ClientServer technology

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Client/Server technology

• Worldlab 99 - IT Symposium

Focus on Information Technology for Laboratory
Medicine
Luca Birolini - OmniLab
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Healthcare changes...

• Competitive Pricing
• Ubiquitous lifetime Records
• Lack of Computing Interoperability

Bologna, 4th June 1999
Luca Birolini - OmniLab
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IT Objectves

• Promoting interoperability among healthcare
  devices, instruments and information systems.
• Improving the quality of care and reducing costs.
• Supporting the reliable and secure sharing of
  medical information among healthcare
  organizations.

Bologna, 4th June 1999
Luca Birolini - OmniLab
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IT de facto

• There will not be consensus on
• h/w platforms
• operating systems
• programming languages
• graphical user interface
• data standards

Bologna, 4th June 1999
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IT facts of life

• .. There MUST be consensus on a Common Interface
  Architecture.

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State of healthcare informatics

• Begin in the late 1960s with HIS (Mainframe)
• Added administrative functions (other than
  billing)
• 1970s born deparmental information systems
  (lower cost minicomputer)
• Mainframe-based HIS added departmental modules
• 1980s the rise of relational database management
  systems and client server computing (healthcare
  slow to respond).

Bologna, 4th June 1999
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State of healthcare informatics

• Healthcare institutuions typically spend a far
  lower percentage of their operating budget on
  informatic.
• Before healthcare delivery is not a business
  and cannot be managed as such.

Most information systems within an Hospital or
healthcare organization cannot interoperate
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Billing
IDS Today
Radiology
Cardiology
Laboratory
GP
Order Entry
Pharmacy
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IDS Trend
Healthcare Record
Access Control
Order Entry
Person ID
Workflow Mngmt
Scheduling
Tracking
Inventory
Result Rporting
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Healthcare needs

• Affordable, interoperable information
  systems

Client-Server computing together with distributed
object technology would seem ideal for this
purpose.
Bologna, 4th June 1999
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Client/Server

• Originally the term was applied to two-tired
  applications (user interface on one computer,
  database on another and divided the process).
• Now it is applied to distribute apps (multiple
  db, multiple processing and transactions center
  and a client).

Bologna, 4th June 1999
Luca Birolini - OmniLab
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Client/Server
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C/S Advantages

• Interoperability
• Scalability
• Adaptability
• Affordability

• Data Integrity
• Accessibility
• Performance
• Security

Bologna, 4th June 1999
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Client/Server Computing

• C/S computing has created a deep change in LIS
  deployment as in other application area.
• Its replacing monolithic mainframe applications
  with applications split across client and server.
• The client, usually a PC, provides the graphical
  interface, while the server provides access to
  shared resources (i.e. Database).

Bologna, 4th June 1999
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C/S computing a new revolution

• Distributed objects Internet a new c/s server
  revolution within the c/s revolution.
• Objects break up the client and server sides of
  an application into smart components that can
  cooperate across network.
• The combination of distributed objects and the
  Web (Object Web) is reinventing the c/s computing.

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• In no way does Internet computing replace
  client/server computing. Thats because it
  already is client/server computing.
• - Herb Edelstein (Euclid Associates)

Bologna, 4th June 1999
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The Object Web

• The existing c/s infrastructure is suited for
  single-server departmental LANs
• 3-tier c/s solutions using distributed objects
  and the Web is the way to dealing with the new
  infrastructure requirements.
• Distributed Web objects JavaBeans, CORBA Beans,
  Enterprise JavaBeans and COM components.

Bologna, 4th June 1999
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IT evolution

• Before the big choice was how to pick the
  right computer vendor.
• Now life is not as simple. C/S is the ultimate
  open platform we have the freedom to mix
  component at almost any level. It is possible to
  put together an incredible number of networked
  client and server combinations.

Bologna, 4th June 1999
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Client/Server integration

• Everithing in the client/server world is sold a
  la carte

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C/S The choice

• Wich server platform ?
• Wich client platform ?
• Wich network protocols ?
• Wich distributed computing infrastructure ?
• Wich database server ?
• Wich middleware ?
• Wich component model ?
• Wich system management base ?

Bologna, 4th June 1999
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C/S apps ERP (1)

• Enterprise Resource Planning (ERP). Applications
  from companies like SAP, Oracle, Baan, J.D.
  Edwards and others.
• ERP Packaged c/s solutions for back-office
  enterprise functions (accounting, payroll, human
  resources, financials, manufacturing).
• ERP Are moving towards front-office and vertical
  applications (sales force automation, online
  catalogs, retail, supply-chain management,..).

Bologna, 4th June 1999
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C/S apps ERP (2)

• A good ERP system lets you to manage from a
  single user interface many of the key functions
  in an enterprise
• The newer ERP products are built on top of an
  open distributed object infrastructure
  (CORBA/JavaBeans or COM/ActiveX) and they are
  integrated with messging system, data warehouse,
  workflow engines and Web.

Bologna, 4th June 1999
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C/S apps ERP (3)

• ERP systems are not really turn-key.
• ERP requires re-enginering of companys process
  and culture.
• ERP must be integrated with the rest of
  applications.
• ERP apps dont give you a competitive advantage
  (source Forrester Research).

