A lot of RFP's these days quote SOA as the preferred architectural pattern. Well it sounds reasonable considering the fact that
Ø Legacy applications/existing systems can be refined to support EHR without the need to make the supporting hospitals introduce new applications as is seen by in case of one national programme which is delayed.
Ø Support for new range of transactions/workflows by enabling orchestration of services in local application and EHR.
Ø Enables faster delivery and deployment of different components of the solution using off- the- shelf solutions.
SOA enables easy separation of EHR and local applications and at the same time the services exposed by applications within local and the EHR settings will be interoperable for the entire infrastructure to be perceived as single system. The separation of components into loosely coupled services optimizes scalability, maintainability and functional flexibility.
However there are huge challenges in using SOA for creation of an EHR.
• Legacy Systems , geographically spread over wide area , fragmented , disparate data types , disparate data sources (electronic/paper), proprietary technological systems including in-house built systems
• Many governments are targeting EHR infrastructure to aid healthcare reforms which is stretching it to the limit and is beyond its intended use.
• Existing systems rich in function , poor in interoperability
• Desire to bridge legacy and provide for future extensibility of the systems is difficult due to absence of uniform standards
• Many EHR implementations are driving point of service vendors to use new industry standards which are not mature , e.g. HL7V3 and SNOMED
Apart from the challenges there are a few pitfalls as well
• Not SO easy to convert closed legacy healthcare systems into open service oriented applications and databases
• Big Healthcare vendors are not “service oriented- Systems that had around for years are now cannot be suddenly, service oriented.
• New SOA Infrastructure e.g. IBM Websphere for ESB or Oracle HTB increases costs
• SOA in Healthcare not implemented and not deployed anywhere on a huge scale