Industry Perspectives: Healthcare and the Single Patient View

By Jim McHugh
Vice President, Software Infrastructure Marketing

As we emphasized in the last issue of Integration Insights, the "single view" is increasingly becoming a key IT goal for enterprises and organizations in virtually every field. I'd like to take this opportunity to give you a closer look at just one of those areas — healthcare — and show you why the delivery of a single patient view has come to be considered so critical to quality care, and how today's healthcare organizations are working toward achieving it.

Just to set the stage, here's a brief, non-industry-specific review of what is meant by a single view. First, it's defined as a view of all the data in an organization or group of related organizations that relates to one customer, patient, constituent, or other relevant entity. Second, it is created by bringing together siloed data from disparate sources so that a user can work with it without having to constantly go back and forth between systems or applications.

The Urgency of the Single Patient View
In healthcare, the single patient view is a real-time, single view of information such as a patient's lab results, radiological images, prescriptions, and doctors' notes. Such a view is rapidly becoming not just a would-be-nice-to-have tool for healthcare organizations, but an integral component of effective care. There are several reasons for this.

• Healthcare organizations are growing, merging, and forming new affiliations — such as regional health information organizations (RHIOs) — at an unprecedented rate. At the same time, quality care continues to rely on an end-to-end view of patient information at the point of care. To achieve the latter in the face of the former, a single view of the information from an infinite number of sources is essential.
• Federal regulations such as HIPAA are imposing requirements on healthcare organizations to consistently identify the parties involved in providing healthcare services, which grows more challenging as more and more parties become involved.
• As the number of applications and systems that house patient information grows, so does the risk of more errors and less efficiency, not to mention data privacy and security breaches. An IT-based approach is invariably going to be more effective in this regard than manual efforts at integrating data and processes.

The Challenge of the Single Patient View
You may be wondering if the single patient view is becoming so important to healthcare, why hasn't it been more widely adopted by healthcare organizations? In Sun's experience, the major obstacle to a successful single patient view so far has been the tendency of organizations to try to achieve it using a single solution such as a centrally administered data repository or master patient index.

But this inevitably takes far too long and costs far too much, usually with far-from-perfect results. This is especially true in this time of constantly growing, increasingly complex relationships between applications, systems, and organizations.

The problem is that no one centrally administered solution is technically equipped to administer the amount of data involved when it's coming from so many sources — not just healthcare providers like doctors, labs, and pharmacies, but also insurance companies, hospital offices, and other related entities. The key is a change in thinking from one physical solution to a virtual solution that can span an infinite number of users and sources of information. And that leads to a solution based on composite applications in a service-oriented architecture (SOA).

An SOA-based composite application can take data from multiple sources, recognize relationships within that data, and then link it all together in a single view, to provide real-time access to patient information and data workflow. Sun's focus on and long experience in linking heterogeneous environments and the information in them makes us unusually well-equipped to lead the charge in this regard.

The Single Patient View at Work in the Real World
Any time we introduce ideas in Integration Insights, we like to include examples of them to show how they work in practice, not just in theory. The following examples describe organizations that are using Sun Java CAPS (Composite Application Platform Suite) and other Sun resources to integrate data across systems, which is essential to delivering a single patient view.

• A major health system in the U.S. with operations including inpatient care, outpatient services, rural clinics, a large research facility, and a major transplant center relies on Sun Java CAPS to integrate and aggregate information from many disparate legacy systems. A primary advantage of using Sun Java CAPS is that the organization can build information-integration projects incrementally, without having to rebuild IT infrastructures or make major changes to legacy systems.
• A U.K.-based health system that serves 280,000 patients and manages a major research center is using Sun Java CAPS to integrate its patient information and theater management systems, resulting in accurate, consistent, and easily shared data. This is the first of a number of SOA-based, composite-application-driven integration projects undertaken by the organization.

These are just two of many examples of how SOA-based composite applications are being used to integrate data from many sources in the service of building a single shared view. For the healthcare organizations described here, we refer to this as a single patient view; in other industries, it refers to other kinds of views, such as a retailer's single customer view or an elected official's single constituent view.

Keep watching this space for more real-world views of the different business challenges that SOA and composite applications can address. And look for Integration Insights to continue to bring you important information about SOA technology, ROI, and much more.