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Connecting the Healthcare Ecosystem - An Architecture for Improved Health

The document outlines an architecture for improved healthcare connectivity, focusing on Prolifics' expertise in integrating IBM solutions for better healthcare management. It highlights the increasing market demand for health IT, emphasizing a shift toward value-based care, automation of data processing, and the importance of connectivity among healthcare providers. Essential components discussed include enterprise service bus (ESB) technology and the advantages of integrating various health information systems to enhance clinical decision-making and patient care outcomes.

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Connecting the Healthcare Ecosystem- An Architecture for Improved Health A.J. Aronoff - Infrastructure Practice Director, Prolifics Kevin Forbes – Healthcare Practice Director, Prolifics
Prolifics at a Glance 2 W h o A r e W e ? S t a b i l i t y, L o n g e v i t y & G r o w t h S o l u t i o n L e a d e r s h i p A Corporate Group of 1000 Employees Worldwide specializing in the expert delivery of end-to-end IBM Solutions New York Boston Philadelphia Washington DC Orlando San Francisco London Hamburg Hyderabad Over 30 years in business, Prolifics is an end-to-end systems integrator specializing in IBM technologies  BPM strategies to streamline and automate your business  SOA solutions and appliances for connectivity and integration  Portal, Collaboration, Content Management and Social  Mobility  Security to manage identities across your IT infrastructure  APM and Managing Applications  Business Analytics and Information Management for Data Cleansing  Business Intelligence and Dashboards  Testing, Governance and Methodology  Technology Migrations to the IBM Software Platform  Enterprise Content Management for business value $0 $20 $40 $60 $80 $100 $120 2006 2007 2008 2009 2010 2011 2012 GrossRevenue (millions)
3 Accomplished Cross-Brand IBM Software Partner A L o n g R e c o r d O f I B M H o n o r s S o f t w a r e S a l e s L e a d e r s h i p T e c h n i c a l I n n o v a t i o n Multi Award-winning:  2013 IBM Beacon Award for Outstanding Technical Vitality  2013 IBM Collaboration Solutions Distinguished Business Achievement  2012 Outstanding Business Agility Solution Award  2012 IBM Smart SOA Impact Award Winner  2012 Global WebSphere Community Customer Recognition Award Winner  2012 ICS Award for Best Industry Oriented Social Business Solution  2012 IBM Awarding Client Excellence (ACE) Award Winner  2010 Impact Best BPM Solution Award  2010 Lotus Best End-User Solution Award  2010 Lotus Best Industry Solution Award  2009 Rational Solution Award  2008 Outstanding SOA Solution Award  2008 Overall Technical Excellence Award  2007 Overall Technical Excellence Award  2007 Impact SOA Process Solution Award  2006 Best Portal Solution Lotus Award  2005 5-Star Partner Award  Serviced over 1500 IBM software accounts in the past 8 years  Closed over 150 competitive wins to IBM software; conducted over 60 migrations to WebSphere from competition  Prolifics boasts over 400 J2EE and IBM software certifications for architecture, development, administration, & project management  Over 300 portal solutions implemented  IBM’s highest technical rating (Level 5)  Most Tivoli AAA Accreditations of all IBM Tivoli Partners  IBM Cloud Certified  Multiple Solutions “Ready for Rational”  The most SVP Industry & Capability Authorizations of any IBM Business Partner: Security, Insurance, Finance, Healthcare & Life Sciences, Banking, Energy & Utilities, Social Business and Enterprise Content Management.  15 Technical Staff are "IBM Champions"  0 50 100 2006 2008 2010 2012 IBMSoftwareResale andInfluence (millions)
4 Accomplished Cross-Brand IBM Software Partner 1 0 0 % A u t h o r i z e d R e s e l l e r A c r o s s t h e B r a n d s  100% Authorized as an IBM Software Reseller with Software Value Plus  Industry and Capability authorized for Finance, Banking, Insurance, Healthcare & Life Sciences, Energy & Utilities, Security, Social Business and Enterprise Content Management.  Authorized for DataPower  Authorized zSeries Software Reseller  Authorized xSeries Reseller  Authorized pSeries Reseller  Authorized PureApps Reseller  WebSphere – BPM, ESB, TX, Message Broker, Business Monitor, ODM, Lombardi, MQ, FTE, Sterling Connect:Direct, Worklight  ICS – Portal, Web Content Management, Connections, Quickr, Mobile Accelerator  Security – Security Identity Manager/Security Access Manager , Security Access Manager Enterprise Single Sign-On, Security Federated Identity Manager , AppScan  Tivoli – IBM Tivoli Composite Application Manager (ITCAM), IBM Tivoli Monitoring (ITM), Tivoli Application Dependency Discovery Manager (TADDM), Tivoli Directory Integrator (TDI)  Rational – Developer Tooling (RTC, etc.), Testing  Enterprise Content Management (EMC) - FileNet; Case Manager  Business Analytics – Cognos TM1  Information Management – InfoSphere  Industries – Finance, Banking, Insurance, Healthcare & Life Sciences, Energy & Utilities Authorized; also focuses in Government and Legal  zSoftware
5 Prolifics Customers F i n a n c i a l S e r v i c e s H e a l t h c a r e G o v e r n m e n t E d u c a t i o n R e t a i l & D i s t r i b u t i o n U t i l i t i e s I n s u r a n c e
Health IT Trends and Market Drivers Connectivity Deep Dive An Architecture for Improved Health 6
7 High deductible health plans; Cost shifting to Employees; Tax on Med Part D employer subsidy Employers & Consumers 32 million formerly uninsured enter the medical delivery system Legislative reform Reform law will bring $1.1 Trillion into the industry by 2019, benefiting providers, pharmaceuticals, insurers, bio medical and life sciences. 31% increase in Health IT market as providers move to electronic medical records Accountable Care Organizations (ACO) / PCMH Value Based Insurance Design / Pay for Outcomes Value Based reimbursements ICD-10 and HIPAA 5010 Compliance (ICD Conversion Impacts EVERY Clinical System) Standards Medical Codes will increase from 18,849 to 140,658 Conversion costs estimated at $10B MARKETREGULATORY $30B+ in federal funds for HIT (Meaningful Use) $547 million in federal funds for HIE(Health Information Exchanges) Stimulus: ARRA - HITECH 31% increase in Health IT market as providers move to electronic medical records Reform Brings Sweeping Changes
But- So Does Consumerism… (Patient Centered, Coordinated Care) 8 Patient Provider Payer Care Management Care Support Wellness / Prevention Service Bus Security Workflow Decision Mgmt Analytics Cloud Services Connected Care Team, Collaboration and Surveillance Targeted content, Interventions, HRA‟s and real time response to incoming data – automating decisions makes data “actionable”
