Business Case for Adoption: Vendor Community June 29, 2009 Copyright 2009. All Rights Reserved. Google Open Source Programs Office Daniel Berlin Senior Engilawyer Copyright 2009. All Rights Reserved. The Goals of NHIN and Google are Complementary The NHIN will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve health. Google’s mission is to organize the world's information and make it universally accessible and useful. “ We now live in a world where you can get information at your fingertips on virtually every topic known to mankind, yet the most important area of all — our health — we can’t easily get the information when we need it. It’s time to change this once and for all. Vish Sankaran, FHA program director 3 Copyright 2009. All Rights Reserved. ” Google Health Embraces These “Rules of the Road” Data Portability Consumers control their data regardless of employers, health plans, or care providers. Interoperability Data owners should be able to securely exchange data with different systems in a consistent manner. Data Liquidity 4 Copyright 2009. All Rights Reserved. Data from different sources should move over networks with minimal costs, ‘friction’, and hassle. Google Fully Supports Free and Open Source – CONNECT is a Natural Fit Google USES millions of lines of open source code Google RELEASES millions of lines of open source code – More effective than writing it all ourselves – Builds communities around software – Shares support costs for software – Faster and more effective development – Gain the improvements of everyone instead of just your own 5 Copyright 2009. All Rights Reserved. – Give back something to the world Google Health Plans to Connect to NHIN The health ecosystem requires an open, interoperable network The value of the network is dependent upon the number of data providers and users in the network — the more providers and users, the more value (exponentially!). 6 Copyright 2009. All Rights Reserved. Google Health Plans to Connect to NHIN The health ecosystem requires an open, interoperable network 7 Copyright 2009. All Rights Reserved. The value of the network is dependent upon the number of data providers and users in the network — the more providers and users, the more value (exponentially!). Initiate Systems Deanna Cagney Director of Product Marketing Copyright 2009. All Rights Reserved. Initiate Systems, Inc. Enabling healthcare providers and state/regional exchanges to connect, share, and securely use patient data within and across boundaries • Industry standard for patient registry & health information exchange (HIE) solutions • Proven experience in HIE and patient data management – 76 Providers / IDNs and 40 health information exchanges – Eight Canadian provinces, supporting the pan ‐Canadian electronic health record. – Patient registry in Nationwide Health Information Network (NHIN II) and all four of the NHIN I demonstrations • 192 customers across 10 market segments • Cited as ‘leader’ by Forrester & Gartner 9 Copyright 2009. All Rights Reserved. The Challenges of Interoperability Processes for data sharing inconsistent Family History Patient Symptoms Availability and quality of data varies Health Data Treatment Records 10 Copyright 2009. All Rights Reserved. Admission History Approved Physicians Prescription History Unclear funding models for sharing Exam Records Data ownership – how to stay up to date? Need to manage and audit patient privacy preferences CONNECT: Addressing the Challenge Hospital 1 • Federated data model • Common message choreography and data sets Hospital 2 Hospital 3 Exchange Hospitals • Patient privacy protection Public Health NHIN • Open and interoperable • EMPI at the foundation 11 Copyright 2009. All Rights Reserved. Payers Social Programs Pharmacies Family Services Target Architecture (message from NHIN) Legend NHINC Components Customizable Components Replaceable Components NHIN Message EMPI: What You Need To Support HIE Subject Discovery Subject Discovery Document Query xx Sub. Management Document Retrieve xx xx xx xx xx xx xx Notification Processing xx xx xx xx Audit Reporting xx xx xx xx UDDI Sharing xx xx xx xx xx xx xx xx xx xx NHINC Service Components Patient Correlation Repository Audit Repository UDDI Document Cache Performance Integration UDDI NHIN Message Orchestration Components xx Accuracy Doc Retrieve / Query NHINC Gateway Authroization/Messaging Framework xx Enterprise Master Patient Index Document Subscription / Notifications Standards and/or NHIE based messages (hl7v3, xds, etc) MPI Subscription / Notifications Policy Document Agency Adapter Security SDK Services Agency Integration Software Subscription Manager CPP Repository Policy Engine MPI Copyright 2009. All Rights Reserved. Doc Registry 12 Transformation Doc Repository Stewardship/Quality Terminology Other services CONNECT: Selecting the Right Solution Initiate’s ContributionCommunity & Technology Enterprise Master Person Index Patient-Provider Relationships Initiate CONNECT Gateway Adapter CONNECT Community Forum for Initiate Customers 13 Copyright 2009. All Rights Reserved. Integration Initiate CONNECT Gateway Adapter Security Data Stewardship Data Quality & Reporting A Connected Community Vision Capital Health Authority Province of BC Province of Newfoundland Province of Saskatchewan Calgary Health Region Province of Alberta Province of Manitoba PAML NORRad Province of New Brunswick Providence State of ND Maine General Deaconess Peace Health MN E-Health BCBS of MN DCIPA St. Alphonsus United Health Surescripts/ Optum RxHub Long’s Sutter HealthSutter Health Catholic Healthcare West Intermountain BS of CA Iowa Health Ingenix UC, Davis Albertsons Children’s Hospital BCBS of Kansas St. Joseph of Orange Luther Midelfort Independent Active Health HealthServe EHealth Health HACCNY Ontario Association UMass HIXNY CVS/Caremark Bronx RHIO Carefirst BCBS Conemaugh Lehigh Rockford Brooklyn RHIO Memorial Valley Hospital NYCLIX Ohio Health West Advocate Spectra/Lab LIPIX Penn Walgreens Kroger’s Veterans Northwest UPMC Affairs (VA) Comm. Hosp. Surescripts/ RxHub Anthem Sentara BJC LEGEND: Riverside Moses Cone Humana Trinity Health ProHealth Carespark OK Health Authority Cedars-Sinai WellPoint Catholic Healthcare West Presbyterian Health NCHICA Carolinas HealthCare Delta Health NGHS Alliance Lovelace Foundation Long Beach Network Pharmacy & PBMs Baylor Sandlot Availity Louisiana Rural Ochsner H Lee Moffitt University Community Copyright 2009. All Rights Reserved. Payers Health Exchanges Athens Regional 14 Providers & IDNs Wal-Mart Banner Health UPH UPH Province of Nova Scotia CONNECT: Business Value Share Information Across Silos Break down data silos between federal agencies and providers Expand to citizen services 15 Copyright 2009. All Rights Reserved. Achieve a Virtual Nationwide View Enable connected communities to leverage existing investments Maintain data ownership Reduce Cost of Care Improve Care & Safety Ensure trust and data integrity across all participants Improve quality of care and patient safety Increase adoption Information at the right place at the right time Eliminate redundant actions Science Applications International Corporation David Dobbs Program Manager Copyright 2009. All Rights Reserved. SAIC Business Overview Our Successes Business Areas – – – – – – Health Energy Environment National Security Critical Infrastructure 40 years of continuous growth » $10.1 billion in annual revenues for fiscal year 2009 » FORTUNE 500® company - #266 – Highly skilled staff of professionals » Nearly 45,000 personnel worldwide » 10,000 employees with advanced degrees » 19,000 with security clearances Experienced Staff 12% With Less Than 5 Years 74% With More Than 10 Years 8% Administrative 10% Managerial 14% With 5–10 Years 82% Technical Professionals 6% Ph.D.s 36% Master’s Degrees Higher Education 58% Bachelor’s Degrees 53% Sciences 17 Copyright 2009. All Rights Reserved. 16% Humanities, Social Sciences 15% Engineering 16% Business, Economics/Law Fortune 500 is a registered trademark of Time, Inc. in the U.S. and/or other countries. Health Solutions • More than 1,900 employees • Health domain expertise includes: – MDs, PhDs, MPHs, RNs, DDSs, epidemiologists, biostatisticians, psychologists, pharmacists, radiologists, labratorians, informatics specialists, biochemists, toxicologists, microbiologists Solutions • Health IT specialists include: – Enterprise architects, network, systems, and security engineers, software engineers/developers, web developers, network administrators, database engineers, software test engineers, configuration and data management specialists 18 Copyright 2009. All Rights Reserved. Technology Domain Expertise U.S. Health IT Context • National imperative for Health IT adoption – Controlling costs – Improving quality and patient outcomes • Critical policy challenges1 – Driving the adoption of electronic health records (EHR) – Making EHRs interoperable – Ensuring EHRs help improve health care quality and efficiency • Health information exchanges (HIEs) are connecting hospitals, clinics, and laboratories to