Upload
dangkhuong
View
224
Download
0
Embed Size (px)
Citation preview
Innovative Approach for Healthcare Integration Using IBM Integration Bus
Nguyen'Tuan'Khang'|'[email protected]/|/0913/008994/Senior/Solu;on/Advisor/IBM/Cloud,/SoDware/Group/
1
REDEFINING VALUE AND SUCCESS IN HEALTHCARE
COLLABORATE TO IMPROVE CARE AND OUTCOMES Improve the quality and efficiency of care while cultivating patient centricity through engagement and health and care personalization.
INCREASE ACCESS TO HEALTHCARE Reduce disparities in access and compel individuals to become advocates for their own health.
BUILD SUSTAINABLE HEALTHCARE SYSTEMS
Build an efficient, flexible organization that proactively manages cost and regulatory
requirements and enables greater transparency and accountability.
Evidence-Centric Healthcare
2
• Health Information Exchange (HIE) • Enterprise, Patient and Clinical Portals • Health Benefit Exchange (HIX) • Smarter Commerce for Healthcare / Consumer 360 • Connected Home Health / Telehealth
• Enterprise, Patient and Clinical Portals • Provider Outcome Analytics / Provider Analytics Platform • Content and Predictive Analytics • Fraud, Waste & Abuse Management • Disease Surveillance and Modeling • Enterprise Forms Management • eHealth Suite • Payer Analytics Platform
• Enrollment and Membership Process Optimization • ICD-10 Transformation • Enterprise Service Bus for Healthcare • Medical Image Storage Archive (Private Cloud) • Privacy, Security and Business Resilience • Application Portfolio and Management Services • Digital Hospital Infrastructure Virtualization and Optimization
IBM HEALTHCARE SOLUTIONS Increase access to healthcare
Collaborate to improve care and outcomes
Build sustainable healthcare systems
Enterprise Analytics
Consumer Services
Business Process Modernization
3
HEALTHCARE INTEGRATION?
• Enterprise'systems'consist'of'many'logical'endpoints'
• Off<the<shelf'applica=ons,'services,'cloud'apps'(SaaS),'web'apps,'devices,'appliances,'custom'built'soEware''
• Endpoints'expose'a'set'of'inputs'and'outputs'which'compromise'
• Protocols'–'e.g.'TCP/IP,'HTTP,'File'System,'FTP,'MQ,'SMTP,'POP3,'etc…'
• Message'Formats,'Binary'(C/COBOL),'XML,'Industry'(HL7,'EDI),'User<defined'
• ‘Integra=on’'is'connec=ng'these'endpoints'in'meaningful'ways'to'achieve'interoperability'
• Route,'Transform,'Enrich,'Filter,'Monitor,'Distribute,'Decompose,'Correlate,'Fire'and'Forget,'Request/Reply,'
Publish/Sucscribe,'Aggrega=on,'Fan<in,'Complex'Event'Processing….'
3'
4
HEALTHCARE INTEGRATION CHALLENGES Proprietary*nature*of*technology*! Most'healthcare'systems'are'closed'systems'and'the'architectures'
and'data'models'are'proprietary'to'different'vendors'
! Various'healthcare'systems'end'up'becoming'siloes'of'informa=on,'
making'data'exchange'very'complex'
Implementa4on*Concerns*! Complex'implementa=on'programs'
! Data'security'challenges'
! Adop=on'of'messaging'standards'
! Cost'and'ROI'implica=ons'
Data*Availability*Challenges*! OEen,'the'necessary'data'is'not'available'in'real<=me'
! Data'needs'to'be'transformed'as'it'is'not'available'in'the'required'format'
! Healthcare'interoperability'and'EMR/'EHR'integra=on'are'symbio=c'in'nature'
! Few'standalone'EMRs'only'contain'pa=ent'demographics'and'the'rest'of'the'clinical'informa=on'is'paper'based,'making'
it'difficult'to'extract'the'en=re'medical'history.'
5
HEALTHCARE INTEGRATION TO SUPPORT HIGHER VALUE INITIATIVES
5'
6
INTEGRATION TOPOLOGIES
'Bridges • OEen'used'for'single'point<to<point'connec=ons'• Usually'cheap'and'quick'to'configure'• More'difficult'to'scale'to'larger'numbers'of'endpoints'
6
cloud
B2B etc.
internet Gateways • Provides connectivity to
third parties or to a specific class of endpoint
• For example, internet, cloud, security, DMZ, B2B
• Combines simplicity of configuration and (commonly) an on-ramp to backend ESB
Enterprise Service Bus (ESB) • Logical construct that combines data movement
and enrichment • Scales very well; can integrate small and large
numbers of endpoints, and can be easily distributed
• Often applied as a backbone for a Service Oriented Architecture (SOA)
• Solutions can usually also be applied to hub and spoke style architectures
7
IBM INTEGRATION ARCHITECTURE FOR HEALTHCARE
Pharmacy
Medical devices
Medical imaging modalities
Medical applications
Clinical repositories
Legacy interface engines
Enterprise Master Patient Index
Laboratory
HL7'Cache'
ODBC'
DICOM' HL7,'
Proprietary,'
RS232'
Web'Services'
HL7v2,'FHIR' HL7'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
IHE'PIX/''
PDQ'HL7'
HL7'
IBM API Gateway Edge
IBM Integration Bus + Healthcare Pack
Mobile Mainframe CICS/IMS
MQ, JMS, MSMQ
ERP / EIS / CRM Files Devices Analytics
Web Services Microsoft Web 2.0 Databases Applications Decision Management / Business Process
Remote patient monitoring Medical insurers Community
Sterling'Connect'
Direct,'HIPAA'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'
8
KEY FEATURES
• Paeern<based'development'tooling'<'fast'integra=on'
without'detailed'knowledge'of'integra=on'technologies'
• Makes'use'of'proven'run=me'of'IBM'Integra=on'Bus'
• Integrates'HL7'based'clinical'repositories'&'applica=ons'
• Produc=on'ready'paeerns'based'around'HL7'v2.x'• Paeern'allows'easy'customisa=on'
• Handles'inbound'and'outbound'MLLP'socket'connec=ons'
• Message'defini=ons'for'all'chapters'of'the''HL7'v2.x'
specifica=ons'
• Integrates'DICOM'based'PACS'&'modali=es'
• Processes'CDA/CCD'documents'
• Direct'connec=vity'to'medical'equipment'<'monitors,'
infusion'pumps'etc'
• Healthcare<oriented'opera=onal'views'
• Single'point'of'visibility'and'control'
Electronic'
Medical'
Records'
Pa=ent'
Administra=on'
System'
PACS'&'
imaging'
Labs'&'
pharmacy'
Medical'
devices'
Remote'
Pa=ent'
Monitoring'
9
HL7'Web'Services'
HL7v2,'FHIR'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
DICOM'
CONNECTING CLINICAL APPLICATIONS
9'
Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Integration Gateway Edge
Remote patient monitoring Medical insurers Community
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'Medical imaging
modalities Enterprise Master
Patient Index Medical
applications Clinical
repositories Laboratory Pharmacy
In*isola4on,*clinical*technologies*cannot*provide*a*single,*360*degree*view*of*the*pa4ent*• e<prescribing,'prac=ce'management,'EHRs,'health'informa=on'systems,'clinical'portals,'etc'
Connect*clinical*applica4ons*across*the*enterprise:*• Enhance*pa4ent*care'–'A'single'view'of'the'pa=ent'supports'more'informed'clinical'decision'making'and'risk'analysis.'
• Reduce*costs'–'Giving'care'staff'access'to'the'right'informa=on'at'the'point'of'care'supports'the'reduc=on'of'duplicate'
ac=vi=es'(such'as'tests)'and'with'beeer'access'to'data,'your'organiza=on'has'the'opportunity'to'gain'new'insights'and'
make'beeer'business'decisions.'
• Save*4me'–'Reduce'=me'spent'on'searching'for'relevant'data'and'add'new'applica=ons'as'the'business'has'need'for'them.'
10
IHE'PIX/''
PDQ'HL7'
DICOM'
HL7' HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'Medical
applications
Clinical repositories Pharmacy Laboratory
INTEGRATE WITH AN EMPI
Integration Gateway Edge
Remote patient monitoring Medical insurers Community
Medical imaging modalities
Enterprise Master Patient Index
Challenges*in*crea4ng*a*longitudinal*pa4ent*record*• Mul=ple'records'may'exist'across'the'enterprise.'Matching'and'linking/merging'records'across'an'enterprise'once'
disparate'systems'are'integrated'can'be'complex'
*By*integra4ng*an*EMPI*you*can:*
• Iden=fy'the'same'pa=ent'across'disparate'systems'to'link'records'helping'establish'an'accurate'pa=ent'medical'
record'
• Store,'view,'and'match'data'within'global'languages'in'mul=ple'character'sets'
• Find,'correct,'and'eliminate'duplica=on'and'other'data'quality'problems'across'systems'and'data'sources'
11
DICOM'
HL7'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'Medical
applications
Clinical repositories Pharmacy
Enterprise Master Patient Index
Laboratory
INTEGRATING MEDICAL IMAGES
11'
Integration Gateway Edge
Remote patient monitoring Medical insurers Community
Medical imaging modalities
Why*automate*flow*of*images*between*archives?*• Provide'access'to'data'held'in'remote'PACS'systems''
*Improving*clinical*process**
• Engage'external'experts'in'diagnos=c'process'by'rou=ng'image'data''
• Ensure'latest'pa=ent'informa=on'at'the'clinicians'finger=ps'by'implemen=ng'pre<fetch'of'
studies'on'admission'
12
Medical imaging modalities
DICOM'
HL7'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'Medical
applications
Clinical repositories Pharmacy
Enterprise Master Patient Index
Laboratory
SHARING DATA BEYOND THE HOSPITAL WALLS
12'
Integration Gateway Edge
Remote patient monitoring Medical insurers Community
Pa4ents*may*move*between*care*facili4es*for*a*number*of*reasons*• Without'medical'records'from'previous'visits'in'other'organiza=ons,'clinicians'may'not'be'aware'of'a'pa=ent’s'history'
• May'lead'to'unnecessary'duplica=on'of'ac=vi=es'(eg.'diagnos=c'tests)'
Integrate*using*‘Integra4ng*the*Healthcare*Enterprise’*profile*for*a*standard*approach*to*sharing*and*receiving*health*related*documents*
• Increase'efficiency'by'reducing'unnecessary'paperwork'
• Provide'caregivers'with'clinical'decision'support'tools'for'more'effec=ve'care'
• Enable'interoperability'among'EHRs'maintained'by'individual'physicians'&'organiza=ons'
13
DICOM'
HL7'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'
Legacy interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'Medical
applications
Clinical repositories Pharmacy
Enterprise Master Patient Index
Laboratory
INTEGRATING MEDICAL DEVICES
13'
Integration Gateway Edge
Remote patient monitoring Medical insurers Community
Medical imaging modalities
Medical devices
Why*automate*data*capture?*• Ensure'consistency'in'hospital'records'
• Single'source'of'truth'for'li=ga=on'
*Remove*need*to*reNkey*data*
• Free'clinicians'to'deal'with'clinical'tasks'
• Reduce'errors'
• Ensure'latest'pa=ent'info'at'the'clinicians'finger=ps'
14
DICOM'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'Medical
applications
Clinical repositories
Medical imaging modalities
HL7'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'
Pharmacy
Enterprise Master Patient Index
Laboratory
HIPAA MESSAGING
14'
Integration Gateway Edge
Remote patient monitoring Community Medical insurers
Eligibility,*claims*and*payment*reconcilia4on*can*be*a*long*and*complex*process*• Interac=ons'with'a'pa=ent'must'now,'under'HIPAA,'send'most'billing'claims'for'services'via'electronic'means'
• Mul=ple'transac=ons'are'needed'to'complete'the'medical'billing'cycle'
Simplify*the*exchange*of*informa4on*between*payers*and*providers*• Integrate'claims'processing'ac=vi=es'with'medical'applica=ons'on'a'single'plalorm'to'simplify'billing'cycle'and'
receive'faster'reimbursements'
15
DICOM'
IHE'XDS,'
CDA/CCD,'
XML,'HL7'Medical
applications
Clinical repositories
Medical imaging modalities
HL7'
IHE'PIX/''
PDQ'HL7'
HL7'
Sterling'Connect'
Direct,'HIPAA'
HL7,'FHIR'
Cache'ODBC'
Web'Services'
Web'Services'
HL7v2,'FHIR'
Medical devices Legacy
interface engines
HL7'Cache'
ODBC'
HL7,'
Proprietary,'
RS232'
Web'Services'
SOAP'HTTP'
MQTT,'Con=nua'
Pharmacy
Enterprise Master Patient Index
Laboratory
REMOTE PATIENT MONITORING
15'
Integration Gateway Edge
Medical insurers Community
Remote patient monitoring
Care*of*pa4ents*outside*of*tradi4onal*care*ins4tu4ons*• Post<acute'care,'chronic'condi=on'sufferers'or'pa=ents'who'need'long'term'health'management'(eg.'
weight'management)'
*Intervene*faster*to*resolve*issues*before*reNadmiQance*
• Support'the'connec=on'and'flow'of'data'from'remote'devices'(medical'devices,'mobile'applica=ons)'
• Track'success'and'personalise'plans'based'on'the'individual'
• Look'aEer'all'pa=ents'while'spending'the'=me'with'those'who'really'need'help'
16
PUTTING IT ALL TOGETHER…
16'
MQTT DICOM PACS
Predicting Deciding
Integrating
Imaging*Modality*
Pa4ent*Report*
Monitoring
Electronic*Health*Record*
Alert*Doctor*
ODBC JDBC
SMS
1. An'ambulance'aeends'a'pa=ent'who'has'collapsed'and'
makes'an'ini=al'assessment,'transmieed'via'MQTT.*
2. Monitoring'displays'summary'data'in'a'Web'UI.'
3. The'Integra=on'Bus'looks'up'the'pa=ent’s'history'in'an'EMR.'
4. An'Event'containing'both'the'pa=ent'assessment'and'
their'medical'history'is'sent'to'an'Analy=cs'engine'to'
determine'the'likelihood'of'pa=ent'admission.*
5. Based'on'the'predic=on,'the'Rules'engine'decides'whether'to'alert'a'doctor'in'readiness'for'pa=ent'
arrival.'
6. Before'the'pa=ent'arrives,'the'Integra=on'Bus'gathers'together'their'image'history'from'PACS'systems'(inside'
or'outside'the'care'centre).*
17
SHARING BIG DATA IN HEALTHCARE
18
MEDIA FILES SHARING TOOLS
19
NEW APPROACH TO SHARING BIG DATA WITH IBM
20
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served. The system's primary service area consists of 16 counties in north central Texas, home to more than 6.2 million people. THR has 12 acute-care hospitals and one long-term care hospital that total 3,355 licensed hospital beds, employs more than 18,000 people, and counts more than 3,600 physicians with active staff privileges at its hospitals
TEXAS HEALTH RESOURCES CLIENT SUCCESS STORY
• Challenges*• THR'needed'to'migrate'from'their'current'middleware'/''transforma=on'
plalorm'(Sun/Oracle'eGate).'The'soEware'had'become'outdated,'and'
con=nuing'support'from'the'vendor'was'in'ques=on.'
• Integra4on*in*Ac4on*– Converted'the'14<hospital'environment'to'the'IBM'Healthcare'Integra=on'
solu=on,'allowing'the'hospital'group'to'integrate'their'disparate'systems'
using'an'open'standards<based'plalorm.'
• Business*Outcomes*" The'conversion'allowed'the'sharing'and'standardiza=on'of'both'message'and'
data'from'all'hospitals'within'the'group,'and'standardized'their'development'
plalorm'
" Func=onality'that'provides'robust'support'for'all'HL7'messaging'and'
heterogeneous'opera=ng'environments'handling'transac=on'volumes'of'
2million+'per'day'
" More'affordable'and'a'lower'TCO'than'the'compe=ng'solu=ons'
" Advanced'transac=onal'capabili=es'enabled'the'client'to'implement'only'one'
processor'license'to'support'current'and'future'messaging'transac=on'needs.'
'
'
21
Dignity Health, headquartered in San Francisco, California, runs 43 hospitals and medical canters in California, Arizona, and Nevada.
Founded in 1986, it is one of the largest not-for-profit providers in California with more than 8,500 physicians providing healthcare services to more than four million people annually.
DIGNITY HEALTH CLIENT SUCCESS STORY
• Challenges*• Working'with'IBM,'Dignity'Health'implemented'a'robust'integra=on'plalorm'
to'meet'the'Electronic'Health'Record'(EHR)'mandate'for'health'informa=on'
flows'between'hospitals'based'upon'the'HL7'standard.'
• Integra4on*in*Ac4on*• Internally'referred'to'as'ConneXion,'the'solu=on,'built'upon'IBM'Integra=on'
soEware,'was'customized'with'over'2500'integra=ons'to'cater'to'the'EHR'
and'HL7'mandates.'
• This'took'full'advantage'of'the'core'values'of'IBM’s'messaging'and'ESB'
solu=on,'to'provide'a'reliable,'high<performance'messaging'system'that'is'
easy'to'scale.''
• Business*Outcomes*" Robust'Backbone'for'transmiqng'EHR'data'
" Handles'millions'of'messages'a'day'
" New'hospitals'can'be'easily'added'to'backbone'" IT'Standards'&'integrity'retained'as'network'grows'
© 2014 IBM Corporation
'
'
22
STRENGTHS AND DIFFERENTIATORS
" Robust'<'Supports'data'integra=on'across'80'plalorms'and'
includes'access'to'a'large'range'of'industry'standard'
databases'and'ERP'systems'
" High*Performance*–'Scalability'and'throughput'leader'with'support'for'more'than'450'million'messages/day,'and'low'
latency'(up'to'2.25x'faster'than'closest'compe==on)'
" Simple'–'Minimize'the'need'for'custom'coding'of'interfaces'
and'reduce'design,'buid'and'test'costs'by'40%'to'60%.'
" Readily*available*skills*<'Extensive'network'of'trained'IBM'
Business'Partners'and'ISVs'with'over'4000'cer=fied'
specialists'worldwide'
" Close'interac=on'with'a'loyal'and'growing'customer'base'
and'product'development'team'through'Beta*and*Lab*Advocacy*Programs*
" Developed,'tested'and'supported'from'IBM’s'Hursley'
soEware'development'laboratory'in'the'UK'in'addi=on'to'a'
24*x*7*worldwide*support*organiza4on*
22'
23
WHY IBM?
" Trusted'integra=on'technology,'with'over'15'years'in'the'market'
" More'than'1000*produc4on*installa4ons*" More'than'600*installa4ons*at*healthcare*sites**
Forrester:''Case'study'revealed:'• Open'source'ESB'would'significantly'increase'risk'of'incidents'($700,000'
savings)'
• Significant'scalability'and'throughput'advantage'($320,000'savings)'
• More'produc=ve'and'efficient'development'environment'($684,000'
savings)'
• Wider'range'of'integra=on'op=ons'resul=ng'in'reduced'development'effort'
than'the'open'source'alterna=ve'($150,000'savings)'*
Gartner:''“IBM'is'a'Leader'in'all'three'applica=on'infrastructure'project'markets,'
because'of'the'depth,'breadth,'adop=on'and'maturity'of'its'technology.'[IBM'
Integra=on'Bus'is'a]'technically'proven'and'powerful'product'[with'a]'broad'
install'base'and'partner'ecosystem.”'*
InfoTech:''“Highly'customizable…'wide'range'of'connec=vity…'makes'
integra=on'intui=ve...'well'suited'for'handling'high'message'volumes...'entry<
level'pricing'may'make'it'en=cing'for'smaller'companies.”'
23'
24
QUESTIONS AND MORE INFORMATION!
25
THANK YOU