Introduction

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.

Introduction

Introduction

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.

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.

The strategies surveyed in this document are based on three different HA technologies:

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.

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.

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.

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

Executive Summary

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.

Business Transformation for Application Providers

Introduction

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

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:

Featuring the results of the HIMSS Analytics Interoperability Study

Introduction

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?

Introduction

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.

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.

What is Integration

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

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.

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.

The CIO Perspective

Executive Summary

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.

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