Integration plays the central role in connecting health systems to effortlessly communicate and share data, ultimately improving the quality and outcomes of health services. With an integration system in place, healthcare organizations can improve communication within their enterprise, connect to external entities, such as HIEs, laboratories, and long-term care facilities, and to patient platforms, such as Microsoft HealthVault. With established and evolving standards, such as HL7 v2 & v3, CDA, XDS, and FHIR, healthcare organizations now more than ever need a robust interoperability solution to meet and support these requirements.

1. Sponsored & Brought to you by
Healthcare Integration | Opening
the Doors to Communication
Ramraj Rajkumar
https://www.linkedin.com/in/ramrajkumar

3. Overview
 Introductions
 Healthcare Integration - background
 Healthcare Integration Requirements
 BizTalk Offering for Healthcare Integration
 Case studies
 Q&A

4. About Myself
 VP of Integration Services at Dapasoft
 Previously at Microsoft
 Worked on BTS Product team (Specifically the HL7 Accelerator)
 10+ years of experience in Healthcare Interoperability solutions

5. Dapasoft and Corolar
Systems Integration partner for Microsoft
• Based in Toronto, Canada
Healthcare integration solutions & services
 Healthcare integration
 Application development
 Portals and collaboration
 Business Intelligence
 Microsoft .NET

6. Background

7. 10 years ago …
Why do I need an Integration Engine / ESB /
Interface Engine?

8. Healthcare Integration

9. HL7 Data
Category Type of Data Fields detail
Patient
Administration
Patient Demographics
Visit Information
Insurance Information
Allergy Information
Diagnosis Information
Etc.
Patient Name, Address, phone numbers, patient location, attending doctor,
consulting doctor, admit date/time, discharge date/time, Insurance Company
Name/Address, Insurance Group Number, Policy Number, Plan ID, Allergy
Code, Allergy Severity Code, Diagnosis Code, Diagnosis Description, Diagnosis
date/time, Diagnosis type, Etc.
Order Entry Lab Order
Pharmacy Order
Imaging Order
Hospitality Order
Clinical Order Information
Etc.
Accession Number, Order Request date/time, Result date/time, Collection
Volume, Specimen Received date/time, Ordering Doctor, drugs, dispensing,
allergies, quantities, Etc.
Laboratory Results Lab Result Information
Lab Specimen Information
Etc.
Result Value Type, Result Value, Result Units, Reference Range, Abnormal
Flags, Result Status, Etc.
Scheduling Appointment Information
Resource Requests
Service Requests
Etc.
Appointment date/time, appointment duration, Requested Service ID,
Requested Resource ID, Location resource ID, Location Type, Etc.
Other domains … …

10. Healthcare Integration
Scenarios

11. Health System Integration

12. External Integration

13. Integration to Patient centric systems

14. Integration and BI

15. https://www.ehealthontario.on.ca/images/uploads/vendor_sessions/eHealthBlueprint_Handout.pdf

16. Now …
Does your ESB provide …?

17. Healthcare Integration

18. Healthcare Integration

19. Healthcare Interoperability
Challenges

20. Healthcare Interoperability Requirements
 Mission critical 24x7 environments
 Established and emerging standards
 HL7 v2, v3, CDA, CCDA, XDS, FHIR, and others
 Complex message formats
 Versioning
 Legacy and modern protocols
 MLLP, WS, REST and others
 Complex environments  Typical environment
 100+ Interfaces (Inter-dependencies)
 > 1M real-time transactions per day
 Ordered delivery

21. Healthcare Interoperability Requirements
 Non functional requirements
 Privacy / security
 Audit
 HA / DR
 Low latency  near real-time delivery
 Ability to handle operational downtimes  Ability to queue 1M+ transactions
 Archiving requirements  90 – 120 days data retention
 Message search, edit, resubmit
 Functional requirements
 terminology services
 Validation and processing rules (XSD, BRE, others)
 Real time deployments
 Infrastructure and Interface level monitoring
 Extensibility

22. What Are healthcare customers looking for?
 Technology that has pre-built healthcare functionality
 Support for standards
 Protocols
 Business rules
 Terminology management, validation rules, etc.
 Proven best practice
 Get it right the first time
 Repeatable  templates
 Analysts vs Developers
 Vendor / Software stability and supportability
 Interface Life Cycle Management
22

23. ESB and Healthcare

24. Healthcare Integration engine Landscape
 Niche Healthcare Integration vendors
 Rich HL7 / Healthcare capabilities
 Difficult to support broad use cases
 Enterprise ESB  Horizontal platforms
 Very powerful
 Lack of vertical features
 Requires significant architecture and development experience

25. BizTalk Server

26. Foundational
Technology
HL7 v2 Solution
Faster
Time to
Value
HL7 Accelerator for BizTalk Server

27. Architectural decisions
 Orchestrations vs Messaging  Ordered delivery, low latency, etc.
 Archiving  Tracking, BAM, Custom solution
 Monitoring  SCOM, 3rd party tools, Interface monitoring
 Queuing  MessageBox, SB, MSMQ, SQL, Custom solution
 Solution templates
 Structure
 Isolation, reusability
 Integration Dashboard
 Support for HL7 standards and rules
 Schema support, rules implementation, etc.
 Need patterns, tools and proven best practices for supporting common
Healthcare Interoperability challenges

28. Corolar/BizTalk as Healthcare
Information Platform

29. Corolar

30. BizTalk and Corolar

31. Corolar – Interface Lifecycle Management

32. Corolar – Clinical Data Repository

33. Corolar – Patient Centric Data

34. Case studies

35. Hamilton Health Sciences
 Integration of Mission critical applications including
EPIC, MEDITECH and others
 Regional Integration Service Provider
• Serves population of 2.3M
• Over 1000 beds
• Regional Service provider
MS Case study
https://customers.microsoft.com/Pages/CustomerStory.aspx?r
ecid=13804

36. Markham Stouffville Hospital
MS Case study
https://customers.microsoft.com/Pages/CustomerStory.aspx
?recid=13797
• Serves population of 400K
• Approx 240 beds
• Achieved HIMSS Analytics Stage 6
EMR adoption model
 Integration of Mission critical applications including
MEDITECH 6.0
 Integration to numerous HIE initiatives

37. BizTalk and Azure

38. What’s Next
Why do I need integration in the cloud?

39. Healthcare and Cloud concerns
 Security and Privacy
 Latency  Real-time scenarios
 Control
 Knowledge and Resource availability

40. Healthcare Services
 Industry specific toolkits / Services
 IHE Profiles ▪ XDS
 HL7 v2 / MLLP ▪ CCDA
 HL7 v3 ▪ FHIR
 Etc.
 CDR in the cloud

41. Contact Details
Name – Ramraj Rajkumar
Email – rrajkumar@Dapasoft.com
41