Ismt s-599 Capstone Seminar in Enterprise Systems Summer 2015 Team 3



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2.5Success Metrics
Indicators

Expected value (1-5 years)

1

Increase revenue

Subscription will provide 20% increase in revenue for outpatient services

2

Reduce operation cost

Flexible architecture will reduce IT operating costs by 10%

3

Improve system uptime

Flexible architecture will provide 99.99% uptime for the system

4

Improve Healthcare

90% of emergency patients will have prepared service setup on arrival, improving casualty department performance

5

Shortened release cycle

New product builds to be released within 15 days


3TECHNICAL SPECIFICATION

3.1Overview


Healthcare is moving from its perpetual IT laggard status to becoming one of today’s most vibrant, dynamic and complex systems7. The health systems of today need to shift to a real-time healthcare system8 management paradigm, which is highly dependent on; real-time infrastructure, predictive information, and intervention abilities. Care coordination, management applications and provider population health analytics are important areas of the Gartner hype cycle for 20159. GlocoHCP’s monolith legacy systems need to be transformed to gain advantage from the benefits of recent technology developments in the health sector. Figure 3 provides an overview of current technological challenges for GlocoHCP:

Figure : Factors influencing hospital systems

GlocoHCP needs to evolve to gain value and differentiation by connecting existing and new systems into a platform where flexibility, high availability and web scale performance can be achieved. Consumer health monitoring devices have grown in popularity, as such GlocoHCP needs to meet this evolution with a remote monitoring system that Integrates with internal hospital systems, in such a way that it can meet customer needs of, a faster response to the market with traceability and quality. The cloud offers the opportunity to meet these goals with; elastic computing, storage and networking. This allows GlocoHCP to host new systems in private, public or hybrid, cloud infrastructure. Finally, mobile advancements enables GlocoHCP to bring smaller healthcare provider into a larger network. The Anywhere HealthCare (AHC) service offered by GlocoHCP will utilize mobile apps to extend their services to ambulatory care and home Healthcare nurses. The architecture for future systems should meet the following technical design principles:


  1. Small services: New components will be deployed as loosely coupled, single purpose services, which can be managed by small, agile teams. This allows for services to be changed quickly and independently.

  2. Application portability: Enable rapid deployment by allowing seamless distribution to any environment in any infrastructure.

  3. Availability and elasticity: Make infrastructure components that can adapt based on needs.

  4. Non-proprietary components: Use technologies that are vendor agnostic.

  5. Polyglot: Allow the services to be developed in the technology most appropriate for the customer and business need.

Architectural Approach


To facilitate business expansion, GlocoHCP is undertaking a redesign of its information technology environment to enable future business initiatives. These goals can be accomplished using an agile, service-based architecture that can be used for system integration while avoiding the spaghetti infrastructure associated with Service Oriented Architecture (SOA) or a cumbersome Enterprise Service Bus (ESB). Microservices based flexible architecture offers a complete solution for both functional and non-functional requirements.

GlocoHCP’s monolithic legacy systems will be converted over a defined period of time. The current approach will initially be to integrate with the Anywhere Healthcare (AHC) system and convert them to independent microservices in future phases.

Flexible microservices will provide the core engine of AHC that will be supported by non-functional attributes such as high availability, elasticity, portability, and polyglots. Patient health data will be collected from data aggregators, with partners providing initial care to the patient.


Figure : Anywhere healthcare architecture
Microservices such as patient monitoring, will receive data for patients and the analytics microservice will generate alarms and send them through the notification services. Legacy system will interface with existing systems using a wrapper for HL-7 and DICOM inside a RESTful API with an AMQP based message bus.

System Context


The following context diagram provides all elements of the proposed system as specified in the business requirements.

Figure : System Context Diagram



Anywhere Healthcare (AHC) Phase 1, has four main components and one external interface for future use:

  1. A Patient enrollment service will interface with the existing EMR to collect information about a patient if available, if data is not available it will create a new patient profile including; demographics, medical conditions (e.g. high blood pressure, diabetic information, etc.), and external health aggregator identifiers. The enrollment system will add patient information to the billing system for the home monitoring service.

  2. Provider Enrollment Service will register ambulatory care and home care nurses into the system; this will include their contact details and billing terms.

  3. Monitoring Service will collect information from health aggregator (e.g. Microsoft HealthVault), based on a patient list generated by the Scheduler Service, and store these patient records in the EMR system.

    1. The analytics service will first check the patient’s billing information and then compute the frequency of data collection needed, based on the medical physician rules and records in EMR. Analytics will send this list of patients to the patient monitoring system through the scheduler service.

    2. The Analytics service will analyze collected data in near real-time to classify patient’s severity levels. It will use 1 to 10 scales and generate alarms for the notification service.

  4. The Notification Service will receive alarms from the analytics service and broadcast them to all four entities; patient, nursing, ambulatory care and the contact center of the hospital.

The proposed technology will meet all the functional requirements as specified in the business requirements, these details can be found in the software solution section. All hardware and software infrastructure components are discussed in the system deployment section. The detail of system integration is given in the integration section.


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