Bologna, 4th June 1999
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Internet commerce
High
Supply chain and vertical specific apps
Customer Management
Competitive advantage apps
Inpact on competitive advantage
Manufacturing
Bread and butter applications
Human Resources (HR)
Financials
Low
Source Forrester Research
Low
High
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Database Servers
Application
Server
SQL Calls
Application
DBMS Server
Application
Clients
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Transaction Servers
Application
Server
Transactions
DBMS Server
Application
TP Monitor
Clients
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Groupware Servers
Application
Server
Groupware messages
Groupware Server
Application
Clients
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Object Application Servers
Application
Server
Object
ORB
Remote Method Invocation
Object
ORB
ORB
Application
ORB
Objects
Clients
Object
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Web application servers
Server
HTML Forms
Web Browser
CGI
Java
HTTP over TCP/IP
Application
Internet
Web Browser
HTML documents
HTML Forms
Web Browser
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Groupware, Transaction, Web Servers
Database, File servers
Distributed objects
Fat Server
Fat Client
GUI
Data
Application
Client
Server
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2-Tier Client/Server
Server
GUI Applications
SQL, File I/O, HTTP
Tier 1
Tier 2
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3-Tier Client/Server
Application Services
Browser/Beans/ActiveX
RPC, ORB, MOM, HTTP
SQL Data Access
Tier 1
Tier 2
Tier 3
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2-Tier versus 3-Tier c/s
Source Orfali/Harkey/Edwards
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2-Tier versus 3-Tier c/s
Source Orfali/Harkey/Edwards
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Source Gartner Group
2-Tier Architecture
Cost to Develop and Mantain
3-Tier Architecture
Application Complexity and Lenght of Application
Life
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Objects in healthcare

• OMG CORBAMed
• Clinical Context Object Working Group (CCOW)
• HL7
• HL7 XML/SGML
• Andover Working Group (AWG)
• ActiveX for Healthcare (AHC)
• ASTM
• X12 Commitee
• CEN TC/251

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The Microsoft Way
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Component based applications

• The primary advantage of using standard-based
  components in healthcare information system
  architecture is that any standard-based
  components can be replaced at any time with a
  later generationn improved, standard-base
  component while the rest of the perocesses and
  technologies involved can remain unchanged.

Bologna, 4th June 1999
Luca Birolini - OmniLab
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Component based applications

• Each component automates a relatively small
  business functions. Clients combine several
  middle-tier components within a single business
  transaction. A component call other components to
  help it to implement a request.

Bologna, 4th June 1999
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Component based applications

• Big application developments in small steps.
• Application can reuse components.
• Client can acces data and functions easily and
  safety.
• Custom apps can incorporate third-party
  components.

Bologna, 4th June 1999
Luca Birolini - OmniLab
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CORBA

• Common Object Request Broker Architecture
• is an emerging open distributed computing
  infrastructure being standardized by the Object
  Management Group (OMG).
• CORBA automates many common network programming
  tasks.

Bologna, 4th June 1999
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OMG Reference Model Architecture
Application Interfaces
Domain Interfaces
Common Facilities
Object Request Broker (ORB)
Object Services
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Interface Repository
IDLCompiler
Implementation Repository
In args
Operation ()
CLIENT
OBJECT (Servant)
OBJ REF
Out args return value
ORB Interface
DSI
IDL skeleton
DII
IDL Stubs
Object Adapter
ORB CORE
GIP/IIOP
Standard Interface
Standard Language Mappping
ORB-Specific Interface
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LIS/Distributed Objects - Examples

• Event handler
• QPL (Quality Programming Language)

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Examples - Events

• Paradigm Event/Action
• Event Scope (domain, configurability)
• Process control/Events Rebuild the entity path
  (i.e. Samples history both positional and
  analytical context).
• Process control the base to support LIS in the
  quality accreditation.

Bologna, 4th June 1999
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Examples - Event Setup (instance)

• Identifier.
• Class/Subclass (i.e. analyzer mngmt, upload).
• Entities (i.e. Hitachi 917, SampleNr, TestCode).
• Source (i.e. POC Server OLE).
• Domain (User/Workstation).
• Action (callback (i.e. traffic-light alarm,
  e-mail, event, QPL).

Bologna, 4th June 1999
Luca Birolini - OmniLab
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Example/Events

• Event Server (DCOM, next CORBA)
• Receives event messages.
• Parse messages and set actions and callbacks
  based on event parametrization (business rules).
• Build the entity history.
• Writing on different Databases (load balancing).

Bologna, 4th June 1999
Luca Birolini - OmniLab
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Business Rules (enhanced by QPL)
Server DCOM iEventMgmt iResultMgmt iQPLMgmt
Event Notification (invoking method)
CallBack (traffic-light)
Server OLE RS-232
Client
Change status
Guid Name
Print Sample Manipulation
Send e-mail
Bologna, 4th June 1999
Luca Birolini - OmniLab
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QPL

• Based on components (easy extensible)
• QPL COM
• QPL DCOM (Next CORBA)
• The object is invoked by procedure, events.
• Procedures (i.e. Validation, After/Before)
• Events
• Time Call QPL Execution
• i.e. checks results, change status, set event log
  for discordance to rules)

Bologna, 4th June 1999
Luca Birolini - OmniLab
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