1. Microsoft Connected Health Platform A Foundation for Service Oriented Health Industry Solutions Dr Ilia Fortunov Industry Technology Strategist - EMEA Microsoft Worldwide Health

2. Connected Health Framework Vision Define an overarching framework for Health Industry Architecture –Best practices for service oriented health information integration and collaboration architectures Enterprise-, state-, province- and country-wide projects Leverage available assets to deliver more value faster Based on open standards and protocols – platform-agnostic –Develop ecosystem of CHF-enabled solutions Deliver value for customers faster and at lower cost Frame of reference for partners solutions Easier integration across multiple solution areas 2 Microsoft Connected Health Framework

3. Connected Health Framework Business Framework The CHF Business Framework uses a service oriented approach to –Define business components and major subject areas –Offer a range of services that can be “orchestrated” to enable and support business processes –Leverage existing sources of functionality and information It provides a Business Pattern for Health 3 Microsoft Connected Health Framework

4. Business Framework Communication Operations Management Security User Processes Business Processes Connected Health Services Hub Data Access Logic Components Business Services

5. Business Framework Microsoft Connected Health Framework 5

6. Connected Health Framework Technical Framework The CHF Technical Framework addresses: –Multiplicity of services, sources of data and systems –Management of patient and clinician identity –Integration across multiple systems –Flexibility and agility –Security –Scalability, Performance and Availability It provides a Reference Architecture for Health 6 Microsoft Connected Health Framework

7. Technical Framework Communication Operations Management Security Collaboration, Presentation and Point of Access, Identity Management, Privacy and Security Services Service Publication and Location, Shared Services System Management Services Communication Services Data Services Connected Health Services Hub Integration Services Business Components Service Component Interface 7 Microsoft Connected Health Framework

8. Connected Health Framework Architecture Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components STABLE AGILE

9. Options For Storing Clinical Data Mostly a matter of ownership and policy Centralized model –Central repository holds replica of full health record –Clinical Data Exchange (CDX) Gateway publishes full health record and manages data synchronization Federated model –Central repository holds no personal data –CDX Gateway publishes registration events and caches full record obtained from multiple sources Hybrid model –Central repository holds record summary –CDX Gateway publishes record summary and caches full record –Could be multi-tier, with many data stores 9 Microsoft Connected Health Framework

10. Flexibility in Deployment 10 Microsoft Connected Health Framework

11. CHF Architecture Blueprint in Context Microsoft Connected Health Framework 11

12. Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components CHF Ecosystem – Who does what? 12 Customer Specific (MS provides Guidelines, Platform Products, Assistance ) ISV Provided (MS provides Business Pattern – Component and Service Definitions) MS or SI Partner Provided SI Partner Provided (MS provides Reference Architecture and SDKs) SI Partner Provided (MS provides Reference Architecture and SDKs) ISV or SI Partner Provided (MS provides platform and guidance)

13. Building Solutions Using the CHF Blueprint Key scenarios depending on the role: –Customer - Formulating Requirements (RFP) –Vendor/Systems Integrator - Meeting Requirements (Responding to an RFP) –Software Vendor - Aligning an ISV Application with the CHF –Infrastructure provider - Establishing the Environment CHF (Part 4) provides guidance for each, e.g.: –Understanding Scope & Boundaries –Understanding the Required Features –Deriving the Architecture –Defining the Solution Microsoft Connected Health Framework 13

14. Connected Health Framework: Levels and Components Connected Health Framework is Microsoft’s multi-year world-wide industry strategy, encompassing our industry solutions, partner strategy, platform offering and policy initiatives. Connected Health Framework – Architecture and Design Blueprint offers a set of vendor-agnostic best practices and guidelines for building the next generation of interoperable e-Health solutions based on a service-oriented architecture (SOA) and industry standards – ranging from within healthcare organizations to regional, national and cross-agency systems Microsoft Connected Health Platform is Microsoft technology offering and prescriptive architecture guidance for e-Health solutions built on the Microsoft platform –Health Connection Engine (HCE) –Common User Interface (CUI) –… etc. Microsoft Connected Health Framework 14

15. Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components Microsoft’s Connected Health Platform Office System Visual Studio,.NET Framework BizTalk Server,.NET Framework Office System, LiveMeeting, Exchange, Windows Server System Operations Manager, System Center SQL Server Windows Mobile

16. Reference Implementations Health Connection Engine (HCE) –Community project on http://www.CodePlex.com/hcehttp://www.CodePlex.com/hce –Accelerates the development and deployment of connected solutions Adapters SDK Standard set of Web Services –Based on BizTalk, SQL Server and the.NET Framework Microsoft Common Health User Interface (MSCUI) –Available at http://www.mscui.nethttp://www.mscui.net –Community project on http://www.CodePlex.com/mscuihttp://www.CodePlex.com/mscui –Facilitates development of consistent and safe clinical user interfaces –Based on.NET Framework IHE Cross-Enterprise Document Sharing-b (XDS.b) –Community project on http://www.CodePlex.com/ihehttp://www.CodePlex.com/ihe –Implements standard IHE Integration Profile to facilitate sharing of clinical and health documents –Based on.NET Framework and SQL Server 16 Microsoft Connected Health Framework

