An overview of the Healthcare Connectivity Pack for WebSphere Message Broker

1. © 2012 IBM Corporation
IBM Integration Bus
Healthcare Integration
Ant Phillips
antphill@uk.ibm.com

2. © 2012 IBM Corporation
Use Restrictions
The Program is capable of being used as a medical device data system to transfer, store, and convert data from one
format to another. The Program may occasionally transmit data to bedside medical devices (e.g., for polling and telemetry).
However, the Program itself is not a medical device.
The following uses of the Program are prohibited:
a. use to control any bedside medical device for clinical, therapeutic or treatment purposes (for example, but without
limitation, the administration of medication, anaesthetics, saline solutions and the like);
b. use for active patient monitoring (i.e., where the Program is used as the sole means of monitoring life-critical patient data
, e.g. heart rates);
c. use for decision support (i.e., where the Program is used as the main basis to determine patient-specific treatment or
immediate clinical action); or
d. use in any active monitoring that depends on the timeliness of data transmission.
Indemnity to IBM
Licensee will indemnify International Business Machines Corporation and its affiliated companies against any and all third
party claims and liability arising directly or indirectly from any use of the Program by or for Licensee for a use or purpose
that is prohibited by the provisions of the foregoing section, "Use Restrictions".
As of December 11th
2012, WebSphere Message Broker Connectivity Pack for Healthcare is currently available for purchase
through the Passport Advantage program only for use in the following specific countries :
Australia; Austria; Canada; Chile; China; Colombia; Denmark, Finland; Germany; Italy; Malaysia, Mexico; Netherlands; New Zealand; Norway; Poland;
Portugal, Singapore; Spain, Switzerland; Sweden, United Kingdom; United States of America
For the current list of licensed geographies please see the following URL:
http://www-01.ibm.com/software/integration/wbimessagebroker/healthcare/license/index.html
Important Disclaimer and Availability Information
WebSphere Message Broker Connectivity Pack for Healthcare

3. © 2012 IBM Corporation
Healthcare Integration Patterns
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 Connecting Clinical Applications
 Medical Device Integration
 Telehealth
 Clinical Portals
 Care Process Management
 Healthcare Analytics
 Clinical Documents
 Digital Imaging
 Mobile
 Health Information Exchanges

4. © 2012 IBM Corporation
Where Does It Fit?
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5. © 2012 IBM Corporation
 The healthcare industry is undergoing a fundamental revolution
– Driven by the compelling need to improve patient care and increase efficiency
– Government mandated changes are causing disruptive effects in many nations
– Customer expectations soar as delivery costs continue to increase
– Integration must address time-to-value and increasing complexity
– IBM has a broad portfolio of technologies which can solve many healthcare issues
 Healthcare Connectivity Pack provides out-of-the-box integration solutions
– This offering brings IBM integration closer to the healthcare industry
– Adds broad range of high value use cases including mobile and analytics
– Clients value building their enterprises on a fully supported product
 IHE, HL7, CDA and DICOM standards provide the solid foundation
– Vendor neutrality enables us to work cross industry – for example with EMR vendors
Why Healthcare Integration?
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8x Faster adoption than the internet
and if tablets included, even faster Morgan Stanley

6. © 2012 IBM Corporation
Connecting Clinical Applications

7. © 2012 IBM Corporation7
Connecting Clinical Applications
 Ensure data is consistent across healthcare applications
– Consistent regardless of the patient’s point of entry
– Ensure data is entered once and only once!
– For example, admissions are reflected across all interested systems
 Reduce effort on clinical and administrative staff
– Changes to demographics are reflected in all interested systems
– Reduces human error from duplicate data entry
 Integration done using good practice and architectural principles
– Enterprise service bus abstracts away point-to-point integrations
– Facilitates better reuse and faster time-to-value for new projects

8. © 2012 IBM Corporation
Connecting Clinical Applications
 Production ready pattern based on HL7 MLLP v2.x
 Mediates between HL7 clinical applications (1:1 and 1:many)
– Focus on ADT, ORU and ORM messages from HL7 standard
 Easy to extend with custom transformation logic
 Pattern has excellent multi-threaded performance characteristics
– Sender and receiver message flows decoupled by WebSphere MQ queues
 Supports message validation, duplicate detection, sequencing, and retry
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9. © 2012 IBM Corporation
Siemens Invision (ADT, BAR, ORU) IMPAC IntelliLab (ADT) Chartlinc (ADT, BAR, ORU)
Emtek (ADT, ORU, ORM) PCN (ADT, SIU) Cerner Pathnet (ADT, ORM, ORU)
IMS (different custom
transcriptions)
GE Logician (ADT, SIU) Xtend (ADT)
APOLLO (ADT) BEDTRACKING (ADT) RehabManager (ADT)
DOMINATOR (ORM) Millbrook (ORU) Cerner RadNet (ADT, ORM, ORU)
Omnicell (ADT) Midas (ADT) MedTrack (ADT)
EPIC (ADT, ORU, ORM, MDM) Meditech (ADT, ORU) McKesson
GE IDX FUJI Cerner Millennium
Power Scribe PineStar AllScripts
Selection of applications integrated using IBM Integration Bus and HL7:
A
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Connecting Clinical Applications

