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Understanding the Sun GlassFish ESB PIX/PDQ Manager

PIX/PDQ Manager Overview

With the current focus on improving the exchange of electronic healthcare information, the ability to share information stored in various healthcare systems and healthcare organizations is becoming a requirement. Integrating healthcare systems makes data more easily accessible to providers and participants, ensures that the data is accurate and current, and provides the basis for the exchange of electronic health data. The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages the adoption of electronic healthcare records by all providers and also defines penalties for breaches of patient health information.

Sun's PIX/PDQ Manager provides a flexible solution to healthcare integration needs in the form of a lightweight enterprise service bus (ESB) that can be easily customized and extended to meet your integration needs. The processing logic in the PIX/PDQ Manager is based on the guidelines and standards put forth by Integrating the Healthcare Enterprise (IHE). This assures compatibility with other vendors and healthcare organizations, making it easier to integrate now and in the future.

The PIX/PDQ Manager forms a specialized implementation of HL7 messaging that facilitates patient health information exchange, and supports both HL7 v2 and HL7 v3 messaging. It leverages the advanced standardization and matching algorithms of Sun Master Index to cross-reference and uniquely identify the patients in your healthcare organization. Master Index provides a single complete view of the participants in your healthcare system and is able to quickly reconcile which information is associated with which patient, allowing you to quickly create a complete medical history.

The PIX/PDQ Manager processes messages based on the IHE frameworks, which define how to process HL7 messages using existing standards when available. In compliance with these frameworks, the PIX/PDQ Manager generates and maintains an audit repository of all events processed by the manager, and also maintains a trace record of how each message was processed through the system and by which components. Information about the state of the PIX/PDQ Manager components is provided by a common logging, alerting, error handling, and reporting mechanism. The PIX/PDQ Manager provides a monitoring and management tool where you can monitor the audit repository, log messages, and message traces.

About the IHE Technical Framework

Integrating the Healthcare Enterprise (IHE) is an organization whose aim is to improve how electronic patient information is shared among healthcare systems and, by doing so, to make sure that current and accurate data is readily available to both patients and healthcare professionals. IHE has developed technical frameworks that define how to process healthcare events, how data is shared, how security is handled, how audit records are generated, and how components interact with one another. The frameworks are made up of integration profiles that provide specifications of how each type of event is processed and how the audit message should be generated for each type of event. The profiles also define standards for security, communication, and time synchronization. These profiles are designed to ensure that data is transmitted securely and accurately among systems, and that data handling is coordinated according to communication and security standards. Having this common framework gives the various participants in a healthcare system a common base for integrating disperse systems.

Sun's PIX/PDQ Manager focuses on the following IT Infrastructure profiles of the IHE framework:

Each healthcare participant registers identifiers for patients in their own computer system, also known as a domain in the IHE framework. Participants maintain control over their own domain's index, but sometimes need access to information in a different domain. They can access the central repository of the PIX/PDQ Manager to find additional local identifiers for their patients. Domains can also be automatically notified when other systems update patient information.

As per IHE standards, Sun's PIX/PDQ Manager cross-references patient IDs (PIX) and supports patient demographic queries (PDQ). It also supports PIX queries for local IDs that are associated with a given local ID from a domain and patient identity feeds, such as when a record is added or updated in a domain. The PIX/PDQ Manager can broadcast notifications to interested domains when certain updates occur in the master patient index.

The Audit Trail and Node Authentication (ATNA) profile defines how audit messages are generated and formatted. The audit repository helps ensure that patient information remains confidential, data integrity is maintained, and users are accountable for accessing data. The Sun PIX/PDQ Manager supports the ATNA profile by maintaining an audit repository that stores information about each event processed through the system, including the source type and source ID, event type, event ID, event action, and event outcome. It also stores the date and time the event occurred and the date and time it was received by the PIX/PDQ system.

PIX/PDQ Manager Architecture

Sun's PIX/PDQ Manager uses various components of GlassFish ESB such as HTTP, JMS, and HL7 Binding Components; the BPEL Service Engine; Composite Applications; Java EE EJBs; and Sun Master Index. The solution includes the following GlassFish ESB components:

The following figure illustrate the interaction of the above components in the PIX/PDQ Manager.

Figure 1 PIX/PDQ Manager Architecture

Figure shows the architecture of the PIX/PDQ Manager.