Engage Patients, Reduce Manual
Processes and Drive Key Insights with
Interoperability
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Perficient is a leading information technology consulting firm serving clients throughout
North America.
We help clients implement business-driven technology solutions that integrate business
processes, improve worker productivity, increase customer loyalty and create a more agile
enterprise to better respond to new business opportunities.
About Perficient
• Founded in 1997
• Public, NASDAQ: PRFT
• 2013 revenue ~$373 million
• Major market locations throughout North America• Atlanta, Boston, Charlotte, Chicago, Cincinnati,
Columbus, Dallas, Denver, Detroit, Fairfax, Houston, Indianapolis, Los Angeles, Minneapolis, New York City, Northern California, Oxford (UK), Philadelphia, Southern California, St. Louis, Toronto and Washington, D.C.
• Global delivery centers in China, Europe and India
• >2,200 colleagues
• Dedicated solution practices
• ~85% repeat business rate
• Alliance partnerships with major technology vendors
• Multiple vendor/industry technology and growth awards
Perficient Profile
BUSINESS SOLUTIONS
Business Intelligence
Business Process Management
Customer Experience and CRM
Enterprise Performance Management
Enterprise Resource Planning
Experience Design (XD)
Management Consulting
TECHNOLOGY SOLUTIONS
Business Integration/SOA
Cloud Services
Commerce
Content Management
Custom Application Development
Education
Information Management
Mobile Platforms
Platform Integration
Portal & Social
Our Solutions Expertise
Nicholas Lecker,Director of Healthcare Architecture and
Interoperability, Perficient
• Trends in Healthcare
• Interoperability & Integration Best Practices
• Examples of Interoperability
• Walkthrough of Specific Use Cases
Agenda
Consumer Experience
Operational Excellence
Value based Care
Healthcare Reform Initiatives
Trends in Healthcare
• Rapid changes are driving many shifts in healthcare.
– Regulatory
– Meaningful Use
– ACOs
– Personalized Care
– Patient Engagement Models
– Value-Based Purchasing
– Population Health
– Narrow Networks
– Health Insurance Marketplace
– Pay for Performance
– Mergers & Acquisitions
– The list can go on….
• Agility of the business
– Business needs to change and flex to meet market demands
– IT systems and processes need to flex and be nimble
– Availability of information – moving to near real time
• Cost pressures are changing
– Organizations are now having to address cash flow as they are losing bread and butter services to their competition
• Consumers are cost conscious and shopping for value
• ACA is changing the landscape of competition for consumers dollars
– The end patient is now becoming the customer rather than the group/employer
– Consumers are expecting more and more information and expecting their data to be available in manners like their financial portfolio
– Consumers demand a richer experience with their healthcare information (portal, mobile, social)
– CRM is not just customer service – need to address the whole lifecycle of CRM
Issues that Need to
Be Addressed
• Trends in Healthcare
• Interoperability & Integration Best Practices
• Examples of Interoperability
• Walkthrough of Specific Use Cases
Agenda
Where Does Interoperability Fit?
• Interoperability:
– The ability to collaborate, whether systematically or organizationally, within and across domains, in a manner easily done with the results being easily understood
• Governance
– Data (vocabulary, code sets, structure, dictionary/glossary)
– Process (complex, serial conversations & rules)
– Service (directory, transport)
– Security
• Information Backbone/ESB
– Messaging Service
– Adapters
– Master Data Management
– Data Quality/Cleansing
– Transformation
– Translation
– ETL
The Need for Interoperability
Sustainability
Need
Value Cost
Collaborate
Governance
• IT supporting the Business
– IT continues to feel the pressures to deliver value
– IT needs to leverage the systems in place
– IT needs to provide operational excellence through
Interoperability
• Architecture/Framework
• Security
• Data Governance
• Transactions/Messages (X12, HL7)
• Translation
• Trust
• Availability
Technical and Business Challenges
z
Architecture – Shared understanding of your strategic, business, solution and information
architectures creates a common nomenclature
Initiative
Program
Mission
Vision ScopeRoadmap
Business Case
Vision
ObjectiveObjective Objective
KPIKPI KPI
InitiativeInitiativeInitiativeInitiative
Business Case
MajorProcess
Business Process DecompositionProcess flows / SIPOC
Methods & Procedures Documentation / Training Materials
Mega Proce
ss
SubProcess
Objective
SubProcess
MajorProcess
SubProcess
SubProcess
Activity
Activity
Activity
Decision
Activity
Tasks:• Step
1• Step
2• Step
3
DomainFamily
Solution Domain MapBusiness Requirements
Backlog / BRD
Domain
Family
SolutionDomain
(Scenario)
Objective
DomainFamily
SolutionDomain
(Scenario)
SolutionDomain
(Scenario)
BusinessRequirement
BusinessRequirement
BusinessRule
DataFacet
Conceptual ModelLogical ModelPhysical Model
ETL Architecture
Subject
Area
Entity Objective
DataFacet
Entity Entity
Fact Fact Fact Dimension
Metric Metric Dimension
Dimension
Attribute
Attribute
STRATEGY ARCHITECTURE BUSINESS ARCHITECTURE SOLUTION ARCHITECTURE INFORMATION ARCHITECTURE
Foundational Architectural
Approach One View
Agenda
• Trends in Healthcare
• Interoperability & Integration Best Practices
• Examples of Interoperability
• Walkthrough of Specific Use Cases
A Small Healthcare System
Success Story
Challenges
• Client had separate EMR
systems for its two hospitals
and practice management and
needed to merge into one
centralized healthcare system
in order to continue to provide
a seamless total healthcare
experience for healthcare
consumers
• In addition to converting to
Epic, the client was upgrading
several critical systems
including cardiology, radiology
and pharmacy
• Needed to migrate more than
150 application-to-application
integration interfaces from its
legacy HL7 integration engine
called eGate. Oracle was ending
support for its current product
and the client was not able to
rapidly adjust to changes in its
business due to an outdated
platform
About the Company
• A full-service, not-for-profit health
system in the Midwest.
