Strategic interoperability —The key to connected care
Introduction
The aging population and increasing incidence of chronic diseases are putting unmanageable pressures on healthcare services, not just in Europe, but worldwide. The current models of healthcare are unsustainable in the face of increased demand for services and rising costs. This was evident even before the financial crisis led to severe cuts in healthcare budgets in many countries.
Lessons from Aviation
Introduction
Despite rapid advances in information technology and medical devices, most healthcare organizations have not achieved the same high reliability and safety as other industries, such as aviation, where mistakes can have catastrophic results. Executives and physicians alike are dissatisfied with costs and outcomes, and patients are rightfully fearful of medical errors, infections and miscommunication.
Introduction
In today's world, an ever-increasing number of purchases and payments are being made by credit card. Although merchants and service providers who accept credit cards have an obligation to protect customers' sensitive information, the software solutions they use may not support "best practices" for securing credit card information. To help combat this issue, a security standard for credit card information has been developed and is being widely adopted.The Payment Card Industry (PCI) Data Security Standard (DSS) is a set of guidelines for securely handling credit card information.
Abstract
In a recent benchmark test of an application based on InterSystems Caché, a sustainable rate of 8.9million database accesses/second, with peaks of 16.9 million database accesses/second, was achieved. These results were from a test performed on a connected system of eight applications servers, using Intel Xeon 5570 processors, and running Linux as the operating system. This benchmark shows that:
Introduction
Running the business efficiently and delivering solid value to customers have always been hallmarks of successful companies. However, today's companies have to cope with much more. For example, over the past few years it has become increasingly important for U.S. organizations to devote appropriate resources to the issues of corporate governance and regulatory compliance. Organizations of all types have tightened internal controls as a result of new regulations and increased investor focus on corporate oversight.
Introduction
If the administrators responsible for securing applications had their way, passwords would be long complex strings of random symbols, and users would memorize different passwords for every application they use. But in the real world, few people are capable of such prodigious feats of memory. The typical user can only remember a handful of relatively short passwords.
That’s why an increasing number of applications are requiring two-factor authentication.
Goals of the project
North Shore-LIJ is a health system serving the needs of over seven million people through 17 hospitals, 400 ambulatory practices, and three skilled nursing facilities as well as home and hospice care. Our healthcare system, including its CareConnect insurance company, is at the forefront of payment reform and population health management.
With our rapid and ongoing growth, the operational complexity of being so large and diverse, and the changes driven by accountable care reforms such as bundled payment, we’ve had to overcome several challenges.
Executive Overview
Accountable care and value-based reimbursement models are causing a seismic shift in the medical device industry. In the new medical device market, the value of the device and data alone will not drive sales. instead, it will be solutions that bundle device, data, and real-time analytics that clinicians, health systems, and payers will want to buy. For improved decision-making and outcomes, they need these solutions to deliver actionable information into existing electronic medical record systems and health information exchanges.
Executive Overview
The healthcare software market offers exciting and significant growth opportunities. Yet, while some healthcare software companies enjoy incredible growth, others under-perform, languish, or even fail. There are many criteria for success in this market, but two are particularly critical:
Introduction
In healthcare, the outcome of a life-or-death decision can depend on the available information. To help deliver the right information at the right time and place, healthcare organizations traditionally have used HL7 interface engines to share data among clinical applications.
But the world of healthcare information technology is changing so rapidly thatHL7 interface engines are no longer sufficient. The technology landscape now includes new protocols and architectures, and the business environment has changed as well.
The Business Case for InterSystems Ensemble
This document presents a business case for replacement of older interface engine software with our next-generation rapid integration product, Ensemble. To illustrate the business case, our primary example will be an InterSystems customer (Metro Health Corporation) that replaced its SeeBeyond eGate (now Sun SeeBeyond) interface engine with Ensemble. Other organizations also will comment on reasons for switching to Ensemble.
Executive Summary
The best way to compare the performance of database products is in a head-to-head test using a real application, preferably one of your own. This is especially true when evaluating Caché's post-relational technology, because "standard" transaction processing benchmarking methodologies assume the restrictive "row and columns" format of a relational database. They cannot accurately predict the performance of real applications, which often use complex data models.
Introduction
The lack of visibility across data silos — data sources that are not integrated with enterprise systems — is a threat to business efficiency and profits in many industries. In financial services, front-office silos may develop where operations are segregated by product and region without coordination on data model design. Mergers and acquisitions may result in additional disparate silos, or regulations may require that data in one arm of the firm be inaccessible to another.
Introduction
Experts estimate that 85% of all data exists in unstructured formats – held in e-mails, documents (contracts, memos, clinical notes, legal briefs), social media feeds, etc. Where structured data typically accounts for quantitative facts, the more interesting and potentially more valuable expert opinions and conclusions are often hidden in these unstructured formats. And with massive volumes of text being generated at unprecedented speed, there’s very little chance this information can be made useful without some process of synthesis or automation.
Introduction
Tying quality of care to reimbursements has been proposed in the last few years as a solution to increase the efficiency and quality of care and replace the costly and ineffective fee-for-service model. Provisions within the Affordable Care Act of 2010 have given accountable care organizations (ACOs) the foundation upon which to build real-world, value based care models.
