Transforming Healthcare One API at a Time at Kaiser Permanente

Kaiser Permanente (KP) is a leader in the healthcare industry and is constantly innovating and deploying technology solutions to enrich the way members receive healthcare. The plethora of backend systems and the complex nature of the industry necessitates a SOA as well as an API strategy.

Delivering functionality and product features in a competitive marketplace that is constantly undergoing regulatory change requires technical foresight to meet the evolving demand from members and consumers for high-quality experiences that educate them, engage them socially, and enrich the overall interaction with the healthcare system. To learn more about how KP delivers solutions to the digital channels one API at a time, come share our journey.

Jeffrey Venetta, IT Director, Kaiser Permanente
Raghu Raman: Sr. Project Manager, IBM Smarter Cities Consulting

1. Transforming+Healthcare+–+One+API+at+a+7me++
25
th
%February%%2015%
%
Presented%by%:%%
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Jeffrey%Vene7a,%Sr.%Director%–%Digital%Shared%Services%,%Kaiser%Permanente%
Raghu%Raman,%Sr.%Manager%–%Perficient%%Inc.%
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2. 2%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Agenda+
%
! Kaiser%Permanente%–%Brief%introducJon%%%
! Kp.org’s%%%API%%journey%%
– Guiding%principles%
– Technology%roadmap%
– Experiences%roadmap%
– %Digital%CapabiliJes%roadmap%%
! Kp..org%%SOA%challenges%%ahead%%
! API%architecture%%
! Q%&%A%
%
%
%
%

3. 3%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kaiser+Permanente+–+A+brief+introduc7on+
Corporate+Overview++
Founded in 1945
9.1+%million%%members%
174,415%%employees%
17,425%%physicians%
48,285%%nurses%
38%%hospitals%
608%medical%offices%and%other%faciliJes%
36.5%million%%doctor%office%visits%

%
%
A%few%staJsJcs%of%%member%usage%on%digital%channels%%
Visits%to%kp.org%(including%visits%to%m.kp.org)%:%162M%
Total%registered%members%:%4.89M%%
Test%results%released%online%:%%78M%
Test%results%viewed%online%:%37.4M%
Emails%sent%to%doctors%and%other%providers%:%20M%
PrescripJon%refills%submi7ed%online%:%17.5M%
Appointments%booked%online%:%4.2M%
Kaiser%Permanente%mobile%app%downloads%:%1.1 million %
%
%
*%Data%as%of%Dec%2013%

4. 4%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kp.org++to++Consumer+API+Journey+++
2009:++SOA?%Why%?%%
%
2012:+When%can%we%start%on%APIs%?%%
%

5. 5%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kp.org+–+Architectural+Focus+
PreI2009 2009+onward
Integra7on+with+external+systems++

Generally%point%to%point,%container%managed%
integraJon%capabiliJes%not%consistently%used
All%integraJons%must%be%API/web%
service%based%and%deployed%to%a%KPjIT%
ESB%and/or%API%Gateway
Integra7on+technology Whatever%is%available%is%used.%i.e.%Servlets/%%
Portlets%opening%up%socket%connecJons%
directly,%JDBC%for%SQL%access%to%external%
databases
Work%with%external%systems%to%
leverage%shared%and%create%new%Web%
Services%and%APIs
Service+Oriented+Infrastructure Limited%to%no%service%oriented%infrastructure%
uJlized.%%Tight%coupling,%metrics%and%
monitoring%must%be%manually%compiled%for%
each%process%involved%in%a%given%request.
UJlize%ESB%for%all%integraJons,%taking%
advantage%of%locaJon%transparency,%
service%metrics,%monitoring%and%
problem%idenJficaJon%capabiliJes
Standards+and+Guidelines+

Rarely%complied%with.%%Varies%greatly%across%
features%based%on%team%lead/developer%
preference.%%
Key%stakeholder%in%DTO%engagement%
and%technical%governance%to%ensure%
core%KPjIT%service%orientaJon%
standards%are%followed.
Documenta7on Varies%from%none%to%some.%%Most%are%not%
detailed%enough%to%implement%to,%all%
different%in%format%and%levels%of%detail
Comply%with%KPjIT%SOA%and%SDLC%
documentaJon%requirements%for%
services.%%Request%it%of%our%service%
providers.%%

