1. © 2014 IBM Corporation
1149
Healthcare Integration with IBM Integration Bus
Ben Thompson <bthomps@uk.ibm.com>

2. Please Note
IBM’s statements regarding its plans, directions, and intent are subject to change
or withdrawal without notice at IBM’s sole discretion.
Information regarding potential future products is intended to outline our general
product direction and it should not be relied on in making a purchasing decision.
The information mentioned regarding potential future products is not a
commitment, promise, or legal obligation to deliver any material, code or
functionality. Information about potential future products may not be incorporated
into any contract. The development, release, and timing of any future features or
functionality described for our products remains at our sole discretion.
Performance is based on measurements and projections using standard IBM
benchmarks in a controlled environment. The actual throughput or performance
that any user will experience will vary depending upon many factors, including
considerations such as the amount of multiprogramming in the user’s job stream,
the I/O configuration, the storage configuration, and the workload processed.
Therefore, no assurance can be given that an individual user will achieve results
similar to those stated here.

3. IBM Integration Bus Industry Packs
Each pack is a fully supported software product, independently delivered from IBM
Integration Bus
The purpose of an IIB Industry Pack is to provide industry-specific development
accelerators which solve common industry integration problems
Help users to deploy working integration solutions in literally a few clicks of the mouse.
IIB Industry Pack content is structured around three delivery pillars:
Connectors
Data Definitions
Integration Patterns Monitoring
Association for Retail
Technology Standards
Open Applications Group
Data Format Description Language
Open Grid Forum
Health Level 7
Digital Imaging and Communication
in Medicine

4. IIB Healthcare Pack Landscape
4
Web Services
HTTP / JSON
SCA
Web Services
SOAP XML
IBM Integration Bus + Healthcare Pack
DICOM
IDOC, BAPI
Proprietary XML
Corporate Applications
Billing, Payroll, ERP, CRM
Web Services
SOAP, XML
ODBC, JDBC,
SQL
Medical Imaging
Modalities
Clinical Repositories
Web Services
SOAP HTTP
MQTT
Continua
HL7v2
Proprietary
RS232
Sterling
Connect
Direct
HIPAA
Pharmacy
HL7v2
NCPDP
Medical Device
Integration
HL7v2
Cache ODBC
Web Services
Electronic Master
Patient Index
Web Services
HL7v2
PIX / PDQ
Web Services
SOAP XML
HL7v2
Cache ODBC
HL7v3
CDA CCD
Home Health DevicesMedical Insurers
Medical Applications
Legacy
Hospital Interface EnginesAnalytics Business Processes
Clinical Mobile Applications
Decision Management
Portal, Web Applications,
Electronic Forms
Dynamics
Siebel
SAP

5. Roadmap
IBM's plans, directions,
and intent are subject
to change or withdrawal
Q4 2011
WMB 8.0.0.0
Q1 2014
IIB Healthcare Pack 3.0
Integration Improvements (Error Handling, DFDL)
Web User Interface
Home Health Pattern
Q1 2013
WMB 8.0.0.2
Q4 2013
IIB 9.0.0.1
Q2 2012
WMB Healthcare Pack 7FP2
Medical Device Input Node
Pattern HL7 Reports
Pattern Medical Device to EMR
Q1 2013
WMB Healthcare Pack 8
ATNA Audit & DICOM nodes
HL7 DFDL Model
Patterns: DICOM, HL7
CDA Data Analysis
IIB vNext
*The first WMB Healthcare Pack (v7) was released in May 2011

6. Key Features
Pattern-based development tooling - fast integration without detailed knowledge of integration
technologies
Makes use of proven runtime of IBM Integration Bus
Integrates HL7 based clinical repositories & applications
• Production ready patterns based around HL7 v2.x
• Pattern allows easy customisation
• Handles inbound and outbound MLLP socket connections
• Message definitions for all chapters of the HL7 v2.x specifications
Integrates DICOM based PACS & modalities
Processes CDA/CCD documents
Direct connectivity to medical equipment - monitors, infusion pumps etc
Healthcare-oriented operational views
• Single point of visibility and control
Electronic
Medical
Records
Patient
Administration
System
PACS &
imaging
Labs &
pharmacy
Medical
devices
Remote Patient
Monitoring

