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…to “replace” our beloved Hospital Communication Module (aka IS-HCM or even HCM, for short). And that’s what we decided to do for the new release of the Business Suite and our SAP Patient Management (EhP5).

Well, don’t worry, we won’t actually be replacing it, but instead providing a fully functional alternative to it, using more modern technology and open standards.
We know that IS-HCM is one of the most widely used technologies for hospital internal communication, but it was becoming somewhat dated and the need arose to develop a functionally equivalent solution. And, as is now the norm, based on the SOA paradigm and framework.

So, what do we mean with functionally equivalent? The goal was to support all existing IS-HCM use cases, messages, and events with the new technology, so that you won’t be missing any of the communication capabilities you had before. And, as I already said, you will still be able to keep on using the existing technology (just in case we missed anything).

What are the expected benefits of this new approach:

  1. First and foremost, actually extending the current functionality of the IS-HCM communication. Examples:
    • Enhance the communication with currently “missing” business objects and fields.
    • Better HL7 and IHE support.
    • Externalization of the internal events that may be of interest to third-party systems.
  2. Second, overcoming some IS-HCM limitations, only natural considering its respectable age, like
    • Transceiver not being supported in 64-bit platforms.
    • In a way, using a sort of proprietary technology.
  3. Finally, increased consistency across SAP solutions, namely:
    • Governance and harmonization with the other Enterprise Services delivered by SAP, be it from Healthcare or from other areas such as the basic ERP.
    • And allowing the use of generic SAP capabilities for managing, monitoring and extending Enterprise Services.

I will now try to cover in more detail the most important points above:

IHE/HL7 support

Through the enterprise services and the corresponding PI mapping created during the EhP5 release, we could enhance our IHE and HL7 support by the following actors:

  • Actor Patient Encounter Supplier in profile PAM (incl. the ZBE segment for Germany)
  • Actor Patient Identity Source in profile PIX
  • Actor Patient Identifier Cross-Reference Consumer in profile PIX.

For more details have a look at the IHE configuration guide.

Patient Encounter Record as carrier for HL7 ADT messages

To adequately support HL7 ADT (encounter related) messages like an A01 communicating the whole set of information related to an inpatient admission, we introduced a new business object: the Patient Encounter Record:

The Patient Encounter Record was defined as a carrier of information about a patient encounter, along with associated medical and billing data that you can see represented as nodes in the above picture.

Due to its structure and reach, this BO can be used, for example, to transmit to SAP Patient Management the complete set of information to be documented for a surgery, or to handle ADT HL7 messages.

New Business Objects and Enterprise Services

To offer a functional equivalent to HCM, we modeled and implemented three new business objects (Patient Encounter Record, Medical Diagnosis, Medical Record Folder) and enterprise services for them, and we also enhanced business objects that were already shipped with EhP4 (Patient, Medical Activity). 

These are the new enterprise services (per Business Object):

For Business Object (BO) Patient:  

  • Inform of Patient Deactivation: this asynchronous outbound service informs connected systems of a deactivated (cancelled) patient in SAP Patient Management

For BO Medical Activity

  • Maintain Medical Activity based on Collective Medical Activity Notification: This asynchronous inbound operation handles the creation, updating, and cancellation of a group of medical activities.

 For BO Patient Encounter Record

  • Inform of Patient Encounter Record: this asynchronous outbound service allows the transmission of the complete set of information related to an ADT event with the goal to generate the corresponding HL7 message.
  • Maintain Surgery based on Patient Encounter Record Surgery Notification: this asynchronous inbound service allows the transmission of the complete set of information to be documented related to a surgery to SAP Patient Management. This covers the information about the surgery itself as well as the documented procedures and diagnoses, and performed medical activities. It handles the creation, the update and the cancelation of the set of data.  

For BO Medical Diagnosis:

  • Maintain Medical Diagnosis based on Medical Diagnosis Collection Notification: This asynchronous inbound operation handles the creation, updating, and cancellation of multiple medical diagnoses

For BO Medical Record Folder there is a set of asynchronous outbound services to inform connected systems about actions on the medical record folders in SAP Patient Management

  • Inform of Medical Record Folder Creation 
  • Inform of Medical Record Folder Change   
  • Inform of Medical Record Folder Cancellation   
  • Inform of Medical Record Folder Status Change

I invite you to have a look  at the new Enterprise Bundle for the hospital internal communication.

There is also a brand new landing page for Healthcare SOA  from which you can navigate to all Enterprise Services Bundles and find all the necessary information related to enterprise services and standards support.

Looking forward to your feedback when using the new services,

 Bettina

(Please note that this information is related to EhP5 which is currently in Ramp-up only, therefore please consider the following disclaimer in your planning:

Legal Disclaimer: The information in this document is confidential and proprietary to SAP and may not be disclosed without the permission of SAP. This document is not subject to your license agreement or any other service or subscription agreement with SAP. SAP has no obligation to pursue any course of business outlined in this document or any related presentation, or to develop or release any functionality mentioned therein. This document, or any related presentation and SAP’s strategy and possible future developments, products and or platforms directions and functionality are all subject to change and may be changed by SAP at any time for any reason without notice. The information on this document is not a commitment, promise or legal obligation to deliver any material, code or functionality. This document is provided without a warranty of any kind, either express or implied, including but not limited to, the implied warranties of merchantability, fitness for a particular purpose, or non-infringement. This document is for informational purposes and may not be incorporated into a contract. SAP assumes no responsibility for errors or omissions in this document, except if such damages were caused by SAP intentionally or grossly negligent.
All forward-looking statements are subject to various risks and uncertainties that could cause actual results to differ materially from expectations. 
Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of their dates, and they should not be relied upon in making purchasing decisions.)

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