share interoperable health information 1- Summarized from D. Blumenthal, The Federal Role in Promoting Health Information Technology, The Commonwealth Fund, January 2009 19 Copyright 2009. All Rights Reserved. Selected SAIC Health Information Exchange Projects Project Stakeholders CDC BioSense Public Health Situational Awareness through Health Information Exchanges Military Health System’s (MHS) Composite Health Care System (CHCS) VA/DoD Data Sharing Research & Development Departments of Veterans Affairs and Department of Defense 20 Copyright 2009. All Rights Reserved. Centers for Disease Control CDC Centers for Disease Control BioSense INHS Inland Northwest Health Services WA DOH Washington State Department of Health MHS Military Health System VA Department of Veterans Affairs DoD Department of Defense CONNECT Business Drivers • Sharing interoperable health information – Enabled by a standards-based, agreed-upon architecture – Extensible because it’s open source • Adoption by health information exchanges (HIEs) and federal / state agencies for clinical data sharing – Between HIEs to improve patient care – Between HIEs and federal agency for reporting, quality and research – Some states are beginning to adopt (such as Washington, Indiana, and New York) 21 Copyright 2009. All Rights Reserved. • CONNECT adoption drives exponential value – Increased access to distributed health care information – Accelerated ability to improve patient outcomes, public health and quality CONNECT – Linking Health Care VA MHS Health Care Delivery Department of Veterans Affairs Hospitals Clinics Pharmacies Military Health System Radiology IHS Indian Health Service CONNECT NHIN CONNECT SOA Platform Laboratories CDC SSA Centers for Disease Control Social Security Administration Health Care Data Users 22 Copyright 2009. All Rights Reserved. CMS State & Local Public Health Centers for Medicare and Medicaid Services NIH National Institutes of Health FDA Food and Drug Administration SOA = service-oriented architecture SAIC CONNECT Services • Make electronic health records (EHRs) interoperable – Terminology Services to create semantically interoperable health care data • Terminology subscriptions • Standards-based encoding of health care data • Encoding translation services – Reliable Messaging for secure information delivery • Security – authentication, encryption, non-repudiation, HIPAA-compliant • Reliability – guaranteed delivery, non-repudiation, audit logs, automated retries • Use EHRs to improve health care quality and efficiency – Health Care Knowledge Base for analyzing EHR data • Public health reportable conditions and outbreak alerts • Centers for Medicare and Medicaid Services quality guidelines • Clinical research support • Adverse event identification 23 Copyright 2009. All Rights Reserved. SUN Microsystems, Inc. Catharine Evans Director, SunFederal Copyright 2009. All Rights Reserved. Sun's Strength in Healthcare History in Healthcare with Thousands of Clients Worldwide Prominent Healthcare Clients Significant Drivers for Health Information Exchange 90% 77% 80% 70% 60% 60% 50% 44% 37% 40% 29% 21% 30% 20% 10% 0% P r o v id e r in e f f ic ie n c ie s d u e t o la c k o f d ata to s u p p o r t p a t ie n t c a r e Innovation 25 Copyright 2009. All Rights Reserved. Ris in g h e a lt h c a r e co s ts Experience A v a ila b ilit y of g r a n t f u n di n g In c r e a s e d n a t io n a l a t t e n t io n o n HIT a n d HIE P u b lic h e a lt h s u r v e illa n c e ne e ds De m a n d f o r p e r fo r m an ce in f o r m a t io n Knowledge Sun's Open Source in CONNECT Sun in Healthcare Health Information Exchange Integration with infrastructure, SOA and composite applications Compliance Privacy, identity management, access control, fraud detection and activity monitoring Secure Data Management Caregiver Mobility with Security Information lifecycle management & identity management Business and clinical transformation through secure, instant access to patient information CONNECT NHIN 27 Copyright 2009. All Rights Reserved. Payer Efficiency Consumercentric approach to healthcare delivery, care management and business workflow Sun's Healthcare Pack: Supported Architecture for CONNECT GlassfishHealth – HL7 Binding Components – Master Patient Index – OpenSSO integration with HTTP BC – PIX/PDQ support – XDS/XCA – Advanced Graphical Mapper (HL7, etc) – NC PDP – XACML Support – Open SSO - graphical support of XSPA policies 28 Copyright 2009. All Rights Reserved. Sun's Healthcare Pack: Supported Architecture for