• Formed in 1995 has more than 80
locations providing clinical,
educational, preventive and social
programs.
• The health system also has non-
hospital services which include:
– Physician practice management
– Fitness centers and fitness center
management
– Occupational health centers
– Home health and hospice care
Solution Deployed
Change management solution to manage rollouts with collaborative technical response
Established a strong knowledge transfer and training to client teams
IBM Integration Bus as the primary integration engine for key exchanges with systems such as Epic
IBM Connectivity Pack for Healthcare, HL7
Tivoli/Omnibus monitoring provided real-time monitoring and a dashboard to identify problems before the field experienced them
Business Value Delivered
• Better overall patient experience and quality of service
• The ability to get to information more quickly improved the overall efficiency of doctors
• System integration is highly scalable and flexible
Efficiency
• Real-time monitoring reduced lost or dropped messages, with controls in place for auditing
• Implementation of HL7 standards established a framework to maintain compliance with government regulations (EMR, etc.)
Compliance
• Knowledge transfer to technical team enabled support of existing implementations and future changes
• Program oversight established to break down walls and establish a collaborative team for operational improvements
Ability to Support Solution Proliferation
Challenges
• eGate replacement for a
healthcare provider with 25
hospitals
• Legacy system soon to lose
vendor support (eGate) – cost
prohibitive support
• Multiple failure points leading
to a brittle system
• Excessive moving parts J2EE,
UNIX scripts, eGate, Queues
• Inadequate monitoring
resulting in diagnostic
overhead
• Maintenance issues leading to
additional expense and client
satisfaction issues
• Using older unsupported
message model (HL7 v2.1,
NO CDA, no MDI)
A Large Hospital
Success Story
About the Company
• One of the largest nonprofit
integrated health care delivery
systems in the United States
• The system's primary service area
is home to over 6 million people
and has 25 acute-care and short-
stay hospitals
• It consists of nearly 4,000
licensed beds and over 5,500
physicians at its hospitals
Solution Deployed
IBM Integration Bus-based solution, leveraging the Healthcare Connectivity Pack
Created a custom framework that sits on top of Healthcare Connectivity Pack and tailors the system to the client’s existing eGate architecture
Integration patterns that facilitate eGate flow migration, making the data sharing easier and faster
Change management solution to manage rollouts with collaborative technical response
Establish a strong knowledge transfer and training to client teams
The technical solution used messaging bus with HL7 adapters as the primary integration engine for key exchanges with systems such as Epic
Business Value Delivered
Data sharing and application integration is facilitated through the IBM Integration Bus system, making the exchange of records faster and easier
The Healthcare Connectivity Pack paired with the IBM Integration Bus solution is customized to the current system, facilitating the transition from the eGate platform
Increased visibility into data flow allows the client to identify and resolve bottlenecks
Summary
• Enables the flow of data to deliver effective patient care
• Supports huge range of use cases from mobile to home health
• Flexibility to support your business wherever it needs to grow
Integration is the key to realizing value in healthcare
• Supports key healthcare standards HL7, DICOM and CDA
• Provides high value use cases including analytics and mobile
• Expert patterns simplify common integration use cases
• Complies with all relevant industry regulations (FDA MDDS)
IBM Connectivity Pack for Healthcare providers and payers
• Fully supported product runs on all editions of IBM Integration Bus
• Robust, scalable and high performing and more systems are integrated
• Easy to deploy and manage in all form factors including virtualised
Builds on top of the #1 integration product worldwide
• Integrate all your siloes of information including ERP, CRM and more
Unparalleled range of connectivity options and capabilities
As a reminder, please submit your
questions in the chat box.
