1

Achieving aSingle Patient View

Eric WilliamsSoftware PracticeSun Microsystems UK Ltd.

Sun in Healthcare• Committed to the Heathcare Sector

> Provider of Servers, Storage, Services, Software & Solutions> Participation in IHE, Open eHealth Foundation, HL7 et al

• Number of Healthcare Customers> Globally – c 3500> Europe – c 750> UK – c 250

• Serving Healthcare> NpfIT> NHS Trusts / SHAs> Scottish Health Boards> US Nationwide Health Information Network (NHIN)

3

The Need for Master Data Management

The Root of the Problem

PatientManagement

ProcedureProcessing

AdmissionScheduling

DataRepositories

Check Consultants

Check Results

Check Patient Status

Check Schedules

Check Patient Status

Check Discharge

Check GP Comms

Monolithic,IndependentApplications

Multiple EntityViewsDispersed, unintegrated data

Check Bed Inventory

Check Patient Status

RadiologyInventoryPAS CalendarsOncologyPathology

A Smarter Approach

Other CompositeApplications

PatientManagement

ProcedureProcessing

AdmissionScheduling

ReusableServices

CompositeApplications

CheckPatient Status

CheckResults

CheckInventory

CheckConsultants

CreateDischarge

Single Entity View

RadiologyInventoryPAS CalendarsOncologyPathologyDataRepositories

Single Patient View

6

MDM in Healthcare: EMPI

Enterprise Patient ViewsElectronic Health RecordsPersonal Health Records

Single Patient View

Portal and Presentation Layer

Framework for Security and Identity Management

Patient Transaction Process

A Single Enterprise Master Patient Record

Connectivity, Integration

& Middleware Infrastructure

Clinical Records Department Practice

GPs, Practice Nurses, Health

Visitors

Hospital Clinicians,Regional

Specialists

District Nurses, Hospice Staff,

Community Practitioners

Aspects of the solution• Ease of integration across legacy and packaged applications

with capability to handle heterogeneous sources of data• Data acquisition, quality management, indexing, stewardship,

and data dissemination• Robust run-time environment; unified development and

monitoring environment

• Rapid development of new functionality and extension to new locales

• Ability to extend framework to cover future applications and protocols

• Federated identity to extend single view to partners

• Component-based; service-enabled architecture• Layered levels of access for privacy and security• Adoption through community and partner ecosystem

Comprehensive

Extensible

Accessible

8

The Sun MDM SOLUTION

9

Sun's EMPI Solution

Master Data Management

Portal

ORCHESTRATION | MEDIATION | ADAPTERS | ROUTING | TRANSFORMATION

APPLICATIONSERVER

DIRECTORYSERVER

SINGLE SIGN-ON | |MESSAGE

SERVER |Infrastructure

Enterprise Service Bus

CUSTOMER | PATIENT | SUBSCRIBER | CITIZEN | IDENTIFIERMaster Index

Probabilistic Matching

EXTRACT | TRANSFORM | LOADData Integration

HIGH PERFORMANCE/PRE-MATCH & LOAD

Initial LoadANALYSIS/STANDARDIZATION/

CLEANSING

Data Quality

Open Source

MURALOPEN ESBOPEN SSOOPEN DSNETBEANSGLASSFISHOPEN SOLARIS

AGGREGATION | PERSONALIZATION

How to develop theMaster Patient Index

Typical Workflow

. . .. . .PAS RadiS2 Telepath

STAGING

MasterIndex

Database

Data Integrator(Source Extract)

Data Quality(Cleanse, Profile,

Standardize, Normalize)

Master Index(Bulk Match,

Generate Master Index)Data Integrator

(Bulk Load)

Master Index ServerMaster Index Web Application

(Resolve Potential Duplicates Assumed Matches Search,Manage Enterprise Profile)

. . .

