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Hello everybody, 

In my last blog I have mentioned our HL7 solution based on the Healthcare Enterprise SOA and technical platform Netweaver.

After that I have got several questions from my blog readers asking whether SAP could really support HL7, how does it work and so on. 

I am really very happy to have got your feedbacks and to know that your are interested in this topic! So now I am going to give you a little bit technical explanations of this.

 

First, will SAP Healthcare be able to “talk” HL7?

Yes, we will! 

All our customers know that before eSOA ISH could only “speak” HCM (SAP healthcare communication module) format but not HL7. In order to get ISH understood from others a “translator” is necessary. 

But this will be changed!

 

How could SAP “talk” HL7?

The answer is via XI and its adapters!  

To explain how it works, I need to give you a picture about how do we define the enterprise services. 

image

 

The picture above shows a process model of a simple workflow, in which SAP Patient Management acts as a Patient Encounter Management (blue box on the right side) and reacts to a HL7 message from a non-SAP healthcare application (orange box on the left side).

 

One HL7 message (see the pink box on the left side) is sent from a non-SAP application to SAP. In react of this a notification message interface shall be defined. That is the one in the pink box on the right side. In this sample: Patient Encounter Create Notification.   

 

This interface connects to an appropriate service operation which is called “Patient Encounter Created Notification”, this service operation is an inbound service to trigger the backend function module: CreatePatientEncounter.   

 

Thus one patient encounter will be created!

 

   

 

What are the roles of XI?
1. Repository of Data, Business Objects, Mappings
  

Still the same picture above. There will be many processes models defined during the Enterprise Service Definition phase. To make all these processes really happen, technical data are also defined. These data are like Business Objects, Data Types, Service Interfaces, and Message Types and so on. All these technical data are stored in XI Enterprise Service Repository (ESR). They are the fundamentals to enable the business process in our case the healthcare process.  

 

All these will be packed as a Healthcare “service packet” delivered to customers.

    

2. Yellow pages of Enterprise services

 

Enterprise Service Registry is like a yellow page.

 

It provides customers or partners a service discovery tool. It help them easily find the services they need to reuse and to build their own business processes. Also it allows customers and partners to publish their own services.

 

  

3. SAP Healthcare XI content

 

Now the most interesting part: healthcare XI content. What is it? 

Please see the picture below. You see the ESR is on bottom; on top of the ESR there are mappings (I just take out the mappings from ESR and put on top of it in order to make it better visible). The left side of the mappings are the SAP healthcare scenarios and the right side of the mappings are the standard messages in an XML format.

The Service operations that we have defined in the business process model are on the left side on this picture. For example Admit Patient, Change Patient and so on. Each service operation will be generated in XI in a XML format, this XML message will be mapped to a HL7 XML format. Afterword they are the “output” from XI and “input” to an HL7 Adapter.

So generally all the service interfaces which are defined by SAP Healthcare, all the appropriate mappings for those services interfaces to HL7 XML are the Healthcare XI Content.

image

 

4. HL7 “translator” – via XI and its adapters

XI provides an Adapter Framework. Various and plenty of industry adapters are and can be integrated in the framework. These adapters could be SAP own generic adapters, industry standard adapters and Adapters from 3rd parties.  

Currently there are 2 solutions provided from XI in regarding to HL7. (Sure XI Adapter Framework is open for every industry adapters from 3rd parties.) 

One is a conversion tool which is called SAP Conversion Agent powered by Informatica. It converts HL7 message to XML format and vice versa. Using the Conversion Agent for HL7 solution at least one of the XI generic technical adapters is required for transport protocol.

Another HL7 solution is a HL7 adapter which is from a 3rd party: iWAY HL7 adapter. This is a complete HL7 adapter not only does the conversion but also supports protocol. 

Base on these HL7 solutions, the HL7 XML message, which is mapped in XI content could be converted to a real HL7 message and sent to any non-SAP healthcare application. 

5. SAP sends applications the “HL7” message

On the other hand SAP could also send a notification message to notify all its subsystems e.g. a patient is created.

Again at the backend system one function module works and triggers one outbound service operation, the service interface which is connecting to this service operation will be generated in XI in an XML format. This XML message will then be mapped to a real HL7 message and sent to other application via HL7 adapter.

 

Summary

So till now I hope I could give you the answer to my blog title in a “simplified” technical point of view. 

I am looking forward to your feedbacks.

Best regards

Jing

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9 Comments

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  1. Rene Spronk
    It is good to see that IS-H (by means of XI) will now be able to support HL7 version 2.