The Industry is Shifting From a Reactive Transaction Based Model to a Proactive Value Based Model Infrastructure Modernization Information Readiness and Analytics Care Delivery Models are Evolving Rapidly Payment Model Shifts Drive a Converging Ecosystem Consumerism Tomorrow's Healthcare SystemFocus is on value, coordinated around the patient and integrated into communities Emphasis is on proactive care to meet health needs Payment is based upon value and outcomes Care is standardized according to evidence-based guidelines We measure quality and make rapid changes to improve it Knowledge is translated into practice 9
An Integrated Strategy to achieve proactive, value based care  Health Plans, Providers and Life Sciences organizations all play key roles in delivering & coordinating care, managing chronic conditions and improving overall health  Access to vital information improves clinical decision making - resulting in better outcomes, improved quality and reduced costs  Once connected the opportunities for care coordination, process improvement, predictive analytics & patient engagement are limitless  The need for a scalable and standards based connectivity solution in healthcare is more relevant than ever before, as integration/workload/workflows extend beyond the confines of a single organization  Integration to HIE‟s or across organizations such as ACO‟s brings new challenges for security and scalability  Incoming data from multiple channels requires automation to be “actionable”  Connectivity, Business Process Management, Decision Management and Predictive Analytics are key elements of an integrated strategy
The Healthcare ESB Optimizing Costs • Integrates hospitals, health plans and governments faster • Improve performance more than 10x, with lower costs • Achieve full ROI within as few as six months ESB Converts between different transport protocols Matches and routes communications between services Connects everything to everything Distributes Business events Transforms between different data formats Healthcare ESB  Built on WebSphere Message Broker: IBM‟s premiere Enterprise Service Bus  World-wide, proven solution that is healthcare specific  Handles all kinds of Healthcare Transaction Types: HL7, EDI (incl. HIPAA)  ESB Components and functionality examples: – Wraps HL7 TCPIP connections with a web service – API calls – for example: to/from JMS – Call to an external databases – query/retrieve and update – Compliance with current HL7 versions, up to and including V3 (CDA/CCR)  High availability, load balancing, disaster recovery options  Re-usability of components, adapters, and in depth installation experiences
Connectivity Deep Dive 12
IBM Healthcare Technical Architecture Clinical Pathway Management – Emergency, Oncology etc Corporate Applications Billing – Payroll - HR Clinical Applications PAS – Orders – Pharmacy – Maternity – Pathology – ER Enterprise Data Warehouse Analytics and Reporting Clinical and Corporate JCAPS Rhapsody eGate InterSystems Existing Hospital Integration Engine Electronic Master Patient Index WebSphere ODM Portal IBM Remote Medical Device Aggregator Business/Event Process Management Home/Telehealth Medical Devices Web Services Web Services XML ODBC, JDBC, SQL XML, IDOC, Proprietary XML, HL72, HL73, Cache ODBC, Web Services Proprietary HL7v2 HL7v2, HL7v3 Clinical Document Sharing XML, SOAP, Web Services, ebRIM Integration Engine - ESB AuthenticationandSingleSignOn Analytics Integration Engine – WebSphere Message Broker Web Services WebSphere BPM Rules Engine WebSphere Transformation Extender Payer HIPAA document management COGNOS
14  WMB Proven robust and scalable across many industries worldwide for the last 10 years  Deployed in many high volume mission critical scenarios including healthcare : US Healthcare provider In production for approx. 5 years all 40+ hospitals in their network handling over 9 million transactions per day HL7 HL7 Payer Admin Laboratory EMR Surgery PAS Payer Emergency Room HL7 Ward HL7 HL7 HIPAA HL7 Patient Index HL7 Pharmacy HL7 HL7 • Direct connectivity to HL7 v2.x over TCP/IP (MLLP) • Validation and parsing of messages • Easily connect applications from different vendors • Optional in flight segment filtering, sequencing etc • Handling of HIPAA messages* * Utilizing WTX Maps natively in WMB The Value of WebSphere Message Broker
Connecting Clinical Applications  Ensure data is consistent across healthcare applications – Consistent regardless of the patient‟s point of entry – Ensure data is entered once and only once! – For example, admissions are reflected across all interested systems  Reduce effort on clinical and administrative staff – Changes to demographics are reflected in all interested systems – Reduces human error from duplicate data entry  Integration done using good practice and architectural principles – Enterprise service bus abstracts away point-to-point integrations – Facilitates better reuse and faster time-to-value for new projects Order Communications Pharmacy Pathology Rules Engine Maternity PAS Integration Engine – WebSphere Message Broker Many Thanks to Ant Philips 15
16 Typical Solution Architectures 1. Multi Hospital Scenario. Sharing of patient data between 5/6 hospitals. Message Broker used as the integration engine for HL7 v2 clinical applications across the payer environment. Various projects in the US where patient discharge information is collected for distribution to regional (state- wide) health information exchanges. Medical Insurer/Payer Payer Admin Acute Care HIPAA 2 Connecting Between payer and provider systems. Providing transformation between Payer HIPAA based system and hospital administration. WMB deployed at various Health Plan and Government Health Departments institutions around the world. WMB handles All HIPAA transactions, claims pre- and post- adjudication 2 (Note does not require WMB HCP - Utilises WMB + WTX HIPAA Pack) ESB for Healthcare/Connectivity Pack for Healthcare Designed to meet the needs of healthcare providers
17 Admin HL7 v3 Regional/ National Backbone EMR PASHL7 v2 3. Access & updates to EMR as part of chronic care. Provision of secure access to patients details as part of continuing care. 4 Bridging from local hospital to HL7 v3 Regional Backbone. Utilizing WMB to provide in flight transformation and mapping of HL7 v2 messages within the hospital into the HL7 v3 CDA format utilised on the regional or national backbone. (Utilises WMB + WMB Healthcare Pack + WTX HL7 Pack) EMR Chronic/Outpatient Care Chronic/Outpatient Care EMR 5. Wellness Connectivity of remote (non life critical) in-home devices such as blood glucometers, blood pressure cuffs etc to allow update to EMR Service Provider Service Provider Typical Solution Architectures ESB for Healthcare/Connectivity Pack for Healthcare Designed to meet the needs of healthcare providers
Overview of an Enterprise Service Bus An Enterprise Service Bus (ESB) is a flexible connectivity infrastructure for integrating applications and services CONNECT everything to everything Integrate with EHRs, HIEs and ACOs MATCHES & ROUTES communications between services CONVERTS between different transport protocols TRANSFORMS between different data formats Including HL7 v2.x MLLP messages 18
