Three days of InterConnected Health 2012 ended today on April 04 in Chicago IL, the conference is organized by OMG®, Health Level Seven® International (HL7), and Healthcare Information and Management Systems Society (HIMSS).
This year's topics focus on approaches, challenges, and solutions affecting the ability to connect health organizations and systems, and the role of IT as an enabler in achieving this connectivity.
The theme of the conference is "Enabling Health through High-Impact IT." Sub-tracks focus on Clinical Decision Support, Clinical Vocabulary and Terminology, SOA, Mobile Health, Enterprise Architecture, the Role of Open Source in Health IT, Devices, and Health Information Exchange.
I co-presented the topic - A Converging Approach from EA to SOA - Singapore's Experience in National eHealth Initiatives as one of the session highlights, we shared our approach and process on developing enterprise architecture and solution design. Two particular attractions are the adoption of incremental business capability and service design approach and the use of ATAM (Architectural Trade-off Analysis Method). The presentation is well received by the audience, they are impressed by the progress Singapore has achieved so far, and some of them even try to seek opportunity on how to make deeper experience sharing.
I greatly enjoyed the conference and the opportunity to showcase Singapore's eHealth experience on world stage, I retrospected on what pushed Singapore ahead of the peers, and also the areas where we need to make progress urgently.
1. The mindset of "just do it" and "just did it"
The Asian mindset tends to quickly get things done and then worry about the potential issues, as a result, once the mandate is set by government, we will make determined plan to get it implemented within the specified timeframe.
But does it really serve more good than bad? I am not exactly sure, in some area it is good, in other ares it is bad. It depends on how the implementer masterfully translates the vision into a robust architecture foundation that enables the system is able to adapt and scale, an architectural trade-off analysis method to analyze the tradeoff objectively, and a realistic roadmap to enable the architecture to build up its capability gradually.
One analogy is the agile development methodology in software engineering, some practitioners said it is easy to develop architecture in agile methodology, since they do not need to build all architecture pieces all together at the same time. However they missed one very important point - What's the key stakeholder of the architecture. It is the developers. In agile development methodology, the architecture foundation can be gradually built up, but one import prerequisite is that any architecture capability built-up SHALL not impact the existing architecture platform level API. As a result, this places tremendous amount of importance to ensure the architecture is able to strengthen its foundation INTERNALLY rather than EXTERNALLY!
Note: If you want to find out more on how to achieve this architectural capability, you can comment on this post.
So back to this discussion of "just do it" and "just did it" mindset, the devil is in the detail! Make sure you use a formal methodology (we use ATAM) to make sure all involved parties VISIBLY aware of the trade-off and its corresponding mitigation, and put in place a governess process to log every decision made.
2. Privacy is a two-edged sword
We need to put in place necessary and sufficient control in privacy, however when there is too much privacy debate, it will freeze the whole thing. One speaker lamented that why people bother so much about privacy at the same time they posted every bits of their personal life and habits on facebook, Linked-in and twitter. Take one example, in US it is not allowed to use SSN (Social Security Number) as the Patient Identification scheme, as a result, it is very hard for US to implement EMPI (Enterprise Master Patient Index).
3. The positioning of National EHR
It is extremely important to position National EHR as a centralized service platform rather than simply yet another data repository which might be useful but not worth the huge amount of money typically being invested. The positioning influences the vision of the architecture, otherwise some of well-thought design decisions will hinder the organic growth of the architecture. Take the example of CDS (Clinical Decision Support) system, you may need to place some services at the central service platform, and some services will rely on the existing implementation from institution's EMR/Ancillary system, similar to the agent/server architecture.
During the planning and EA refresh of National EHR, we have been trying to make the transition from repository to service platform to get ourselves ready for the real technical challenges ahead.
4. Use of Standards
OMG CEO/Chairman Richard Mark Soley emphasized the importance and value of standards in his keynote speech on second day, the pitch is that the primary purpose of standard is to reduce the cost of adoption and adaptation. Since I already blogged the similar topic in my previous post, so I am not going to repeat here, for more detail please go to this post - Standards-based implementation.
In this particular space, we need to catch up and move fast, one of my wishes is that we need to actively participate in the development of the international standards that will be applied to Singapore's national EHR system and other national eHealth initiatives.
For the detail conference program and presentation download, please visit the following web site
InterConnected Health 2012 Presentations