EHR Implementations: Revolutionising Health Information Management Denis Tebbutt Managing Director, InterSystems ANZ

Software for Connected Healthcare HealthShare – #1 health information exchange platform Regional / National EHR TrakCare – Advanced Web-based healthcare information system Institutional / Community EPR Ensemble - #1 rated healthcare integration software InterSystems is the only company with an end-to-end solution for “Connecting Healthcare” – institutional, communities, through to national solutions -- through our community of healthcare application providers and with our own technology Note: this slide simply positions ISC capabilities, to enable you to engage in dialogue regarding the prospect’s organisation. Additional slides exist as required for more detailed positioning of our core technology products and credibility-building for InterSystems. Application Level Caché - #1 database in clinical applications worldwide

National & Regional Sharing of Clinical Information Around the world healthcare delivery systems are increasingly focused on the creation of an EHR Increases accessibility of important health information across the spectrum of care Improves the quality of care Reduces the costs of care through elimination of duplicate tests and prescriptions In emergency situations can literally save lives Facilitates the development of integrated community based care Can outreach to health based NGO’s

The EHR Basics Identify the patient across facilities Authentication of the requesting clinician/viewer Consent Management Security Terminology Messaging Leave clinical data at the source

Technology Challenges HealthShare Clinical access through a ‘Portal’ There must be an integrated clinical application that fits all levels of a facility A powerful, health focused, integration platform supporting HL7 and other IT based standards A strong standards based approach Repository and Record Locator Service Rapid Application development and deployment with incremental and massive scalability Clinical Viewer & Patient Portal TrakCare Clinical Patient Record Ensemble HL7/CDA/CCD/DICOM/NCPDP/RLS EMPI/RLS Cache

So What is HealthShare? Massively scalable integrated healthcare suite for the deployment of Regional and National Electronic Health Records: Clinical Viewer Enterprise Master Patient Index Clinically proven database and application Fully integrated and clinically proven integration and development platform Harvests the data held in all of the repositories that support the operation of a healthcare facility/state/region/country

The Structure of HealthShare? The HealthShare EPR is a sophisticated browser-based Electronic Patient Record that doctors and other clinicians use to access patient data The HealthShare Hub is a central index of patients and providers, it uniquely identifies a patient and specifies which edge Caches maintain data for that patient The HealthShare Edge Cache Repository is a clinical database that holds all of the data that a provider is willing to share The HealthShare Gateway is a health integration platform optimised for providing multiple provider organisations

Populating the Hub

Locating Patient Records

HealthShare Patient Viewer

Ensemble at the Heart of HealthShare One data model One metadata repository One development environment One management environment One learning curve

HealthCare Deployment Examples Long Island, Rhode Island RHIO’s, Sweden & Netherlands National Systems

Long Island Patient Information eXchange Mission Mission: To create an achievable, sustainable and replicable model for integrating clinical information across multiple health care organizations in order to improve access to patient data at the point of care; improve health care quality; and reduce inappropriate utilization and cost. Focus on support for the “transitions of care” Emphasis on infrastructure and Proof of Concept in Phase 1 Benjamin Stein, MD Chief Executive Officer, LIPIX Director of CIS, North Shore LIJ Health System

Long Island Patient Information eXchange Scope Clinical Data Exchange (CDE) “Data of convenience” Workflow integration Need to support “pull” and “push” transactions Meta - Master Patient Index (M-MPI) Supports health information exchange Provides patient identification services to individual member organizations Future growth Public Health module E-imaging e-Rx Ambulatory EMR PHR

Long Island Patient Exchange (LIPIX) 5.2 Million Residents 8,000 GP’s (Assoc with NS-LIJ Health System)   Connecting 15 healthcare organizations on New York’s Long Island Initial LIPIX Deployment 4 Hospitals 2 Physician Practices Home Care Agency Municipal Health Center EMS Organization Reference Laboratory Long Term Care Facility Public Health Department

Long Island Patient Information eXchange Scope

USA Rhode Island Having a useful, usable and used interconnected health information system that: A total of 1.1Million Residents 3,000 GP’s Puts the right information into the hands of clinicians and their patients when and where it is needed Allows for population health information to be analyzed and used for surveillance, health policy, and research Using InterSystems HealthShare for state-wide master patient index and clinical data exchange Connecting 14 healthcare organizations across the state (85%+ of all lab and medication data) Governor has an “Anytime, Anywhere Healthcare” agenda

Sweden - National Patient Overview (NPO) Population 9 million 21 healthcare regions National EHR Carelink is Government appointed group to manage the project. InterSystems in partnership with Tieto Enator. Contract signed March 18th

Netherlands (NICTIZ) National solutions for Access, Identity & Consent National Healthcare Messaging Hub National solutions for Access, Identity & Consent HL7 V.3 for Health Information Exchange Strategy of inclusion for existing suppliers and end-user solutions Concept of “well-behaved systems” [GBZ] Encouraging utilisation of the infrastructure

EHR Implementations: Revolutionising Health Information Management Denis Tebbutt Managing Director, InterSystems ANZ