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.

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.

Executive Summary

An accountable care organization (ACO) is a group of providers that are collectively responsible for the total cost and quality of care provided to a specific population of patients. Together, the group assumes risk and shares rewards. As with high-performing organizations in other industries, the hallmarks of ACOs are quality measurement and continuous improvement.

Like other care models that are experiencing changing reimbursement structures, ACOs require new competencies to coordinate the delivery of care, and to manage populations, finances and risk.

Introduction

Software services, in a service-oriented architecture (SOA), can be used again and again in many different business processes, making for a very flexible, efficient, and vibrant business and information technology infrastructure. Providing, of course, that IT has the right platform in place for modeling business processes and implementing the SOA. Using the InterSystems Ensemble product as an example, this paper examines two key technologies that are absolutely essential for successful SOA implementation, but missing from most SOA development platforms.

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.

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.

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.

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.

Introduction

With the maturation and wide acceptance of Java, object-oriented programming has moved to the foreground of the application development landscape. Because of their rich data models and support for productivity-enhancing concepts such as encapsulation, inheritance, and polymorphism, object technologies like Java, C++, and COM, are favored by today's application developers.

However, much of the world's data still resides in relational databases.

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.

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.

Using Intel® Advanced Encryption Standard New Instructions with InterSystems Caché Substantially Improves Encryption Performance and Reduces Computational Overhead

Executive Summary

Financial services companies have an ever-growing need to encrypt databases containing sensitive customer and trade data. However, using encryption on these databases can require significant computational resources, potentially impacting trading latencies.

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.

Business Transformation for Application Providers

Introduction

InterSystems regards the enterprise service bus (ESB) as a business transformation engine for application providers.

Why the emphasis on transformation? For many application providers meeting today’s customer demands will require a change in business model. Customers are looking for unified solutions instead of application portfolios from vendors. They want these solutions delivered on their device of choice, from desktop to mobile. Above all, these solutions must be focused on the user experience.

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:

1. Caché can achieve unheard of levels of performance for an object database. It provides full persistence of data at speeds that are normally only reached by in-memory databases.

Featuring the results of the HIMSS Analytics Interoperability Study

Introduction

Interoperability - the ability of health information systems to exchange, transform and interpret shared data across multiple systems and devices, and across organizational boundaries, in order to advance the health status of, and the effective delivery of healthcare for, individuals and communities - gained widespread attention in the United States when President Bush called for interoperable electronic health records (EHRs) in his 2004 State of the Union Address.

Customers who switch to Caché from relational databases report that their average performance is up to 20 time faster, running on the same hardware, with no changes to the application. What is it about Caché that lets applications run so fast?

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.

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.

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.

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.