InterConnect2015_BCBSNC_Healthcare Provider Network Management Integration Architecture

An independent licensee of the Blue Cross and Blue Shield Association. U7430b, 2/11

BCBSNC’s Healthcare Provider

and Network Management

Integration Architecture for a

Changing Market

AEC-5560

Arman Atashi

Senior Enterprise Solutions Architect

Blue Cross Blue Shield of North Carolina

Current State

Future State

Architecture Models

Architecture Vision

Integration Architecture

Message Model

Runtime Model

Deployment Model

Q&A

From Architecture Vision to Reality

Agenda

2

Current State

“Establishing a Software Architecture Vision is not necessarily Implementing a Software Architecture.”

+ Applications and interfaces are built independently

+ Standalone projects deliver data limited to specific function

Business Challenges

4

The Result

+ Complexity has been building over time

+ Systems need to interact and integrate for decision making

Complex IT Landscape with Dispersed Data across

Disparate Systems

The Result

IT Silos in the Enterprise with Bunch of Provider Data

Managed within Multiple Systems

+ Provider Data Integration ▪ Inflexible

▪ Reactive

▪ Manual

▪ Batch

Business Challenges

5

Limited Visibility in Systems Interactions

Hinders Agility and Productivity

+ Consumers of Provider Information Entity within BCBSNC

Provider Information Usage

6

Future State

+ Business Architecture ▪ Enterprise Capabilities

▪ Collaborations & Interactions

▪ Process and Information Flows

Architecture Models

8

+ Logical Architecture ▪ Business Services

▪ Components & Interfaces

▪ Messages & Data

+ Technology Specification ▪ Software & Hardware Platforms

▪ Portals & Web Services

▪ Database and XML Schemas

Busin

ess C

oncern

s

Refinem

ent

+ Capabilities

Architecture Models - Business Architecture

9

+ Context Diagram


10


11

+ Establish a single Provider Information System of Record responsible for

creating and maintaining the Provider Information Entity

+ Service Architecture

Architecture Models - Logical Architecture

12

+ Service Architecture

Architecture Models - Logical Architecture

13

Architecture Models - Technology Specification

14

Web Applications & Portals

Workflows & Services

Enterprise Service Bus (ESB)

Message Composition

Rules & Events

Routing & Mediation

Adapters

Infrastructure

Message Server Database

Server

Application Server

Directory Server & SSO

Architecture Vision - Implementation Principles

15

+ Provider Data Integration ▪ Flexible

▪ Proactive

▪ Event Based

▪ Right Time

Clear and Recognizable Systems Interactions

Improves Productivity and Value of the

Provider Information

+ Information as a Service

+ SOA: Decouple systems and applications from each other (code,

data, and communication) while allowing them to communicate

with each other in a consistent way


16

System A Private Code & Processes

System B Private Code & Processes

Contract Shared Code & Processes

Interoperable

Protocol

Interface

Interface

Interface

Interface

Interoperable

Protocol

+ Canonical Message: Use message-specific common data in

canonical format expressed in XML to mediate data exchanges

between systems


17

Enterprise Service Bus

Adapter Adapter

System A

System C System B

Adapter

+ Cloud Analytics: Enhance Provider Self-Service Strategy by

including Cloud Analytics to help Providers to have insights in

patient health and get answers in real-times


18

BCBSNC Provider Portal

Cloud Analytics

Healthcare Provider

Episode Bundling

Risks Adjustment and Scoring

Implantable Device Management

Others

+ Safeguard Access to Applications/Services: Establish policies

for user access privileges and allow access to cross domain web

based applications using SAML for web browser Single Sign-On


19

BCBSNC Portals

Workforce User

Site 1

Non-Workforce User

Site 2

Private Cloud A

Site n

Public Cloud

Site A Site Z

Private Cloud Z

SAML SSO

Architecture Vision - Information Exchange

20

+ Three key technology layers participate in the exchange of

information:

+ Vendor Integration Layer: This layer includes the components that provide

information exchange via IBM Managed File Transfer as SDE (Secure Data

Exchange), SAML SSO using IBM WebSEAL and TFIM, and Web Services

for real-time integration

+ Enterprise Integration Layer: The components at this layer implement

BCBSNC Enterprise Service Integration Framework together with IBM

WebSphere Message Broker as the Enterprise Service Bus

+ Information Layer: The components managing data sources (provide data to

other systems and programs) such as Databases, Web Services, and Files

(XML, CVS, etc.) or deliver data to end users such as web browsers

Architecture Vision - Reference Architecture

21

Architecture Vision - Logical Architecture

22

Integration Architecture

+ Canonical Message Model (CMM) represents the

standardized format used for exchanging BCBSNC Provider

business information on an Enterprise Service Bus (ESB)

+ XML schemas are used to represent the message definitions

and types

+ CMM XML XSDs are based on and derived from

McKesson’s Network Performance Management (NPM)

Standard Outbound XML (PSOX) XSDs

+ CMM is also the foundation for describing the functionality

provided by BCBSNC Provider Web Services used in

Services Definition Language (WSDL) schemas

Message Model

24

+ CMM specification consists of the following: ▪ Structure and names of the data types and format

▪ Rules governing data composition/aggregation and the allowable values, expressed in XSDs

▪ Business terms definitions of the types (Data Dictionary)

▪ A set of messages each including defined elements, types, and attributes to provide a specific business context

– Provider Message, a coarse-grained message reflecting BCBSNC provider business context

– Practitioner Message, a coarse-grained message reflecting BCBNSC practitioner business context

– Additional fine-grained messages will be defined/constructed to provide desired capabilities in the future

Message Model

25

+ IBM RSA (Rational Software Architect) is extensively used in

the construction and maintenance of CMM ▪ PSOX to CMM mapping

▪ CMM XSD-to-UML round trip transformation

▪ PSOX to CMM Transformation using XSLT & STX transformation Style Sheets

Message Model - Message Transformation

26

NPM PSOX XML

NPM PIMS

NPM PSOX File

Single CMM XML

XSLT Processor WMB XSLT

Processor MQ

Full CMM XML

RSA XSLT

Processor

Full CMM XML

STX Processor

Message Model - Provider Message

27

Message Model - Practitioner Message

28

Message Model - Provider/Practitioner Identifier

29

Runtime Model

30

Runtime Model

31

PIMS Adapter Overview

MFT from

Database

Server to

WMB server

Database Server

PSOX XSL

Transformation

RunSplit.sh

PSOX Document

PSOX Feed

RunPSOX.sh

PSOX Provider

Documents

PIMS

Provider

Adapter

CMM Provider

Messages

PSOX Provider

Documents

Copy from

staging to

processing area

Message Broker Server

Copy

for MFT

Runtime Model

32

PIMS Adapter Overview

MFT from

Database

Server to

WMB server

Database Server

PSOX XSL

Transformation

RunSplit.sh

PSOX Document

PSOX Feed

RunPSOX.sh

PSOX Practitioner

Documents

PIMS

Practitioner

Adapter

CMM Practitioner

Messages

PSOX Practitioner

Documents

Copy from

staging to

processing area

Message Broker Server

Copy

for MFT

Runtime Model

33

Deployment Model- Reference Model

34

Q&A

From Architecture Vision to Reality

“Establishing a Software Architecture Vision is not necessarily Implementing a Software Architecture.”


37

Information as a Service

Service Oriented Architecture

Canonical Message

Cloud Analytics

Safeguard Access

Architecture Vision - Reference Architecture

38

Architecture Reality – [Information As a Service + SOA + CMM]

39

Architecture Reality - [Cloud Analytics + Safeguard Access]

40

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