6. 6%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Guiding+Principles+
! Loose%coupling%is%the%strategic%integraJon%approach%for%business%data%and%funcJonality%
! UJlize%domain%based%informaJon%models%in%service%interface%
! Partner%with%domain%owners/service%providers%to%ensure%our%architectural%goals%are%
realized%in%their%service%design%
! Support%and%parJcipate%in%Enterprise%SOA%Governance%and%infrastructure%
! Encourage%the%use%of%industry%best%pracJces%in%the%design%and%implementaJon%of%web%
services%and%APIs%
! Encourage%our%business%partners%to%provide%requirements%at%a%business%funcJon%level,%not%
applicaJon/screen%level%
! Be%pragmaJc%when%balancing%our%principles%with%Jme%to%market,%but%always%provide%
tension%towards%strategic%architecture%

7. 7%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
To Do
Change
Complete
Legend
Medication Order Service
REST Transform
ePharmacy Online Medication Service
View Prescriptions Refill Prescriptions
ePIMs/PIMS EPIC
Facility Directory Service
Find Facilities
ISG
Event Notification Service
REST Transform
MyChart Get Alerts Service
MD Email Alerts Appointment Alerts Test Results Alerts Department Email
EPIC
User Data Service
REST Transform
Change Password Identity Information Notification Settings
eBiz UDR
Secure Message Service
REST Transform
Email Department
Kana/CSC EPIC
Test Results Service
REST Transform
Test Results
EPIC
Get Allergies Service
REST Transform
Allergies Immunizations Health Conditions
Get Immunizations Get Curretn Health Issues
Planned+Transforma7on+–+From+SOA+to+APIs+







S
O
A
P

8. 8%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
SOA+to+API:++Quick+enablement+of+Mobile+and+Web+2.0+
Medication Order Service
REST Transform
ePharmacy Online Medication Service
View Prescriptions Refill Prescriptions
Facility Directory Service
Find Facilities
Secure Message Service
REST Transform
Email Department
Test Result Service
REST Transform
Test Results
User Data Service
REST Transform
Change Password Identity Information Notification Settings
REST Transform
PAM Service
Allergies Immunizations Health Conditions
Event Notification Service
REST Transform
MyChart Get Alerts Service
MD Email Alerts Appointment Alerts Health Reminders Test Results Alerts Department Email







S
O
A
P




R
E
S
T

9. 9%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Consumer+API++journey+I+++Technology+evolu7on+
2009% 2010% 2011% 2012% 2013% 2014% 2015%
Kp.org%%j%IBM%portal%%
Web%service%IBM%WAS%
ESB%j%%IBM%DataPower%
API%%gateway%
Deployments%–%IBM%urbancode%
Technology%
2008%
Service%VirtualizaJon%%
Web%service%IBM%WAS%

10. 10%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Consumer+API++journey+I+Digital+experiences+for+our+members+
2009% 2010% 2011% 2012% 2013% 2014% 2015%
Digital%Membership%%Cards%
Video%Visits%
Experiences%
2008%
Migrated%and%enabled%legacy%kp.org%%to%
target%architecture%%IBM%portal,%IBM%WAS%
%etc,%
NoJficaJon%Plaporm%
Kp.org%%j%IBM%portal%%
Web%service%IBM%WAS%
ESB%j%%IBM%Datapower%
API%%gateway%
Deployments%–%IBM%urbancode%
Service%VirtualizaJon%%
Web%service%IBM%WAS%
Non%Member%Accounts%

11. 11%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Consumer+API+journey+I++Expanding+our+digital+offering+
Without%%changing%the%technology%stack,%
KP.org%has%focused%on%adding%digital%
capability%to%our%API%offerings%to%
support%the%business.%
2009% 2010% 2011% 2012% 2013% 2014% 2015%
CapabiliJes%%
2008%
AuthorizaJon%and%enJtlements%%
Provider%and%member%
Digital%a7achments%,%Video%Visits%%
Health%Record.%Messaging%and%appointments%
Content,%Account%creaJon%,%registraJon%%
Kp.org%%j%IBM%portal%%
Web%service%IBM%WAS%
ESB%j%%IBM%Datapower%
API%%gateway%
Deployments%–%IBM%urbancode%
Service%VirtualizaJon%%
Digital%Membership%%Cards%
Video%Visits%
NoJficaJons%
Non%Member%Accounts%
Web%service%IBM%WAS%

12. 12%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Consumer+API++journey+–+Reasons+we+are+succeeding++
ExecuJve%
sponsorship%
Architecture%
and%Design%%
ExecuJon%
and%delivery%
Renewed%
Investment%
Reaping%the%
benefits%
Strong%execuJve%sponsorship%and%leadership%
laid%the%foundaJon%for%the%digital%channel%%
Use%of%best%in%breed%tools%,%technology%and%framework%
for%a%Scalable,%sustainable%and%available%infrastructure%
Focused%delivery%and%execuJon%over%
several%Projects%and%iniJaJves%
Leveraging%on%investments%
made%earlier%
Responsive%
to%change%