CONNECT • Sun's Product Support – 7x24 Support • Indemnified • Sun Professional Service Offerings – CONNECT – Setting up the CONNECT Environment – Assisting the MPI configuration – Integration Support 29 Copyright 2009. All Rights Reserved. Vangent, Inc. Jeanne O’Kelley Senior Vice President Technology Excellence Center Copyright 2009. All Rights Reserved. Business Case for Adoption • CONNECT – Instantiation of Health Standards • Open Source – Government/Industry Collaboration • Customer Support – Federal Agencies – State and Local – Commercial 31 Copyright 2009. All Rights Reserved. XDS.b – An Essential Part of CONNECT Gateway Capability Supports federated document repositories and a document registry that create a longitudinal record of patient information within a healthcare community Consumer Preferences Profile Subject Discovery Query Audit Log Query for Documents Retrieve Documents Health Information Event Messaging Authorized Case Follow-up NHIE Services Registry Authorization Framework Messaging Platform 32 Copyright 2009. All Rights Reserved. Diagram Source: FHA CONNECT Software Architecture Document, 31 March 2009 XDS.b “Plug and Play” CONNECT Gateway Integration AGENCY B AGENCY A Locate Patient Records CONNECT Solution Locate Patient Records Retrieve Patient Records CONNECT Solution XDS.b Registry Locate Patient Records Existing Agency System(s) Register Patient Records Store Patient Records Retrieve Patient Records XDS.b Repository Retrieve Patient Records IHE/HITSP compliant solution that unleashes EHR data from agency systems and makes data available for use over the NHIN 33 Copyright 2009. All Rights Reserved. Health Information Exchange Open Source (HIEOS) Released in “Open Source” Vangent’s XDS.b implementation is available in “open source” – Is scheduled to be part of CONNECT’s September release – Part of Vangent’s Health Information Exchange Open Source (HIEOS) project available at the following URL: http://kenai.com/projects/hieos – Includes: • Wiki Site – Architecture Description – Setup and Configuration Guide • Discussion Forums • Mailing Lists • Issue Tracker • Software Source Code 34 Copyright 2009. All Rights Reserved. Harris Corporation Dr. Bart J. Harmon Chief Medical Officer Copyright 2009. All Rights Reserved. CONNECT: Addressing Integrator Motivation and Challenges • A part of the new Health Ecosystem • Current work is developing the freely available CONNECT services, providing Help Desk Support and Engineering Services • Supported government agency participation in the December, 2008 NHIN Forum • Culture, tool sets and partners vary widely across various institutions and Health Information Exchanges, creating slightly different challenges when supporting each entity 36 Copyright 2009. All Rights Reserved. Why does an integrator want to work in this space? Reasons for supporting CONNECT: • Helping establish part of a new health ecosystem where entities compete on value and customer service rather than controlling information • Based on national standards • Enabling providers • Empowering patients • Streamlining payors • Supporting the protectors • Opportunity to work in a space where we will have a chance to be useful as long as we are helpful 37 Copyright 2009. All Rights Reserved. CONNECT’s Value for an Integrator Converting waste into value via information availability – Supporting fundamental transformation in – Clinical processes – Health business processes – Surveillance processes – Lighten the burden of run-away health costs on the economy – Provide quality care to more people – Put individual people more in control of their health information and health experience Many entities will want help with these services, to include integration support Platform on which to re-purpose technologies from other areas of expertise into the health space 38 Copyright 2009. All Rights Reserved. RelayHealth, Spartanburg Regional Health System, NXT Health Partnership to Provide Continuity of Care for Wounded Warriors Chris Ingersoll Director, Interoperability Product Management Copyright 2009. All Rights Reserved. CONNECT: Addressing RelayHealth’s Goals • RelayHealth’s Business Drivers – Maximize the breadth of longitudinal information that can be provided to health systems, physicians and patients – Prepare health system customers for transformation caused by ARRA and health reform – The need to share and exchange clinical information – Provide improved access, support and continuity of care for military personnel receiving private sector health care • RelayHeath’s