Discover How Allscripts Uses InfluxDB to Monitor its Healthcare IT Platform

2. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 2 • Introduction • Allscripts company overview • The Problem • Solution Requirements and Overview • Outcomes and Future Projects • Q&A Agenda

5. 5 Global Healthcare Crisis How we Interact COVID-19 Protection Working Location Social distancing Personal Protection Equipment (PPE) Stay at (work from) home Challenges we see in healthcare are unprecedented

6. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 6 Together, we can connect medicine We can change what’s possible Strengthen Your Foundation Drive quality care with essential solutions Engage Your Patients Coordinate care and help patients take charge of their health Connect Your Community Deliver data and insights to where they are needed most Build Your Future Ensure organizational agility and capacity to thrive

7. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 7 Helping you deliver smarter care • Industry-leading Specialty Content • Actionable Insights at Point of Care • Intuitive Workflows for Ease of Use • Care Coordination Across the Continuum

8. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 8 We’re recognized by the industry • 2017: Mindshare Population Health Management • 2016-2017: Mindshare Leader in Revenue Cycle Management • 2016–2017: Mindshare Leader in Patient Engagement • 2018: #1 Population Health Management Market Leader • 2020: Best in KLAS Global (non-US) Acute Care EMR – Canada • 2018 – 2019: Best in KLAS Anesthesia—iProcedures 2017 Highest in usability in small practice ambulatory EHR|PM • 2016: Highest in usability in Population Health Management Report—Population Health UX • 2015–2016, 2013: Lab Best in KLAS • 2020: #1 Critical access, specialty hospitals, and integrated community health systems • 2020: #1 EHR-Based Analytics & Support • 2020: #1 Ambulatory EHR for Government Providers • 2020 Black Book #1 Practice Management solution (10-49 physicians) • 2019: #1 Healthcare IT vendor in UK, Canada, Australia, and New Zealand • 2019: #1 Ambulatory EHR for Multispecialty clinics • 2017-2020: #1 Inpatient Hospital EHR for Community Hospitals 101- 250 beds • 2014-2017, 2019: #1 Large Inpatient Hospital 250+ • 2014-2020: #1 Ambulatory EHR 26-99 • 2018-2019: #1 Rehabilitation Hospitals • 2018: #1 Hospital Chains, IDNs and Networks for Integrated EHR, Interoperability, PHM & RCM Solutions • 2019, 2017: Microsoft Health Partner of the Year • 2015: Microsoft CXO Next Innovation Award • 2015: Microsoft Health User Group Innovation Award • 2020: US Healthcare Interoperability EMR Market Leader • 2019: Best Practices Award—US Population Health Management Product Leadership Award • 2019, 2017: Best Practices Award—US Ambulatory Revenue Cycle Management Product Leadership Award • 2018: Becker’s Hospital Review Top Places to Work in Healthcare

10. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 10 The Problem Various Cloud Solutions 3rd Party Solutions Self-Hosted Solutions Multiple Allscripts Datacenters Various Monitoring Solutions 3rd Party Datacenters Different VisualizationsDifferent Alerting Methods Support Operations and Development Management

11. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 11 Unified platform to monitor any system, Allscripts solutions, and allow custom development Key Solution Requirements Flexible Economical Adaptable Scalable Replace costly commercial tools and leverage solution to monetize new service offerings Monitor any environment – Hosted, Self- hosted, 3rd Party, Cloud, Hybrid and rapidly changing technologies Extreme scalability and implement quickly through orchestration

12. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 12 No downtime required to implement meeting the demand of highly available healthcare systems Additional Solution Requirements Zero Downtime Security Modular Reporting Meet Customer, Allscripts, HIT, and in some cases government/regional security requirements Swap out modules without affecting the entire monitoring solution Centralized, accessible, robust reporting and dashboards

14. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 14 Solution Overview Three Primary Components  Configuration Management  Log Analytics  Telemetry/Metrics Analytics In Scope:  Operating System: primarily Windows Server; some Linux  Application: Middleware (IIS, SQL Server, etc.) and Business services Out of Scope:  Infrastructure (e.g. Storage, Network, & Virtualization layers)  APM / Distributed Tracing (for now) Composed of open-source (enterprise backed) pluggable, modular, event driven frameworks Stretch goal: provide a framework for automation/orchestration of product installation/upgrade/troubleshooting activity, in addition to monitoring

15. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 15 Telemetry Vs. Existing Proprietary Tools  Operational and Cost complexity Vs. TimeScaleDB  Product Maturity  Data Model Flexibility: TagSet vs Relational Schema  TimeScaleDB lacks alerting Vs. Prometheus  Push vs Scraping  Horizontal Scalability Why InfluxData?

16. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 16 Configuration Management & Log Analytics SaltStack: Configuration Management Vs. Ansible, Chef, Puppet, and Azure Automation  Push vs Pull  Conflicting/Multi-Homing agents  Salt's event driven architecture and modularity fit well with project requirements  Python vs Ruby ElasticSearch: Log Analytics Vs. GreyLog, Splunk, and Azure Log Analytics  Cost, Complexity; Keep it simple

17. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 17 Visualization & Alerting Visualization: Grafana - Single pane of glass Alerting Telemetry: Kapacitor Logs: ElasticSearch Alerting vs Open Distro (work in progress)

21. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 21 Outcomes: • Fast delivery – thousands of agents deployed in minutes, not manually over days or weeks • Smaller footprint to manage, maintain and secure; reducing operational costs and security risks • New service revenue opportunities – solution allows us to deploy monitoring in areas not feasible in the past due to costs • Improved support and service delivery - centralized dashboards accessible directly from ITSM solution Learning Experiences: • Tuning InfluxDB Disk IO performance • Saturating network PAT & bandwidth • Saturating Telegraf Relay request volume • Input-specific jitter for Telegraf plugins (#3634) • Tuning batch size, metric buffers, and flush intervals • TLS client certificate monitoring (#7754) • Fixed in a day! Thanks @danielnelson! Outcomes

22. © 2020 Allscripts Healthcare, LLC and/or its affiliates. 22 • Consolidate custom developed monitoring tools using Influxdata and other solutions – Shim Plugin for custom SQL Queries • Resolve challenges with Telegraf relays in multi-datacenter configuration • Consolidate commercial monitoring tools and footprint – line of sight to drastic cost reduction in 2021 • Leverage the solution to “monitor the monitoring systems” • InfluxDB 2.0/Flux Future Projects

23. 23 Questions?

24. facebook.com/allscripts allscripts.com @allscripts linkedin.com/company/allscripts

25. We look forward to bringing together our community of developers to learn, interact and share tips and use cases. www.influxdays.com/virtual-experience-2020/ November 10 – 11, 2020 Virtual Experience