The CIO Perspective
Executive Summary
Addressing the challenge of reducing hospital readmissions using manual processes is not a viable long-term solution. With other IT mandates demanding time and attention, your readmissions initiatives may suffer. However, with the right health information technology (HIT) platform, you can sustain efforts to reduce readmission rates and make processes more efficient and effective. Enabling interoperability and access to real-time data is key.
Introduction
Because of increasing business and governmental pressures to integrate their operations, the financial services industry is developing a number of standards for data exchange and other common functions. Standards such as XBRL, FpML, MDDL, RIXML, and FIXML are all specialized dialects of XML (Extensible Markup Language). Any financial services application with good support for XML will be able to communicate effectively using one or more of the emerging industry standards.
Efficient data exchange increases the need for fast, scalable data persistence.
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.
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.
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.
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.
Overview
Integrated Delivery networks (IDNs) face complex challenges in getting the right data into the right hands, at the right time, with the goal of more informed decision-making and improved clinical and financial performance.
In many cases today, even with the use of traditional business intelligence tools and an enterprise data warehouse, important data often remains hard to access and difficult to aggregate and present to healthcare providers in a useful, unified format.
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
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.
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.
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.
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.
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 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.
Executive Overview
One way financial services firms can improve their operational efficiency is to revamp their data management infrastructure. Creating a central repository for data that is used by multiple applications can ensure data consistency and quality across the enterprise, ease integration bottlenecks, and lower the number of failed trades.However, different applications have different database usage patterns.
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.
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.
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.
Comprehensive patient view, communication and data sharing, and population health management are key components
Federal agencies have been incenting healthcare providers to leverage their electronic health records (EHRs) to get patients involved in the management of their care. Most organizations, however, haven’t moved beyond patient engagement as an item to be checked off in order to receive meaningful use incentive funding.
Typically, providers rely on patient portal functionality that healthcare IT vendors package with their EHR products.
A business case for the transition from eGate to InterSystems EnsembleÆ From interface engine to integration platform Healthcare IT is evolving so rapidly that the term "HL7 interface engine" may soon become extinct.
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.
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.
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.
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:
InterSystems Caché 2015.1 soars from 6 million to more than 21 million end-user database accesses per second on the Intel® Xeon® processor E7 v2 family compared to Caché 2013.1 on the Intel® Xeon® processor E5 family
Overview
With data volumes soaring and the opportunities to derive value from data rising, database scalability has become a crucial challenge for a wide range of industries. In healthcare, the rising demands for healthcare services and significant changes in the regulatory and business climates can make the challenges particularly acute.
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.
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.
Introduction
In healthcare, information accessibility can impact the outcome of a medical decision, or the success of a bundled payment initiative. To ensure that the right information is available at the right place and time, healthcare organizations typically have used HL7® interface engines to share data among clinical applications. But the demands on healthcare information technology are changing so rapidly that these simple engines are no longer sufficient.
