National Patient Records System Gets Boost From SOA
With a patient’s permission, a doctor can use LSP to access treatment records in other medical IT systems.
The Dutch Ministry of Health is upgrading information exchange among medical practitioners to improve the quality and reduce the cost of healthcare in the Netherlands. Teaming with CSC, the ministry created a highly secure system that lets doctors share medical records without compromising the privacy of patients.
The system, Landelijk SchakelPunt (LSP), or the National Switch Point, pulls together records from multiple healthcare providers to create a more complete picture of past medical treatment. LSP can’t store patient histories, and doctors’ systems can’t store records retrieved by LSP. This makes breaches in privacy more difficult to achieve. For the Ministry of Health, the added security is key to garnering the trust of the Netherlands medical community and its patients, who must voluntarily join the system for its benefits to be fully realized.
"LSP is crucial to establishing the safe, nationwide exchange of up-to-date healthcare information," says Gerard van der Hoorn, LSP program manager for the Dutch government. "CSC not only delivered LSP on time, but proved to be a true partner in the further development and implementation of LSP."
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The Ministry of Health established NICTIZ, the Dutch National IT Institute for Healthcare, in 2002 to pursue an information upgrade that would allow remote access to secure data in independent medical IT systems. NICTIZ issued a request for proposals requiring proof that the requirements could be met within the short timeframe mandated by the government.
According to Bob Schat, a CSC solutions architect, other players in the medical IT community focused on protecting the pre-existing technological base. They saw limits to what the architecture could handle and their proposals envisioned complex, time-consuming projects and slow, inflexible systems. "CSC, on the other hand, was fresh and innovative and had the attitude that this could be done," says Schat.
CSC based its proposal on service-oriented architecture (SOA), which allows global communication between enterprise applications without integrating them at the structural level. CSC partnered with InterSystems, the Massachussetts-based creator of Ensemble integration software, which enhances portal development on data, integration and application servers. CSC ran tests that demonstrated to NICTIZ that the Ensemble platform would provide advantages over conventional technologies in both development time and operating speed. Proving the deadline could be met, CSC won the tender. "CSC’s offer reflected our need to deliver a high-quality and extremely secure product in a very short period," says van der Hoorn.
Service-oriented architecture made easy
CSC and InterSystems chose CSC’s Catalyst methodology to design and build LSP as a hub that connects to healthcare providers’ systems using a series of standard interfaces. Physicians use their own applications — and a Java card that authenticates their identities — to access patient data retrieved by LSP from other applications. To retrieve data, LSP keeps an index of specific patient information kept by each healthcare practitioner. It also maintains a log of who accesses what information, and when. Doctors can only see information pertinent to their specializations and to which patients have previously granted them access. In this way, LSP enables a level of accessibility usually found in centralized systems, yet achieves greater security and cost savings through decentralization.
The LSP platform can be scaled according to the number of healthcare institutions connected and the amount of online traffic. This maximizes system efficiency and saves money as LSP grows during the adoption process. CSC connected early adopters to the LSP pilot program in 2006. One year later, LSP is working so well that CSC is in talks to build similar systems for other Dutch government ministries, including economic affairs and education. "We can provide the same system for any customer — all we need to do is change the interface," says Schat. "We proved that decentralized architectures work very well and that using SOA can be very beneficial to a project."