Current HIE Offerings – Clinical health record viewer – Integrated patient PHR with secure messaging – Referrals and patient health record sharing – Results and clinical documentation distribution – Clinician messaging amongst physicians and members of a Care Team 40 Copyright 2009. All Rights Reserved. RelayHealth-Spartanburg Partnership Spartanburg Regional Health System • Network of hospitals and physician offices across five counties in SC • “Hospital of the Future”: recipient of Congressional Special Interests projects NXT Health • Non-profit research and design organization affiliated with SRHS • Undergoing study of health record sharing between military and private health systems through Spartanburg’s grant Partnered with RelayHealth • Demonstrate Spartanburg physician and patient access to medication history, allergies, and diagnoses data from DoD • Project funded by Spartanburg and McKesson managed through TATRC • Three developers for two months 41 Copyright 2009. All Rights Reserved. Demonstration Use Case 2. Dr. Smith receives webVisit, indicates in RelayHealth that he has Sonja’s consent to view DoD data 4. Dr. Smith notes a possible medication allergy, prescribes new medication and schedules in-person appt EHR webVisit Sgt. Sonja 1. Sgt Sonja, recently returned home, develops an infected rash from lingering burn wound. She fills out online consultation to Dr. Smith, her private sector PCP 42 Copyright 2009. All Rights Reserved. RelayHealth Health Summary Manager Dr. Smith CONNECT DoD Test Server (Harris) 3. Via CONNECT, DoD data is added to Sonja’s RelayRecord Personal Health Record Sgt. Sonja 5. Sonja receives message, sees that her PHR has been updated with DoD health data Health Summary Viewer Physician view Patient consent designation Allergies from DoD Medications from SureScripts, DoD, patient entered, and physician entered Diagnosis from DoD 43 Copyright 2009. All Rights Reserved. Personal Health Record Patient view The data that the physician pulled from DoD can be viewed by the online patient. 44 Copyright 2009. All Rights Reserved. Selecting the Right Technology for RelayHealth Demonstration goals: – Data integration: Automated load of health summary data into RelayHealth through CCD Long-term goal: – Plug RelayHealth network into the NHIN – Connectivity: Ability to pull data from a federal facility CONNECT Gateway provided connectivity – Successful integration from .NET environment – Took care of plumbing, allowed us to focus on data integration and presentation changes – Good documentation and support 45 Copyright 2009. All Rights Reserved. CONNECT’s potential as a complete network-network connectivity solution – Comprehensive functional scope – Open-source – Federal adoption Value of CONNECT for RelayHealth, Spartanburg and NXT Health RelayHealth – More connectivity means higher quality care and better patient outcomes – SaaS model: low costs to provide this connectivity to all of our customers – Step towards providing comprehensive care for our men and women in uniform accessing private sector health care Spartanburg Regional Health System – Recognition as the National test site for connectivity of patient record systems – Serves as a model for data sharing within the larger civilian community – Potential to expand RelayHealth personal health record capabilities to patient population NXT Health – Use this interoperability model and apply it to other research projects within the larger context of the patient room of the future – Serves as a proof of concept phase to assist in recruiting potential partners for continuation of research efforts 46 Copyright 2009. All Rights Reserved. Cisco’s ‘Medical Data Exchange’ (MDES) Solution Greg Pippin Solution Architect Copyright 2009. All Rights Reserved. Market Drivers & Current Environment Drivers Current Environment – Cost reductions and avoidance – Manual fax, copy – Lost productivity – Burn and transport CD ($10/CD) – Interoperability of patient data exchange – Multi-system log-ins – Data is needed locally but stored centrally – Importation of unstructured data into structured data 48 Copyright 2009. All Rights Reserved. – Point to point proprietary interfaces – Proprietary health information exchanges (HIE) Medical Data Exchange – Enabling The Method Patient Centric Access System A System B DICOM HL7 v 2.5 HL7 v 2 HL7 v 3 ISO 10781 IETF EDI XML SOAP Network Broker 49 Copyright 2009. All Rights Reserved. IHE Network Broker Solution Benefits Cost Reduction – Eliminate $10/CD & associated labor – CD burner