Achieving a Single Patient View Eric Williams Software Practice Sun Microsystems UK Ltd. 1
Sun in Healthcare Committed to the Heathcare Sector > Provider of Servers, Storage, Services, Software & Solutions > Participation in IHE, Open ehealth Foundation, HL7 et al Number of Healthcare Customers > Globally c 3500 > Europe c 750 > UK c 250 Serving Healthcare > NpfIT > NHS Trusts / SHAs > Scottish Health Boards > US Nationwide Health Information Network (NHIN)
The Need for Master Data Management 3
The Root of the Problem Multiple Entity Views Dispersed, unintegrated data Admission Scheduling Procedure Processing Patient Management Monolithic, Independent Applications Check Patient Status Check Bed Inventory Check Patient Status Check Schedules Check Results Check Patient Status Check Discharge Check GP Comms Check Consultants Data Repositories PAS Inventory Pathology Radiology Oncology Calendars
A Smarter Approach Single Entity View Single Patient View Composite Applications Admission Scheduling Procedure Processing Patient Management Other Composite Applications Reusable Services Check Patient Status Check Results Check Inventory Check Consultants Create Discharge Data Repositories PAS Inventory Pathology Radiology Oncology Calendars
MDM in Healthcare: EMPI GPs, Practice Nurses, Health Visitors Hospital Clinicians, Regional Specialists Enterprise Patient Views Electronic Health Records Personal Health Records Single Patient View District Nurses, Hospice Staff, Community Practitioners Portal and Presentation Layer Framework for Security and Identity Management Patient Transaction Process A Single Enterprise Master Patient Record Connectivity, Integration & Middleware Infrastructure Clinical Records Department Practice 6
Aspects of the solution Comprehensive Ease of integration across legacy and packaged applications with capability to handle heterogeneous sources of data Data acquisition, quality management, indexing, stewardship, and data dissemination Robust run-time environment; unified development and monitoring environment Extensible Rapid development of new functionality and extension to new locales Ability to extend framework to cover future applications and protocols Federated identity to extend single view to partners Component-based; service-enabled architecture Accessible Layered levels of access for privacy and security Adoption through community and partner ecosystem
The Sun MDM SOLUTION 8
Sun's EMPI Solution Open Source MURAL OPEN ESB OPEN SSO OPEN DS NETBEANS GLASSFISH OPEN SOLARIS Portal Master Data Management Master Index CUSTOMER PATIENT SUBSCRIBER CITIZEN IDENTIFIER Initial Load HIGH PERFORMANCE/ PRE-MATCH & LOAD AGGREGATION PERSONALIZATION Probabilistic Matching Data Integration EXTRACT TRANSFORM LOAD Data Quality ANALYSIS/STANDARDIZATION/ CLEANSING Enterprise Service Bus ORCHESTRATION MEDIATION ADAPTERS ROUTING TRANSFORMATION MESSAGE SERVER APPLICATION SERVER Infrastructure DIRECTORY SERVER SINGLE SIGN-ON 9
How to develop the Master Patient Index
Typical Workflow PAS RadiS2 Telepath...... Data Integrator (Source Extract) STAGING Data Quality (Cleanse, Profile, Standardize, Normalize) Master Index Database Data Integrator (Bulk Load) Master Index (Bulk Match, Generate Master Index) Master Index Server Master Index Web Application (Resolve Potential Duplicates Assumed Matches Search, Manage Enterprise Profile)
The Problem First Name Last Name Use ID Address Information ID #1 ID #2 Jones Ed EJON 88 Queens Street Edward Jones EDJON 88 Queens St Weight (0 to 1) = 0.9 + 1 + 0.7 + 1 = 3.6 Total Max 4.0 High Threshold is 3.5 Low Threshold is 3.2 Min 0.0 Automatic Match Potential Match New Customer AUTOMATIC MATCH!
The Solution: Enhanced Matching First Name Last Name Use ID Address Information ID #1 ID #2 Jones Ed EJON 88 Queens Street Edward Jones EDJON 88 Queens St Weight (0 to 1) = 0.9 + 1 + 0.7 + 1 = 3.6 Total Max 4.0 High Threshold is 3.5 Low Threshold is 3.2 Min 0.0 Automatic Match Potential Match New Patient AUTOMATIC MATCH!
Master Index Web Application PAS RadiS2 Telepath... Data Integrator (Source Extract) STAGING Data Quality (Cleanse, Profile, Standardize, Normalize) Master Index Database Data Integrator (Bulk Load) Master Index (Bulk Match, Generate Master Index) Master Index Server Master Index Web Application (Resolve Potential Duplicates Assumed Matches Search, Manage Enterprise Profile)
Typical UI for Health Records Staff 15
Master Index Web Application
Compare Duplicates
Select Duplicates
Preview Records Ready to Merge
A Single Integrated SOLUTION 20
Synchronisation on the ESB Backplane Index exposes master data events INDEX Workflows orchestrate update channels SYNCHRONISATION WORKFLOWS Update channels synchronize changes through the ESB ESB Wide range of adapters and services leveraged from ESB Messaging Web Services Database Adapter APPLICATION LANDSCAPE
CUSTOMER SUCCESSES 22
Regional and National ehealth: Sun is the World Leader - General Medical Services Ireland Deployed Patient Matching for more than 40 million transactions from 5,000 primary care contractors NY Presbyterian Hospital Real-Time Single Patient View. Linked to 70+ systems, 9 million+ person records, 20m history records & Passive feeds from 28 hospitals National Health Service United Kingdom Manage over 50 million members, 250 hospitals & 600,000 medical practitioners; Encompasses 10,000 systems across 40,000 sites. Largest Integration & Single Patient View Project In The World! New South Wales Australia Largest health department established of a Unique Patient Identifier for every individual in the State Sussex HIS England Integration of 2 PAS systems due to restructuring of the HIS Region. 2 Trusts merging. 900,000 patients
McKesson's Clearing House Solution: Highly scalable Enterprise Master Patient Index (EMPI) that fits into existing SOA infrastructure. Resolves all inbound and outbound transactions with a unique patient identifier. Highly scalable. Use Case: McKesson s clearing house, PerSe, is the largest processor of prescriptions in the US. With data coming from thousands of sources, the client needed uniquely identify patients across multiple sources. Sun s EMPI greatly enhanced PerSe s ability to report and analyze data. Volume Statistics: 10-14 million NCPDP scripts / day 180 million unique people in database
SUN MDM SUITE HIGHLIGHTS
Solution Benefits Integrated, consistent view of master patient data leveraging current directories, data, and systems Dramatic improvements in visibility of clinical data across the Local Health Boards Real-time access to Master Patient data Accessibility to the right information, clinician, place, time and equipment Improved productivity, heightened compliance and reduced costs Leading to dramatic improvements in clinician satisfaction, retention and patient safety 26
Sun Solutions and MDM Improve Patient Safety Remove Duplicate Records Consistent/Complete Patient view Extensible Matching and Standardisation MDM proven expertise 18 years+ of solutions to Healthcare Organisations Robust and Scalable architecture
Achieving a Single Patient View Eric Williams Software Practice Sun Microsystems UK Ltd.