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.

• New data sharing and interoperability standards and protocols arise and evolve continuously
• The volume, variety, and velocity of data —

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.

InterSystems Caché is a high-performance object database with a unique architecture that makes it suitable for applications that typically use

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:

• Operating System Failover Clusters
• Virtualization-Based HA
• Caché Database

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.
2. Caché demonstrates

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?

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.

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.

In preparation of the extreme data requirements for this project, InterSystems recently engaged in a

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.

Whereas in the past the frontier of healthcare it was

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.

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.

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.

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

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.

To foster this collaboration and engagement, payer organizations must make critical

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.

In addition to providing an availability solution for unplanned downtime,

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.

Patients are increasingly relying on multiple specialists and healthcare organisations for treatment, due to the complexity of their medical conditions