The ProblemFirst Name

Last Name

Use ID Address Information

JonesEd EJON 88 Queens StreetID #1

Edward Jones EDJON 88 Queens StID #2

Max 4.0

Low Threshold is 3.2

High Threshold is 3.5

Min 0.0

Weight (0 to 1) = + 1 + 0.7 + 1 = 3.6 Total0.9

Automatic Match

Potential Match

New Customer

AUTOMATIC MATCH!

The Solution: Enhanced MatchingFirst Name

Last Name

Use ID Address Information

JonesEd EJON 88 Queens StreetID #1

Edward Jones EDJON 88 Queens StID #2

Max 4.0

Low Threshold is 3.2

High Threshold is 3.5

Min 0.0

Weight (0 to 1) = + 1 + 0.7 + 1 = 3.6 Total0.9

Automatic Match

Potential Match

New Patient

AUTOMATIC MATCH!

Master Index Web Application

. . .. . .PAS RadiS2 Telepath

STAGING

MasterIndex

Database

Data Integrator(Source Extract)

Data Quality(Cleanse, Profile,

Standardize, Normalize)

Master Index(Bulk Match,

Generate Master Index)Data Integrator

(Bulk Load)

Master Index ServerMaster Index Web Application

(Resolve Potential Duplicates Assumed Matches Search,Manage Enterprise Profile)

15

Typical UI for Health Records Staff

Master Index Web Application

Compare Duplicates

Select Duplicates

Preview Records Ready to Merge

20

A Single IntegratedSOLUTION

Synchronisation on the ESB Backplane

Index exposes master data events

Workflows orchestrate update channels

Update channels synchronize changes through the ESB

Wide range of adapters and services leveraged from ESB

INDEX

SYNCHRONISATION WORKFLOWS

ESB

APPLICATION LANDSCAPE

Adap

ter

Mess

agin

g

Web

Ser

vices

Data

base

22

CUSTOMERSUCCESSES

Regional and National eHealth: Sun is the World Leader -

New South Wales

Australia

Largest health department established of a Unique

Patient Identifier for every individual in the State

National Health Service

United Kingdom

Manage over 50 million members, 250 hospitals &

600,000 medical practitioners; Encompasses 10,000 systems

across 40,000 sites.

General Medical ServicesIreland

Deployed Patient Matching for more than 40 million transactions from 5,000 primary care contractors

NY Presbyterian Hospital

Real-Time Single Patient View. Linked to 70+ systems, 9 million+

person records, 20m history records &

Passive feeds from 28 hospitals

Sussex HIS

England

Integration of 2 PAS systems due to restructuring of the HIS Region. 2 Trusts merging.

900,000 patients

Largest Integration & Single Patient View Project In The

World!

Solution: Highly scalable Enterprise Master Patient Index (EMPI) that fits into existing SOA infrastructure. Resolves all inbound and outbound transactions with a unique patient identifier. Highly scalable.

Use Case: McKesson’s clearing house, PerSe, is the largest processor of prescriptions in the US. With data coming from thousands of sources, the client needed uniquely identify patients across multiple sources. Sun’s EMPI greatly enhanced PerSe’s ability to report and analyze data.

Volume Statistics:

10-14 million NCPDP scripts / day

180 million unique people in database

McKesson's Clearing House

SUN MDM SUITEHIGHLIGHTS

26

Solution Benefits• Integrated, consistent view of master patient data leveraging current

directories, data, and systems• Dramatic improvements in visibility of clinical data across the Local

Health Boards• Real-time access to Master Patient data• Accessibility to the right information, clinician, place, time and

equipment• Improved productivity, heightened compliance and reduced costs

Leading to dramatic improvements in clinician satisfaction, retention and patient safety

Sun Solutions and MDM Improve Patient Safety

Remove Duplicate Records

Consistent/Complete Patient view

Extensible Matching and Standardisation

MDM proven expertise

18 years+ of solutions to Healthcare Organisations

Robust and Scalable architecture

Achieving aSingle Patient View

Eric WilliamsSoftware PracticeSun Microsystems UK Ltd.