Design principles for using Message Broker patterns  A pattern in Message Broker is a template that generates one or more production ready projects  Common properties:  Creates top-down, parameterized connectivity solutions • Web Service façades, message oriented processing, queue-to-file  Reduces common problems in flow development  Communicates best practices to the broker community  Complements existing bottom-up construction for connectivity  Reduces time-to-value for solution development  Patterns are a first class citizen in Message Broker  Patterns have bubbled right to the top in the navigator view! 19 “Brilliant people solve problems geniuses prevents them” - A. Einstein
20 Patterns for Simplified Development  Creates top-down, parameterized connectivity solutions  Reduces common problems in flow development  Communicates best practices to the broker community  Reduces time-to-value for solution development  Complements regular solution development in broker “Brilliant people solve problems geniuses prevents them” - A. Einstein Many Thanks to Ant Philips 20
Connecting Clinical Applications  Production ready pattern based on HL7 MLLP v2.x  Mediates between HL7 clinical applications (1:1 and 1:many)  Focus on ADT, ORU and ORM messages from HL7 standard  Easy to extend with custom transformation logic  Pattern has excellent multi-threaded performance characteristics  Sender and receiver message flows decoupled by WebSphere MQ queues  Supports message validation, duplicate detection, sequencing, and retry Many Thanks to Ant Philips 21
Connecting Clinical Applications Selection of Document Types using Healthcare Connectivity Pac A Many Thanks to Ant Philips 22 820: Health Care Payment Order 270: Eligibility and Benefits Inquiry 271: Eligibility and Benefits Response 276: Claim status inquiry 277: Health Care Claim Status Notification 278: Health Care Service Review Information 837: Claims submission 835: HealthCare Claim Payment Advice 834: Enrollment
Connecting Clinical Applications Siemens Invision (ADT, BAR, ORU) IMPAC IntelliLab (ADT) Chartlinc (ADT, BAR, ORU) Emtek (ADT, ORU, ORM) PCN (ADT, SIU) Cerner Pathnet (ADT, ORM, ORU) IMS (different custom transcriptions) GE Logician (ADT, SIU) Xtend (ADT) APOLLO (ADT) BEDTRACKING (ADT) RehabManager (ADT) DOMINATOR (ORM) Millbrook (ORU) Cerner RadNet (ADT, ORM, ORU) Omnicell (ADT) Midas (ADT) MedTrack (ADT) EPIC (ADT, ORU, ORM, MDM) Meditech (ADT, ORU) McKesson GE IDX FUJI Cerner Millennium Power Scribe PineStar AllScripts Selection of applications integrated using Message Broker and HL7: A Many Thanks to Ant Philips 23
© 2009 IBM Corporation Building a smarter planet A Clinical Document Architecture (CDA) document is a defined and complete information object that can exist outside of a message. In addition to text, it can include images, sounds, and other multimedia content. The CDA is a three-level architecture with each higher level (2, 3) adding an extra section (more specificity to the mark-up) of the document.  The XML parser in Message Broker can validate and transform any XML message.  Through the use of a „Message Set,‟ Message Broker can store the CDA schema and greatly accelerate the processing of these complicated XML messages. The Connectivity Pack for Healthcare and WebSphere Message Broker)fully supports all versions of HL7 and, more specifically, the CDA. Clinical Document Architecture and the ESB
Journaling  Journaling writes a copy of every inbound HL7 message to a queue Many Thanks to Ant Philips 25
Duplicate Detection  Message control identifier (MSH.10) used as key for duplicate detection MSH|^~&|ADT1|MCM|LABADT|MCM|198808181126|SECURITY|ADT^A01^ADT_A01|MSG00001-|P|2.5 MSH|^~&|MB7BROKER.RECEIVER| |ADT1|MCM|201012340084041||ACK|460f99f3a25ca40bd50f|P|2.5 Many Thanks to Ant Philips 26
Remainder Processing  Additional fields and segments not in the model can be saved to a queue Many Thanks to Ant Philips 27
Report Generation  Production ready pattern to generate reports from HL7 MLLP v2.x  Out-of-the-box solution for text-based reports and file distribution  Easily customised for different destinations (FTP/sFTP/email)  Inbound HL7 message used as the input data for a report template  Standard set of connectivity options for the inbound HL7 MLLP  Transport options including leading/trailing bytes, port number and timeout  Acknowledgments, duplicate checking and journaling (audit)  Source feed provided either direct to queue, or published to topic Many Thanks to Ant Philips 28
HL7 MLLP Nodes  These nodes encapsulate the MLLP protocol and HL7 message parsing  Nodes handle de-duplication, validation, acknowledgments and timeout handling  Easy to use nodes enable new HL7 message processing scenarios  Examples include HL7 to data warehouse and HL7 device aggregator integration Many Thanks to Ant Philips 29
Message Broker Built-In Nodes The HL7 pattern uses a variety of Message Broker built-in nodes HL7 v2 MLLP protocol is built on top of TCP/IP connections Messages must be kept in order as they are transformed and routed  Sequencing nodes enable high performance multi-threaded processing Persistent messages ensure data is kept safe and secure HL7 pattern instances can be extended in many different ways! Many Thanks to Ant Philips 30
 Message Broker Explorer is our administration application  Provides a secure broker administration and monitoring environment  Enhancements provide insight into the healthcare environment  How many HL7 MLLP messages have been processed?  Are my clinical applications connected and working?  What status messages have been sent from my medical devices?  When were the TCP/IP connections last created and dropped?  Visual warnings when queues approach limits and applications disconnect Operational Monitoring Many Thanks to Ant Philips 31
Distribute Database Information to Where It’s Needed! Provide timely access to changed database information Move to near real-time data trickle from infrequent ETL extract  Database Node allows tables to be treated as input source  Typical scenarios include database to queue & file, or PubSub data distribution  Captures database changes (Insert Update, Delete) to trigger connectivity processing  Supports single & multiple tables, complex joins, and other database oriented semantics  Extends database capabilities in MB to provide comprehensive inbound/outbound support  Works with full range of broker databases including Oracle, DB2, SQL server, & solidDB a • Most existing Event table and data table structures supported without database change  RAD tools construct skeleton database queries to simplify user experience • Power users can create sophisticated SQL routines if required or desired Event Table  Fully Transactional with High Performance and Scalability  Distinct event cache & data transactions minimizes contention  Exploits SQL engine for full 2Phase commit transactions 32
