InterSystems Ensemble technology demonstrated at HIMSS10 and used in United States and European hospitals

Atlanta, Eton, Cambridge 15 March 2010InterSystems Ensemble was the software platform for the first-ever successful electronic transmission of comprehensive genetic data. The information was sent cross-country from Boston-based Partners HealthCare Center for Personalized Genetic Medicine (PCPGM) to Intermountain HealthCare in Salt Lake City, Utah. The announcement about reaching this milestone in personalized medicine came at the HIMSS10 conference as well as the news that the Long Island Patient Information eXchange (LIPIX) has added three major health care providers to its InterSystems HealthShare-based health information exchange (HIE) network. Rush University Medical Center has completed phase one of an organisation-wide move to the InterSystems Ensemble rapid integration and development platform. The HIMSS10 conference spotlighted this growing trend among health care providers to leverage integration software on an enterprise scale.


The clinical genomic networking system, called VariantWire, used InterSystems Ensemble as the foundation of a secure data transfer hub between the PCPGM laboratory and the health care centre. "InterSystems is very committed to the personalized medicine space and has provided us with excellent and enthusiastic support", stated Sandy Aronson, Executive Director of Information Technology at PCPGM. The Ensemble rapid integration and development platform is used by health care organisations worldwide for multiple initiatives including integrating systems and data repositories, building composite applications and establishing a Service-Oriented Architecture (SOA) infrastructure.

Personalized medicine is based on the concept that genetic/genomic testing can provide information about a person that can be used to tailor medical care to individual needs. The addition of a patient's genetic variation to an electronic health record (EHR) can, for example, help guide selection of drugs to minimize side effects or help build a strategy for a more successful treatment outcome.

For this first genetic data transfer case, a man from Utah was tested at PCPGM for an inherited heart condition called hypertropic cardiomyopathy. The results were sent via VariantWire to Intermountain where the information was added to the individual's EHR. The test showed that the patient wasn't at risk for the heart condition and provided additional genetic data that is now available for storage and future analysis.

The large amount and extreme complexity of the data that results from genetic testing are major challenges in the personalized medicine area. Completed genetic records are not typically provided to patients or physicians because they carry too much data to put in a paper record and many physicians would not be able to make effective use of the complicated data. "There was a huge amount of validation testing that had to be done to ensure information accuracy", stated Sandy Aronson.

Another challenge is to make the genetic data practical to use by most physicians. "We'll take this information and work with genetics specialists to write programmes and create protocols that will assist doctors", stated Stan Huff, MD, Chief Medical Informatics Officer at Intermountain. "A physician will not need to be an expert in family medicine and genetics to effectively use this information for the benefit of his or her patients - our programmes will help."

"It's a privilege to provide the software technology that helped enable the attainment of this significant test milestone", stated Paul Grabscheid, InterSystems Vice President of Strategic Planning. "InterSystems is committed to the ongoing research and development that results in breakthroughs for information technology and we applaud PCPGM and Intermountain for this leap forward in personalized medicine."

The Partners HealthCare Center for Personalized Genetic Medicine (PCPGM), a partnership between Harvard Medical School and Partners HealthCare System (PHS), was founded in 2001 to promote genetics and genomics in research and clinical medicine. One of the foremost centres for clinical research in the world, the centre aims to change the rate of discovery of genes involved in human disease, and develop programmes to help in the understanding of the roles of the large number of human genes and how changes in these genes result in predisposition to common diseases. In addition, the centre strives to use this knowledge to better manage and treat the patient population served by the Partners institutions. Overall, it seeks to translate and integrate the science of genetics and genomics into medical practice.

Intermountain Healthcare is a non-profit system of hospitals, surgery centres, doctors, clinics, and homecare & hospice providers that serves the medical needs of Utah and southeastern Idaho. Key medical services include cancer, heart, women and newborns, orthopaedics, sports medicine, and more.

LIPIX is a regional organisation of public and private stakeholders committed to creating a sustainable and replicable model for integrating and sharing data among Long Island health care providers. It is the first independent HIE in the New York metropolitan area to electronically transfer live patient data across multiple unaffiliated health care organisations. With the addition of Brookhaven Memorial Hospital Medical Center, John T. Mather Memorial Hospital, and New Island Hospital, LIPIX now provides authorized physicians in health care facilities across Long Island with secure access to more than 834.000 patient medical records. As a result, critical data from patient electronic health records (EHRs) is shared to improve care delivery in any location, while at all times protecting patient privacy.

