DEVELOPMENT OF AN OPEN SOURCE PROVIDER AND

ORGANIZATION REGISTRY SERVICE FOR REGIONAL

HEALTH NETWORKS

Oliver Heinze

, Alexander Ihls

and Björn Bergh

Center for Information Technology and Medical Engineering, University Hospital Heidelberg

Tiergartenstraße 15, Heidelberg, Germany

Open eHealth Foundation, Industriestraße 41, Walldorf(Baden), Germany

Keywords: eHealth, IHE, Open source, Regional health networks, Provider and organization registry.

Abstract: In the Rhine-Neckar Region a Healthcare Information Exchange Network (HIEN) should be implemented

providing a personal electronic health record for patients and health professionals. Therefore a standards-

based architecture following IHE profiles especially from the IT-Infrastructure domain was conceptualized.

One of the central components will be a provider and organization registry service (PORS) in order to

provide a unique identification and to resolve identifications to concrete information. Each network partner

has to be registered via manual data entry or preferably by standards-based massage interaction (HL7 v2

MFN M02). The PORS will be implemented as open source project using current technologies in order to

be a reference implementation to be available for other related projects. It consists of a multi-tier-layer

architecture fitting into an over-all service oriented architecture. A PORS will be a central component of any

HIEN to provide a unique identifier and to resolve information of providers and organization. The described

open source project can be used by other related projects to avoid the reinvention of the wheel.

1 INTRODUCTION

The University Hospital Heidelberg is implementing

a personal electronic health record (PEHR) to

improve the information exchange between other

hospitals, primary care givers and the patient itself

(Heinze et. al., 2009). Based on the first experiences

of a pilot of two hospitals and one medical practice a

regional Healthcare Information Exchange Network

(HIEN) should be implemented as part of a joined

initiative led by the Metropolitan Region Rhine-

Neckar in the mid-west region of Germany. The

HIEN should provide a PEHR and other services for

citizen, patients and health professionals. The sub-

project “Health IT Platform” of this initiative led by

the University Hospital Heidelberg has

conceptualized a standards-based health IT

architecture using IHE (Integrating the Healthcare

Enterprise) profiles in a service oriented

architecture. The following profiles are considered

to be used: ATNA, BPPC, CT, PDQ, PIX, XDS.b,

XDS-I, XPHR. The implementation itself and all of

the applied software components have to be open

source software. An important component of this

architecture is a Provider and Organization Registry

Service (PORS) whose principles and architecture

will be described in this article.

2 OBJECTIVES

By now in Germany a unique identification for

physicians, the so called “lifelong physician

number” and for organizations, the so called

“permanent establishment number” are available for

billing purposes but there is no central electronically

repository to use them in other systems. Hence, the

Provider and Organization Registry Service (PORS)

was determined to be one of the first essential

components of the HIEN to be implemented. Every

organization and its providers participating to the

HIEN in the Rhine-Neckar Region have to be

registered to PORS in order to enable their

administration and unique identification.

On the one hand PORS will enable other

services and components to resolve an ID to specific

535

Heinze O., Ihls A. and Bergh B. (2010).

DEVELOPMENT OF AN OPEN SOURCE PROVIDER AND ORGANIZATION REGISTRY SERVICE FOR REGIONAL HEALTH NETWORKS.

In Proceedings of the Third International Conference on Health Informatics, pages 535-537

DOI: 10.5220/0002787105350537

 SciTePress

information about a provider or organization to e.g.

enhance document meta-data located in the XDS

Registry with the “confidentiality codes” to ensure

legal data access to authorized providers. On the

other hand it can be used as yellow pages providing

unique and consistent information about all

participating healthcare providers.

Providing, updating and querying information

should be only possible for authorized users and

systems via a graphical user interface as well as via

a HL7 v2 message-based or file-based web service

interfaces. The access will be secure, auditable and

controlled. For that reason other components of the

HIEN will be used following the IHE IT -

Infrastructure whitepaper “Access control”

(Caumanns et. al., 2009).

3 METHODS

The PORS will be developed as Open Source

Software (OSS) hosted on the gforge platform

as a

project of the Open eHealth Foundation under the

Apache Software Licence 2. Until the first stable

release it will be a closed project.

The technical implementation is based on Java

and Groovy. In addition to the Open eHealth

Integration Platform (IPF) the ICW eHealth

Framework (eHF) is used. IPF is an enterprise

service bus with a Groovy-based domain specific

language (DSL) which enables easy HL7 message

parsing pre-processing and routing. The eHF focuses

on modularization and supports model driven

software development. Because the framework

provides modules for standard functionalities like

security and authorization it is possible to spend

most of the development time on the functional

aspects. Supported standard-based messages are the

functionalities add, update and disable of the master

file notification HL7 v2 MFN M02. The graphical

user interface (GUI) for manual administration is

based on Java Server Faces (JSF). Data storage for

testing is realized via HSQL data base.

4 RESULTS

The PORS is designed to fit into a service oriented

IHE compliant HIEN architecture. As the PORS will

be published as open source software the service can

be used in any other HIEN.

http://gforge.openehealth.org/gf/project/pors/

The PORS can be linked to each health system

uniquely identifying all providers (hospitals,

physicians, nurses, pharmacists and dentists)

allowing all the information related to a healthcare

provider to be pulled from multiple sources into a

single holistic view.

The PORS itself consists of a multiple-tier-layer

architecture (see Fig.1). To add, update and disable

data sets in PORS automatically, flat files (XML,

CSV) as well as HL7 messages (HL7 v2 MFN M02)

can be received via a web service interface provided

by the IPF. IPF has two adapters, one for flat files

and one for HL7 messages, to receive data sets and

to route them to the application logic layer provided

by eHF. On this layer data will be extracted,

processed and converted into Java objects according

to the specific domain model (see Fig. 2). These

objects can be stored to the database. All changes

will be stored in a history. Additionally PORS can

be administrated through a web based GUI realized

with JSF.

A web service interface is foreseen to query the

PORS using the GUI or by HL7 query/response

conformance statements interfaces.

Figure 1: Architectural overview of PORS.

5 CONCLUSIONS

The PORS will assist healthcare providers in

communicating with each other by acting as a type

of electronic ‘yellow pages', making it easier for

them to coordinate care for patients. Without a

PORS a regional HIEN will not be realizable

because it is a central component necessary for all

other services to have a unique identifier. The fact

that it will be open sourced will make it easer for

other related projects to make a quick progress

because it is not necessary to reinvent the wheel.

Another issue is to enforce security and

authentication. Technically in this project it is not

vital to cope with it due to the use of eHF which

foresees to provide security to all eHF-based

HEALTHINF 2010 - International Conference on Health Informatics

536

Figure 2: Specific domain model of PORS.

applications. If the implemented service will be

plugged into the overall architecture these security

mechanisms will be used. Authentication can be

supported by client certificates. It is possible to run

in problems due to the lack off certificate support of

older applications like many primary systems are.

REFERENCES

Heinze, O., Brandner, A., Bergh, B., 2009. Establishing a

Personal Electronic Health Record in the Rhine-

Neckar Region. In Proceedings of MIE 2009 – The

XXIInd International Congress of the European

Federation for Medical Informatics. Stud Health

Technol Inform. 150:119

Caumanns, J., Kuhlisch, R., Pfaff, O., Rode, O., 2009.

Access Control. IHE IT-Infrastrucutre White Paper.

Public Comment.

DEVELOPMENT OF AN OPEN SOURCE PROVIDER AND ORGANIZATION REGISTRY SERVICE FOR

REGIONAL HEALTH NETWORKS

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