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.

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.

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.

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.

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.

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.

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.

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.

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?

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.

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.

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.

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

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.

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.

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.

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.

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.

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.