maintenance costs Improve Productivity – Interoperability between systems reduces efficient record access – Reduce retests & rescans Improve Quality of Care – Reduce delays in patient care – Address incomplete information for treatment decisions – Reduce delays in patient care 50 Copyright 2009. All Rights Reserved. Medical Data Exchange Enables Patient Centric Integration & Access of Records • Enables interoperability between disparate systems • Enables the network as the platform for secure & standards based access & exchange • Eliminates the need for manual transport of records & images • Standards based (IHE) based PACS & EMR access • Common patient identifier with network based IHE Cross Reference Manager & XDSi 51 Copyright 2009. All Rights Reserved. What is the Medical Data Exchange Solution? Cisco AXP Network module Cisco ISR Router + Globally leading SW solution for IHE based medical data exchange Cisco and Tiani-Spirit offering a joint Medical Data Exchange Platform consisting of the ‘Spirit’ IHE SW stack based on the globally standardized IHE framework. Tiani Spirit-AXP runs on the Application eXtension Platform inside Cisco’s Integrated Services Router (ISR+AXP). It connects general practitioner’s systems, pharmacy software systems & hospital information systems with the eHealth infrastructure. 52 Copyright 2009. All Rights Reserved. Federated Data Distribution Enables Scaling • Interoperability is based on a federated concept • Avoids copying all data centrally (Cross Reference Manager) • Retains data where it was produced originally. • Data is kept as well on a regional level for redundancy purposes (orange level) • IHE‚ Cross Reference Manager enables communications between the regions (red) or countries (white) Cross-Community Level (scalable to any hierarchic level) Community (Cross-Enterprise) Level Responding Gateway PIX+ PIX/PDQ XDS (Repository, Registry) Responding Gateway Initiating Gateway Spirit Archive Spirit Central Adapter (SCA) Enterprise Level 53 Copyright 2009. All Rights Reserved. Spirit Local Adapter (SLA) Spirit Archive IHE Client, Legacy Client DICOM Client MDES Reference in Wels Healthcare (Austria) Prior Environment • 64 sub-systems in one hospital • Organizational environment constantly changing • Unscalable • Difficult to integrate GP’s into the hospital environment • 1500 proprietary data interfaces • Multiple patient Indexes “ Tiani Spirit software, based on Cisco and Intel technology has enabled us to substantially raise the level of information where it is needed and when it is needed, to help our doctors in their effort to provide the best care possible for our patients. Dr. Walter Aichinger, Chief Physician of the Klinikum Wels-Grieskirchen 54 Copyright 2009. All Rights Reserved. ” MDES Value Proposition: Better & More Cost-effective Care • Improve productivity – Clinicians can access records from different institutions in a simple and straightforward manner • Lower cost – Avoid redundant clinical tests or procedures w/ access to this data • Improve patient care – Diagnosis & treatment plans w/ a more holistic view of a patient's record • Avoid Costs – Eliminate the need for production of CD's to transport images 55 Copyright 2009. All Rights Reserved. CONNECT and Mirth Gateway – Streamlining NHIN Connectivity Gary Teichrow Vice President and Chief Architect Mirth Corporation Copyright 2009. All Rights Reserved. Who is Mirth Corporation? Mission: • Mirth Corporation delivers standards-based open source infrastructure tools and services for healthcare • We reduce the time, cost and technology barriers to information exchange in healthcare, leveling the HIT playing field for healthcare organizations of all sizes Vital Stats: • Launched in 1993, focused since 1999 on Health IT • Incubator of open source Mirth Project – 70,000 downloads worldwide • Provide OSS, support, professional services, purposebuilt appliances • Technology partner to leading HIEs and HIE Vendors 57 Copyright 2009. All Rights Reserved. CONNECT: Addressing Real World HIE Interconnect Challenges • How to connect Orange County ConnectCare with Long Beach Network for Health? – OC and LBNH HIEs wanted to share health information – Each used different software with different capabilities • Possible Opportunity using NHIN interface – LBNH had NHIN gateway as an NHIN trial cooperative participant – OC interested in using the NHIN interface, but needed software • Challenges – Not enough time to develop custom NHIN gateway for OC – No apparent commercial NHIN gateway software