ESB: Connect Everything to Everything. Universal Connectivity  A Universal Message Bus for access to data wherever it exists to support your business  A comprehensive range of messaging capabilities to support your business requirements for data integration  Managed File Transfer  Messaging integration patterns  Provides appropriate data access and data privacy controls to help meet audit and regulatory requirements  WMQ Telemetry is one step in extending the reach to a wider world of data relevant to your business (“ The internet of things”) 33 Petrol Forecourt Branch Outlet Regional Office Retail Store Refinery Mobile Phone Sensor e.g. RFID Enterprise Pervasive Device CSS: F S
Graphical Transformations 34  IBM Graphical Data Mapper (GDM)  Visually map & transform source to target data • Code-free, high performing & scalable  GDM designed for whole IBM product set • e.g. Full map exchange with MDM Server V9 • Mapping Script Language(MSL)format  Simple & powerful graphical mapping experience  Apply transformations to single and multiple elements • Conditionals (if then else), Loops(for each), Functions(target=f(source)) & more!  Database mapping sources and targets for routing and enrichment scenarios • Broad data base support(Oracle,DB2,SQLServer,Sybase,Informix...)  Complements and supports existing transformation languages • Call user defined transformation in Java, SQL, XPath, .NET...   Simple deployment, high performing & scalable  Maps can be deployed with solution BAR file or stand-alone  JIT compile means technology advances improves existing, deployed solutions • Source deploy + runtime compilation = enhanced performance
WebSphere Message Broker Version 8 Summary  Universal Connectivity FROM anywhere, TO anywhere  Simplify application connectivity for a flexible & dynamic infrastructure  Comprehensive Protocols, Transports, Data Formats & Processing  Connect to applications, services, systems and devices • MQ, JMS 1.1, HTTP(S), SOAP, REST, File (incl. FTP, FTE, Connect Direct), Database, TCP/IP, MQTT, CICS, IMS, SAP, SEBL, .NET, PeopleSoft, JD Edwards, SCA, CORBA, email...  Understand the broadest range of data formats • Binary(C/COBOL),XML, CSV, JSON, Industry(SWIFT,EDI,HL7...), IDOCs,  Built-in suite of request processors • Route, Filter, Transform, Enrich, Monitor, Publish, Sequence  Simple Programming with Patterns & Graphical Data Flows  Patterns for top-down, connectivity of common use cases • e.g. Service façades, Message processing, Queue2File...  Graphical data flows represent application & service connectivity • Custom logic via Graphical mapping, PHP, Java, ESQL, XSL, WTX  Extensive Management, Performance & Scalability  Deployment options include Trial, Express, Standard and Advanced  Connectivity Packs for Industry Specific Content  Connectivity Pack for Healthcare includes HL7 Connectors, Patterns & Tooling 35
WebSphere Message Broker – Health Care Quick Start - 8 week effort  High Level Architecture - 5 days  Conduct an interactive workshop (whiteboard sessions) that will focus on WebSphere Message Broker and WebSphere MQ integration specifically in your environment  Provide a high-level architecture document  Deliver a proposal with recommendations for achieving both short and longer term goals  Coding and Testing (Implement 3 use cases) – 15 days  Conduct a requirement gathering session for each use case  Document the requirements and create a low-level technical specifications document, describing the implementation details for each use case  Develop techniques and best practices  Connecting Clinical Applications(HL7 to HL7 processing)  Production ready pattern based on HL7 MLLP v2.x  Mediates between HL7 clinical applications (1:1 and 1:many)  Focus on ADT, ORU and ORM messages from HL7 standard  Report Generation (using PHP scripts)  Production ready pattern to generate reports from HL7 MLLP v2.x  Out-of-the-box solution for text-based reports and file distribution  Easily customized for different destinations (FTP/sFTP/email)  Inbound HL7 message used as the input data for a report template 36
What are your next steps?  Free Dedicated Discovery Call - Conference call between you and our certified Solutions Experts. Discovery call identifies current IT infrastructure and requirements to recommend the best strategy for you.  Free Healthcare ESB Discovery Call - For clients who want to gain a deeper understanding of how an IBM Healthcare ESB can help with their business integration needs.  Free Message Broker Quick Start Discovery Call - For clients who want to get the most out of message broker as quickly as possible.
An Architecture for Improved Health 38
39
Identify, Segment, Target and Engage 4040 TRANSFORM HEALTHCARE ENGAGE AND COLLABORATE TO IMPROVE CARE AND OUTCOMES: Improve the quality and efficiency of care while cultivating patient centricity through engagement and health and care personalization. IDENTITY and SEGMENT: Identify and segment the overall population. Determine appropriate course of action. TARGET Targeted Information, Content, Interventions and Actions- Personalized Care Plan
From Point of Care to Population Management Data aggregated from multiple sources such as encounter, self reported, in- home devices and cloud services leads to better clinical decisions and aids in driving targeted information and content to better manage the health of an individual as well as an entire population. Incoming data from multiple sources/channels can be used to discover, segment, target and engage. From prevention to intervention- a personalized care plan tailored to the individual‟s needs
Contact – A.J. Aronoff Infrastructure Practice Director Email - aj@prolifics.com Resources http://expert-tech.blogspot.com/ Blog Entry: Zero Downtime http://expert-tech.blogspot.com/2013/02/the-messaging-whisperers-zero-downtime.html

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In this document
Powered by AI

Introduction to Prolifics and its extensive services, IBM partner status, and global presence with key financial insights.

Exploration of trends like cost shifting, reforms, and value-based care models that are reshaping the healthcare industry.

The role of the Healthcare ESB in facilitating communication between healthcare systems and various transaction types.

Overview of IBM Message Broker capabilities and its utility in handling HL7 messages, ensuring data integrity, and facilitating integration.

Connecting clinical applications using various integration strategies to streamline data consistency across healthcare systems.

Discussion on strategic next steps for integrating IT infrastructure with a focus on improving health outcomes through targeted engagement.

Connecting the Healthcare Ecosystem - An Architecture for Improved Health

  • 1.
    Connecting the HealthcareEcosystem- An Architecture for Improved Health A.J. Aronoff - Infrastructure Practice Director, Prolifics Kevin Forbes – Healthcare Practice Director, Prolifics
  • 2.
