumers based on both pre-configured rules, data and dynamically directs the data towards. This one of the key feature provided by ESB, which helps to make use the services for various business conditions.
• Enhancement: The ability to retrieve missing data from incoming messages, based on the existing message data, and appends it to the message before delivery to its final destination.
• Monitoring / Administration: ESB provides an easy method of monitoring the performance of the system, the flow of messages through the ESB architecture, and a simple means of managing the system in order to deliver its proposed value to an infrastructure.
• Security: ESB security supports involves two main components – making sure that the ESB itself handles messages in a fully secure manner, and negotiating between the security assurance systems used by each of the systems that will be integrated.
• Location Transparency: A way of centrally configuring endpoints for messages, so that a consumer application does not require information about a message producer in order to receive messages

Advantages of using ESB for Healthcare Integration

There are many fortune enterprises already adopted ESB based middleware platform for integration both internal and external systems. Many healthcare software service providers also support ESB based integration interfaces for effective collaboration with customer systems. Just to list down, the following are some of advantages of using ESB for healthcare integration:

• Provides business rules and policies to check the HIPAA standards. No additional efforts required.
• Provides EDI and Application adapters to accommodate transactional data from various systems and partners.
• Adding or modifying a new business or integrations service can be handled dynamically.
• Default support for authenticating serve requests and message encryption.
• Supports auditing for collecting metrics and adhering to compliance needs.
• Scalable to accommodate new  customer requests and adding new services
• Lightweight: ESB is made up of many interoperating services, rather than a single hub that contains every possible service, ESBs can be as heavy or light as an organization needs them to be, making them the most efficient integration solution available.
• Easy to expand: If an organization knows that they will need to connect additional applications or systems to their architecture in the future, an ESB allows them to integrate their systems right away, instead of worrying about whether or not a new system will work with their existing infrastructure.  When the new application is ready, all they need to do to get it working with the rest of their infrastructure by hook it up to the bus.
• Cost Effective: ESB functionality can easily be dispersed across a geographically distributed network as needed.  Additionally, because individual components are used to offer each feature, it is much simpler and cost-effective to ensure high availability and scalability for critical parts of the architecture when using an ESB solution.
• SOA-Friendly: ESBs are built with Service Oriented Architecture in mind.  This means that an organization seeking to migrate towards an SOA can do so incrementally, continuing to use their existing systems while plugging in re-usable services as they implement them.

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Note: The above article is authored by Mr.Arun Mathew and VijayKumar from Enterprise Integration & Information Management Practice @ Aspire Systems.