Redwood MedNet Presentation

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Open Source Solutions


experience, solutions, results

Open Source Solutions

1

Misys Open Source Solutions (MOSS)


Healthcare



Redwood MedNet Presentation

A Practical Application of Open Source Strategies in a Not
-
So
-
Conventional
Health Care Company



Tim Elwell

VP, Misys Open Source Solutions

May 20, 2009



Open Source Solutions


experience, solutions, results

Open Source Solutions

experience

solutions

results


Treasury

& Capital

Markets

Global

Services

Banking

Health
-

care

Open

Source

Misys Integrated Businesses



Before Oct. 2008





$1B revenues, 4,500 employees,


1st software company listed on FTSE100


Substantial Expertise


30 years experience in Banking


25 years experience in Healthcare


Installed Base


1,200 financial institutions, including every one
of the world’s top 50


110,000 Physician users


Global Footprint


Customers in more than 120 countries,


36 Offices around the World


Market Position



Award
-
winning solutions across each business
unit,


Market leader in banking IT worldwide by
customer base


2


Open Source Solutions


experience, solutions, results

Open Source Solutions


Open Source Solutions


experience, solutions, results

Open Source Solutions

experience

solutions

results


Treasury

& Capital

Markets

Global

Services

Banking

Open

Source

Misys Integrated Businesses



Post Oct. 2008



4


Allscripts &


Misys Healthcare


Solutions



NASDAQ: MDRX



Glen Tullman


CEO



Mike Lawrie


Chairman

Health
-


care

Misys plc

FTSE: MSY.L


CEO: Mike Lawrie

Open Source Solutions

“The Innovator’s Dilemma”

by Clayton M. Christensen


In doing what a company is expected to do (and is
rewarded by the market), that company is preparing a way
for its own disruption.




BUT, it also is the beginning of the
innovator’s solution
.

Open Source Solutions

2009 Opportunity


ARRA


19.2


17.2



2


300


100



CareSpark


18


40

Open Source Solutions

Healthcare and Open Source

Open Source Solutions


MOSS Purpose




Meaningful

disruption

Generates Revenue

Causes change to happen

Open Source Solutions

Open Source Solutions



Healthcare

Objective:

Committed to improving healthcare delivery using a standards
-
based, open source approach to

build interoperability tools between
disparate electronic medical records (EMR) systems and healthcare
enterprises.


Organization:

Independent division inside of Misys plc


Community:

The team is collaborating with prominent medical
informatics, technology companies, and policy influencers to support and
develop Health Information Exchange (HIE).


Goal:

Support US
-
based Nationwide Health Information Network (NHIN)
initiatives to provide lower cost, higher quality options that will result in
greater EMR adoption and improved healthcare delivery.


Market Opportunity:

Estimated that the creation of a NHIN will reduce
the cost of healthcare expenditures by $77.8 billion annually.
(1)


Business Model
: HIE organizational consulting, customer application
development, hosting, and support.








(1) Walker, Jan, Pan, Eric, Johnson, Douglas, Adler
-
Milstein, Julia, Bates, David W., Middleton, Blackford. The Value of Health

Information Exchange and
Interoperability. Marketwatch Health Tracking. Jan. 19, 2005.


Open Source Solutions

Uses Case Scenarios


Ambulatory Specialist Referral


Provider to Emergency Department Referral


Unplanned Access to Patient Medical Summary


Ante
-
Partum Care Delivery

Open Source Solutions

Clinical
Health Record
(Tolven - eCHR)
EMR
(OpenMRS)
PreNatal
EMR Plug-in
(Misys)
Clinical—ED
(Hospital)
Ambulatory
Care (EMR)
Integration
Layer
Consumer/
Retail Layer
IHE
PIX Manager
(Initiate)
IHE Adapters
(Misys)
Patient
Health
Record
(Tolven - ePHR)
In Development
Existing
IHE XDS Registry/
Repository
Infrastructure
(IBM)
Interface Engine
(WebReach - Mirth)
Ambulatory Specialist Referral

Open Source Solutions

Clinical
Health Record
(Tolven - eCHR)
EMR
(OpenMRS)
PreNatal
EMR Plug-in
(Misys)
Clinical—ED
(Hospital)
Ambulatory
Care (EMR)
Integration
Layer
Consumer/
Retail Layer
IHE
PIX Manager
(Initiate)
IHE Adapters
(Misys)
Patient
Health
Record
(Tolven - ePHR)
In Development
Existing
IHE XDS Registry/
Repository
Infrastructure
(IBM)
Interface Engine
(WebReach - Mirth)
Unplanned Access to

Patient Medical Summary

Open Source Solutions

SCALE 2008


MOSS “Coming Out”

Updated Plan Based on Customer Needs



IHE library


A basic set of IHE profiles implemented in Java.


This library has been accepted to and
successfully completed the Connectathon for the
last three years.



Connect application


A basic eMPI application


A viewer to retrieve and view a patient record
that encompasses all practices in the community
(the longitudinal patient record).



