#HealthShare

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. As a result, healthcare organizations across the country are exploring what they must do in terms of restructuring and realigning their operations in order to manage costs efficiently, and to improve outcomes and o

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 Mirrori

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. Among the first is improving

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. This document describes the observed characteristics,