    Looking at the HCM functionality (which was originally loosely based on HL7 version 2, and which has been mapped to HL7 version 2 using all kinds of middleware translation tools) some questions that pop up in my head are:

    * Have the SAP IS-H trigger events been aligned with those of HL7 version 2? The trigger events have traditionally been different and were occasionally hard to map to HL7 v2 events. The so-called “historic movements” are not supported by most other systems and had to be filtered out. I hope the ZBE segment as defined by the IHE PAM profile will be used for historic movements.

    * Will IS-H now also support the receipt of trigger events it hasn’t supported before? For example: queries (for demographics information), registrations of new patients by systems other than IS-H? This functionality has only been available via BAPI calls (if supported at all), not via messaging.

    Cheers,

    -René

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    1. Anton Wenzelhuemer
      To my knowledge there is no such thing as HL7 v2. There is HL7 v2.3, v2.5 and of course the version supported by HCM so far, 2.1 (released back in the eighties I think).

      Nowadays everyone talks of(and works on) HL7 v3.

      So if one says HL7 is supported it would be  nice if the versions actually supported are more precisely referred to.

      For example, from what I know of the v2.5 specification I can hardly imagine IS-H supporting the patient entity in its entirement, e.g. the cardinality of PID-3(patient identifier list).

      my 2 cents,
      anton

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  2. Bettina Lieske
    Hi René, hi Anton,
    I am trying to add some ideas to both of your comments.
    As Jing described in her blog, we are currently developping Enterprise Services for different areas (that we called “Enterprise Services Bundles”) and one of the most important ones is Patient Administration. The Wiki (https://www.sdn.sap.com/irj/sdn/wiki?path=/display/espackages/patient+administration&) might give you an idea on what will be delivered in this area.

    With this new technology we will not base our communication on HCM anymore.
    Talking in terms of IHE, we will with the upcoming enhancement package support different actors, this means both the Patient Demographics Source and the Patient Demographics Consumer within PAM. This will be done, in a first step, for the basic subset.
    Concerning PDQ we will support both actors as well (Patient Demographics Supplier and Patient Demographics Consumer). This means that there will be a message based communication to ask an MPI for patient related data (outbound interface) and another one to be asked by a connected system (inbound interface).

    Concerning the supported HL7 version, we are, in a first phase, following the IHE profiles mentioned above and within this the HL7 version 2.5. The enterprise services that we will offer, will then be compliant to this HL7 version, which means that the relevant fields will be covered, but the HL7 message itself will be provided by XI and its adaptors as described above. For other HL7 versions the existing infrastructure (service interfaces, XI, adaptor, etc.) can be used or enhanced.

    Concerning the patient identifier list, we are developing an asynchronous outbound service called “Inform on Patient Identifier List change” notifying connected system about changes in the patient identifiers. The SAP Patient Management application currently supports an internal ID (which is not relevant for the A47 message), an external one, a social security number, and different types of identification numbers that the customer can configure and identify (which then could be matched to the HL7 Identifier Type Code)).

    best regards, Bettina

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  3. David Rodriguez Díez
    I mean… From the reading it’s clear that it will support HL7 in flat format (i.e: with pipes) which will be converted from and to XML XI format but, Will be able to send (and receive) HL7 in xml format using the standard schemes provided by the HL7 consortium?

    regards,

    David R.

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    1. Jing Chen-Schirrmeister Post author
      Hi David,
      Hello Anto, Rene,

      I am Sorry to answer you so late since I was away for several days.

      Again, as my colleague Bettina has answered and as I have mentioned in my blog: support of HL7 including message format (version 2.x and version 3.0) will be done by Netweaver XI and its adapters.

      This means the HL7 adapter provides a complete HL7 library which shall also contain the HL7 XML part and all the required protocols.

      SAP ISH (Patient Management) itself will not send HL7 format directly. But since the XI is in between ISH and other applications, the other applications will get a message from ISH via XI and/or HL7 adapter in an XML format.

      I hope this answers your questions.

      Best regards
      Jing

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  4. Matthias Tripp
    Hello Jing,

    do you know when the XI content including the adapters will be available to customers? Or if it’s already available where I can get it?

    best regards

    Matthias

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    1. Jing Chen-Schirrmeister Post author
      Hi Matthias,

      The XI content will be available later this year.

      The adapters are currently not included in the XI content, however there are 2 partners working with PI platform currently available:
      The first one is: “SAP Conversion Agent powered by Informatica”, it is a conversion tool enables any format to HL7. It is on Netweaver price list or you may go direct to Informatica to buy it.

      The second is iWAY, iWAY provides an HL7 adapter. You need to buy the HL7 adapter directly from iWAY.

      I hope this helps.
      Best regards
      Jing

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