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Red Hat JBoss Fuse - The next step of integration for healthcare industry

I wanted to build a JBoss Fuse demo for healthcare industry, and started doing my research on the internet, at first, I thought, it is not going to take long, since there is already a standard out there: HL7 for data exchanging, how difficult can it be? Integration in healthcare should be a piece of cake...  But I was WRONG! After reading through materials, and looking at this humongous confusing HL7 hierarchy with various version, possible new format, medical terms, and don't even get me started on customization of different parties. I admit, OK, I get why it is complicated now.

The fundamental reason of why healthcare is so complex is the number of diverse aspect it needs to cover. Think about this, if you accidentally break your bone, and rushed to an ER to be treated, other then the actual medical treatment you received, the people, information involving behind the scenes are much more then one can imagine, at least for me it is.

First is when we got to the ER, they need to figure out who you are, and pull out your correct medical record (EHR/EMR), these record could be from anywhere, sometimes, it's another hospital, a clinic you visited, for some countries, it could come from a centralized government owned source, which requires special security setups. Not only just pulling the records  out, it also needs to verify if these record belong to the right person. Then you might be sent to do tests, scans or checkups in labs, these result data and reports are generated by machines made by various vendor, so they each has different format and interpretation of conditions. Then all these info and data are gathered into a human readable format, to your doctor, so he/she can make the right decision for your treatment. But wait, even the best doctor can remember everything, so the support from transcription systems showing the possible actions, medication or even warnings of alerts will be very beneficial to both patients and doctors. Then how physicians doctors document you medical records is another complicated story. A series of treatment will be given after the diagnoses, these action items are deliver to each department, and they will carryout the treatment and record patient's reaction to it. Patient might be prescribe with medications, these information will need to be available to pharmacies, so the pharmacist can make final checks. Other then this, your treatment billing information will also make it's way to cashier in hospital, your insurance company and possibly government. Last but not least, you, the patient, continuos care and followups after your first treatment is essential too.

I notice, although HL7 standard itself is complicated and full of information, it is still not enough to cope with the rapidly increasing and ever changing environment and needs. Fifteen years ago who would ever imaging RFID would play such a big part in hospital, how Internet of Things would turn the industry upside-down with benefit it brings to proactively report patients immediate health condition. In order to consolidate these information silo from vendors, hospitals, clinics, and overcome the interoperability problem, the integration solution should be highly flexible, easy to customize, built in the concept of modularity, and extendable, but at the same time comply to current compliance.

From integration solution perspective, how do we build a robust, flexible application? Let's see what are the possible architectural issues we will face, and how does JBoss Fuse can help?

Complex Data Standards and custom interoperation

HL7 is the main data standard to define back-and-forth exchange of patient health data among different organizations, it is founded in 1987, as the needs and technology advances, people soon find they have to customize this standard to meet their requirement. Of course, how each vendor or makers interoperate this can be very much different, so another version of HL7 has evolved. That's what this mystery "Z segment" for. The version 2 HL7 structure uses (|) and(^),  and HL7 v3 is based on XML.  They are significantly different aren't they? JBoss Fuse has a built-in Camel components that is used for working with the HL7 MLLP protocol, it supports

  • HL7 MLLP codec 
  • Type Converter from/to HAPI and String
  • HL7 DataFormat using the HAPI library
Apart from HL7, the format could be everything, from EDI, XML, JSON or even flat files. JBoss Fuse support all these format, and also allows you to build you own customized transformation through drag and drop tooling base on Dozer technology. 

Multiple, intertwined structure of parties

When a patient is sent to hospital, the information of this patient will need to be gathered from possibly anywhere, from large public office or small community clinics, and then your physician or doctor will need data from laboratories, registration. Visibility of medical reports to insurance company, to governments are also critical and maybe part of the regulation that must comply. Pharmaceutical information exchange and contacting patients is another important end as well. These different parties uses different protocol, endpoint, and to build a integration solution around them you must have a solution that support all that. It could be as simple as HTTP or REST call, or it needs to go through (S)FTP if the volume of the data gets too large, Emails, Siebel, JDBC, even messaging broker could be used. Luckily JBoss Fuse is famous for it's variety of endpoint it supported.