    Prolifics at aGlance 2 W h o A r e W e ? S t a b i l i t y, L o n g e v i t y & G r o w t h S o l u t i o n L e a d e r s h i p A Corporate Group of 1000 Employees Worldwide specializing in the expert delivery of end-to-end IBM Solutions New York Boston Philadelphia Washington DC Orlando San Francisco London Hamburg Hyderabad Over 30 years in business, Prolifics is an end-to-end systems integrator specializing in IBM technologies  BPM strategies to streamline and automate your business  SOA solutions and appliances for connectivity and integration  Portal, Collaboration, Content Management and Social  Mobility  Security to manage identities across your IT infrastructure  APM and Managing Applications  Business Analytics and Information Management for Data Cleansing  Business Intelligence and Dashboards  Testing, Governance and Methodology  Technology Migrations to the IBM Software Platform  Enterprise Content Management for business value $0 $20 $40 $60 $80 $100 $120 2006 2007 2008 2009 2010 2011 2012 GrossRevenue (millions)
  • 3.
    3 Accomplished Cross-Brand IBMSoftware Partner A L o n g R e c o r d O f I B M H o n o r s S o f t w a r e S a l e s L e a d e r s h i p T e c h n i c a l I n n o v a t i o n Multi Award-winning:  2013 IBM Beacon Award for Outstanding Technical Vitality  2013 IBM Collaboration Solutions Distinguished Business Achievement  2012 Outstanding Business Agility Solution Award  2012 IBM Smart SOA Impact Award Winner  2012 Global WebSphere Community Customer Recognition Award Winner  2012 ICS Award for Best Industry Oriented Social Business Solution  2012 IBM Awarding Client Excellence (ACE) Award Winner  2010 Impact Best BPM Solution Award  2010 Lotus Best End-User Solution Award  2010 Lotus Best Industry Solution Award  2009 Rational Solution Award  2008 Outstanding SOA Solution Award  2008 Overall Technical Excellence Award  2007 Overall Technical Excellence Award  2007 Impact SOA Process Solution Award  2006 Best Portal Solution Lotus Award  2005 5-Star Partner Award  Serviced over 1500 IBM software accounts in the past 8 years  Closed over 150 competitive wins to IBM software; conducted over 60 migrations to WebSphere from competition  Prolifics boasts over 400 J2EE and IBM software certifications for architecture, development, administration, & project management  Over 300 portal solutions implemented  IBM’s highest technical rating (Level 5)  Most Tivoli AAA Accreditations of all IBM Tivoli Partners  IBM Cloud Certified  Multiple Solutions “Ready for Rational”  The most SVP Industry & Capability Authorizations of any IBM Business Partner: Security, Insurance, Finance, Healthcare & Life Sciences, Banking, Energy & Utilities, Social Business and Enterprise Content Management.  15 Technical Staff are "IBM Champions"  0 50 100 2006 2008 2010 2012 IBMSoftwareResale andInfluence (millions)
  • 4.
    4 Accomplished Cross-Brand IBMSoftware Partner 1 0 0 % A u t h o r i z e d R e s e l l e r A c r o s s t h e B r a n d s  100% Authorized as an IBM Software Reseller with Software Value Plus  Industry and Capability authorized for Finance, Banking, Insurance, Healthcare & Life Sciences, Energy & Utilities, Security, Social Business and Enterprise Content Management.  Authorized for DataPower  Authorized zSeries Software Reseller  Authorized xSeries Reseller  Authorized pSeries Reseller  Authorized PureApps Reseller  WebSphere – BPM, ESB, TX, Message Broker, Business Monitor, ODM, Lombardi, MQ, FTE, Sterling Connect:Direct, Worklight  ICS – Portal, Web Content Management, Connections, Quickr, Mobile Accelerator  Security – Security Identity Manager/Security Access Manager , Security Access Manager Enterprise Single Sign-On, Security Federated Identity Manager , AppScan  Tivoli – IBM Tivoli Composite Application Manager (ITCAM), IBM Tivoli Monitoring (ITM), Tivoli Application Dependency Discovery Manager (TADDM), Tivoli Directory Integrator (TDI)  Rational – Developer Tooling (RTC, etc.), Testing  Enterprise Content Management (EMC) - FileNet; Case Manager  Business Analytics – Cognos TM1  Information Management – InfoSphere  Industries – Finance, Banking, Insurance, Healthcare & Life Sciences, Energy & Utilities Authorized; also focuses in Government and Legal  zSoftware
  • 5.
    5 Prolifics Customers F in a n c i a l S e r v i c e s H e a l t h c a r e G o v e r n m e n t E d u c a t i o n R e t a i l & D i s t r i b u t i o n U t i l i t i e s I n s u r a n c e
  • 6.
    Health IT Trendsand Market Drivers Connectivity Deep Dive An Architecture for Improved Health 6
  • 7.
    7 High deductible healthplans; Cost shifting to Employees; Tax on Med Part D employer subsidy Employers & Consumers 32 million formerly uninsured enter the medical delivery system Legislative reform Reform law will bring $1.1 Trillion into the industry by 2019, benefiting providers, pharmaceuticals, insurers, bio medical and life sciences. 31% increase in Health IT market as providers move to electronic medical records Accountable Care Organizations (ACO) / PCMH Value Based Insurance Design / Pay for Outcomes Value Based reimbursements ICD-10 and HIPAA 5010 Compliance (ICD Conversion Impacts EVERY Clinical System) Standards Medical Codes will increase from 18,849 to 140,658 Conversion costs estimated at $10B MARKETREGULATORY $30B+ in federal funds for HIT (Meaningful Use) $547 million in federal funds for HIE(Health Information Exchanges) Stimulus: ARRA - HITECH 31% increase in Health IT market as providers move to electronic medical records Reform Brings Sweeping Changes
  • 8.
    But- So DoesConsumerism… (Patient Centered, Coordinated Care) 8 Patient Provider Payer Care Management Care Support Wellness / Prevention Service Bus Security Workflow Decision Mgmt Analytics Cloud Services Connected Care Team, Collaboration and Surveillance Targeted content, Interventions, HRA‟s and real time response to incoming data – automating decisions makes data “actionable”
  • 9.
    The Industry isShifting From a Reactive Transaction Based Model to a Proactive Value Based Model Infrastructure Modernization Information Readiness and Analytics Care Delivery Models are Evolving Rapidly Payment Model Shifts Drive a Converging Ecosystem Consumerism Tomorrow's Healthcare SystemFocus is on value, coordinated around the patient and integrated into communities Emphasis is on proactive care to meet health needs Payment is based upon value and outcomes Care is standardized according to evidence-based guidelines We measure quality and make rapid changes to improve it Knowledge is translated into practice 9
  • 10.