7. Standards
STANDARD SUPPORT NOTES
HL7 v2.x
V2.2 up to v2.7 (inclusive)
JAXB bindings provided
Data Analysis profile provided2
HL7 v3 Supported directly by IBM Integration Bus
HL7 CDA
CDA / CDT
Continuity of Care Documents (CCD)
Consolidated CDA (C-CDA)
HITSP (C32 / C83)
Data Analysis profile provided2
DICOM
C-STORE3
SCU and SCP
C-FIND SCU
C-MOVE SCU
Data Analysis profile provided
IHE Profiles
PIX Manager
PDQ Supplier
ATNA Secure Node
2013 European Connectathon in Turkey alongside IBM Initiate
1
HIPAA and NCPDP supported by IBM Integration Bus with WebSphere Transformation Extender (WTX)
2
CDA and HL7 v2 Data Analysis profiles are integrated with the LOINC terminology code system
3
DICOM C-STORE SCP (DICOMInput node) is fully configurable with the target presentation contexts

8. Putting it all together
MQTT DICOM
PACS
Predicting Deciding
Integrating
Imaging
Modality
Patient
Report
Monitoring
Electronic
Medical Record
Alert
Doctor
ODBC
JDBC
SMS

9. What’s new in the IIB Healthcare Pack
IIB Healthcare Pack v3.0 released in March 2014
• 3rd release building on top of existing functions including HL7 connectivity,
DICOM, ATNA, MedicalDevice connectivity and Data Analysis Profiles
New Web User Interface
• Clinical Application monitoring
• Operational views to understand flow activity
HL7 Transformation Pattern
• Generates graphical data maps for creation of
HL7 messages from scratch
• Assigns for individual fields in the MSH
HL7 Error handling enhancments
Home Health Pattern
• Generates message flows to support a WAN interface
• SOAP/HTTP interface using the IHE industry standard
“CommunicatePCDData” WSDL
• Security PEP node for SAML Token security (with external STS)
• Mapping solution for all 3 forms of acknowledgement

10. Clinical Application Integration
PAS
Patient
Administration
System
Labs &
pharmacy
Electronic
Medical
Records
Integrate EMR and clinical applications such as PAS, Pharmacy, Labs
HL7 v2.x predominant standard but wide variations in application implementation
Pack provides connectors, schemas (HL7, DICOM, ATNA, Data Devices, Data Analysis
profiles for CDA and CCD) and development patterns for easy integration
Uses many features of IIB including Graphical Mapping tools
Requesting
Application
Receiver
Flow
Destination
Application
Sender
Flow
Filter Transform
AckAck
HL7 to HL7 DFDL Pattern
• MLLP over TCP/IP, Message Validation and Parsing
• Journaling
• Duplicate checking and Sequencing
• Exception Handling
• Transformation to canonical XML format
• Message & Segment Filtering
• Message Distribution

11. Pattern: HL7 Transformation
HL7 messages typically contain many data
segments. For example the commonly
used ADT_A01 message gives you
information about a patient admission:
• 23 segments
• 2 substructures (contain +6 segments)
Each segment can also contain large
numbers (tens or hundreds) of individual
fields.
In total it would not be uncommon for for
an HL7 message to contain hundreds of
individual fields
Creating this message tree structure
hierarchy in a flow can be time-consuming,
even when you use a graphical mapping
tool.
Patient
Administration
System
Labs &
pharmacy
Electronic
Medical
Records

12. Pattern: HL7 Transformation Patient
Administration
System
Labs &
pharmacy
Electronic
Medical
Records

13. Patient
Administration
System
Labs &
pharmacy
Electronic
Medical
Records

14. Web User Interface
IIB Healthcare pack provides its
own Context Root
Uses internal HTTP server to
serve data
Can reconfigure to listen on user
port or disable
SSL connector configured via
mqsichangeproperties
Displays built upon REST API
queries exchanged with IIB node
Clinical Application Monitoring
(specific view for HL7 to HL7
patterns)
Operational Monitoring (relevant
to all patterns involving flows)
http://localhost:4414/healthcare

15. Web User Interface
Connected Clinical Applications
X Ray
Maternity
Admissions
Out Patients
PAS Hospital West Wing
Out Patients
PAS
X Ray West WingX Ray
Pattern Instance
Hospital_West_Wing
Pattern Instance
XRay_West_Wing

16. Built-in Healthcare Data Test Tools

17. The Continua Alliance Remote Patient
Monitoring
Defined actors:
• Application Hosting Device (AHD)
• WAN Interface
Associated Standards:
• IHE CommunicatePCDData
• HL7v2.6