We will get to as many as possible.
Agenda
• Trends in Healthcare
• Interoperability & Integration Best Practices
• Examples of Interoperability
• Walkthrough of Specific Use Cases
Kiran Ghanta, Senior Solutions Architect, Perficient.
SOA Reference Architecture
IBM Integration Tooling
Why IBM Integration Bus
Edge
IntegrationGateway Integration Bus
• Out of box built-in patterns,
Intuitive user Interface,
Graphical mapping service
• Streamline integration
• Enable intelligent
processing
• Improve operational
management
• Scalability and performance
• Universal integration capabilities
– Many connectivity protocols –
MQ, JMS, SOAP, Files, HTTP/S,
Database and core
– Many development languages –
ESQL, Java, .Net, XSL,
Graphical Data Maps (GDM)
– Application server capabilities
– Rapid development lifecycles
and prototyping
Why IIB Healthcare Pack
Why IIB Healthcare Pack
Message Models
Healthcare Nodes
Medical Device Integration
DICOM Image Integration
HealthCare Specific Patterns
HealthCare Operational Monitoring
ATNA Audit Events
HealthCare Data Analysis
IIB Design Patterns
Healthcare Pack Patterns provide additional
patterns once installed in the IIB Toolkit
Healthcare Patterns
HL 7 TransformationsHL7 to HL7HL7 to HL7 DFDL
HL7 to reports
Home Health
Medical devices to EMR
Web service to DICOM
What We Did
Utilized IBM Integration Bus with Healthcare Pack at multiple healthcare providers
At the large hospital system we migrated 560 interfaces.
At the small Healthcare provider system we migrated 150 interfaces utilizing pub sub model
Built common frameworks
Developed a common rapid development/migration approach from different legacy integration engines utilizing pattern based
approach:
Customized patterns
Developed custom patterns
Developed custom nodes
Implemented new interfaces and migrated legacy interfaces at faster pace.
• Analyzed existing legacy integration engine
• Infrastructure setup and configuration
• Built common frameworks: audit logging, error handling and monitoring, notification
• Identified and documented unique integration interface candidates for patterns
• Customized out-of-the-box patterns and created new patterns based on analysis done
• Developed significant use cases/integration interfaces per each pattern Pilot Phase
• Built project plans
• Split use cases/interface for each phase
• Executed project plans iteratively with backlog prioritization
• Enhanced common frameworks
• Rapid implementation of use cases
• Project go live for each phase
Next Phase
How We Did It
Used Perficient Enable Methodology
(Envision, Execute & Evolve)
Patterns
Large Hospital System
• HL7 to HL7
• File to HL7
• HL7 to File
• SNA to SNA
• SNA to HL7
• HL7 to SNA
• SNA to File
• File to SNA
• Medical Device Integration
Small Healthcare System
• Pub Sub Model with HL7 to HL7
Transform Your Enterprise from Being Transactional to Being Interactive
Perficient IBM Connectivity
Offerings
Solution Architecture Design/Implementation
• Integration/SOA roadmap and strategy
• Appliances-based integration solutions with data power
• Integration/connectivity solutions with WebSphere
• Cloud integration with CastIron
• API management solutions using IBM Connectivity tools
• B2B solutions using DataPower/WebSphere Partner Gateway
• Migrations to IIB – From WESB, from WMB, from ICS
• Migration from any ESB/ EAI Solutions – TIBCO, SeeBeyond eGate, Cloverleaf, Rhapsody and more
Perficient IBM Connectivity Offerings
Enablement & Mentoring
• Customizable programs for enablement/mentoring using IBM Connectivity tools (PRFT QSRs):
• IBM Integration Bus (IIB)
• WebSphere Message Broker (WMB)
• DataPower Appliances
• WebSphere MQ (WMQ)
• CastIron
• Programs include health check, best practices, methodologies, processes, document templates, design/architecture patterns, guidebooks, administration/ monitoring guidelines, provisioning, etc.
POCs/POTs/Demos
• Packaged solutions to show capabilities of IIB/WMB
• Work with IBM Labs and/or directly with Clients for POCs/POTs for IIB(WMB)/DataPower/WMQ
Perficient IBM Connectivity Offerings
Assets - Repository of Reusable Artifacts
• Design patterns using Healthcare Pack for Healthcare which accelerates development time by 25-30%
• Pre-built frameworks related to performance testing, ESB environment monitoring, auditing, error handling, error notifications, etc.
• Repeatable processes/patterns for retail and healthcare industry use cases
• Design patterns, methodology, best practices, SDLC processes, error handling/audit logging solutions, document templates etc. facilitate faster time to production for services/integrations during project implementation
Questions?
Thank you for your participation today.Please fill out the survey at the close of this session.
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