This presentation was at the CDC Public Health Information Network conference in August 2009. The presentation focuses on the APHL and CDC sponsored Route-not-Read Hub Project.
1. PUBLIC HEALTH LABORATORY INTEROPERABILITY PROJECT Implementing Two Interoperable PHINMS RnR Hubs to Support Laboratory Data Exchange PHIN Conference 2009 September 1, 2009 1:30 PM – 3:00 PM
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9. Direct Send Model Encrypt Send > > > Decrypt Single Sender to Single Receiver
21. Contact Information Florida Department of Health Eduardo Gonzalez Loumiet, MBA, PMP Project Coordinator 850.766.5338 [email_address] Nebraska Public Health Laboratory John Glock Information Technology Manager 402.559.3592 [email_address] Association of Public Health Laboratories (APHL) Michelle Meigs Sr. Manager of Informatics 240.485.2771 [email_address]
22. Brought to you by your Route not Read Team APHL Michelle Meigs CDC PHINMS Team The St. John Group Charles Pippin Jon Lipsky Srinath Remala Minnesota Dept of Health Gary Jones Virginia Dept of General Services Sam Martin Nebraska Public Health Laboratory | LabPoint John Glock Jim Svoboda Interalle Inc. Bob Williams Florida Dept of Health | Uber Operations Frans de Wet John Butler Eddie Gonzalez Loumiet
Hinweis der Redaktion
Welcome everyone, to the PHINMS Route Not Read Hub Project presentation. As mentioned, I am Eduardo Gonzalez Loumiet, I work with the Data Integration Team at the Florida Dept of Health
The agenda for this talk will consist of: PHLIP PHINMS Route-not-Read A Year Later What's next?
The participants for the RNR Hub Project are: Centers for Disease Control and Prevention Association of Public Health Laboratories HUB States Nebraska Public Health Laboratory Florida Department of Health Partner States Minnesota Iowa California Virginia Colorado Texas If you are from any of these organizations or states or are a member of the RnR Hub Team, Please raise your hand.
How many of you here today are participating in PHLIP? How many are not and want to participate in PHLIP or plan on participating in PHLIP? The Public Health Laboratory Interoperability Project otherwise known as PHLIP, (founded by the CDC and APHL) has had the goal of creating tools for the exchange of lab data at all levels of public health labs. The vision of PHLIP is to achieve bi-directional laboratory data exchange, focusing on the state public health labs with the CDC in addition to partners within the state. There are obviously many benefits to this project, and some are: to improve the data quality and accessibility, improve the data sources for active surveillance, and to develop and test future system approaches.
Some of the building blocks of PHLIP are: Implement by national collaborative process as I mentioned Provide detailed vocabulary implementation guidelines Build PHL capability for electronic test ordering and result reporting Develop and pilot data exchange architecture Establish process to help additional state PHL’s acquire capability
One of the support services and projects is the Route-not-Read Hub Project for regional exchange, its actually an intermin solution that can grow while we wait for PHIN-MS 3.0 and the Nationwide Health Information Network, also know as NHIN.
Here you have one of the use cases for PHLIP, which is the RNR Hub Project. The use case describes the overall plan for the project, which is to implement 2 hubs, develop interoperability with the 2 hubs, and ultimately, exchange data with the CDC via the Hub versus direct send. We have successfully completed these phases, which, I am honored and proud to state!
The foundation of the RNR Hubs is the CDC sponsored, open source messaging solution, called PHINMS, which stands for Public Health Information Network Messaging System. Many of you use PHINMS today, and for those that don’t, its important to know what it is and how far we have come with it. Provides public health applications a common platform for message transport Secure & Reliable over the Internet Standards-based Available at no cost to users “ De-facto” standard for secure message transport Some of the Applications using PHINMS include: BioSense, ELR, LRN, NBS,NND, NHSN, LabCorp, PerSe, Foodborne, BSIO, PHLIP Some states using PHINMS internally: NYS, NYC, MN, OK, CA, SC, WI, FL, IN, AL, NE Used by PHIN Certification 6-year old product deemed “mission critical” by CDC Over 700 PHINMS nodes used in U.S.
With PHINMS you can send messages and data via the DIRECT SEND model, which is a single SENDER to a SINGLE receiver, which is was most users use today. Yesterday afternoon at the PHIN Certification session, someone compared PHINMS to FEDEX, where you send “something” by first wrapping it, package it send it and its received and acknowledged by the recipient or receiver, which I thought was an interesting analogy. Examples are: your state pubic health lab sending influenza tests to the CDC or a private lab in your state sending to the state public health lab of your state. Direct send model is functional and is a great tool, however, as the network exchanging information grows, it could pose challenges as you will see in the next slide.
In the Direct Send model, each direct connection requires certain efforts to setup and maintain. As you can see in the slide, it can create a web of connections, which can grow exponentially, potentially also growing your efforts and resources required in your IS dept for example.
