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Unit 2: Modelling Concepts

proposals to manage access control. Another RFP is in the development stage to manage Notes
the transcription process.

CORBAmed is based on the Common Object Request Broker Architecture (CORBA)
distributed object model. It provides scalable infrastructure for a distributed object model
of computing. The CORBAmed domain task force has to develop standards for the “business
objects” for healthcare.
By viewing a set of hosts as a network of distributed, communicating “objects”, clients are
able to obtain processed information over an enterprise-scale network. In the long run,
hosts may use each other’s distributed object services to provide information on demand,
thus providing an alternative to the exchange of HL7 messages. However, CORBAmed
will best be used in client-server communications. By providing an object-oriented view
of clinical information, CORBAmed allows hosts to “protect” their data by exposing only
specific “methods” to clients.

Clients can rely on CORBA hosts to provide information on demand and need not keep
duplicates of information in local storage, eliminating problems of freshness and
authenticity which are inherent in message exchanges. CORBA standards are platform
and language neutral, which is a key requirement for any large-scale client-server
integration effort.
HL7 is a messaging standard which is used to exchange healthcare related information via
a coded textual message. The messages may be sent ad hoc, e.g., based on certain trigger
events in the sending system, or may be sent in response to a query (however, the latter
mode is not well supported at present). HL7 has been criticised for the lack of an
information model to standardise the semantics of the information being exchanged. This
has been rectified in version 3.0.

In addition, real-world HL7 experience will be used to define clinical observation
information to be exchanged via the forthcoming CORBAmed Clinical Observation Access
Service (COAS). The COAS, request for proposal (RFP) mandates that existing standards
(including HL7, DICOM, MIB and others) be looked at for definitions of the information to
be exchanged. Further, CORBAmed has an active working group looking at
inter-operability with HL7.
HTML/XML: XML stands for extensible markup language. It is a universal language in a
network’s middleware layer, the conduit that ties together distributed applications with
software components based on CORBA (Component Object Request Broker Architecture)
COM (Common Object Model) and Enterprise Java.
The healthcare industry has yet to resolve the problem of data confusion. Applications
built for legacy mainframe, Unix, NT or Linux systems all define data in patient records,
financial statements and insurance forms differently. As expansions and mergers reshuffle
IT infrastructures of large healthcare organisations; there must be a common ground for
defining data so that old and new applications can communicate with each other.
Universal Pipeline

Healthcare-savvy application developers and integrators find XML particularly appealing.
Healthcare providers could eventually use similar Web-based systems for insurance
eligibility checks, claims processing and clinical referrals. The tools that were used before
XML came in to vogue were data-interchange standards such as Network File System
(NFS) or ANSI X.12.
XML’s data definitions are simpler and more universal than existing specifications such as
Standard Generalised Mark-up Language (SGML) or the proprietary specifications used in
Contd...

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