HealthShare leverages advanced software technologies from InterSystems that have made its CACHÉ high performance object database and Ensemble rapid integration platform the premier application platforms in health care. "InterSystems has, as a company, made a strong commitment to the success of New York regional health information organisations (RHIOs)", stated Dr. Ben Stein, MD and Executive Director of LIPIX. "InterSystems' technologists have made major contributions to the New York State eHealth Collaborative work groups and are focused on providing the capabilities and enhancements necessary to facilitate RHIO success."

LIPIX plans to continue the aggressive roll-out of the HIE network with the expectation that the majority of all major health care providers on Long Island will be using the service by year's end. New capabilities including secure messaging and central hub-based results delivery technology will be added over the same time period. An estimated two-and-a-half million people will be able to receive the benefits of clinical data exchange by the end of phase one of the implementation, according to Dr. Stein. He expects that the HIE will eventually expand to serve about five million people in Long Island and Queens.

"HealthShare's underlying technology continues to play a pivotal role for LIPIX by serving as the core functionality as we develop and implement value added services that will be layered onto the HealthShare platform providing for a flexible and scalable solution to meet the current and future needs of Clinical Data Exchange", stated Dr. Stein of LIPIX.

"HealthShare provides advanced standards-based capabilities that satisfy HIE requirements while reducing associated risks and costs", stated Paul Grabscheid, InterSystems Vice President of Strategic Planning. "The growth of LIPIX illustrates how this combination is optimal for implementation and expansion of a secure regional or national EHR system that enables quality care delivery."

LIPIX is an independent, not-for-profit corporation established to develop a Regional Health Information Organization (RHIO), also known as a Health Information Exchange (HIE). Headquartered in Manhasset, New York, LIPIX's primary mission is to fundamentally improve the quality and efficiency of health care for the betterment of patients, providers and the community with the ultimate goal being to organize the world's health information so that it is globally accessible and useful while maintaining the highest standards of patient privacy. LIPIX receives direction from major care providers on Long Island as well as from health professional organisations including the Medical Society of the State of New York and the American College of Physicians.

Chicago-based Rush is nationally ranked in nine of 16 specialty areas in U.S. News & World Report's 2009 "America's Best Hospitals". Rush is also included in the 2009 100 Most Wired in Healthcare annual survey conducted by Hospitals & Health Networks. The choice of Ensemble for enterprise integration is the latest example of the medical centre's focus on utilizing top-tier technology to enable quality care delivery.

Limitations of its legacy eGate integration platform drove the transition to a new environment, according to Scott Finkle, Director of Development, Architecture and Integration at Rush. "We were using an outdated version of eGate that didn't provide adapters for technologies such as SOAP and XML. With our existing vendor, the update path would have required a total rewrite of all interfaces", he continued. "And, it would have been extremely complicated and expensive to create a high-availability environment and to support our disaster recovery data centre if we stayed with the legacy software."

Evaluation of integration alternatives involved running proofs of concept designed to test product functionality and operational stability when building HL7 interfaces. Ensemble was selected based on increased developer productivity, superior operational monitoring and architectural flexibility that are critical in the medical centre's high-availability environment.

"Based on benchmarking the development process, Ensemble clearly enables higher productivity than the other products we evaluated", stated Scott Finkle. "Ensemble also provides the ability to track transactions at a level of detail that we view as extremely important", he continued. Because Ensemble tracks every message that flows through an integrated system and supports real-time access to message data, IT staff can respond quickly to events throughout the organisation.

"And, Ensemble's flexible architecture allows for both clustered and shadowed support, which enables us to scale on multiple platforms as well as to test on Windows, for example, while running production systems on Sun MicroSystems. With Ensemble, we're positioned for fast disaster recovery as well as the high availability that's a critical requirement in the medical centre", Scott Finkle added.

Rush selected Ensemble and rolled out phase one of its enterprise integration plan at the end of January with financial interfaces, operational monitoring and the high-availability architectural infrastructure implementation first to run in production mode. More than 100 real-time HL7 interfaces and over 500 batch interfaces will be moved to Ensemble by mid-2011. "Keep in mind that we will be developing other critical solutions as they are needed throughout the transition to Ensemble. In addition, we're in the midst of a multi-year roll-out of clinical systems from Epic. Deployment of the Ensemble HL7 interfaces will be coordinated with the Epic application deployment throughout the roll-out", Scott Finkle stated.

"We operate in a fast-changing environment and Ensemble makes it possible to focus on development rather than middleware issues and to utilize technologies such as XML and SOAP. The bottom line is that Ensemble enables our team to deliver projects at a quicker, more consistent pace and, ultimately, reduce our project backlog", Scott Finkle stated.