    An Integrated Strategyto achieve proactive, value based care  Health Plans, Providers and Life Sciences organizations all play key roles in delivering & coordinating care, managing chronic conditions and improving overall health  Access to vital information improves clinical decision making - resulting in better outcomes, improved quality and reduced costs  Once connected the opportunities for care coordination, process improvement, predictive analytics & patient engagement are limitless  The need for a scalable and standards based connectivity solution in healthcare is more relevant than ever before, as integration/workload/workflows extend beyond the confines of a single organization  Integration to HIE‟s or across organizations such as ACO‟s brings new challenges for security and scalability  Incoming data from multiple channels requires automation to be “actionable”  Connectivity, Business Process Management, Decision Management and Predictive Analytics are key elements of an integrated strategy
  • 11.
    The Healthcare ESB OptimizingCosts • Integrates hospitals, health plans and governments faster • Improve performance more than 10x, with lower costs • Achieve full ROI within as few as six months ESB Converts between different transport protocols Matches and routes communications between services Connects everything to everything Distributes Business events Transforms between different data formats Healthcare ESB  Built on WebSphere Message Broker: IBM‟s premiere Enterprise Service Bus  World-wide, proven solution that is healthcare specific  Handles all kinds of Healthcare Transaction Types: HL7, EDI (incl. HIPAA)  ESB Components and functionality examples: – Wraps HL7 TCPIP connections with a web service – API calls – for example: to/from JMS – Call to an external databases – query/retrieve and update – Compliance with current HL7 versions, up to and including V3 (CDA/CCR)  High availability, load balancing, disaster recovery options  Re-usability of components, adapters, and in depth installation experiences
  • 12.
  • 13.
    IBM Healthcare TechnicalArchitecture Clinical Pathway Management – Emergency, Oncology etc Corporate Applications Billing – Payroll - HR Clinical Applications PAS – Orders – Pharmacy – Maternity – Pathology – ER Enterprise Data Warehouse Analytics and Reporting Clinical and Corporate JCAPS Rhapsody eGate InterSystems Existing Hospital Integration Engine Electronic Master Patient Index WebSphere ODM Portal IBM Remote Medical Device Aggregator Business/Event Process Management Home/Telehealth Medical Devices Web Services Web Services XML ODBC, JDBC, SQL XML, IDOC, Proprietary XML, HL72, HL73, Cache ODBC, Web Services Proprietary HL7v2 HL7v2, HL7v3 Clinical Document Sharing XML, SOAP, Web Services, ebRIM Integration Engine - ESB AuthenticationandSingleSignOn Analytics Integration Engine – WebSphere Message Broker Web Services WebSphere BPM Rules Engine WebSphere Transformation Extender Payer HIPAA document management COGNOS
  • 14.
    14  WMB Provenrobust and scalable across many industries worldwide for the last 10 years  Deployed in many high volume mission critical scenarios including healthcare : US Healthcare provider In production for approx. 5 years all 40+ hospitals in their network handling over 9 million transactions per day HL7 HL7 Payer Admin Laboratory EMR Surgery PAS Payer Emergency Room HL7 Ward HL7 HL7 HIPAA HL7 Patient Index HL7 Pharmacy HL7 HL7 • Direct connectivity to HL7 v2.x over TCP/IP (MLLP) • Validation and parsing of messages • Easily connect applications from different vendors • Optional in flight segment filtering, sequencing etc • Handling of HIPAA messages* * Utilizing WTX Maps natively in WMB The Value of WebSphere Message Broker
  • 15.
    Connecting Clinical Applications Ensure data is consistent across healthcare applications – Consistent regardless of the patient‟s point of entry – Ensure data is entered once and only once! – For example, admissions are reflected across all interested systems  Reduce effort on clinical and administrative staff – Changes to demographics are reflected in all interested systems – Reduces human error from duplicate data entry  Integration done using good practice and architectural principles – Enterprise service bus abstracts away point-to-point integrations – Facilitates better reuse and faster time-to-value for new projects Order Communications Pharmacy Pathology Rules Engine Maternity PAS Integration Engine – WebSphere Message Broker Many Thanks to Ant Philips 15
  • 16.
    16 Typical Solution Architectures 1. MultiHospital Scenario. Sharing of patient data between 5/6 hospitals. Message Broker used as the integration engine for HL7 v2 clinical applications across the payer environment. Various projects in the US where patient discharge information is collected for distribution to regional (state- wide) health information exchanges. Medical Insurer/Payer Payer Admin Acute Care HIPAA 2 Connecting Between payer and provider systems. Providing transformation between Payer HIPAA based system and hospital administration. WMB deployed at various Health Plan and Government Health Departments institutions around the world. WMB handles All HIPAA transactions, claims pre- and post- adjudication 2 (Note does not require WMB HCP - Utilises WMB + WTX HIPAA Pack) ESB for Healthcare/Connectivity Pack for Healthcare Designed to meet the needs of healthcare providers
  • 17.
    17 Admin HL7 v3 Regional/ National Backbone EMR PASHL7 v2 3.Access & updates to EMR as part of chronic care. Provision of secure access to patients details as part of continuing care. 4 Bridging from local hospital to HL7 v3 Regional Backbone. Utilizing WMB to provide in flight transformation and mapping of HL7 v2 messages within the hospital into the HL7 v3 CDA format utilised on the regional or national backbone. (Utilises WMB + WMB Healthcare Pack + WTX HL7 Pack) EMR Chronic/Outpatient Care Chronic/Outpatient Care EMR 5. Wellness Connectivity of remote (non life critical) in-home devices such as blood glucometers, blood pressure cuffs etc to allow update to EMR Service Provider Service Provider Typical Solution Architectures ESB for Healthcare/Connectivity Pack for Healthcare Designed to meet the needs of healthcare providers
  • 18.
    Overview of anEnterprise Service Bus An Enterprise Service Bus (ESB) is a flexible connectivity infrastructure for integrating applications and services CONNECT everything to everything Integrate with EHRs, HIEs and ACOs MATCHES & ROUTES communications between services CONVERTS between different transport protocols TRANSFORMS between different data formats Including HL7 v2.x MLLP messages 18
  • 19.
