Resources

From detailed guides to online courses – resources are available to provide you with the knowledge necessary to build and integrate EHR applications.

Example of HIAL Processing

An advantage of a service-based approach is that specialized components can be created and used like building blocks in business processes. The ‘orchestration’ features of the HIAL allow eHealth Ontario and its partners to take advantage of this strategy to enable flexibility and agility. 

Orchestration manages the order and operations required to process a composite business transaction. It automates and integrates multiple services, executing on heterogeneous platforms, into a composite business process or workflow. It invokes activities or services in a particular order, according to a set of rules; manages the complex flow logic and process state; manages transactions and error handling; and correlates responses from downstream and upstream systems to a service orchestration instance. Processes are modeled in the abstract, with subsequent specification of technical details for the implementation of individual process steps. Business process interactions are not hard-coded, making it easier to change process definitions to adapt to new business requirements.

Using the example of a service request for data related to lab tests, the orchestration might start with a call to a security service, and then proceed to a transformation, before calling the laboratories repository. Subsequently, the continuing orchestration might check with the consent management service (and any resultant masking of data) and submit a copy of the response to the audit service before returning information. The sequence of orchestration steps can be redefined as necessary, for example to reflect a change in a business policy.

 Figure 8: HIAL High Level Process Flow

Figure 8 provides a high level process flow of what happens when a request enters the HIAL from a point of service application. At the highest level, the HIAL receives the request and carries out processes on the message (A). It then (B) sends the request to the line of business system which fulfills the request and sends it back to the HIAL. The HIAL then runs a few more processes on the response and then sends it to the requesting point of service application (C). 

 

Figure 9: HIAL Processing of Input Message

Figure 10: HIAL Processing of Input Message

Figure 11: HIAL Processing of Input Message

Figures 9-11 provide details on what happens once the inbound data request is received. 

A: The message is first validated and transformed as required. Authentication and authorization checks are carried out. Then the appropriate orchestration is prepared, which is the process flow developed for the request – this will mostly be generic but at times may contain activities that are specific to a request. This is followed by verification of the client, providers, and terminology. The output is a validated and normalized message.

Figure 12: Sending Message to LOB

B: (Figure 12): Once the activities for the received inbound request are carried out, the message is prepared to be sent to the line of business system. The line of business system processes the request sent by the point of service application through the HIAL and returns its response to the HIAL.

Figure 13: Response Message

C: The HIAL (Figure 13) adds any required information, logs appropriate information for audit purposes, prepares the response message, and sends it to the point of service application.

The process flows show how a request from a point of service application is fulfilled by the line of business system through the integration capabilities of the HIAL. The HIAL transparently and seamlessly integrates the line of business, the various registries, and other services such as logging, auditing, consent etc., and provides a single point of entry for the point of service application. Without the HIAL, the point of service applications would have to know the technical details of each line of business system and all the registries, and how to communicate with them.

The following are the steps taken for a representative EHR service request. In this example, a physician (Dr. Jane) is treating a health care client (Bob). Dr. Jane wishes to use her point of service application (an EMR system) to get a lab test result from the EHR repository of lab test results (OLIS). The HIAL will:

  • Receive a message from Dr. Jane’s EMR system for the transaction, via an approved communication channel and interface
  • Decrypt, parse, and interpret the envelope surrounding the message
  • Identify and launch the appropriate orchestration to fulfil this type of transaction
  • Invoke security services to validate Dr. Jane’s identity and her authorization to use this transaction
  • Log the transaction and its contents, as required
  • Decrypt, parse, and interpret the payload of the message 
  • Validate identifiers for key entities referenced in the message (Dr. Jane, Bob, any other providers or provider organizations involved)
  • Validate conformance with terminology standards (e.g. the code for the lab test)
  • Apply any applicable consent directives from Bob
  • Prepare a transaction and invoke the provincial lab repository service to fulfil the request
  • Receive the response from the lab repository
  • Apply consent directives to the response, masking data as appropriate
  • Package, encrypt, and send the response back to Dr. Jane’s EMR system
  • Throughout, provide overarching services such as session management, system logging, management of alerts and errors, etc.
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