Looking to the future, Scott Finkle foresees the possibility of using Ensemble for device integration as well as for optimizing business processes that will be automated by an enterprise resource planning (ERP) system. "We'll examine multiple opportunities for leveraging Ensemble in ways that extend beyond application and data integration."

"In addition to integrating mission-critical applications, health care organisations are using Ensemble in a variety of ways to create new enterprise solutions", stated Paul Grabscheid, InterSystems Vice President of Strategic Planning. "Examples include building composite applications, establishing an enterprise service bus or SOA infrastructure and implementing BPM supported by a rules-based engine. We're pleased to work with Rush as they identify the multiple ways that Ensemble can be leveraged to increase productivity and optimize business and technical processes."

Rush University Medical Center is an academic medical centre that includes a 671-bed hospital serving adults and children, the 61-bed Johnston R. Bowman Health Center and Rush University. Today, Rush is a thriving centre for basic and clinical research, with physicians and scientists involved in hundreds of research projects developing and testing the effectiveness and safety of new therapies and medical devices.

InterSystems has also signed a framework contract with NHS National Service Scotland to supply its InterSystems TrakCare connected health information system as the new national patient management system for Scotland. The contract is a national framework in line with Scotland's eHealth Strategy that will enable any Health Board access to the system and associated modules over the next four years.

The new system will help to speed and improve the effectiveness of patient care in Scotland by ensuring patient information will only need to be entered once to make it immediately accessible by authorised staff in other care settings. The TrakCare patient management system includes hospital and mental health patient administration, order communications, results reporting and clinical support tools. A number of optional modules are available for accident and emergency; hospital electronic prescribing and medicines administration; pharmacy management; maternity; neonatal; and theatres.

Initially the five purchasing Consortium NHS Boards involved - Ayrshire & Arran, Borders, Grampian, Greater Glasgow & Clyde, and Lanarkshire - will take advantage of this national framework agreement. Together with NHS Lothian, an existing TrakCare customer, these five Boards provide care for 70 percent of the Scottish population. The total value of the initial contract will be in excess of GBP 44 million. Additional Health Boards are already in discussion about how this framework can benefit them.

Commenting on this development, Scottish Health Secretary, Nicola Sturgeon stated: "This contract will enable Health Boards across Scotland to implement a single, nationally available patient management system that will play a major role in improving patient services. Clinicians and patients will both be winners from a system which will track patient journeys from referral to discharge. It means clinicians will have easier and quicker access to medical records and patients will benefit from having more time with health care professionals."

Alan Lawrie, Programme Board Chairman, stated: "We believe that this solution will play an important role in streamlining patient services leading to faster diagnosis and treatment while enhancing patient safety. Not only will this give us a modern technical base but it has been chosen by the staff who will be using it."

The contract award follows a rigorous 20-month Competitive Dialogue procurement process. In total, more than 160 front-line health care staff, including doctors, nurses and other health professionals, took part in the evaluation of the solutions being proposed.

This contract for InterSystems TrakCare follows other recent successes including the States of Jersey and the States of Guernsey (Channel Islands); the Santiago Military Hospital (Chile) and the new Sharjah Teaching Hospital (United Arab Emirates). Together, these underline the global recognition of TrakCare as a proven, internationally adaptable and versatile connected health care information system, suitable for a wide range of care delivery models in acute, community, mental health and polyclinic settings.

TrakCare puts the patient at the very centre of the system, which means a record only needs to be created once, upon first admission. All subsequent treatments, admissions and visits can then be added to the initial record. Furthermore, by creating one structure for a common, shared record, information is simultaneously available wherever it is needed, and accessible from within each TrakCare module.

Kerry Stratton, Healthcare Managing Director of InterSystems, stated: "The decision to use Health Board staff from many departments in the selection process has given us a clear understanding of NHS Scotland's immediate requirements and long-term vision. We are now ready to focus on delivering TrakCare for the benefit of patients and staff across Scotland."

InterSystems Corporation has achieved a strategic expansion in the Italian health care technology market with the acquisition of Prosa srl, a part of Gruppo Sistema SpA. A long-time InterSystems technology partner, Prosa is based in Cesena, and provides a wide range of implementation and support services to health care organisations in Italy, primarily those located in the Emilia Romagna and Veneto Area regions.

"InterSystems is absolutely committed to providing the highest levels of service and support to its customers in the Italian market", stated Jean-Pierre Giannetti, InterSystems Country Manager for Italy. "Building on our close and highly successful association with Prosa, which extends over 15 years, we felt that it was the appropriate time to expand our direct relationship with the health care providers that are using InterSystems' advanced software technologies. This will ensure that our customers, who include many of the most innovative hospitals in Italy, can realize maximum benefit from our latest health care software advances."

