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The Hospital Communication Module (IS-HCM) ES bundle uses application-to-application (A2A) services to seamlessly integrate SAP Patient Management (based on SAP ERP 6.0) with the many third-party systems typically deployed in today's healthcare facilities.

The system landscape within a healthcare provider organization is typically very heterogeneous and complex and SAP Patient Management is only one of the multiple applications running there. Therefore interoperability is a key requirement to ensure patient safety and efficient healthcare processes through accurate information being available at the right place and at the right time.
The intention of this bundle is to provide a functional equivalent to the widely-used hospital internal communication capabilities of SAP Patient Management (usually known as IS-HCM or simply HCM), in order to overcome its current technological restrictions (see below) and allow for stronger support of Industry Standards and initiatives such as HL7 and IHE, respectively.

Currently, SAP Patient Management offers asynchronous interfacing possibilities through its Hospital Communication Module (IS-HCM), but this technology is becoming dated, and some functional and technical shortcomings were starting to be noticeable, namely:

  • Technical shortcomings:
    • Extensibility to meet new requirements, e.g. new attributes for physicians in Germany have to be communicated to non-SAP systems (German law: "Vertragsarztänderungsgesetz").
    • Transceiver Platform Support: the current transceiver implementation cannot be executed on all 64-bit processors/operating systems.
    • Size limits: due to the size limitations in the HCM, some messages have to be split up into several ones.
  • Functional shortcomings :
    • Historic movements cannot be distinguished from current movements which causes a problem in receiving systems that might overwrite actual movements with data from old ones - see blog from René Spronk.
    • Communication on additional objects, attributes: since HCM has not been continuously aligned with new developments made in SAP Patient Management, a set of objects and attributes are not supported by HCM (e.g. localization for diagnoses).
    • Quality of service: the support of different communication patterns is missing (e.g. exactly once in order, etc.).
    • Acknowledgements as required by HL7 are not provided by HCM.

Hospital Communication Module (IS-HCM) (click to enlarge)

Audience

Any entity, large or small, that is engaged in providing public or private healthcare and is a user of SAP Patient Management will benefit from the services in the Hospital Communication Module (IS-HCM) ES Bundle

Business Objects and Service Operations

This bundles uses many services of the Bundle Patient Administration. The additional ones are mentioned below:

InterfaceServiceDescription
Patient Encounter Management / Patient Encounter Record Event OutInform of Patient Encounter Record 

To inform third-party systems about an event that relates to a patient encounter and its related data.

Patient Financials / Medical Activity In Maintain Medical Activity based on Medical Activity Collection Notification To maintain a medical activity (or medical activities) based on a notification from a third-party system.

How To Use This ES bundle

With the new Hospital Communication Module (IS-HCM) ES bundle, healthcare providers have at their disposal a method of integrating their myriad systems that offers connectivity and standardization.

Use Case 1: Immediate Notifications of Admissions

Sending of immediate notifications of patient admission events. Since very often the hospital departmental systems need information about a recently admitted patient, it is of utmost importance that admission information be transmitted from the Patient Management system in an almost immediate way (or with very little delay).

Note: this functionality was known as "express dispatch" in HCM.

Step

Enterprise Service Invoked

Step 1: Patient John P. shows up at the clinic for its planned examination and goes directly to the Gastroenterology department (decentralized admission).

(No Enterprise Service invoked during this step)

Step 2: The department's admission clerk Martin B. captures his personal and insurance data, confirms his billing address and admits him to the clinic.
As soon as he saves the admission data, an event is triggered and sent to the clinic's ancillary systems.

Inform of Patient Encounter Record

Step 3: He then switches to the departmental application of the gastroenterology service (in the meantime already aware of John P.'s data) and marks him as having arrived, fulfilling the examination's requirements (fasting for a certain number of hours, etc.), and therefore ready to be examined.

(No Enterprise Service invoked during this step)

Use Case 2: Change Outpatient Case to Inpatient Case

After being admitted to ambulatory treatment and due to the preliminary results that may indicate a serious condition, a patient is advised to stay at the hospital for further examination. His initial case must therefore be converted to an inpatient case.

Step

Enterprise Service Invoked

Step 1: Patient Charles M. goes to the ambulatory service of the local clinic because he's been feeling some shortage of breath and chest pain.

(No Enterprise Service invoked during this step)

Step 2: Clerk Jack R. admits him to the emergency room, where he's immediately scheduled for an ECG.

Inform of Patient Encounter Record

Step 3: As soon as the results of the ECG are out, it becomes quite clear that Charles is suffering a mild heart attack, and the physician on duty immediately instructs him to be stationed for further observation and control.

(No Enterprise Service invoked during this step)

Step 4: Based on the doctor's instructions, clerk Jack R. therefore changes the current outpatient case to an inpatient one, and assigns Charles to the Cardiology Observation Room.

Inform of Patient Encounter Record

Use Case 3: Organizational Unit-related medical services

After being performed, medical activities such as radiology exams or laboratory tests need to be assigned to the respective requesting organizational units for billing, costing, and accounting purposes.

Step

Enterprise Service Invoked

Step 1: After finishing his round of examinations for the day, radiologist Elvis P. documents the findings and closes the orders in his radiology departmental system.

(No Enterprise Service invoked during this step)

Step 2: When saving, the radiology system, based on the processed orders, generates the activities or services, assigns them to the requesting OU (organization unit - actually, the cost center that will be charged) and sends them to the SAP Patient Management system for billing and accounting.

Maintain Medical Activity based on Medical Activity Collection Notification

Future Directions

Further support for additional HL7 messages and IHE Integration Profiles.

Connectivity

The Hospital Communication Module (IS-HCM) ES bundle connects to SAP Patient Management and SAP ERP 6.0. Because of the standards-based communication offered by enterprise services, the ES bundle supports the Integrating the Healthcare Enterprise (IHE) initiative, which provides guidance for deploying standards such as HL7 and enabling the to integrate with those third-party systems typically deployed in the healthcare industry.

System Requirements

Related ES Bundles

This bundle is actually a collection of services provided in other bundles, namely:

SAP
SAP Developer Network
Enterprise Services Wiki Homepage on SDN

Healthcare Landing Page on the ES Wiki (currently https://wiki.wdf.sap.corp/wiki/display/PTGSOA/Healthcare)

Links to SAP Healthcare Blogs

"How to find & test Enterprise Services for Healthcare" by Bettina Lieske

"Engineering a Business Process Platform for Healthcare Part 5 - How To Provide Value" by Claudius Metze

"Engineering a Business Process Platform for Healthcare Part 4 - Here's the beef" by Claudius Metze shows the wiki for Patient Administration.

Health Level 7
Integrating the Healthcare Enterprise (IHE)

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