Abstract
The European Space Agency (ESA) has chosen InterSystems Caché as the database technology for the AGIS astrometric solution that will be used to analyze the celestial data captured by the Gaia satellite.
The Gaia mission is to create an accurate phase-map of about a billion celestial objects. During the mission, the AGIS solution will iteratively refine the accuracy of Gaia's spatial observations, ultimately achieving accuracies that are on the order of 20 microarcseconds.
Abstract
A benchmark of a real-world application, which loads data into a data warehouse for subsequent analysis, was performed. To conduct the benchmark, one module of the Oracle-based application was replicated in Caché ObjectScript. Only about 40 person-hours of work was required to duplicate the functionality of the original module in Caché.
The time required to complete certain tasks was measured running the Caché-based module, and was compared to existing data.
Information Sharing Enables Health Plans to Leverage Data and Analytical Assets to Deliver Sustained Value
Executive Summary
The shared-risk payment models that are central to health reform all require tight coordination among payers, providers, and patients if they are to succeed. As payers and providers enter into more and more such agreements, they need to enhance success by communicating and collaborating more effectively with their partners and actively engaging, supporting, and empowering their members.
Introduction
By now, anybody working in the technology sector will have heard of Cloud computing. But the concept is increasingly being paid attention to outside of IT departments, with growing recognition among boardlevel executives of the potential of this range of innovations. Frequently, senior personnel are hearing stories about how the Cloud helps organizations reduce costs, boost efficiency and expand their operations, so they’ll be excited about what the Cloud can do for them.
As a result, Cloud is one of the fastest-growing parts of the IT industry.
Introduction
Australia's recent launch of the Personally Controlled Electronic Health Record (PCEHR) - a significant step towards establishing a national e-Health infrastructure - has simultaneously provided a boost to shared Electronic Patient Record (EPR) projects and delivered a wake-up call to healthcare providers about their readiness for connected care initiatives. In countries around the world, the era of connected care is here.
The PCEHR has increased both the push and pull factors that will lead to widespread shared EPR adoption.
Executive Summary
InterSystems HealthShareÆ and InterSystems EnsembleÆ both provide a rapid integration and development platform with built-in capabilities for the high-speed processing of HL7 messages. For the purposes of HL7 v2 message routing the two products are equivalent in performance. For brevity, this document will just say Ensemble in many places but it should be taken to apply equally to both products.
We have recently completed a performance and scalability benchmark of Ensemble version 2015.1, focusing on HL7 version 2 messaging.
Providing a reliable infrastructure for rapid, unattended, automated failover
Technology Overview
Traditional availability and replication solutions often require substantial capital investments in infrastructure, deployment, configuration, software licensing, and planning. Caché Database Mirroring (Mirroring) is designed to provide an economical solution for rapid, reliable, robust, automatic failover between two Caché systems, making mirroring the ideal automatic failover high-availability solution for the enterprise.
InterSystems has implemented a broad set of MultiValue extensions for its Caché multidimensional database. These extensions enable the migration of MultiValue applications to Caché and bring the full range of Caché object and SQL development technologies to MultiValue developers. The result: your existing MultiValue investments are preserved, you gain a broad spectrum of highly scalable deployment options, and your developers can combine the best of MultiValue, object, relational, and technologies to extend existing applications and build new ones.
Introduction
Impedance mismatch is a term commonly used to describe the problem of an object-oriented (OO) application housing its data in legacy relational databases (RDBMS). C++ programmers have dealt with it for years, and it is now a familiar problem to Java and other OO programmers.
Impedance mismatch arises from the inherent lack of affinity between the object and relational models.
Improved Access to Clinical Data Across Hospitals and Systems Helps Pharmaceutical Companies Reduce Delays and the Costs Associated With Bringing New Treatments to Market
Executive Summary
The pharmaceutical and life sciences industry has a strategic imperative to accelerate clinical research in order to reduce overall R&D costs while delivering innovative treatments.
Executive Summary
For twenty years or more, large financial institutions have been locked in a battle between the need for extremely high performance transaction processing and the demands of downstream applications that can deliver competitive advantage if they can get real time access to this transactional data. When individual database servers could no longer handle simultaneous transaction and query workloads, many firms turned to replication, offloading data access onto read-only copies of production databases.
Introduction
This document is intended to provide a survey of various High Availability (HA) strategies that can be used in conjunction with InterSystems Caché, Ensemble, and HealthShare Foundation. This document also provides an overview of the various types of system outages that can occur, as well as how each strategy would handle a given outage, with the goal of helping you choose the right strategy for your specific deployment.
Abstract
A global provider of mobile telecommunications software tested the performance of InterSystems Caché and Oracle as the database in a simulated data mart application. They found Caché to be 41% faster than Oracle at building a data mart. When testing the response time to SQL queries of the data mart, Caché's performance ranged from 1.8 times to 513 times faster than Oracle.
Introduction
Telecommunications companies, because they generate and must analyze enormous amounts of information, are among the most demanding database users in the world.
Providing a reliable infrastructure for rapid, unattended, automated failover
Technology Overview
Traditional availability and replication solutions often require substantial capital investments in infrastructure, deployment, configuration, software licensing, and planning. Caché Database Mirroring (Mirroring) is designed to provide an economical solution for rapid, reliable, robust, automatic failover between two Caché systems, making mirroring the ideal automatic failover high-availability solution for the enterprise.