Prosa CEO Massimo Rocchi commented: "InterSystems' decision to strengthen its direct relationship with Italian health care customers is the next logical step towards ensuring the highest customer satisfaction. The team from Prosa will bring new depth to InterSystems' expertise in local implementation, project management and maintenance of critical hospital systems. The results for health care end-user organizations will be extremely significant and highly positive."

InterSystems is a global expert in software for connected health care, with major electronic health record projects under way in multiple countries including Sweden, Scotland, Holland, England, Chile and Brazil.

Prosa srl, headquartered in Cesena, Italy provides a wide array of consulting, project management, implementation and support services to health care providers in Italy, with a primary focus on the regions of Emilia Romagna and Veneto Area. Prosa's teams have the expertise and experience needed to understand the perspectives and requirements of clinicians, patients, and health care administrators and the knowledge to select and implement the most appropriate technologies for enabling quality care delivery in the dynamic, complex health care environment.

Holland Hospital is implementing the InterSystems Ensemble rapid integration and development platform as its enterprise integration engine. Holland Hospital, a 209-bed hospital in Western Michigan that is nationally recognized for quality practices and exceptional patient care, chose Ensemble to address several integration challenges in an effort to continually improve patient care. Among those challenges were the needs to interconnect more systems across the hospital and to integrate with electronic medical record (EMR) systems at affiliated physician groups. Ensemble, which is used to develop and integrate mission-critical applications, leverage previous software investments through composite applications, and establish an enterprise service bus or SOA infrastructure, offered significant advantages over Holland Hospital's legacy integration platform.

"We wanted to add more interconnectivity internally as well as connect to physicians and multiple external organisations. Our previous platform didn't offer a good upgrade path for achieving our objectives", stated Randy Paruch, Director of Information Systems.

After examining a variety of integration products including several standard interface engines and open source alternatives, the hospital selected InterSystems Ensemble. "Our developers found Ensemble easy to understand, easy to use and very straightforward to work with", Randy Paruch stated. "It's a very stable product and the creation of new interfaces is extremely fast - maybe half the time needed for development on the previous platform."

Holland Hospital has completely converted all legacy interfaces over to the Ensemble platform and has also connected the hospital's laboratory information system, radiology information system, and other internal applications to the hospital's hospital information system (HIS) and billing systems.

"We needed a system that could handle an expanding number of new connections and facilities and that's what we received with Ensemble", stated Randy Paruch. "We keep throwing more projects at this platform and it just keeps running. There has been no unscheduled downtime. We're also adding multiple interfaces to make care delivery as seamless and easy as possible for physicians. Not only does this enable improved care delivery, but the easy connectivity means increased business opportunities for both our hospital and the physician groups with whom we work." The health care delivery network is currently using Ensemble to connect Holland Hospital's HIS with other EMR systems in use at several physician groups.

In addition to providing enterprise-wide integration, future plans may lead to Holland Hospital evaluating the InterSystems DeepSee business intelligence software to enable trends analysis and provide early warning of system problems.

"Health care providers like Holland Hospital are increasingly leveraging technology in innovative ways in order to support ongoing improvements in high-quality, cost-effective care delivery", stated Paul Grabscheid, InterSystems Vice President of Strategic Planning. "We're focused on helping them reach their goals by providing integration and business intelligence solutions that grow with them as their needs change and expand."

Holland Hospital is the leading hospital in the West Michigan Lakeshore area, serving more than 150.000 residents within its primary service area. Its advanced technology, comprehensive services and compassionate care also make it the health care choice for thousands more throughout Ottawa and Allegan counties. Holland Hospital is nationally recognized for quality practices and exceptional patient care with awards that include being named one of the nation's Top 100 Hospitals by Thomson Reuters, a Magnet designated hospital and being included for seven consecutive years as one of West Michigan's 101 Best and Brightest Companies to Work For.

InterSystems Corporation is a global software technology expert with headquarters in Cambridge, Massachusetts, and offices in 23 countries. InterSystems provides advanced software technologies for breakthrough applications. InterSystems CACHÉ is a high performance object database that makes applications faster and more scalable. InterSystems Ensemble is a seamless platform for integration and the development of connected applications. InterSystems HealthShare is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee is software that makes it possible to embed real-time business intelligence capabilities in transactional applications for better operational decisions.

InterSystems is the world's no. 1 vendor of database and integration technologies for health care applications. InterSystems products are used by thousands of hospitals and labs, including all 21 hospitals on the Honor Roll of America's Best Hospitals as rated by U.S. News and World Report. More company news is available in the VMW December 2009 article States of Guernsey take major step towards integrated care.

Source: InterSystems

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