In-Depth

Web services cure integration problems in health care enterprise

• By Rich Seeley
• August 1, 2004

“A couple of years ago, we began breaking down application suites into XML-based service methods,” said Steve Flammini, CTO at Partners Healthcare, headquartered in Boston. This began to move the IT infrastructure for the multibillion dollar integrated health care delivery system into the Web services world.

Flammini cites a number of benefits achieved as IT enhanced one of the largest integrated client/server networks in the country, which includes hundreds of servers and an estimated 35,000-plus PC clients.

To begin with, medical applications that were once difficult to integrate now could interoperate thanks to XML and SOAP.

“What we began to find is that there are a lot of applications in the enterprise that had fairly steep barriers to interoperability or integration, and that those barriers were lowered significantly by breaking the apps into suites of services,” he noted. “So if there’s an app somewhere in the enterprise that needs to know what medications a patient is on to do some type of disease management, if you enable that through Web services, we found that the integration is easy to do.”

Another plus was the ability of XML to be easily formatted for the wireless laptops and Tablets that are increasingly used by physicians, nurses and other clinicians. “If the apps are serving up their results as an XML payload in a Web services environment,” said Flammini, “that payload can be transformed pretty flexibly for whatever the end-user presentation needs to be. That’s certainly a lot easier than tearing out your app and structure and rewriting it from the ground up to work on a PDA or what have you.”

But perhaps the biggest advantage in an enterprise focused on helping patients and saving lives was the ability to bring together multiple medical apps running on different platforms, so that doctors can see them in one unified view. This is the concept of Web services-enabled composite applications, where existing applications are presented to the end user, in this case a physician, as a new application developed mainly through XML integration.

“You can actually create new applications on top of your existing application infrastructure without replacing that application infrastructure,” Flammini said.

Partners Healthcare has created one such composite application that gives doctors a single view of lab results and notes on patient visits right along with radiology images, the CTO said.

“Underneath the covers those are several very different platforms, each of which grew up separately, each of which has very different architectures underneath. But the one thing they do have in common is that they can all play in a Web services environment,” he said. “What the doctor sees at the Web browser presentation layer is one app that brings together all the clinical information that they are interested in, and to them it looks seamless.”