10. © 2012 IBM Corporation
Medical Device Integration

11. © 2012 IBM Corporation
Nurses Dashboard
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 Web based presentation of the infusion pump device data feeds
– Data is transformed, stored in a database and surfaced as a web service
– This example comes from a UK hospital that uses BBraun infusion pumps

12. © 2012 IBM Corporation
Medical Device Integration
 Supported medical devices categorised as follows:
– Patient monitors
– Anaesthesia workstations
– Infusion pumps
– Ventilators
 Range of manufacturers including Philips, GE and Draeger
– This capability is strictly limited to device monitoring not control
 Additional devices can be added on request!
 Device connectivity is supported on Windows, SLES 10 and RHEL 5
– Windows has traditionally been the platform for device connectivity
– The product adds Linux support (RHEL/SLES) and also 32/64-bit options
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13. © 2012 IBM Corporation
Telehealth

14. © 2012 IBM Corporation
Telehealth
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 IBM Integration Bus fits well with the Continua view of the world
– Logically acts as a WAN receiver to integrate with the HRN/EMR systems
– IBM is a co-founder of Continua and has co-chaired several key standards
 Continua currently specifies the use of web services as the transport
– Ongoing work to extend this specification to include MQTT as the transport
– MQTT is well suited for efficient low bandwidth communication from devices

15. © 2012 IBM Corporation
St. Jude Medical - Patient Care Network
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Patients
Clinics and
Physicians
Cardiac
Devices
Merlin@home
HouseCall
Merlin Programmer
EMRs
Remote Transmission
Enables remote monitoring capabilities that allow physicians to
provide remote care for patients with implanted cardiac devices
St. Jude Medical, Inc. (SJM) is a leading manufacturer of
implantable medical devices and provider of support services

16. © 2012 IBM Corporation
Clinical Portals

17. © 2012 IBM Corporation17
 Portal provides a single view to the user dependent on their role
– Portal provides the security infrastructure around the HL7 standard
– No requirement to log on to multiple clinical applications
– Portal includes demographics, medications, allergies, images and much more!
Portal and Electronic Forms

18. © 2012 IBM Corporation18
 SmartRoom is a leading edge touch screen workflow system for clinicians
– Clinicians can chart critical information directly in the patient room
– Integration to hospital systems (such as MEDITECH) is through IBM Integration Bus
– SmartRoom application uses web services to HL7 (both inbound and outbound)
SmartRoom

19. © 2012 IBM Corporation
Care Process Management

20. © 2012 IBM Corporation
Care Process Management
 Addressing the whole care continuum is key to The Ottawa Hospital
– Needed patient focused processes to improve quality of care with better visibility
– Lack of timely information to staff at the point of care and across operational areas
– Need to improve key metrics: patient wait times, discharge rates, instances of relapse
 Required products that could integrate within and beyond the enterprise
– Business rules, business process management all underpinned by integration
– Improved patient care delivery through e-orders and closed loop medication delivery
– Standardised individual department level systems: LIS, HR and financial budgeting
– Connect provincial e-health initiatives: diabetes registry, labs and regional supply chain

21. © 2012 IBM Corporation
Care Process Management

22. © 2012 IBM Corporation
Digital Imaging
DICOM

23. © 2012 IBM Corporation
External Expert / Second Opinion
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 In many geographies radiology skills are in critically short supply
– IBM Integration Bus can be used to route DICOM images to external experts
– Routing based on data in the DICOM image (for example, a SNOMED code)
– Solves the larger integration picture such as email notification to physicians

24. © 2012 IBM Corporation
Pre-Fetch on Admission
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 Preparing studies in advance when patients are admitted to hospital
– Flexible routing options to retrieve studies and send them to the right specialists
– Routing based on data in the DICOM image (for example, a SNOMED code)
– Requires a mixture of DICOM commands including C-FIND, C-MOVE and C-STORE