17. Health Connection Engine (HCE) Community project on http://www.CodePlex.com/hcehttp://www.CodePlex.com/hce Accelerates the development and deployment of connected solutions –Adapters SDK –Standard set of Web Services Based on BizTalk, SQL Server and the.NET Framework First reference implementation in line with the Connected Health Framework – Architecture and Design Blueprint Developed in partnership with SIMPL Health (NZ) Microsoft Connected Health Framework 17

18. Health Connection Engine Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components HCE Services and Registries Messaging Management Services Adapters Messaging Management Services

19. Industry Priority Solution Areas Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components Caregiver Collaboration Health Information Networks Portals Healthcare Analytics

20. IHE/XDS Reference Implementation Adapters Tools: Auditing - Reporting Access - Configuration Tools: Auditing - Reporting Access - Configuration 1. Sources post document packages to the Repository 2. Repository registers the documents metadata and pointer with the Registry 3. Consumers search for documents with specific information 4. Consumers retrieve documents from Repository(ies) XDS Document (Metadata): Type Patient Author Facility Authenticator … XDS Document (Metadata): Type Patient Author Facility Authenticator … Repository Origin of Documents Package Registry Microsoft IHE XDS.b Reference Implementation

21. Connected Health Accelerator Common User Interface

22. Operational considerations: smart-client…web-based…multi-device… Clinical User Interface Fundamentals 22 Microsoft Connected Health Framework

23. Creating a Safe Useable Clinical UI Fast and Effective User Interaction Optimised for multiple styles of interaction e.g. keyboard, mouse, stylus Auto-populate to minimize data entry Present relevant options at the right time Fast and Effective User Interaction Optimised for multiple styles of interaction e.g. keyboard, mouse, stylus Auto-populate to minimize data entry Present relevant options at the right time Consistent Navigation and Layout Based on established norms and standards Draws on generally accepted best practice design Strong familiarity between different applications Reduces cognitive load on user Consistent Navigation and Layout Based on established norms and standards Draws on generally accepted best practice design Strong familiarity between different applications Reduces cognitive load on user Leveraging Technology Developments Intelligent systems behaviour Built-in decision and knowledge support Context-sensitive information presentation Leveraging Technology Developments Intelligent systems behaviour Built-in decision and knowledge support Context-sensitive information presentation Compelling User Interface Easy and intuitive to user Easy to learn User goal-driven workflow Compelling User Interface Easy and intuitive to user Easy to learn User goal-driven workflow “Safe by Design” User-centred iterative design process Built in safety and hazard assessments Evidence based recommendations “Safe by Design” User-centred iterative design process Built in safety and hazard assessments Evidence based recommendations 23 Microsoft Connected Health Framework

24. Common User Interface Communication Operations Management Security Collaboration Services Presentation and Point of Access Services Identity Management Services Privacy and Security Services Service Publication and Location Shared Services System Management Services Communication Services Data Services User Processes Business Processes Connected Health Services Hub Integration Services Business Components Service Component Interface Data Access Logic Components Medical Research and Reference Services User Interface Components

25. Medical Research Services

28. Clinical Application - Demonstrator 28 Microsoft Connected Health Framework

29. Clinical Application - Design Guidance 29 Microsoft Connected Health Framework

30. Resources and Next Steps The Connected Health Framework – Architecture and Design Blueprint is available now –More details on http://msdn.microsoft.com/healthhttp://msdn.microsoft.com/health –Contact your local Microsoft subsidiary or health@microsoft.com to engage health@microsoft.com –Provide feedback and discuss on http://SolShare.nethttp://SolShare.net Understand the Health Connection Engine –Submit bugs and feature requests –Contribute to the development Think service oriented business and technical architectures –Leverage Microsoft’s platform for security, collaboration, management, integration… 30 Microsoft Connected Health Framework

31. © 2007 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries. The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

32. Case Study - Asklepios Asklepios 92 Facilities with: 86 in Germany (with 68 General Hospitals, 48 Spedcialist Hospitals) 6 in USA 14 Rehabillitation 2.000 Staff One IT Physician Portal Reach out to local primary care physicians to share care with Asklepios shared clinical records Online booking of appointments Scope covers Healthcare services hub, Identity Management, portal

33. CHF - Solution in Switzerland Initiative MeDI swiss - Cardiology Network Cardiology Network National eHealth Strategy Solution (Features & Benefits) eHealth Initiatives

34. Case Study: Singapore Singapore health systems split over 2 clusters with 31 Hospitals and 40+systems Connected Health Platform principles applied to build EMRx (Electronic Medical Record Exchange) to improve quality of care flow of patient data Completed system to transfer of 4m health records between clusters in 6 months under $600k Stage 2 opens data securely to patient portal