    Design principles forusing Message Broker patterns  A pattern in Message Broker is a template that generates one or more production ready projects  Common properties:  Creates top-down, parameterized connectivity solutions • Web Service façades, message oriented processing, queue-to-file  Reduces common problems in flow development  Communicates best practices to the broker community  Complements existing bottom-up construction for connectivity  Reduces time-to-value for solution development  Patterns are a first class citizen in Message Broker  Patterns have bubbled right to the top in the navigator view! 19 “Brilliant people solve problems geniuses prevents them” - A. Einstein
  • 20.
    20 Patterns for SimplifiedDevelopment  Creates top-down, parameterized connectivity solutions  Reduces common problems in flow development  Communicates best practices to the broker community  Reduces time-to-value for solution development  Complements regular solution development in broker “Brilliant people solve problems geniuses prevents them” - A. Einstein Many Thanks to Ant Philips 20
  • 21.
    Connecting Clinical Applications Production ready pattern based on HL7 MLLP v2.x  Mediates between HL7 clinical applications (1:1 and 1:many)  Focus on ADT, ORU and ORM messages from HL7 standard  Easy to extend with custom transformation logic  Pattern has excellent multi-threaded performance characteristics  Sender and receiver message flows decoupled by WebSphere MQ queues  Supports message validation, duplicate detection, sequencing, and retry Many Thanks to Ant Philips 21
  • 22.
    Connecting Clinical Applications Selectionof Document Types using Healthcare Connectivity Pac A Many Thanks to Ant Philips 22 820: Health Care Payment Order 270: Eligibility and Benefits Inquiry 271: Eligibility and Benefits Response 276: Claim status inquiry 277: Health Care Claim Status Notification 278: Health Care Service Review Information 837: Claims submission 835: HealthCare Claim Payment Advice 834: Enrollment
  • 23.
    Connecting Clinical Applications SiemensInvision (ADT, BAR, ORU) IMPAC IntelliLab (ADT) Chartlinc (ADT, BAR, ORU) Emtek (ADT, ORU, ORM) PCN (ADT, SIU) Cerner Pathnet (ADT, ORM, ORU) IMS (different custom transcriptions) GE Logician (ADT, SIU) Xtend (ADT) APOLLO (ADT) BEDTRACKING (ADT) RehabManager (ADT) DOMINATOR (ORM) Millbrook (ORU) Cerner RadNet (ADT, ORM, ORU) Omnicell (ADT) Midas (ADT) MedTrack (ADT) EPIC (ADT, ORU, ORM, MDM) Meditech (ADT, ORU) McKesson GE IDX FUJI Cerner Millennium Power Scribe PineStar AllScripts Selection of applications integrated using Message Broker and HL7: A Many Thanks to Ant Philips 23
  • 24.
    © 2009 IBMCorporation Building a smarter planet A Clinical Document Architecture (CDA) document is a defined and complete information object that can exist outside of a message. In addition to text, it can include images, sounds, and other multimedia content. The CDA is a three-level architecture with each higher level (2, 3) adding an extra section (more specificity to the mark-up) of the document.  The XML parser in Message Broker can validate and transform any XML message.  Through the use of a „Message Set,‟ Message Broker can store the CDA schema and greatly accelerate the processing of these complicated XML messages. The Connectivity Pack for Healthcare and WebSphere Message Broker)fully supports all versions of HL7 and, more specifically, the CDA. Clinical Document Architecture and the ESB
  • 25.
    Journaling  Journaling writesa copy of every inbound HL7 message to a queue Many Thanks to Ant Philips 25
  • 26.
    Duplicate Detection  Messagecontrol identifier (MSH.10) used as key for duplicate detection MSH|^~&|ADT1|MCM|LABADT|MCM|198808181126|SECURITY|ADT^A01^ADT_A01|MSG00001-|P|2.5 MSH|^~&|MB7BROKER.RECEIVER| |ADT1|MCM|201012340084041||ACK|460f99f3a25ca40bd50f|P|2.5 Many Thanks to Ant Philips 26
  • 27.
    Remainder Processing  Additionalfields and segments not in the model can be saved to a queue Many Thanks to Ant Philips 27
  • 28.
    Report Generation  Productionready pattern to generate reports from HL7 MLLP v2.x  Out-of-the-box solution for text-based reports and file distribution  Easily customised for different destinations (FTP/sFTP/email)  Inbound HL7 message used as the input data for a report template  Standard set of connectivity options for the inbound HL7 MLLP  Transport options including leading/trailing bytes, port number and timeout  Acknowledgments, duplicate checking and journaling (audit)  Source feed provided either direct to queue, or published to topic Many Thanks to Ant Philips 28
  • 29.
    HL7 MLLP Nodes These nodes encapsulate the MLLP protocol and HL7 message parsing  Nodes handle de-duplication, validation, acknowledgments and timeout handling  Easy to use nodes enable new HL7 message processing scenarios  Examples include HL7 to data warehouse and HL7 device aggregator integration Many Thanks to Ant Philips 29
  • 30.
    Message Broker Built-InNodes The HL7 pattern uses a variety of Message Broker built-in nodes HL7 v2 MLLP protocol is built on top of TCP/IP connections Messages must be kept in order as they are transformed and routed  Sequencing nodes enable high performance multi-threaded processing Persistent messages ensure data is kept safe and secure HL7 pattern instances can be extended in many different ways! Many Thanks to Ant Philips 30
  • 31.
     Message BrokerExplorer is our administration application  Provides a secure broker administration and monitoring environment  Enhancements provide insight into the healthcare environment  How many HL7 MLLP messages have been processed?  Are my clinical applications connected and working?  What status messages have been sent from my medical devices?  When were the TCP/IP connections last created and dropped?  Visual warnings when queues approach limits and applications disconnect Operational Monitoring Many Thanks to Ant Philips 31
  • 32.
    Distribute Database Informationto Where It’s Needed! Provide timely access to changed database information Move to near real-time data trickle from infrequent ETL extract  Database Node allows tables to be treated as input source  Typical scenarios include database to queue & file, or PubSub data distribution  Captures database changes (Insert Update, Delete) to trigger connectivity processing  Supports single & multiple tables, complex joins, and other database oriented semantics  Extends database capabilities in MB to provide comprehensive inbound/outbound support  Works with full range of broker databases including Oracle, DB2, SQL server, & solidDB a • Most existing Event table and data table structures supported without database change  RAD tools construct skeleton database queries to simplify user experience • Power users can create sophisticated SQL routines if required or desired Event Table  Fully Transactional with High Performance and Scalability  Distinct event cache & data transactions minimizes contention  Exploits SQL engine for full 2Phase commit transactions 32
  • 33.
