Changes in reimbursement approaches in healthcare are unleashing unprecedented business forces in the industry. As a result, providers are consolidating into larger integrated delivery networks, hoping to achieve economies of scale and operating efficiency.

But it’s difficult to truly integrate organizations, and that’s particularly true when it comes to getting disparate information systems to work together. Overall, consolidation has become more difficult because providers now have a variety of IT systems in place.

Strategic Interoperability

Executive Overview

This white paper discusses the critical requirements for the U.S. Departments of Defense (DoD) and Veterans Affairs (VA) to share Service members’ medical records – including real-time access to a complete composite health record – and it proposes an immediate solution via implementation of a health informatics platform. This approach will provide significant and clearly visible results in a matter of months, while positioning the Departments for strategic improvements in the years ahead.

Introduction

As healthcare providers face increasing pressures to lower costs and reduce readmissions, they're rapidly shifting towards accountable?care organizations (ACOs) and other coordinated, quality-based reimbursement systems. However, most providers have historically?organized their data and workflows in ways that best fi t the fee-for-service payment model. Now that so many providers are sharing?risks and rewards, they must also share and coordinate information by adopting more streamlined health information technology?solutions.

Introduction

With the growing popularity of smart phones and tablet computers, consumers are coming to expect that software solutions will be presented as "apps" on their mobile devices. The challenge for most application developers is to find ways to make their existing solutions run on modern mobile platforms without incurring the delay and cost of a complete rewrite.

Introduction

To overcome the performance limitations of traditional relational databases, applications - ranging from those running on a single machine to large, interconnected grids - often use in-memory databases to accelerate data access. While in-memory databases and caching products increase throughput, they suffer from a number of limitations including lack of support for large data sets, excessive hardware requirements, and limits on scalability.

What is Integration

Integration of enterprise applications and data to simplify and automate business processes has become an important focus for many CIOs. It refers to both the tasks of integrating data and applications, as well as to software products that provide integration frameworks and associated tools. Integration enables the sharing of data and business functions across applications.Integration has become popular because most traditional enterprise applications were custom built to address a specific business need.

InterSystems encourages the adoption of a flexible, practical approach to application development, rather than strict adherence to one of the prevalent development theories. This paper offers advice based upon our experience. However needs, attitudes, and styles vary; we recommend that each programmer choose the development approach that works best for them. Caché supports a wide range of development methodologies, not just those recommended here.

Introduction

Application integration at its simplest is often just one application sending a message to another to notify it of some change. Perhaps when a patient arrives at a hospital, the registration system will send a message to clinical systems so they have all demographic data ready to use. Of perhaps it is just a nightly file transfer from the sales system to the accounting system.

But modern application integration platforms or suites can do a lot more than this to help applications work together and add real value to the enterprise.

Introduction

HL7 V2 message routing solutions often have hundreds of business services, processes and operations. Inevitably things will go wrong and you have to monitor the production to be able to react quickly and resolve any problems before they can become serious issues.

Ensemble includes some powerful alerting capabilities that can help, but if you aren't careful you will be inundated with alerts and your inbox more or less becomes a copy of the event log defeating the object of the exercise.

Introduction

This paper describes how Ensemble behaves after a system crash or similar uncontrolled shutdown or failover. Ensemble is normally configured to start processing messages automatically when the operating system restarts or when the system has failed over to a cluster member or mirror member. No manual intervention is required. But, in order for your system to robustly handle system failure and restart, you must understand how Ensemble handles these conditions and develop your productions using the rules and guidelines in this document.

Ensemble is based on message flow, and a data transformation is a way to convert from one message type to another. DTL (Data Transformation Language) adds a layer to this - it provides a graphical way to do the conversion. This is really helpful because most of the time, people with domain-specific knowledge may not have extensive coding skills. However, you always have the ability to do some coding, so if you need or want to, this is available.

DTL has several components: the data transformation engine, the language itself, and the DTL editor.

An introduction to virtual documents

Ensemble virtual documents enable your productions to work with large and complex documents with little overhead.

What is a virtual document?

A virtual document is a special kind of Ensemble message, for use with Electronic Data Interchange (EDI) messages and with XML documents.

How are virtual documents different from standard messages?

The body of any Ensemble message is represented by a persistent class that has one property for each value that the message is intended to carry.

The Business Processing Language - for orchestration and long-running business processes.

Ensemble can orchestrate calls to external systems. Very often this is done to implement or automate a long-running business process - that is, real business processes where people interact with a series of different systems to complete complex tasks. BPL (the Business Processing Language) provides a graphical way to create these orchestrations.

How do you balance the need to achieve an early success with SOA against the requirement for an architecture that will deliver long term success? You don't want to get bogged down in architectural committees for three years, but you don't want to make short term decisions that will be roadblocks to long term success.

If your first project is to deploy a small number of reusable services in a matter of months but you know that four years from now you might have hundreds of services, an enterprise SOA infrastructure and specialized governance technology you have a dilemma.

Are you new to Ensemble? InterSystems provides several tools to learn the basics of Ensemble and get on your way to becoming an expert in the technology. Before installing Ensemble, take a look at the Ensemble Technology Overview and Getting Started with Ensemble in documentation. Respectively, these documents explain features and major components of Ensemble as well as how to install the software.