NJ 08055 USA
Group IV: Modelling and Planning in Healthcare
Federation for Medical Informatics
Sussex BN12 4SN UK
Service provision pathways; Security & confidentiality; Application service
developments in Internet technology now provide "thin-client" services
that host and distribute software applications to users. This combination of
Application Service Providers ("ASPs") and Management Service
Providers ("MSPs") provides a low-cost information utility option to
provide secure inter-agency collaboration. This approach provides the
opportunity to provide seemless end-to-end Community Services by linking up all
the agencies in the client service supply-chain. This adaptation of e-commerce
principles provides the basis for service optimization whilst maintaining
necessary confidentiality of sensitive information and operational autonomy for
the agencies involved.
presentation discusses the process of developing an ASP/MSP Model for Health and
Human Services ("HHS") utilizing "thin-client" technology.
Workflow analysis techniques are used to establish the end-to-end Service
Provision Pathways to required meet specific types of client need. These are
supported, as appropriate, by guidelines and/or action checklists for steps or
stages down these Pathways.
potential closer coupling provided between agencies by this approach not only
allows more effective planning, provision and management of individual cases,
but also enables more effective inter-agency resource planning and service
development together with a quicker response to variation s in demand.
the Service Provision Pathways are used interactively for planning and reporting
they provide a semi-automatic means of generating case records with more
detailed notes appended as attachments. As these records will undoubtedly
include information whose components will need varying levels of security both
within agencies and between agencies, security and confidentially modeling
techniques are an integral component. This includes the application of
domain-based security and public key infrastructure [PKI] methodologies,
including the application of provisional ISO standards.
ASP/MSP Model creates closed Internets (Intranets) that allow HHS agencies to
access a server and exchange data using existing public lines and a browser.
These Intranets create connectivity between community-based providers,
government agencies, and large institutions.
Intranets are utilities where interoperative functionality can be acquired by
each agency or user as a service. The utility becomes a network that all
providers can use, but no particular agency or group owns or controls, and
effectively acts as an “information banking” service.
the banking paradigm the ASP/MSP Services are billed on a per subscriber basis.
This has the major advantage that it is a revenue issue rather than a
capital expenditure item, which in European countries has significant time and
cost impacts. It also allows the ASP/MSP to add subscribers and services with
minimum capital investment in hardware, software or staff.
model offers turnkey capabilities and network provisioning for Virtual ISP
Services (VISP), managed port services and all ISP functions including Web
hosting thus allowing agencies to focus on the development of the requisite protocols and client and agency relationships.
thin-clients contain few if any, of their own applications and are set up to
access applications either via the Internet from ASPs or from network servers
they benefit from reduced hardware, software, maintenance and
personnel costs because these workstations are less expensive than
"fat- client" machines that host the applications on their own hard
ASP phenomenon has propelled the new MSP marketplace, which has to service a
large number of customers efficiently. For any service provider serving a market
with huge potential, scalability is a primary concern. The systems must be able to scale to handle the thousands, or
possibly even millions, of customers the MSP is hoping to sign up at reasonable
cost with the ability to add hardware as the service grows, rather than all at
once, making a huge difference in capital costs and risk for the service
The development of the Model for Health and Human Services ("HHS") approach will enable agencies to achieve their objectives in the following areas: