CONNECT 4.0Enhancing Health Information Exchange for Interoperability Success

February 12, 2013

Introduction

Greg Turner

CONNECT Product Manager

Brian Humphrey

CONNECT Architect

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Webinar Technical Details

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What is the largest file size I can stream usingCONNECT 4.0?

What is CONNECT ?

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What is CONNECT?

CONNECT is a software platform that supports health information exchange

CONNECT uses Nationwide Health Information Network standards and governance to ensure HIEs interoperate with other current and future exchanges

CONNECT is a low cost open source solution that is designed to be flexible to support an evolving health data exchange environment

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Why CONNECT?

CONNECT can be used to:• Set up a health information exchange

within an organization

• Set up a Direct health information service provider (HISP)

• Tie a health information exchange into other HIEs including the eHealth Exchange, CMS esMD or Direct

• Support patients by providing the technology that allows them to electronically “carry” their health record as they traverse the healthcare system.

• Support providers by enabling a more complete picture of a patient’s medical record increasing quality of care

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CONNECT Building Blocks

CONNECT sits between the HIE implementation system, or EMR, and “exchange partners”

CONNECT sends and receives NwHIN Exchange and NwHIN Direct messages to other practices, hospitals, and HIEs

A CONNECT adopter is required to create or implement services called adapter services that allow for processing the messages to and from CONNECT

CONNECT provides reference adapters that include sample code on how to connect back-end systems to CONNECT using adapter services

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Master PatientIndex (MPI) System

EMRor HIE System

EMR or HIEAdapter Service

Creates/sends messages to CONNECT and receives/processes and responds to messages from CONNECT

Document Registry System

Document Repository

Policy Engine

Regional Health Information Organization

Government Agency

Health Information Exchange

Hospitals, physicians, practices

Disease Oriented Care Network

NwHIN Exchange

Any mail server

EMRor HIE System

EMR or HIEAdapter Service

Creates/sends messages to CONNECT and receives/processes and responds to messages from CONNECT

Regional Health Information Organization

Government Agency

Health Information Exchange

Hospitals, physicians, practices

Disease Oriented Care Network

NwHIN Direct

CONNECT 4.0 Direct Overview

CONNECT is Open Source Software

• Open source license

• Open release planning, sprint review and planning sessions

• Community contributions welcomed

– Bug reports + fixes

– Features requests + implementations

– Testing and requirements

• FHA-sponsored Product Management, Curation, Development

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CONNECT 4.0 Release Overview

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CONNECT 4.0Release Features

① Increased throughput targeting increased numbers of PD, QD, RD, AD, and DS transactions

② Exchange and process large payload sizes of up to 1 GB

③ Run CONNECT on additional application servers such as IBM WebSphere and Oracle WebLogic to meet their environment needs

④ More comprehensive event logging and metric data

⑤ Ability to determine the state of a transaction across messages in order to better review and analyze the operation of CONNECT and adopters’ trading partners

⑥ Minimize deployment load by supporting a lightweight gateway which allows smaller server footprint and use of system resources

⑦ Support Direct messages to allow for greater adoption and exchange

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#1 – Increase Throughput for CONNECT

FEATURE

Increase throughput, targeting increased numbers of PD, QD, RD, AD and DS transactions

BENEFITS

More efficiency of gateway at higher volumes

Support more widespread or national rollout plans for health data exchange

Better utilization of adopter infrastructure

1600 messages/minute

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Test Plan and Test Report https://developer.connectopensource.org/display/CONNECT40/Performance+Testing

#1 – Increased Throughput for CONNECTIncreasing CONNECT’s throughput and efficiency

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*These numbers are based on the same testing methodology performed during the CONNECT benchmark testing for release 3.3.

Achieving Gains•Reduction in memory usage

•ApacheCXF & OpenSAML

•Reduced number of static classes

•Fewer number of Webservices running

•Removed redundant and duplicative code flows

#2 – Large Payload Support

Provide the ability to exchange and process large payload sizes of up to 1 GB

BENEFITS

Increased ability to support the data exchange needs of more adopters

Enable additional use cases that require the exchange of larger file sizes

Positive impact on performance of gateway when handling larger payloads

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FEATURE

#2 – Large Payload Support

Large Payload (Combinations of Messages with payloads totaling 1 Gigabyte)

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 Document Submission

Document Submission Deferred Req

Document Retrieve

1 - GB Message    119 s*      143 s     63 s

2 - 500 MB Messages      84 s        87 s     29 s

10 - 100 MB Messages      48 s        45 s     25 s

20  - 50 MB Messages      45 s        48 s     24 s

50 - 20 MB Messages      50 s        50 s     25 s

100 - 10 MB Messages      54 s        55 s     30 s

*Seconds

#3 – Support for Multiple App Servers

Run CONNECT on additional application servers such as WebSphere and WebLogic to meet expanded environment needs

BENEFITS

More deployment options

Remove any tech stack waivers

Model for the community to add support for other app servers

Adopters can use their preferred app servers and take advantage of internal sys admin expertise for things like security, scalability, etc.

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FEATURE

CONNECT Deployment Diagram

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#4 – Event Logging

Provide more comprehensive event logging and metric data (counts and duration) using improved logging in CONNECT

BENEFITS

Allows adopters to better understand usage and performance

Supports better planning and management of deployment

Provides opportunity for automated monitoring

Provides opportunity for dynamic scaling based on load

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FEATURE

#4 – Event Logging

Goals and Data Points

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Two formal high level business goals:

CONNECT provides the ability to count and produce durations for the following values:

• Number of a given transaction type (PD, QD, RD, etc.)• Number of a given transaction group• Number of transactions from a specific gateway• Total duration for given transaction type• Total duration for a given transaction group

CONNECT can track and report on the following data points:

• Error• Performance• Transaction Type• Payload• Error Messages log (without PHI data)

#5 – Transaction Logging

Provide the ability to determine the state of a transaction across messages in order to better analyze the operation of CONNECT and adopters’ trading partners

BENEFITS

Provides a more holistic view of a complete transaction with any given exchange partner

Increased insight for troubleshooting and issue resolution

More input for transaction management and planning

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FEATURE

#5 – Transaction Logging

Transaction Logging Example

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Database and log output for a related transaction chain (Patient Discovery, Document Query, and Document Retrieve messages as a single transaction)

Note that there are two transaction entries logged for each service The response Nhin message ID was logged based on its RelatesTo message ID

#6 – Lightweight Gateway

Minimize deployment load by supporting a lightweight gateway which allows smaller server footprint and use of system resources and allows the adopters to maximize the use of custom-built adapters

BENEFITS

Adopters with capable back-end systems can have a more lightweight deployment footprint

Allows for more economical allocation and use of infrastructure resources

Paves ground for community-contributed adapter layers – to EMRs & etc.

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FEATURE

#7 – Direct Integration with CONNECT

Include ability to support Direct messages to allow for greater adoption and exchange

BENEFITS

Tool for Meaningful Use (Stage 2)

Provides a means to support both NwHIN Exchange and Direct spec transactions through one deployment

Offers a built-in growth or migration path for additional use cases

Supports expanding federal, commercial, and state and regional HIE needs

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FEATURE

Direct Deployment

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Upcoming Events February 11, 2013CONNECT Release 4.0

February 19, 2013 (2pm ET) CONNECT 4.0 Technical Deep-Dive webinar https://www1.gotomeeting.com/register/749358937

February 25, 2013 (10am ET)Next Sprint Review + Planning meeting

March 4 -7, 2013 HIMSS Interoperability Showcase demo

Spring 2013 (date to come, D.C. area)CONNECT User Group Meeting

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Join Us for Sprint Review + Planning

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Join us for sprint review and planning sessions, every other Monday, 10am-noon ET.

The CONNECT product team will share the work of the last sprint for community review and feedback. We’ll then transition into a high-level planning session to set the themes for the coming sprint, in the context of the product roadmap. Community input and insights are welcome, so please join us!

The meeting will start with a review of the work accomplished during the past sprint which leads into a planning discussion for the upcoming sprint, we flow from one topic to another based on content, questions and conversation.

Sprint Review + Planning: Every other Monday 10am-12pm ETTel: 646-216-4772 866-946-0485 Participant Code 922 914 63Web: https://arkadin.webex.com/arkadin/j.php?J=703876882 (meeting id 703 876 882)

More Details on CONNECT

https://developer.connectopensource.org/display/CONNECT40

https://developer.connectopensource.org/display/CONNECTWIKI/Requirements+Artifacts

https://github.com/CONNECT-Solution/CONNECT

http://issues.connectopensource.org

http://www.connectopensource.org/developer-resources/forums/developer-forum

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Release info:

Requirements artifacts:

GitHub:

JIRA:

Forums:

Useful Links

Community Resources:

www.connectopensource.org

https://developer.connectopensource.org

mailto:connect@hhs.gov

Contributing code:https://developer.connectopensource.org/display/CONNECTWIKI/Contributing+Code

Sprint info:https://developer.connectopensource.org/display/NHINProgress/Progress+Summary+Page

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Questions and Discussion

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Webinar Technical Details

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Type questions in advance; click send Questions + answers appear in chat window

During discussion time, “raise hand” to speak

What is the largest file size I can stream usingCONNECT 4.0?

Thank you for watching!Please post questions to the community forums on connectopensource.orgor email to connect@hhs.gov