Approaches to Hospital Integration

Clinical Portal and Interface Engine

Brendon McAlevey Senior Consultant

Orion Health/Apollo

• This presentation examines tools for two separate aspects of integration:

• Integration of Systems at Back-End / Messaging Level• Requirements for Interface Engine - Rhapsody

• Integration of Applications into a “Unified View” for Clinical Users

• How a Clinical Portal helps achieve integration - Concerto

• Illustrated with two case studies• eThekwini Hospital and Heart Centre (South Africa)• Hospital Son Dureta (Spain)

Hospital Systems Integration

What should an Interface Engine Do?

- Connect together multiple hospital I.T. Systems- Handle complex format translations (eg. HL7 v.2 -> XML)- Make it easy to create/edit interfaces- Allow real-time monitoring and alerts of faults & errors

Rhapsody Integration Engine

• Avoid hand-coding new interfaces

• Easily edit/update existing interfaces

• Work collaboratively across I.T. team

• Automatically create documentation for interfaces

Interface Engine : Creating Routes

• Create custom mappings

• Use/edit standard mappings

• Reduce hand-coded mappings

• Avoid proprietary code

Interface Engine: Mapping Formats

Interface Engine: Monitoring

• Monitor status of routes, communication points, message queues, error logs

• Access archived messages

• Stop/start routes

• Remote access

Durban, South Africa

Rhapsody at eThekwini Hospital

• 250 Bed Private Hospital• Specialist Cardiology Unit• Maternity Unit• Paediatric Unit• 7 Operating Theatres

Interface Engine at eThekwini Hospital

• Brand New Facility – built 2007, opened 2008• SAP-based Hospital Information System• Clinical Systems by GE • Integration to SAP systems using Rhapsody• Rhapsody Integration Engine

Concerto Clinical Portal

Patient information is typically stored in separate clinical systems, each with its own login and password.

A Clinical Portal with Single Sign-On can manage a user’s access credentials so that they only need to sign-in once.

Once a patient is selected, the clinical user has immediate one-click access to all integrated clinical applications

Single Sign-on

Centralised enforcement of patient privacy and user security

Single Complete Source of Information

Unified View of Data from Multiple Sources

Supports incremental implementation across a hospital/ enterprise

“Best of Breed” – not “Big Bang”

Clinical Portal

• Assembled in real-time from multiple sources

• Alerts, Recent Results/Orders

• Document + Results Tree

• Click-Through to further information

Clinical Portal : “Dynamic Patient Summary”

Web-based view of individual and cumulative numerical data, such as laboratory results

Clinical Portal : Results Reporting

Spain

Concerto Portal at Hospital Son Dureta, Spain

Palma de MallorcaBalearic Islands, Spain900 bedsRegional reference hospital50 year-old infrastructureUrban population 375,000 (Palma)

Hospital Son Dureta

Clinical Portal Solution providing:

Lab Results Reporting Clinical Notes

Emergency Whiteboard Electronic Clinical Orders

Focus on ED deptwhere all specialties closely interact

Go-Live November 2006

Oracle HTB as Clinical Data RepositoryRhapsody™ provides HL7 v.3 conversion for

data from legacy source systems

Concerto™ provides Unified UI• ED Whiteboard• Results reporting• Electronic clinical orders

Clinical Portal: Phase One

Clinical Portal: Electronic Whiteboard

• electronic version of the traditional ED whiteboard

• Integrated to existing PAS & ED System

• Patient status data pulled from multiple systems, eg:

-location

-responsible clinician

-availability of lab results

• Updated in real time

Go-Live April 2007

Second Electronic Whiteboard deployed - Paediatric ED

Web-based Clinical Notes for both Emergency Departments

Discharge Summaries, automatically populated from Clinical Notes

Alerts for Frequently Admitted Patients (notification to clinicians when a patient who is a “frequent flyer” presents again in the ED)

Expanded Dynamic Patient Summary and Patient Search

Searchable History Report for ED

Clinical Portal: Phase Two

• Expansion of solution beyond the Emergency Departments

• Deployment of Electronic Whiteboard on wards

• Deployment in specialist departments

• Expanded capabilities for Clinical Orders, Results Reporting

Clinical Portal: Future Plans

Back-end integration -A interface engine is the “beating heart” of an integrated hospital IT framework- A well-designed interface engine can make integration simpler for hospital I.T. Teams – allowing them to focus on more “high value” projects

Front-end integration- A clinical portal approach can deliver the benefits of integrated data to clinical users- Using the integrated infrastructure to support better processes, better care

Summary

Apollo SAwww.apollo.gr

Orion Healthwww.orionhealth.com

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