Server


Side Concentration


PIX
-
PDQ


XDS Registry and Repository


X

X

X

X

X


experience, solutions, results

14

MOSS
-

Mission


Objectives


-

Create broad
-
base adoption of the MOSS Platform

-
D
evelop
lower cost
Health Information Exchange (HIE)

-
Standard’s based


-

S
upport Nationwide Health Information Network (NHIN) initiatives


-

Improve healthcare delivery by increasing EHR adoption

-
EHR ‘on
-
ramp’ through the creation of Clinical Groupware


Approaches


-

P
rovide
standard
-
based

IHE
interoperability options


-

Develop open source IHE infrastructural components


-

Leverage core


monetize plug
-
ins and SaaS; Consulting and Support

Open Source Solutions


experience, solutions, results

15

IHE Standards Based Healthcare Network

Open Source Solutions

16


PIX/PDQ
Server
-

OpenPIXPDQ

Open Source Solutions


experience, solutions, results

17

IHE Standards Based Healthcare Network

Open Source Solutions


Open Source Solutions


experience, solutions, results

Open Source Solutions

IHE Profiles:
Server Components

April 2009

Pressures:


Moving project from Source
Forge


Continue harmonization
work with the IHE Profiles
project


Demonstrate community
value, establish precedent for
committer status


Tooling harmonization



Dependencies:


JDK 1.5


or 1.6


JBoss: 4.0.5 or above


Hapi: 0.5.1


Braid: 1.1


PostgreSQL

8.3


Apache: Commons, Log4J,
Xerces, Axis2


OpenEMPI


Beepcore


Jaxb

Milestones:


Jan ’09


go
-
live for project home


Jan 16
-

pre
-
connectathon MESA
testing for openPIXPDQ



March 31
-

post connectathon
milestone: move openPIXPDQ from
Source Forge



April 15
-

HIMSS milestone



2Q09


XDS Repository/Registry
development begins


3Q09


IHE Client Library
harmonization



Plan Content:



Committed:


PIX Manager (PIX Feed, PIX Query &
PIX update notification)


PDQ Supplier (PDQ Query)


ATNA transactions specific to PIX/PDQ


Audit Log (Audit Trail Client)


TLS Secure Transaction


Actor Configuration


eMPI & eMPI Adapter


XDS Repository


XDS Registry


Proposed:


PIX v3 Manager (PIX Feed, PIX Query
and PIX Update Notification)


PDQ v3 Supplier (PDQ Query)





Deleted/Changed:


Full ATNA/CT moved to post 2Q09
(may use Connect Code)

Configurations:


JBoss 4.0.5


PostgreSQL 8.3


Braid 1.1


JDK 1.5/1.6

Added:



IHE Client Libraries harmonization



IHE Profiles roadmap harmonization



XCA



Open Health Tools Presentation: BOCA Chart


Open Source Solutions


experience, solutions, results

Open Source Solutions

MOSS


(OHT) Roadmap

OHT Charter Project Approval
December ‘08

Connect
-
a
-
thon

February ‘09

IHE Project
harmonization

January ‘09

Move OpenPIXPDQ to OHT
March ‘09

IHE Client library harmonization

3Q 2009

HIMSS Showcase

April ‘09

Begin OpenPIXPDQ Development

October

‘08

Begin XDS Development

2Q 2009

ATNA/CT/XCA

2009

Connect Gateway Code Review

2Q 2009

Open Source Solutions


experience, solutions, results


World Congress

20


Portal Decomposition

20

Viewer

Liferay

Misys SaaS

Misys

SaaS

Platform

Value
-
Add

Components &

Portal

E
-
Prescribing

Encounter Mgmt.

Document Mgmt.

Lab Orders Mgmt.

Scheduling

Billing

CRM

Reporting

Clinical Data Repository

PIX/PDQ

eMPI

XDS Registry

& Repository

ATNA

IHE CORE

Misys Connect

Server Platform:

SaaS

Core

Open Source

Infrastructure

Clinical Groupware

Open Source Solutions

Fundamentally Different EMR Strategy

Outside
-
IN


EMR


EMR


EMR


EMR

Afterthought

Open Source Solutions

Mashable Universe Strategy

INSIDE
--
OUT

Meaningful

Use as defined

By our customer

Information and Related Technology
Governance

Open Source Solutions

The CoBIT framework is the property of the Information Systems Audit

and Controls Association and has been referenced with permission.

Consulting Plan


Solution approach


Collect and translate business

As
-
is


To
-
be


Map requirements to technical utility


Introduce “best practices”


Create detailed milestone development


Recommend a
rchitectural platform


Leverage open source components


Utilize standards
-
based approach


Include customer resources


Development Approach



Leverage open source center of
competence


Iterate with continuous feedback


Leverage customer resources


Value Alignment Approach


• Multi
-
stakeholder strategic
planning session


Identify


• Stakeholder value

• Milestone development

• Governance Framework

• Policies and Procedures

• Funding resources

• Business model analysis

Open Source Solutions

Open Source Solutions

Thank you

Questions?