Many organizations are looking to SOA to tie together systems within the
enterprise or among partners. But few face the diversity and complexity that the
state of Massachusetts did when it tried to connect independent insurer,
hospital, and physician systems with one another -- and with the state's own
systems for care, reimbursement, and billing.
“How do you craft enterpriselike functionality across hundreds of moving
parts that don’t interoperate with each other?” was the question the state faced
in 1997, recalls Harvard Medical School CIO Dr. John Halamka, who spearheaded
the effort. Because the Health Insurance Portability and Accountability Act of
1998 required that every doctor, hospital, and insurer be able to exchange data
for transactions, doing nothing was not an option.
The state's major hospitals and insurers examined three options. The first was to deploy a common platform and to require insurers, hospitals, and physicians who had business with the state to implement and use it. This option, however, was too complex to pursue seriously, Halamka says.
The second option was to create a unified database for patient medical, billing, and insurance data that participants could access using their own systems. That solution would have cost $50 million, Halamka recalls. But the third option -- to implement an SOA that would provide the data and application translation necessary for various services to interoperate without changing their code or data structures -- was viable and ended up costing just $1 million.