    ESB: Connect Everythingto Everything. Universal Connectivity  A Universal Message Bus for access to data wherever it exists to support your business  A comprehensive range of messaging capabilities to support your business requirements for data integration  Managed File Transfer  Messaging integration patterns  Provides appropriate data access and data privacy controls to help meet audit and regulatory requirements  WMQ Telemetry is one step in extending the reach to a wider world of data relevant to your business (“ The internet of things”) 33 Petrol Forecourt Branch Outlet Regional Office Retail Store Refinery Mobile Phone Sensor e.g. RFID Enterprise Pervasive Device CSS: F S
  • 34.
    Graphical Transformations 34  IBMGraphical Data Mapper (GDM)  Visually map & transform source to target data • Code-free, high performing & scalable  GDM designed for whole IBM product set • e.g. Full map exchange with MDM Server V9 • Mapping Script Language(MSL)format  Simple & powerful graphical mapping experience  Apply transformations to single and multiple elements • Conditionals (if then else), Loops(for each), Functions(target=f(source)) & more!  Database mapping sources and targets for routing and enrichment scenarios • Broad data base support(Oracle,DB2,SQLServer,Sybase,Informix...)  Complements and supports existing transformation languages • Call user defined transformation in Java, SQL, XPath, .NET...   Simple deployment, high performing & scalable  Maps can be deployed with solution BAR file or stand-alone  JIT compile means technology advances improves existing, deployed solutions • Source deploy + runtime compilation = enhanced performance
  • 35.
    WebSphere Message BrokerVersion 8 Summary  Universal Connectivity FROM anywhere, TO anywhere  Simplify application connectivity for a flexible & dynamic infrastructure  Comprehensive Protocols, Transports, Data Formats & Processing  Connect to applications, services, systems and devices • MQ, JMS 1.1, HTTP(S), SOAP, REST, File (incl. FTP, FTE, Connect Direct), Database, TCP/IP, MQTT, CICS, IMS, SAP, SEBL, .NET, PeopleSoft, JD Edwards, SCA, CORBA, email...  Understand the broadest range of data formats • Binary(C/COBOL),XML, CSV, JSON, Industry(SWIFT,EDI,HL7...), IDOCs,  Built-in suite of request processors • Route, Filter, Transform, Enrich, Monitor, Publish, Sequence  Simple Programming with Patterns & Graphical Data Flows  Patterns for top-down, connectivity of common use cases • e.g. Service façades, Message processing, Queue2File...  Graphical data flows represent application & service connectivity • Custom logic via Graphical mapping, PHP, Java, ESQL, XSL, WTX  Extensive Management, Performance & Scalability  Deployment options include Trial, Express, Standard and Advanced  Connectivity Packs for Industry Specific Content  Connectivity Pack for Healthcare includes HL7 Connectors, Patterns & Tooling 35
  • 36.
    WebSphere Message Broker– Health Care Quick Start - 8 week effort  High Level Architecture - 5 days  Conduct an interactive workshop (whiteboard sessions) that will focus on WebSphere Message Broker and WebSphere MQ integration specifically in your environment  Provide a high-level architecture document  Deliver a proposal with recommendations for achieving both short and longer term goals  Coding and Testing (Implement 3 use cases) – 15 days  Conduct a requirement gathering session for each use case  Document the requirements and create a low-level technical specifications document, describing the implementation details for each use case  Develop techniques and best practices  Connecting Clinical Applications(HL7 to HL7 processing)  Production ready pattern based on HL7 MLLP v2.x  Mediates between HL7 clinical applications (1:1 and 1:many)  Focus on ADT, ORU and ORM messages from HL7 standard  Report Generation (using PHP scripts)  Production ready pattern to generate reports from HL7 MLLP v2.x  Out-of-the-box solution for text-based reports and file distribution  Easily customized for different destinations (FTP/sFTP/email)  Inbound HL7 message used as the input data for a report template 36
  • 37.
    What are yournext steps?  Free Dedicated Discovery Call - Conference call between you and our certified Solutions Experts. Discovery call identifies current IT infrastructure and requirements to recommend the best strategy for you.  Free Healthcare ESB Discovery Call - For clients who want to gain a deeper understanding of how an IBM Healthcare ESB can help with their business integration needs.  Free Message Broker Quick Start Discovery Call - For clients who want to get the most out of message broker as quickly as possible.
  • 38.
  • 39.
  • 40.
    Identify, Segment, Targetand Engage 4040 TRANSFORM HEALTHCARE ENGAGE AND COLLABORATE TO IMPROVE CARE AND OUTCOMES: Improve the quality and efficiency of care while cultivating patient centricity through engagement and health and care personalization. IDENTITY and SEGMENT: Identify and segment the overall population. Determine appropriate course of action. TARGET Targeted Information, Content, Interventions and Actions- Personalized Care Plan
  • 41.
    From Point ofCare to Population Management Data aggregated from multiple sources such as encounter, self reported, in- home devices and cloud services leads to better clinical decisions and aids in driving targeted information and content to better manage the health of an individual as well as an entire population. Incoming data from multiple sources/channels can be used to discover, segment, target and engage. From prevention to intervention- a personalized care plan tailored to the individual‟s needs
  • 42.
    Contact – A.J.Aronoff Infrastructure Practice Director Email - aj@prolifics.com Resources http://expert-tech.blogspot.com/ Blog Entry: Zero Downtime http://expert-tech.blogspot.com/2013/02/the-messaging-whisperers-zero-downtime.html

Editor's Notes

  • #8 In a nutshell…standardize, digitize, connect and share! Talk about the timeline for meaningful use and why mobile is key to stage 2…and 3 
  • #9 Connectivity, Process and Decision Automation IS what will power healthcare in the futureDiscuss scenario’s i.e. discharge or post op order summaries and content, predict at occurrence of discharge the likely hood of readmit --score models, decision automation etc…Care team interaction and monitoring progress, sensors and remote monitoring data and ability for care team to engage appropriatelyContent from wellness, DM, caregiver
  • #11 Discuss influx of data from multiple channels- need to automate decisions and employ predictive analytics to respond accordingly to event – alerts, interventions, tailored content etc.Mention that cloud can achieve elasticity, scale on demand, and help ease the burden
  • #15 WelcomeAbout ProlificsOfferings and sales playsQ and A
  • #16 WelcomeAbout ProlificsOfferings and sales playsQ and A
  • #35 WelcomeAbout ProlificsOfferings and sales playsQ and A
  • #36 WelcomeAbout ProlificsOfferings and sales playsQ and A