available – Limited budget to perform the work 58 Copyright 2009. All Rights Reserved. Selecting the Right Solution for OC/LBNH • Possible Solution with CONNECT – CONNECT 2.0 released during analysis phase of project – Provided OSS solution to OC NHIN gateway requirement • Scope of Work – Download and understand software – Port to Linux and PostgreSQL – Adaptor integration (ER Connect, Mirth Match, Mirth Connect) • Solution – Use Mirth Connect (integration engine) as glue between ER Connect (OC) and NHIN CONNECT adaptor layer – Download to demo in less than a month 59 Copyright 2009. All Rights Reserved. CONNECT in Action: One Success Leads to Another California eHealth Collaborative Statewide NHIN Demo Participants • Kaiser Permanente (KP NHIN Gateway) • Long Beach Network for Health (MedPlus/FirstGateways) • Orange County ConnectCare (CONNECT) • Redwood MedNet (CONNECT) • Santa Cruz HIE(Axolotl) Redwood MedNet connects to NHIN for demo • Mirth Corporation implemented CONNECT at Redwood MedNet • Integrated to Mirth Results • Up and running in 3 days! 60 Copyright 2009. All Rights Reserved. CONNECT in Action: …and Another HealthBridge and Redwood MedNet Interstate Demo Participants • HealthBridge – – – – – 24 hospitals in KY, OH and IN 5000+ physicians at 700+ practices 25 million results delivered in 2008 17 local health departments National, hospital and physician office labs – 70+ EMR feeds to MD practices – Interfaces with 25+ EMR vendors – 70+ HIS/Data inbound connections • Redwood MedNet HIE – – – – – – Mendocino, Lake and Sonoma Counties 4 rural hospitals 3 independent laboratories 2 local health departments FQHCs, RHCs, and private practices Long Term Care 61 Copyright 2009. All Rights Reserved. NHIN What’s Next: Mirth Gateway – How You Can Leverage CONNECT Mirth Gateway Appliance Ready-to-run appliance based on OSS stack • CONNECT (OSS NHIN gateway) • Mirth Match (OSS EMPI) NHIN • Mirth Connect (OSS interface engine) Accelerates NHIN Deployment • Simplified setup and configuration • Simplified administration and monitoring • Automated patch management • Physical or virtual appliance Mirth Connect simplifies “last mile” • Channel-based connectors ease integration • Connect to NHIN via HL7, database, web services, FTP/SFTP/file system 62 Copyright 2009. All Rights Reserved. Jericho Systems Corporation Brendon Unland President and Founder Copyright 2009. All Rights Reserved. Historical Analogy: Transcontinental Railroad • Engineering Marvel of 19th Century • Began 1862: Finished 1869 • Shortened Trip of 5 months to 5 Days • Extreme Technical Challenges • Ingenius Collaboration Between Government and Business • Necessity of Standards • Bound the Nation Revolutionizing Population and Economy 64 Copyright 2009. All Rights Reserved. Jericho Systems’ Current Business Model • Founded in 2002 • Security Decisioning Software and Services – Primary Clients are U.S. DoD, Intelligence Community, and Federal Agencies – SOA-enabled Products Incorporate Open Standards: SAML, XACML, WS-Security – Flagship Product: EnterSpace Decisioning Service (EsDS) Includes Policy Decision Point (PDP) 65 Copyright 2009. All Rights Reserved. Jericho Systems’ Current Business Model Traditional Software Business Model Licenses Maintenance Professional Services Move into Health Care Market 66 Copyright 2009. All Rights Reserved. Jericho Systems’ Health Care Background Participated in CrossEnterprise Security and Privacy Authorization (XSPA) Demo at HIMSS 09 • Demonstrated OASIS Advanced Privacy, Consent, Access Control-Beyond Opt in/ Opt out • Functionality Moving into Future CONNECT Solution Release 67 Copyright 2009. All Rights Reserved. Component of Flagship Product Utilized • Policy Decision Point (PDP) • XACML Compliance • Logging Jericho Systems’ Health Care Business Model EnterSpace Continuum for Health Care • Embrace Open Source: Donate EnterSpace Health Care Community Edition for Inclusion into CONNECT Solution • Potential Cloud Offering • Provide Professional Services including: – SOA-centric Identity and Access Management Consulting – Standards Compliant Integration – Policy Engineering for Security & Privacy 68 Copyright 2009. All Rights Reserved. Conclusion: CONNECT Community Opportunity to Join Community that: •Impacts and Improves the Future Cheyenne, Wyoming: 1882 and Now 69 Copyright 2009. All Rights Reserved. •Profits Those that Labor for the Community CONNECT Seminar Presentations are Available for Download Online at http://www.connectopensource.org 70 Copyright 2009. All Rights Reserved.