13. 13%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Flagship+app+–+APIs+in+play++
Click%image%to%Launch%Video%
(https://www.youtube.com/watch?v=_VH01BqrDos)%

14. 14%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
KP+API++Consumers+
*%Data%is%from%2014%%
Client+Applica7ons+ #+of+APIs+
Consumed+
kp.org% 23%
kp%Mobile%Flagship%(Android/iOS)% 27%
kp%PrevenJve%Care%App% 8%
NCAL%My%Doctor%Online%% 2%
Video%Visits%(Provider)% 1%
IVR%Pharmacy%system% 1%
eServices% 4%
Medicare,%Claims%connect% 4%
#%of%KP%IT%OrganizaJons%using%Consumer%APIs/Services/Plaporms%6%

15. 15%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
KP+API++I+Metrics++
APIs/Components%developed%for%Consumer%Digital%Capabilites% 29%
NonjPROD/PROD%%Endpoints%Under%Management% 468%+%
Yearly%TransacJons%processed%by%all%API%and%Web%Services%% 1.4%Billion%
Yearly%TransacJons%driven%by%Mobile%App% 234%million%
Number%of%ApplicaJons%Consuming%APIs/Components% 8%
Websphere%Prod%JVMs% 48%
Websphere%%NonjProd%JVMs% 84%
*%Data%is%from%2014%%

16. 16%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
DIGITAL Channels
KP+Digital+Offering+–+High+level+system+architecture+
APIs/DIGITAL%SHARED%COMPONENTS%
Membership%
Systems%
%
%
Electronic%Medical%
Record%Systems%%
%
%
Health%Plan%
Systems%
Benefits%Systems%%
Pharmacy%
Systems%%
Kp.org%
Flagship%%
IOS%App%
Flagship%
Android%
App%
KP%
PrevenJve%
App%
Provider/%
Workforce%
App%
Non%public%/%Internal%Kaiser%applicaJons%

17. 17%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kp.org%
Current+Architecture+–+High+Level+
HTML%over%HTTPS%
Portal+Server+
Portal+
Applica7ons+
Mobile%ApplicaJons%iOS%Android%M.kp.org%
HTML%over%HTTPS%HTML%over%HTTPS%
API%Security%Gateway%
API+Server+
JSON%over%HTTPS%
JSON%over%HTTPS%
Web%APIs%
SOAP%over%HTTPS%
KP+Consumer+Integra7on+Servers+
Consumer+Web+Services+
%%%%%%%%%%%%%Reverse%Proxy%Web%Server%%%%%%%%%%%%%%%%%%%%%%%WSSO%Plug%In%
IIS+Servers+
EPIC%MyChart%Web%
ApplicaJon%
SOA+Services+Gateway+(+Data+Power)+
Other+KP+Systems+and+Services+
Membership%TPMG%%
KP+Consumer+PlaZorm+
WSSO/Access+Server+
+
User+Directory+
+
Consumer+Database+
Content+Management+ Search+Engine+
FSSO/Federa7on+Server+
CPM% PARRS% KPHC%&%EPIC%Web%Services%
Pharmacy% Claims%KANA% FDB/FDS% MSSA%Web%Services%
Internet%(Cloud)%
DMZ%
PresentaJon%Tier%%in%KP%Intranet%
Business%and%Data%Tier%%in%KP%Intranet%
SOAP%over%HTTPS%
SOAP%over%HTTPS%
CA+Available%in%mulJple%data%centers%to%support%ConJnuous%Availability%of%KP.ORG%
CA+ CA+
CA+ CA+
CA+
CA+
CA+CA+

18. 18%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kaiser+Permanente’s+API+journey+–+Challenges+ahead+
! Release%and%deployment%to%mulJple%release%streams%
%Leveraging%IBM%Urban%Code%in%2015%for%API%and%Web%Service%deployments%
! MulJple%versions%of%APIs%%
%Leveraging%IBM%Sot%Layer%to%add%container%capacity%
! Data%availability%for%development%and%regression%
%LISA%Service%VirtualizaJon%for%more%efficient%development%
! %Consuming%ApplicaJon%Management%and%CommunicaJon%
%Exploring%IBM%API%Management%in%conjuncJon%with%our%exisJng%API%Gateway%
%soluJon%

19. 19%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Kaiser+Permanente+–+Transforming+the+future+++
Click%image%to%Launch%Video%
(https://www.youtube.com/watch?v=gxz9ZVvduGc).
%

20. 20%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Q&A+

21. 21%
©%2015%Kaiser%FoundaJon%Health%Plan,%Inc.%% ConfidenJal,%not%for%distribuJon%or%duplicaJon%
Digital Technologies
& Operations
Contact+Info+
Jeff% Raghu%