25. © 2012 IBM Corporation
Healthcare Analytics

26. © 2012 IBM Corporation26
Healthcare Analytics
 The healthcare world is increasingly reliant on data for business insight
– Analytics can provide dramatic real world cost savings and efficiency improvements
– It is an enabling technology allowing scarce resources to be used more effectively
 Analytics works at many levels across the healthcare continuum
– Small departments all the way up to population management and health economics
 IBM Integration Bus is an outstanding source for analytics applications
– Huge amounts of healthcare data flow through IBM Integration Bus every day
– Using the integration engine to feed downstream applications makes great sense
– Covers three key healthcare standards: CDA, DICOM and HL7 (v2)
 Tooling simplifies many scenarios when working with healthcare data

27. © 2012 IBM Corporation
 What really caused re-admissions at Seton Healthcare?
– 100+ candidate predictors from structured and unstructured data sources
– Structured data was less reliable as a predictor than unstructured data
– Many predictors were only found in unstructured data such as history notes
– Some key indicators like Assisted Living were only in unstructured data
Patient Care and Insights
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28. © 2012 IBM Corporation28
Predictive Analytics
▪Demonstration system that combines in-flight events with historical data
▪ Used to predict the outcome of a healthcare scenario with levels of confidence
▪ Same technology is highly applicable across many industries
▪ Instructive as well for future IBM Integration Bus enhancements

29. © 2012 IBM Corporation
Health Information Exchanges

30. © 2012 IBM Corporation
Exchanges Begin and End with Accuracy
 Health Information Exchanges are a pre-requisite to:
– Patient Centred Medical Healthcare (PCMH)
– Deploying an Accountable Care Organisation (ACO)
– Achieving Meaningful Use criteria in the US
 High quality interoperability is a foundation for HIEs
– Examples include clinical results, referrals, orders and claims
 Goal is to automate as much as possible while maintaining accuracy
– Ensures clinical data is accurately mapped, routed, monitored and delivered
 The solution combines the following best-of-breed products:
– IBM Initiate Patient and Provider for accurate identity management
– WebSphere Message Broker Healthcare Pack for connectivity and integration
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31. © 2012 IBM Corporation31
IPA
Network
Hosted
EMR
HIE Services
Orthopedic
Oncology/
Hematology
Family
Practices
Remote
Office 6
Remote
Office 5
Remote
Office 7
Results
Viewer
EMR
EMR
Orders Delivery
EMR Generated
Orders
Remote Printing &
Document Capture
Clinical
Systems
Other
Systems
Results Delivery
PM
Remote
Office 2
Remote
Office 1
Acute Care
Setting
Remote
Office 3
Lab Location-
Drawing Station
Remote Printing
PM/EHR
Integration
Consolidated Billing
Analytics
Warehouse
Shared
Registration
Encounter
Summary
IBM
Integratio
n Bus
IBM
Initiate
Patient
IBM
Initiate
Provider
Healthcar
e
Connectivi
ty Pack
CDR
Discharge
Summary
Public HIE
Public Health
Referrals
IBM Initiate and Integration Bus

32. © 2012 IBM Corporation
Mobile

33. © 2012 IBM Corporation
Types of Mobile Application
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34. © 2012 IBM Corporation
Worklight Overview
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35. © 2012 IBM Corporation
 Worklight integration makes developing mobile services simple!
– Four patterns makes mobile service integration quick and easy
– Pattern source included for flexible customization to many other tools
 IBM Integration Bus provides a range of mobile patterns
– Mobile enablement for Microsoft .NET applications
– Create flexible mobile services on top of IBM Integration Bus
– Resource management including security and caching
– Outbound push notifications for asynchronous data delivery
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Mobile

36. © 2012 IBM Corporation
Summary

37. © 2012 IBM Corporation
Summary
 Integration is the key to realising value in industry
– Enables the flow of data to deliver effective cross enterprise integration
– Supports huge range of use cases from mobile to analytics
– Flexibility to support your business wherever it needs to grow
 Connectivity packs bridge the gap from product to solution
– Supports key industry standards: HL7, DICOM, CDA etc
– Provides high value use cases including analytics and mobile
– Expert patterns simplify common integration use cases
– Complies with all relevant industry regulations (for example, FDA MDDS)
 Builds on top of the #1 integration product worldwide
– Fully supported products run on all editions of IBM Integration Bus
– Robust, scalable and high performing as more systems are integrated
– Easy to deploy and manage in all form factors including virtualised
 Unparalleled range of connectivity options and capabilities
– Integrate all your siloes of information including ERP, CRM and more
 Content is driven by your requirements, participation and feedback
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38. © 2012 IBM Corporation
Healthcare Connectivity Pack
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39. © 2012 IBM Corporation
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