Medsphere.org: Extending the Platform

Extending the Platform

21st VCM, George Mason University, Fairfax, Va.
Andy Pardue & Ben Mehling

OVID

The OVID (OpenVista Interface Domain) layer is a
set of development tools designed to enable
software developers easier access to OpenVista
data and applications.

OVID is a foundational technology that allows
developers to build upon OpenVista (and VistA
derivatives) using alternative languages (such as
Java) or architectures (such as Web Services/SOA).

Vital stats:
Originally released: April 2009
License: AGPL
Technologies: M, Java
Downloads: Open Repository & 2000+
Home: http://medsphere.org/community/project/ovid
Recent whitepaper: http://www.medsphere.com/ovid-white-paper
2 Copyright © 2010 Medsphere Systems Corporation

OVID Technical Capabilities
• Useful for building on the OpenVista/VistA platform:
Traditional applications
Web/Mobile applications
Exposing OpenVista data/logic as Web Services
Console based applications
Automation and Integration
• Ability to create M to Java calls, allowing M applications to call
external Java APIs
• Ability to create Java to M calls, allowing Java applications to
call into M APIs
• Supports creating Java domain objects


Web/Mobile
OVID Architectural Overview
Apps

• How does OVID work?
Communicates over generic
transports, such as RPC Broker
or CIAi Broker
Web Services Repo Java Apps
(Thick and Console) Implements an interface for
calling existing RPCs
Implements an interface to
Domain Object Repository FileMan’s “silent” database API
(Patient, Order, Medication, etc.)
OVID Message
OVID Connection

RPC/CIAi Broker

OVID M/RPCs

M/RPCs FileMan

OpenVista

A Platform

Using the OVID technology and
framework, community contributors and
Medsphere have created new tools and
applications:

Web Services to CCR/CCD gateway
Web Services to DoD KMR middle tier
IHS/Medsphere Clinical Flowsheet,
Pharmacy and more in development
iPhone/iPod application to view
patient record in real-time
Registration application built on OVID
RESTful interface to OpenVista


When to consider OVID

VistA provides a strong integrated solution
...but, Integration is a double-edged sword
VistA has not easily adapted to the changing world

s in computing,
platforms and devices
OVID can be used in projects with varying goals:
• Integration – the glue between disparate systems
• Extension – or a platform on which to build
• Migration – a transitional path


Integration

HL7
OpenVista

Image
XML Interface

OVID
Files WebDAV
Image Repo
Mirth Engine


Extension

Patient
Dashboard
OVID
OVID Application
Domain
OpenVista Layer


Extension

Patient
Dashboard
OVID
OVID Application
Domain
OpenVista Layer
RESTful
WebService


Migration

Clinical
Flowsheets

OVID-based WebServices

MySQL

OpenVista


Migration

Clinical
Pharmacy
Flowsheets


MySQL FDB
DIF
OpenVista


Migration

Clinical
Pharmacy
Flowsheets


MySQL FDB
DIF
OpenVista
Bigtable
AWS


Domain Layer

• A layer of business objects focused on defining the
properties and behavior of the concepts they represent.
Object oriented, reusable across applications.
Isolate, as much as possible, underlying complexity and
details from the users of the objects.
For our purposes, a domain layer should be a simple,
repository based approach to accumulating useful domain
objects.
Extensible to other architectures and platforms (SOAP,
REST, Web, etc.)
Lowers the ramp up time for new developers to become
productive.


OVID API

• RPCBroker, CIABroker, VistalinkBroker interfaces
• Connection pooling
• Temporal caching
• FileMan/Mumps RPC Access
• Support for annotated Java beans


OVID Domains

• Patient (Demographics) • Vital Signs

• Patient Contacts (NOK, • Drug information
Guarantor) • Medication Administration Log
• Location/Ward/Institution • Orders/Orderable Items
Information • Order status/dialog
• Kernel Info (e.g. Platform • Patient Movement
detection)
• Prescriptions/refills
• Users/Clinicians (New Person)
• Immunizations/refusals
• Laboratory Test Results
• TIU Document Retrieval
• Problems


DDSS & KMR Project
• Middle-tier DDSS
Research Project
Data Services (C83)
from RPMS and
OpenVista
“Service Orienting”
the Rules Engine
Web app container for
VueCentric

For details, see: http://socraticgrid.org/index.php/documentation.html


KMR Services -- What’s available

• CAL layer defines what web services are implemented
• Utilizes HL7 V3 XML objects for data requests and responses
• All service providers (RPMS, OpenVista) implement this interface.
(These implementations are called “mappers” because they map from
native data elements to the HL7 v3 objects required by the CAL layer.)
• CAL layer is implemented as a SOAP Java web services (jax-ws)
• Runs within the Glassfish application server
• Coding systems are used when available in source data: LOINC,
ICD, CPT, NDC, HL7
• Currently implements the following CAL domains:
FindPatients GetMedications
GetPatientInfo GetAllergies
FindProviders GetImmunizations
GetProblems GetVitalSigns
GetLabResults


Demonstration

• CCD Document Creation
Used anonymized data from a large sample RPMS dataset
Aggregation of ~5 domains into a CCD XML file
Built on OVID, automated the CCD creation from RPMS in
a few hours of developer time
• Populating popHealth1 Repository
One CCD XML file 2 was created for each patient
The import process reads a directory of CCD records in
batch, loading each patient into the repository
• Population Health Reporting
Influenza Vaccination
Hypertensive BP Under Control
Ad hoc reporting...
1 http://www.projectpophealth.org/
2 Incomplete CCD record due to popHealth limitation -- clinical coding incomplete/hardcoded


FM Projection
FM (File Manager) Projection is a technology that
“projects” the data structure of OpenVista into a
relational database format.

Users can query against FM data structures using
SQL queries and tools.

Vital stats:
Planned release: January 2010 VCM!
License: AGPL, LGPL
Technologies: M, Java, C
Downloads: Open Repository
Home: http://medsphere.org/community/project/fm-projection

FM Projection
Architecture:
• M-engine agnostic (GT.M or Cache)
• Implements a MySQL storage engine that is backed via a
network connection to an OpenVista server
• Projection model uses SQLi package

Capabilities:
• Data can then be accessed via J/ODBC data tools and
compatible data access development libraries
• A Java-based schema and data viewer is included
• Current version provides read-only access

Uses:
• Connect open source or COTS data analysis, reporting, BI
tools

FileMan Projection Architecture

MySQL Clients

SQL Parser/Optimizer

MyISAM InnoDB FileMan FileMan
Storage Engine Storage Engine Storage Engine

Visualizer

RPC Broker SQL RPCs

FileMan SQLi


To do

• Indexes on "New Style" FileMan indexes
• Provide better optimizer hints
• Foreign keys
• Prefetch results instead of RPC call per row
• Custom network socket connection for
performance
• Eventually, write abilities


Demonstration


FM Visualizer (FMVis)

• Inspect Files
Fields
Data
Globals
Relationships
Graph


Standard SQL via DBVisualizer

• Schema inspection
• Queries:
Titles
Users with their titles
Average Age & Standard Deviation of Patients
Most recent signed notes

• Project Files to MySQL from FMVis
STATE


Jasper - iReport

• Sample Reports
Users by Title
Signed notes (previous two weeks)
Patients w/ Allergies

• Projection, not Replication
Run Report
Data alteration
Re-run Report


• Semantic Web EMR, Wed 6/9 @ 3:15pm
• Medsphere Overview, Fri 6/11 @ 9:00am

Questions
http://medsphere.org/


Medsphere.org: Extending the Platform

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