Supporting Healthcare Systems InteroperabilityInterSystems / Ensemble

Duncan Allenwww.intersystems.com

Topics

• Healthcare Integration and InteroperabilityHealthcare Integration and Interoperability– Market PerspectiveMarket Perspective

• Ensemble for Healthcare IntegrationEnsemble for Healthcare Integration

• Ensemble todayEnsemble today

Market Perspective

InterSystems Market Perspective

Premier platform for building, running and connecting healthcare applications worldwidePremier platform for building, running and connecting healthcare applications worldwide

Healthcare PlatformHealthcare Platform

Packaged Packaged ApplicationsApplications

Custom Custom ApplicationsApplications

Hospitals, Clinics, Hospitals, Clinics, Laboratories, GPs …Laboratories, GPs …

Many (useful) Standards

• Message formats: HL7v2, HL7v2 XML, HL7v3, CDA, Message formats: HL7v2, HL7v2 XML, HL7v3, CDA, CCR, CCD, CRS, X12, X12 CICA, NCPDP, DICOMCCR, CCD, CRS, X12, X12 CICA, NCPDP, DICOM

• Medical vocabularies: LOINC, SNOMED CT, ICD 9/10, Medical vocabularies: LOINC, SNOMED CT, ICD 9/10, CPT, RxNorm, READCPT, RxNorm, READ

• Exchange architectures: CfH (US), IHE, CfH (UK)Exchange architectures: CfH (US), IHE, CfH (UK)

• Single sign-on: CCOWSingle sign-on: CCOW

• Governance: HIPAAGovernance: HIPAA

Many (useful) Standards

• Message formats: HL7v2, HL7v2 XML, HL7v3, CDA, Message formats: HL7v2, HL7v2 XML, HL7v3, CDA, CCR, CCD, CRS, X12, X12 CICA, NCPDP, DICOMCCR, CCD, CRS, X12, X12 CICA, NCPDP, DICOM

• Medical vocabularies: LOINC, SNOMED CT, ICD 9/10, Medical vocabularies: LOINC, SNOMED CT, ICD 9/10, CPT, RxNorm, READCPT, RxNorm, READ

• Exchange architectures: CfH (US), IHE, CfH (UK)Exchange architectures: CfH (US), IHE, CfH (UK)

• Single sign-on: CCOWSingle sign-on: CCOW

• Governance: HIPAAGovernance: HIPAA

Commitment to Healthcare Interoperability

HL7 BenefactorHL7 Benefactor

IHE US and European Participant IHE US and European Participant

InterSystems Technology in English NHS

Approx 175,000Approx 175,000licensed userslicensed usersin English NHSin English NHS

Convergence

Driving a need for Driving a need for rich platforms that rich platforms that seamlessly combine seamlessly combine application application development and development and integration integration

Analyti

cs

Analyti

cs

Orches

tratio

n

Orches

tratio

nDevelopment

Development

Integration

Integration

See Gartner’s research on Application Platform Servers (APS)

Universal Business Integration

Technology Requirements• AdaptersAdapters• Abstraction and ProjectionAbstraction and Projection• Messaging and TransformationMessaging and Transformation• Business process modeling/executionBusiness process modeling/execution• Real-time message warehouseReal-time message warehouse• Metadata repositoryMetadata repository• Cross application indexingCross application indexing• Event Management and alertingEvent Management and alerting• Rules and Workflow EngineRules and Workflow Engine• Analytic tools and DashboardsAnalytic tools and Dashboards• Web / portal developmentWeb / portal development• End-to-End ManagementEnd-to-End Management

Analyti

cs

Analyti

cs

Orches

tratio

n

Orches

tratio

nDevelopment

Development

Integration

Integration

Ensemble for Healthcare Integration

Ensemble Design Goals

Composite Composite ApplicationsApplications

DataDataCoordinationCoordination

Business ProcessBusiness Process/ Work Flow/ Work Flow

Business ActivityBusiness ActivityMonitoringMonitoring

Universal Business Integration PlatformUniversal Business Integration Platform

TechnologyTechnologyApplicationApplicationDataData

Ensemble Architecture

Development

Development

Messaging

Messaging

BPMBPM

AnalyticsAnalytics

Abstraction + Execution + RepositoryAbstraction + Execution + Repository

TechnologyTechnologyApplicationApplication DataData

OneOne• AbstractionAbstraction

LayerLayer• RepositoryRepository• ExecutionExecution

EngineEngine• ManagementManagement

ConsoleConsole

Abstraction

AbstractionAbstraction

Connect to diverse data,Connect to diverse data,applications, technologiesapplications, technologies

Expose as Web Services,Expose as Web Services,classes, tables, …classes, tables, …

Abstract into consistentAbstract into consistentdata + functionality modeldata + functionality model

Shorten learning curve, speedShorten learning curve, speedintegration and developmentintegration and development

Native Projection

Use any development tool / technologyUse any development tool / technology

PAS / PAS / LABLAB

Oracle /Oracle /SQL/ServerSQL/Server

HL7 HL7 V2.x & V3V2.x & V3

Pick / Pick / CobolCobol

JavaJava .Net.Net EJBEJBWSWS SQLSQL XMLXML

Rapid Development & Customisation

““Ensemble has a strong design Ensemble has a strong design environment and doesn’t leave the environment and doesn’t leave the user to grapple with disparate user to grapple with disparate utilities…utilities…

