HL7 Roadshow 2009HL7 Roadshow 2009Connected HealthcareConnected Healthcare

Chris Norton, March 2009

Agenda

• InterSystems at a GlanceInterSystems at a Glance

• ProductsProducts

• Analysts’ viewsAnalysts’ views

• InterSystems and the NHSInterSystems and the NHS

• Ensemble and the NPfITEnsemble and the NPfIT

• Example integration architectures using Example integration architectures using EnsembleEnsemble

InterSystems at a Glance

• Established 30 years Established 30 years

• Over 700 people, offices in Over 700 people, offices in 19 countries19 countries

• US $255m revenue, consistent US $255m revenue, consistent growth and profitabilitygrowth and profitability

• Private, no outside investors, Private, no outside investors, no debtno debt

• Sell directly to end users as well as Sell directly to end users as well as with 1400+ partnerswith 1400+ partners

• Long term supplier to the NHSLong term supplier to the NHS

Healthcare Partners

ReStartConsultingReStartConsulting

InterSystems Software for Connected Healthcare

Regional /

National EHR

Institutional / Community EPR

Application Level

Ensemble - #1 interface engine in healthcare (KLAS 2006, 2007, 2008)

HealthShare – for developing secure electronic health record systems on a regional and national level

TrakCare – an advanced Web-based healthcare information system that rapidly delivers patient-centric data and Electronic Patient Record benefits

Caché - #1 database used in clinical applications worldwide

Caché: High Performance Database &Rapid Application Development

Unified Data ArchitectureUnified Data

ArchitectureMultidimensional Storage Engine

Unified Data Architecture

Objects

Java

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EJB

C+

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SQL

Enterprise

Cache

Protocol

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VB

PY

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XML

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AP

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Middleware/ApplicationSQL

DatabaseSQL Database

Caché @ America’s Best Hospitals*

* Hospitals on the 2008 U.S. News Honor Roll

Johns HopkinsJohns Hopkins

Mayo ClinicMayo Clinic

UCLAUCLA

Cleveland ClinicCleveland Clinic

Mass GeneralMass General

NY PresbyterianNY Presbyterian

UC San FranciscoUC San Francisco

Brigham & Women’sBrigham & Women’s

DukeDuke

U. of PennsylvaniaU. of Pennsylvania

U. of WashingtonU. of Washington

Barnes-JewishBarnes-Jewish

U. of MichiganU. of Michigan

U. of PittsburghU. of Pittsburgh

VanderbiltVanderbilt

StanfordStanford

U. of ChicagoU. of Chicago

Cedars-SinaiCedars-Sinai

Yale-New HavenYale-New Haven

All use Caché for clinical applications All use Caché for clinical applications

World’s largest civilian World’s largest civilian EHREHR • 8.7 Million patients 8.7 Million patients

supported in Outpatients supported in Outpatients settingsetting

• 2 Million active Personal 2 Million active Personal Health Record usersHealth Record users

• 10 hospitals live with 10 hospitals live with InpatientsInpatients

• >11,000 Physicians>11,000 Physicians

Kaiser Permanente and EPIC Systems

Partners Healthcare

• 10 major hospitals10 major hospitals

• 4 million outpatient visits4 million outpatient visits

• 160,000 admissions160,000 admissions

• 8,000 physicians8,000 physicians

• 3,250 beds3,250 beds

• >800 applications>800 applications

• 55,000 named users55,000 named users Dr John Glaser

Caché User base in the NHS

27,639 users

29,928 users

22,834 users

42,411 users

35,621 users

InterSystems Software for Connected Healthcare

Regional /

National EHR

Institutional / Community EPR

Application Level

Ensemble - #1 interface engine in healthcare (KLAS 2006, 2007, 2008)

HealthShare – for developing secure electronic health record systems on a regional and national level

TrakCare – an advanced Web-based healthcare information system that rapidly delivers patient-centric data and Electronic Patient Record benefits

Caché - #1 database used in clinical applications worldwide

The most powerful technology for buildingThe most powerful technology for buildingand running connected applicationsand running connected applications

The most powerful technology for buildingThe most powerful technology for buildingand running connected applicationsand running connected applications

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Business Process Modeling/ExecutionBusiness Process Modeling/ExecutionBusiness Process Modeling/ExecutionBusiness Process Modeling/Execution

Messaging EngineMessaging EngineMessaging EngineMessaging Engine

Data Transformation EngineData Transformation EngineData Transformation EngineData Transformation Engine

Workflow EngineWorkflow EngineWorkflow EngineWorkflow Engine

Rules ProcessingRules ProcessingRules ProcessingRules Processing

DashboardsDashboardsDashboardsDashboards

The Ensemble Approach to Integration

OneOne Architecture Architecture

RepositoryRepository

Managem

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BP

Composite Apps

BAM

OneOne data model data model

OneOne metadata metadatarepositoryrepository

OneOne development developmentenvironmentenvironment

OneOne management managementenvironmentenvironment

OneOne learning learningcurvecurve

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

widest range of projects, one learning curve

• Faster Integration & Composite App. DevelopmentFaster Integration & Composite App. Development – Rapid ROI

• Easier Management & Scalable PerformanceEasier Management & Scalable Performance

– Lowest cost of ownership

The Benefits of Ensemble

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

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

Increased Development Productivity

Gartner’s Magic Quadrant for SOAComposite Application Projects

InterSystems positioned in the Leaders Quadrant

Magic Quadrant for Application Infrastructure for SOA Composite Application Projects, 4Q08 Massimo Pezzini, Yefim V. Natis, Kimihiko Iijima, Daniel Sholler, Jess Thompson, Dale Vecchio. December 19, 2008.