  • REST
  • HTTP(S)
  • (S)FTP
  • File
  • JDBC
  • SMTP
  • and more... 150 + components

And how Fuse can structure how the integration message should be routed, using existing enterprise class pattern will significantly reduce workload and makes it easier to maintain.

Change management for regulation, and functional update

Information technology in Healthcare industry is old and rigid? Nope, not anymore, being flexible and extendable is crucial in healthcare world, recently, people has tried ever harder to improve the quality of patient's experience. There for demand of interconnect between organization and event with organization has increase, that mean interoperability are more complex, we need to talk to existing old mainframe, but also taking in data from latest devices or give orders to most advance medical equipment that is automatically linked. How do we insure we can deliver services on-time without sacrificing the quality of our application and at the same time does not affect old services? There are two ways we can take advantages of JBoss Fuse here, here is to improve the delivery cycle with DEVOPS, JBoss Fuse made continuous integration and continuous delivery easy,

  • Automatic pick changes from version control tools
  • Automatic build packages and manage them with maven
  • Adding automatic testing with Testing Suite
  • Containers and environment is controlled base on latest Fabric, Docker, Kubernetes technology. 
  • Flow from testing to production by integrating with Jenkins

And the other approach is how we architected our software, and the way to deploy it.  Yep, it's microservice I referring to.

  • Isolated boundary of function, so service do not affect others with Camel routes, and we can bring more people to the development.
  • The AMQ messaging broker inside creates a perfect environment for independent module and allowing them exchange the message with preferred topology. 
  • The lightweight nature of Fuse by Karaf or Docker, we can start and stop a service rather quickly, we redeploy it ASAP when needed. 

The continuous wave of evolving technology

To adapt the rapid changing technology, like IoT, we need to support new protocols to collect the data, JBoss Fuse support most common used protocol MQTT in IoT world. And data doesn't mean anything unless we process it.  JBoss Fuse integrate with JBoss BRMS with developer can build rules to process the incoming data and can provide preliminary assistance and make quicker response to some urgent medical situations.

OK. That's it for this time, next time, we can take a look at how we can implement healthcare service with JBoss Fuse! See you around.


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效能沒有什麼Best Practice, 反正能調整的就那些。 通常,一個程式的效能大概有70-80% 都跟程式怎麼寫的其實比較有關係。

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JBoss 的 SubsystemDatasource WebWeb Service EJB Hibernate JMSJCAJVM 調校OS (作業系統)

先來看一下 DataSource Subsystem, DataSource 的部分主要是針對Connection Pool 做調校。

通常,程式都會需要跟資料庫界接,電腦在本機,尤其是在記憶體的運算很快,但是一旦要外部的資源連接,就是會非常的耗資源。所以現在的應用程式伺服器都會有個Pool 放一些先連接好的 資料庫connection,當程式有需要的時候就可以馬上提供,而不用花那些多餘的資源去連接資料庫。

這就是為什麼要針對Connection Pool 去做調校。

以下會討論到的參數,都是跟效能比較有關係,Datasource 還有很多參數,像是檢核connection 是否正確的,我都不會提到。如果你追求的是非常快速的效能,那我建議你一個檢核都不要加。當然,這樣就會為伺服器上面執行的程式帶來風險。這就是你要在效能與正確,安全性上面的取捨了。 (套句我朋友說的話,不可能又要馬兒好,又要馬兒不吃草的..)

最重要的調校參數就是 Connection 的 Pool 數量。(也就是那個Pool 裡面要放幾條的connection.) 這個參數是每一個應用程式都不一樣的。


Connection Pool 最少會存留的connection 數量


Connection Pool 最多可以開啓的 connection 數量


事先將connection pool 裡面建立好min-pool-size 的connection.

我的建議是觀察一下平常程式要用到的量設定為 min-pool-size 。

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