This means, that we don’t have to This means, that we don’t have to write as much code as before, which write as much code as before, which gives us a massive head-start ....” gives us a massive head-start ....” Mike Eagles, Head of Software DevelopmentMike Eagles, Head of Software DevelopmentBarts and the London NHS Trust Barts and the London NHS Trust

Increased Development Productivity

Universal Execution Engine

Single run-time environmentSingle run-time environmentfor:for:

Superior performance and completeSuperior performance and completeend-to-end managementend-to-end management

ExecutionExecution • MessagingMessaging• PortalsPortals• Business Business

processesprocesses

• WorkflowWorkflow• AnalyticsAnalytics• ApplicationApplication

logic …logic …

Complete End-to-End Management

Graphical Data Transformations of HL7

In-built HL7 Capabilities

Universal Repository

Maximum availability,Maximum availability,scalability and RADscalability and RAD

RepositoryRepositoryMessagesMessages

MetadataMetadata

Index / CacheIndex / Cache

Open access via SQLOpen access via SQL

Native object storageNative object storage

Rich

Obj

ects

Rich

Obj

ects

EASE OF USEMonitoring the Integrated Environment

• Realtime AlertsRealtime Alerts• SMS, Email, PagerSMS, Email, Pager

• Web Based MonitorWeb Based Monitor• User definedUser defined

Ensemble Today

Worldwide Ensemble Healthcare Clients

• Partners Healthcare

• New York City Health & Hospital Corporation

• Boston Medical Center

• Providence Healthcare

• George Washington University Medical Assoc.

• Hunterdon Healthcare

• Metropolitan Healthcare

• US Veterans Affairs

• Pathology Medical Systems

• CH Roubaix (France)

• Department of Defense (Canada)

• Bolton NHS Trust (UK)

• Royal Marsden (UK)

• Stanford Hospital & Clinics

• Evanston Healthcare

• NHS Lothian (UK)

• Koine Hospital (Italy)

• AO Vimercate (Italy)

• Dr. Negrin Hospital (Spain)

• UK Cancer Registries

• European Food Safety Admin. (Belgium)

• Iris Nord (Belgium)

• Motoman / Kaiser (USA)

• SUH (Finland)

• Peterboro & Stamford NHS Trust (UK)

• Institute of Cancer Research (UK)

• Nictiz Dutch National EHR

• Serum Institute (Denmark)

• Athena Diagnostics (USA)

• Barts NHS Trust (UK)

• Hospital Ambroise Pare (Belgium)

• Moorfields Hospital (UK)

• IKEM (Austria)

• Okinawa Hospital (Japan)

• TUCH (Finland)

• PSSHP (Finland)

• Sultan Qaboos (Saudi)

• Cedars Sinai (USA)

• Plymouth NHS S/Services (UK)

• Mid Essex Hospital NHS trust (UK)

Ensemble rated Number One by KLAS

KLAS helps healthcare providers makeinformed technology decisions by offeringaccurate, honest, impartial vendor performance information.

KLAS independently monitors vendor performance through the active participation of thousands of healthcare organizations. KLAS uses a stringent methodology to ensure all data and ratings are accurate, honest and impartial.

#1 KLAS RatingOverall Vendor Rankings

93.6Ensemble90.5Orion

83.6Quovadx81.9Siemens

76.6Eclipsys76.2Sun eGate

67.8Sybase

““ InterSystems outscored all other Interface Engines softwareInterSystems outscored all other Interface Engines softwareproducts in overall vendor rating, in all four of the indicatorproducts in overall vendor rating, in all four of the indicatorcategories measured, and in percent positive commentary.categories measured, and in percent positive commentary.””

““ InterSystems outscored all other Interface Engines softwareInterSystems outscored all other Interface Engines softwareproducts in overall vendor rating, in all four of the indicatorproducts in overall vendor rating, in all four of the indicatorcategories measured, and in percent positive commentary.categories measured, and in percent positive commentary.””

Ensemble in the NHS

TrustTrust VersionVersion Messages/dayMessages/day StatusStatus

Moorfields Eye HospitalMoorfields Eye Hospital 4.04.0 7500075000 LiveLive

PeterboroughPeterborough 4.04.0 2500025000 LiveLive

Plymouth Plymouth 3.13.1 2500025000 LiveLive

Barts and London HospitalBarts and London Hospital 4.04.0 90009000 LiveLive

Lothian Region, EdinburghLothian Region, Edinburgh 4.04.0 25002500 LiveLive

Mid-EssexMid-Essex 4.04.0 No info.No info. LiveLive

Bolton Bolton 4.04.0 No info.No info. LiveLive

Royal MarsdenRoyal Marsden 4.04.0 n/an/a Planned go live November 07Planned go live November 07

East & North HertsEast & North Herts 4.04.0 n/an/a Planned go-live November 07Planned go-live November 07

Sheffield Children’s Sheffield Children’s 4.04.0 n/an/a Go-live TBDGo-live TBD

• Comprehensive and Consistent ArchitectureComprehensive and Consistent Architecture – Reduced complexity, maximum reusabilityReduced complexity, maximum reusability ,,

widest range of projects, one learning curvewidest range of projects, one learning curve

• Fast Integration & Composite App. DevelopmentFast Integration & Composite App. Development – Rapid ROIRapid ROI

• Easier Management & Scalable PerformanceEasier Management & Scalable Performance

– Low cost of ownershipLow cost of ownership

The Benefits of Ensemble

Thank you

Duncan Allenwww.intersystems.com