Several points to consider about the Direct Send Model are: Each node exchanges their credentials with every trading partner Each node manages the trust relationship with every trading partner Communication between nodes is a separate and distinct connection Adding a new node to the community results in exponential growth of direct connections and maintenance
What we have been working on is the Route Not Read model, still using, what I stated is the foundation, which is PHIN-MS. As you can see in this illustration, you can have two partners, as sender and pollers, exchanging data via a Hub, in the case of this pilot project, either the Nebraska or Florida RNR Hubs.
This illustration shows the RnR Hub, with 5 partners, that are both sending and polling. One of my colleagues, John Butler, a data integration engineer for the Florida Dept of Health and Uber Operations, likes to use the analogy of an email server. Someone sends you an email, it sits in the server until you receive (or in the case of the RnR Hub, poll) from the server. An interesting measure of the RnR Hub is that the Hub doesn’t not “read” the message, just acts as a transport mechanism, which is a question people often ask.
This is my favorite illustration, where you have 2 hubs (Nebraska and Florida) and the interoperability piece comes into play here. For example, Colorado, a partner on the Nebraska Hub wants to send to Virginia, which is a partner on the Florida hub, it can do so with the work recently developed regarding interoperability, which I will get into in a few slides.
Some of the benefits of the RNR Hub are: A PHINMS receiver is not required for bi-directional messaging Additional firewall configuration is not typically required for each Trading Partner Facilitates rapid implementation of electronic message exchange Low deployment costs for partners Ability to send pre-configured install “package” Infrastructure needs are low Reduction of management burden Message routing Certificate management Hardware and bandwidth needs Dynamic Collaboration All parties talk via a single interface to their respective hub Centralized Support
As mentioned a few slides earlier, one of the key pieces to the work accomplished over the last year is the interoperability piece. The team focused on assuring that not only partners can communicate with each other and exchange data but that both Hubs (Nebraska and Florida) can communicate with each other, as well. This piece of the project goes back to the collaboration objective, where all RnR Hub Team members had to communicate and work together over the last year, sharing ideas, suggestions, recommendations, and even coming together in person to test in order to reach the success that was reached.
The interoperability solution is based on web services. There are many benefits and features, which you can see on this slide like: 2 of the main benefits are: Synchronization of users (partyIds and usernames) between the hubs Audit trail for status messages on local and remote hubs.
As you can probably imagine, its been a great year, being able to work with such talented people, from different organizations and from different states has really allowed all to share ideas and work together towards the ultimate goal of public health interoperability and information exchange. I am proud to say that both hubs (Nebraska and Florida) are in production. There are 9 partners on the hubs, tested and ready to move forward, including our friends from the CDC, which we finalized testing with 2 weeks ago.
This is another one of my favorite illustrations….the illustrations before where generic, conceptual…here you have the actual diagram of the two hubs, with their partners, and as I mentioned earlier, thanks to the interoperability developments, and overall architecture created, Virginia, which is on the Florida Hub, can send to a partner on the Nebraska Hub. We hope to be here at the PHIN Conference, next year showing you an updated diagram, with many more partners!
So, what next? Speaking at a Latino IT conference in D.C. a few months back, I had the honor to meet with Vish Sankaran, Program Director for the Federal Health Architecture under Dr Blumenthal. I am sure some of you may have seen him as he presented. Vish is in charge of the Nationwide Health Information Network, or NHIN. In speaking to him about this project, he was excited of the successful work that has been accomplished during year 1 and was looking forward to working together to find an interoperable and cost effective way to integrate the RNR Hub with NHIN. In addition to work related to NHIN, we look forward to bringing on new PHLIP partner states in the next few months and enhance some of the work we have developed, like interoperability.
Here you have the contact info for Michelle Meigs from APHL, John Glock from the Nebraska Hub and myself representing Uber Operations and the Florida Hub. The slides will be posted on the PHIN Web Site shortly and please feel free to contact us if you have any questions. The Team and I will be here after the presentation and throughout the conference. Association of Public Health Laboratories (APHL) Michelle Meigs Sr. Manager of Informatics 240.485.2771 [email_address] Nebraska Public Health Laboratory John Glock Information Technology Manager 402.559.3592 [email_address] Florida Department of Health Eduardo Gonzalez Loumiet, MBA, PMP Project Coordinator 850.766.5338 [email_address]
Here is the list of the RNR Hub Project Team Members: APHL Michelle Meigs CDC PHINMS Team The St. John Group Charles Pippin Jon Lipsky Srinath Remala Minnesota Dept of Health Gary Jones Virginia Dept of General Services Sam Martin Nebraska Public Health Laboratory | LabPoint John Glock Jim Svoboda Interalle Inc. Bob Williams Florida Dept of Health | Uber Operations Frans de Wet John Butler Eddie Gonzalez Loumiet