,#,医疗云上健康新生态课件,1,目,录,Outline,健康医疗业务服务的趋势和多样化,Healthcare Business Services:Challenges,&,Trend,医院业务服务的微服务化及,API,治理,Hospital Business Services:Microservices,&API,Governance,区块链及网络功能微服务,Blockchain,and,NFV,as,Microservices,混合云及数据中心策略,Hybrid,Cloud,and,Data,Center,Strategy,目录健康医疗业务服务的趋势和多样化,2,大健康向左走，降低成本提升,质量,Assisted,Living,Skilled Nursing,Facility,Residential,Care,Acute,Care,Specialty Clinic Community,Hospital,Inpatient,/,Acute,high,l,ow,high,Level,of,Patient,Autonomy,low,Cost,of,Care,low,Telemedicine,Go,left to,improve,quality of,life,reduce,cost,high,Home,Care,Population,Health with,Senior Care for Aging,in Wearables,Place,Remote,Patient,Monitoring,Q,u,ality of,Life,大健康向左走，降低成本提升质量Residential Car,3,医疗服务的新趋势,Medical Service,Trends,in,Healthcare,医疗服务的新趋势,4,技术催生多样化的医疗业务形态,Diversified Healthcare,Business Models,Driven by,IT,互联网医院,Internet,Hospital,远程医疗,Telemedicine,医联体,Hospital,Union,健康管理,Health,Management,5,医养结合,Aging Medical,Care,医药分开,Separation of Clinic From,Pharmacy,技术催生多样化的医疗业务形态互联网医院远程医疗医联体健康管理,5,微,服务,Microservices,医院业务应用的微服务化,Hospital,Business,Decomposed,as,Microservices,R,E,ST,API,挂号,Registration,数据库适配器,ADAPTER,Reg,i,st,r,at,i,o,n,Database,R,E,ST,API,支付,Payment,数据库适配器,ADAPTER,Payment Data,b,a,s,e,R,E,ST,API,药房,Pharma,数据库适配器,ADAPTER,Payment Data,b,a,s,e,虚拟机实例,EC2,Instance,1,DOCKER,CONTAINER,容器,挂号,Registration,R,E,ST,API,DOCKER,CONTAINER,容器,挂号,Registration,R,E,ST,API,虚拟机实例,EC2,Instance,2,DOCKER,CONTAINER,容器,挂号,Registration,R,E,ST,API,DOCKER,CONTAINER,容器,挂号,Registration,R,E,ST,API,负载均衡器,Load,Balancer,单个微服务易于开发、理解和维护,Faster,to,develop,much easier,to,understand and,maintain,每个服务可自由选择开发技术单独,开,发,Free,to,choose development,technologies,每个服务可独立快速部署,Deployed independently and,rapidly,每个服务可独立扩展,Scaled independently,&,easily,优势,Advantages,分布式系统中进程间通讯更复杂,Complex,IPC,mechanism in distributed,systems,分区数据库的事务一致性难保证,Business transactions issue due,to,partitioned,database,服务间依赖关系影响测试和变更,Test,&,change impacted due,to,dependencies among,services,高可用部署困难,Hard,to,deploy for high,availability,不足,Drawbacks,6,微服务 Microservices医院业务应用的微服务化RE,6,典型的针,对患者的移动,APP,同时使用多个微服务,A,Typical Patient,Mobile APP,Consumes,Multiple,Microservices,in,One,Page,挂号,Registration,R,E,ST,API,支付,Payment,R,E,ST,API,检查,Lab,Test,R,E,ST,API,导医,G,u,i,d,a,nc,e,R,E,ST,API,候诊,Awa,i,t,i,n,g,R,E,ST,API,通知,No,t,i,f,i,c,at,i,o,n,R,E,ST,API,客户端直接访问微服务,Direct Access,to,Microservices,客户端实现复杂,Complex client side,coding,不能支持某些,Web,不友好的协议,Unable,to,handle web-unfriendly,protocols,难以应对可能的服务重构,Challenge,to,adapt,to,restructuring