18. Home Health Pattern
Points of variability in the pattern control:
• URL fragment to which WAN requests are sent
• Support for SAML Token Authorization and Authentication
Remote Patient
Monitoring

19. Home Health Pattern Remote Patient
Monitoring

20. Medical Device Input Node
IIB HCP provides connectors integration patterns to capture data
from bedside medical devices and route observations
Medical
devices
Electronic
Medical
Records
For example, you could use a MedicalDeviceInput in an integration flow to
connect to a group of heart rate monitors and transfer the observations to
a data warehouse, EMR, or dashboard for remote viewing
Why Automate data capture?
• Ensure consistency, single source of truth for litigations, reduce errors
• Speed data collection, free up clinicians for clinical tasks(!)
Each MedicalDeviceInput node gathers readings from one or more
physical device and presents the data in a consistent logical format.

21. Medical Device - Input Node
One to one relationship between a MedicalDeviceInput node and its configurable service
Configurable Services relate “Device Connections” and “Measurement Sets”
Medical
devices
Electronic
Medical
Records
Medical Device Configurable Service
Device Connection
DeviceID_001
Device Connection
DeviceID_003
Device Connection
DeviceID_002
Measurement Set
MeasurementSet_001
Measurement Set
MeasurementSet_002

22. Medical Device - Configurable Service
Medical
devices
Electronic
Medical
Records

23. Medical Device – Device Connection
Medical
devices
Electronic
Medical
Records

24. Medical Device – Measurement Set
Medical
devices
Electronic
Medical
Records

25. Medical Device – Supported Devices
The Medical Device Input node currently supports connections from:
• Patient Monitors (GE, Philips, Somanetics, Tyco)
• Anaesthesia Workstations (Draeger)
• Infusion Pumps (Cardinal Health)
• Ventilators (Draeger)
Medical
devices
Electronic
Medical
Records
Alaris Asena CC Draeger CiceroEM GE Dash 4000 Medical Virtual Monitor 3 Philips IntelliVue MP90 Siemens SC9000
Alaris Asena GH Draeger Evita GE Eagle Medical Virtual Ventilator Philips Viridia 24 Siemens Vista
Alaris Asena GS Draeger Evita2 GE Eagle 3000 Medical Virtual Ventilator 2 Philips Viridia 26 Siemens Vista XL
Alaris Asena TIVA Draeger Evita4 Dura2 GE Eagle 4000 Nellcore NPB-190 Siemens Delta Somanetics Invos
Datex Ohmeda AS/3 Draeger Julian GE Eagle 4000N Nellcore NPB-195 Siemens Delta XL
Datex Ohmeda Cardiocap/5 Draeger PM8014 GE Solar 7000 Nellcore NPB-395 Siemens Gamma
Datex Ohmeda CS/3 Draeger PM8030 GE Solar 8000 Philips CMS Siemens Gamma X XL
Datex Ohmeda CS/3 Compact Draeger PM8040 GE Solar 8000N Philips IntelliVue MP20 Siemens Gamma XL
Datex Ohmeda S/5 Draeger Sulla GE Solar 9500 Philips IntelliVue MP30 Siemens Kappa
Draeger 8000 Draeger Vitara GE Tramscope 12 Philips IntelliVue MP40 Siemens Kappa XLT
Draeger 8000IC Draeger Evita Capnostat GE Tramscope 12C Philips IntelliVue MP5 Siemens SC 6002 XL
Draeger 8004 Draeger Savina Medical Virtual Device Philips IntelliVue MP50 Siemens SC 6802 XL
Draeger Cato GE Dash 2000 Medical Virtual Monitor 1 Philips IntelliVue MP60 Siemens SC7000
Draeger Cicero GE Dash 3000 Medical Virtual Monitor 2 Philips IntelliVue MP70 Siemens SC8000

26. Pattern: Medical Device to EMR
Production ready pattern to integrate medical devices with an EMR
• Converts device measurements into HL7 observation results (ORU R01)
• Supports alerts, discrete variables and waveforms (continuous sampling)
• Observation results are easily customised for different HL7 destinations
Standard set of connectivity options for the outbound HL7 MLLP
• Transport options including leading/trailing bytes, port number and timeout
• Acknowledgments, automated retry and journaling (audit)
• Source feed provided either direct to queue, or published to topic
Medical
devices
Electronic
Medical
Records

