Framework di architettura di servizi per la sanita'


The general problem of interoperability in the healthcare sector is dealt with in a new way by the international program HSSP Healthcare Service Specification Project, jointly sponsored by Health Level Seven International HL7 and the Object Management Group OMG and it is regulated by the Statement of Understanding (SOU) between HL7 International and OMG.

In the current context in any particular collaboration architecture between specific clinical-health actors, the contents of the exchange are totally standardized (for example through the systematic use of documents drawn up in compliance with the HL7 Clinical Document Architecture - CDA 2), while them are defined and redefined ad hoc the communicative actions, which, at the application level, put in place the procedures and protocols of interaction. 

HSSP has the general objective of putting in place effective interoperability between distributed and heterogeneous applications and devices, belonging to organizations in the health and social system without ties of subordination between them, having identified some basic functions, which are applied in every systematic clinical-health process and which are geographically homogeneous and stable over time. The HSSP approach is to ensure the interoperability of the basic functions recurring in the social health processes, through the standardization of methods for providing and use these functions, regardless of their internal implementations by the actors and their use in social health processes.

Such an approach allows to develop the processes, designed as combinations of exchanges of standardized services, at very low cost, putting in place the flexibility required by the rapid scientific and organizational changing in the healthcare sector.

The paradigm of service-oriented architecture (SOA) emerges as a meta-model of collaboration between entities, independent from the organizational point of view, that inhabit the health care ecosystem, ensuring the complex collaboration of a large number of heterogeneous subjects.

Technically speaking, an service architecture is defined as an architecture for collaboration among entities, it is implemented as an service exchange - a service is an activity carried out by an entity operator (regulator), it produces results that have value in use for another user, carried out in accordance with a service contract signed by both parties.

The HSSP projects, taken together, have as their purpose the standardization of "generic" services, sets of recurrent functions in most clinical-health processes, which play a key role in these processes, such as identification of the entities, control access to resources, handling of clinical health documents.  

The HSSP working groups are formed on general topics, whose solution, in terms of interoperability, is a prerequisite for the implementation of open architectures of collaboration:

Ø   the interoperability of the treatment of the elements of distributed electronic health records - RLUS

Ø    interoperability of demographic - the serviceable, operators, structures, devices, and in general of the entities in the clinical health universe - IXS

Ø    interoperability of access to forms of decision support in the clinical health field - DSS

Ø    interoperability of the recording and research of operators and health services - HCSPD, according to predefined criteria

Ø    interoperability of the management of terminologies, codification, classifications, .... - CTS2

Ø    the general theme of the interoperability of security procedures in health--clinical processes - PASS




In accordance with the general principle of separation of concern, which requires services strictly independent and "unaware" of one another, each HSSP project handles standardize a service relating to a specific clinical health functional domain: the object of the standard is a generic service, and the result is a generic standard service contract - a specific part of the report service - which is not directly operational, but can be used as a "matrix" to build specific operational contracts.



The cycle of HSSP standardization, the result of an agreement between HL7 and OMG International, allows the standardization of the "generic" services, at the functional level (HL7) and technical level (OMG), and produces two levels of service specifics: the Functional Service Model (SFM), operated by HL7 International, and the Technical Service Model (STM), which is managed by the OMG