of,microservices,7,典型的针对患者的移动 APP 同时使用多个微服务挂号REST,7,ONC,关注利用,APIs,提供更多的健康服务,ONC Focus,on,Improving,Individuals,Shopping,for,Their,Own Care Through,APIs,ONCs interoperability efforts focus,on,improving individuals ability to control their health information so they,can,shop for,and,coordinate their,own care.,While,many,patients,can access,their,medical,information through multiple,provider,portals,the,current,ecosystem is frustrating,and,cumbersome.,National,Coordinator for,Health,Information,Technology,数据安全,Data,Security,8,成本,Cost,新生态,Echo,System,ONC关注利用APIs提供更多的健康服务ONCs inte,8,API,s,的技术演进和互操作性发展,Technology,Evolution,of APIs and,Interoperability,Development,APIs,Access,EDI,机器解读,，,格式简,单，数据共享内容,有限,重量级，基于标准的互操作,简单易用的,REST,API,SOA,for,Healthcare,支持基于临床数据的创新,App,应用,通过数据分析提供数据服务,为第三方提供标准化的数据 接口,架构的变革,实施复杂,性能和效率,在私有网络中进行的,成本高,9,用简单的方法解决复杂,的,问题,AP,I,s,将数据提供给数据 使用者以及创新合作 伙伴，带来的价值远 远超出想象,APIs的技术演进和互操作性发展Technology Evo,9,微服务,APIs,的部署,The,deployment,of,Microservices,and,APIs,公有云,Public,健康云,Public,2,私有云,Private,医院数据中心,Hospital data,center,外联平台,Outreach,Platform,10,微服务APIs的部署公有云健康云私有云医院数据中心外联平台1,基,于,FHIR,实,现,APIs,对数据标准的访问,APIs using FHIR allow,applications to,access,data,in a,standardized,way,R,ES,T,消息,Me,ssa,g,e,文档,Do,cu,me,n,t,服务,Service,CDA,FHIR,FHIR,资源,RESOURCES,FHIR,支持不同的互操作范式,The,FHIR Standard,Supports Multiple,Interoperability,Paradigms,HL7 C,D,A XDS,11,基于 FHIR 实现APIs对数据标准的访问REST消息文档,通,过,API,网关管,理,API,的使用,Manage API,Consumption Through,API,Gateway,简化通讯,simplify,client-service,communication,简化客户端代码,simplify,client-side,coding,挑战,Bad,又一个高可用,组,件,new component,developed,成为更新瓶颈,bottleneck,when,add,service,points,API,网关,GATEWAY,R,E,ST,API,请求转发 与合成,Request,routing,composition,协议转换,Protocol,translation,FHIR,CDA/XDS/HL7,认证和授权,Authentication,&,access control,监控,Health check,&,monitoring,负载均衡,Load,balancing,缓存,Caching,Cache,policies,请求分片 和管理,Request shaping,&,management,静态响应处理,Static,response handling,高性能,/,高可,用,/,可扩展,High,performance,availability,scalability,支持各种异步和,同步通信机制,Support various inter-process,communication mechanism,支持服务注册与,发现,Support service registration,and,discovery,故障处理,Fault,handling,优势,G,oo,d,12,通过 API 网关管理 API 的使用简化通讯 simpli,交换机,/,路由器,/,防火,墙,Switch/Router/Firewall,医院外网,Hospital,Internal,N,e,twork,医院,SaaS,服务,Hospital SaaS,Services,医院业务微服务及,APIs,网,络拓扑,A,Hospital Microservice Network,Diagram,医院内网,Hospital Internal,Network,DMZ,区域,外部客户端,Clients,API,网关,GATEWAY,R,E,ST,API,支付,Payment,R,E,ST,API,HIS,挂号,REST,Registration,API,智能诊断,Image,AI,R,E,ST,API,门诊,Ou,t,p,a