27. DICOM Nodes
Provides flow of image and supporting data
between medical image archives and
modalities
Both inside & between care establishments
Support for common DICOM commands
including MOVE, FIND and STORE
Images are routed as XML messages and
stored on the file system
PACS &
imaging
PACS PACS
DICOM nodes:
• IBM Integration Bus can act as both a client
(SCU) and server (SCP)
• Metadata for DICOM images are propagated
through IBM Integration Bus as XML messages
• Message does not contain the pixel data (this is
stored on the file system!)
• Shared file system locations (NFS) supported
DICOM Pattern provided for WebService
DICOM Test Application

28. Example DICOM Scenario
Collect Studies for Patient Admission PACS &
imaging
IBM Integration Bus Healthcare Pack

29. Data Analysis
Recursive nature of CDAs makes working from the schema very difficult
• component, section, entry and entryRelationship to mention just a few!
• Great flexibility in representing and modelling rich clinical statements
IIB Data Analysis helps you to rapidly understanding the structure of clinical documents
Analyze a set of sample documents according to their data content
The Healthcare Connectivity Pack provides four built-in Data Analysis Profiles for HL7v2, HL7
CDA, HL7v2 (ORU), and DICOM.
It is pre-configured with CDA, C-CDA, CCD, HITSP (C32 and C83) template IDs and set up for
use with a LOINC gloddary of terms to make clinical codes more readily understandable.

30. Clinical Document Data Analysis
Understanding your clinical documents is the vital first step
• Recursive nature of CDAs makes working from the schema very difficult
• component, section, entry and entryRelationship to mention just a few!
• Great flexibility in representing and modelling rich clinical statements
The Healthcare Connectivity Pack understands clinical documents
• IBM Integration Bus is configured with a CDA Data Analysis Profile
• Load example documents representing your implementation guide(s)
• Pre-configured with CDA, C-CDA, CCD, HITSP (C32 and C83) template IDs
• A glossary of LOINC terms is built-in so that codes are understandable
Import your source documents
into a Data Analysis project – the
summary page shows you how
many documents were loaded,
validation issues, and information
about missing LOINC codes

31. Navigating Documents
The Data Analysis
project shows you
the meaning of
different parts of
your documents
Search for clinical
concepts across all
your source
documents
See where the
relevant
information is
actually stored in
your documents
Data Analysis Profile identifies key sections in the clinical document
• Navigate easily from the logical model to your source documents
• Multiple example documents can be loaded into your Data Analysis project
• Cardinality of the clinical data can be explored across the document set

32. Target Model
The target model represents the information you want extracted
• The goal is to identify and map out the relevant clinical information
• The Data Analysis Profile creates an XML schema for the target model
• Typically large amounts of the clinical document is not relevant
Simply drag-and-drop your clinical data onto the target model
• By default all attributes and elements are assumed to be required
• Refine the target model by removing unnecessary data and renaming elements
• Often this refinement means removing structural attributes like classCode
The target model contains just the
information you want to extract
from the source documents – the
tooling creates an XML schema to
represent this simplified model

33. Generation
Generate the map, XSD, XSLT and subflow from the target model
• The XSD defines a schema for the data specified in the target model
• The map (MSL) extracts data in CDAs into the target model
• As with XML schemas, maps can be deployed direct to IBM Integration Bus
The XPATH expression shows what has been mapped automatically
• Clearly building this kind of expression by hand would be tedious (at best!)

34. Questions and More Information!

35. Legal Disclaimer
• © IBM Corporation 2014. All Rights Reserved.
• The information contained in this publication is provided for informational purposes only. While efforts were made to verify the completeness and accuracy of the information contained
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subject to change by IBM without notice. IBM shall not be responsible for any damages arising out of the use of, or otherwise related to, this publication or any other materials. Nothing
contained in this publication is intended to, nor shall have the effect of, creating any warranties or representations from IBM or its suppliers or licensors, or altering the terms and
conditions of the applicable license agreement governing the use of IBM software.
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future product or feature availability in any way. Nothing contained in these materials is intended to, nor shall have the effect of, stating or implying that any activities undertaken by you
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• If the text contains performance statistics or references to benchmarks, insert the following language; otherwise delete:
Performance is based on measurements and projections using standard IBM benchmarks in a controlled environment. The actual throughput or performance that any user will
experience will vary depending upon many factors, including considerations such as the amount of multiprogramming in the user's job stream, the I/O configuration, the storage
configuration, and the workload processed. Therefore, no assurance can be given that an individual user will achieve results similar to those stated here.
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