EnsembleKLAS #1 Rated 2006, 2007 & 2008

Ensemble #1 InEnsemble #1 In• Product quality ratingProduct quality rating• Delivery of new technologyDelivery of new technology• Quality of trainingQuality of training• Money’s worthMoney’s worth• Overall satisfaction with Overall satisfaction with

vendor / productvendor / product

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

• 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

• 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)

National EHR Infrastructure success

• NICTIZ - National ICT Institute NICTIZ - National ICT Institute for Healthcare, Netherlandsfor Healthcare, Netherlands

• Contract for Contract for National Healthcare National Healthcare Messaging HubMessaging Hub awarded to CSC awarded to CSC using InterSystems Ensemble using InterSystems Ensemble Integration PlatformIntegration Platform

CSC Selects Ensemble for NetherlandsEHR Project

General Principles of the Project

• The general goal is patient data interchange– Complete data, except (for now) imaging, and limited

only by privacy laws– Includes medical and administrative data

• Patient data are not stored at a central location– The central system records the localization of the

information, not the information itself– It is hence a « meta-index », not a « repository »

• Users of the system: GPs, hospitals, clinics, pharmacists nationwide

InterSystems Software for Connected Healthcare

Regional /

National EHR

Institutional / Community EPR

Application Level

Ensemble - #1 interface engine in healthcare (KLAS 2006, 2007, 2008)

HealthShare – for developing secure electronic health record systems on a regional and national level

TrakCare – an advanced Web-based healthcare information system that rapidly delivers patient-centric data and Electronic Patient Record benefits

Caché - #1 database used in clinical applications worldwide

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Regional Hospital

RegionalHospital

RegionalHospital

RegionalHospital

Regional Hospital

Regional Hospital

Regional Hospital

Regional Hospital

Regional Hospital

Regional Hospital

RegionalHospital

RegionalHospital

Central Hospital

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Regional Project:• 17 Hospitals• 134 Health Clinics• 3 Diagnostic

Laboratories• 20 Emergency Units• 3 Specialist Diagnostic

Units• Home Care• More than 5000 health

professionals using just one Electronic Health Record

Brazil – Federal region of Brazilia

Brazila – Citizens portal

Ensemble in UK Healthcare

•Moorfields Eye Hospital•Peterborough•Plymouth•Barts and London•Lothian Region, Edinburgh•Mid-Essex•Bolton •Royal Marsden•East & North Herts•Gateshead

•Sheffield Children’s•St Georges•Kings Lynn•Co Durham and Darlington•Rotherham•Mid Yorks•Calderdale•Barnsley•Doncaster

Ensemble is widely used by Hospital Trusts throughout the NHS as a Trust-wide integration engine

Ensemble in UK Healthcare

•Jersey Hospital•Guernsey Hospital•St Vincents, Dublin•Thames Cancer Registry•Institute for Cancer Research•Northgate Information Solutions – National Hearing Screening Programme •North Western Cancer Registry•Northern and Yorkshire Cancer Registry and Information Service

and in many other Healthcare environments...

InterSystems and the NPfIT

North East / Yorkshire & Humberside

North West / West Midlands

East Midlands / East of England

London

South West / South East

CSC Alliance

CSC Alliance

No Current LSP

No Current LSP

BTBT

CSC Alliance

CSC Alliance

CSC Alliance

CSC Alliance

CSC selects InterSystems for trust integration10th Sep 2008

Computer Sciences Corporation is to use InterSystems Ensemble for the integration of all new applications it

provides to existing trust systems.CSC, the local service provider for the North East and

Midlands regions in England’s NHS National Programme for IT, has selected Ensemble as the standard trust integration

engine (TIE).

InterSystems and the NPfIT

InterSystems and the NPfIT

North East / Yorkshire & Humberside

North West / West Midlands

East Midlands / East of England

London

South West / South East

CSC Alliance

CSC Alliance

No Current LSP

No Current LSP

BTBT

CSC Alliance

CSC Alliance

CSC Alliance

CSC Alliance

EnsembleEnsembleEnsembleEnsembleEnsembleEnsembleEnsembleEnsemble

EnsembleEnsembleEnsembleEnsemble

Questions?

Questions??• Chris.norton@interSystems.com• www.intersystems.co.uk/TIE