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Open Source Solutions experience, solutions, results

Open Source Solutions

1

Misys Open Source Solutions (MOSS) – Healthcare

Redwood MedNet PresentationA Practical Application of Open Source Strategies in a Not-So-Conventional Health Care Company

Tim ElwellVP, Misys Open Source SolutionsMay 20, 2009

Open Source Solutions experience, solutions, results

Open Source Solutions

experiencesolutions

results

Treasury & CapitalMarkets

GlobalServices

Banking

Health-care

OpenSource

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

experiencesolutions

results

Treasury & CapitalMarkets

GlobalServices

Banking

OpenSource

Misys Integrated Businesses – Post Oct. 2008

4

Allscripts & Misys Healthcare Solutions

NASDAQ: MDRX

Glen Tullman CEO

Mike Lawrie Chairman

Health- care

MOSS

Misys plcFTSE: 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 Solutions2009 Opportunity

• ARRA– 19.2 – 17.2– 2– 300– 100

• CareSpark– 18– 40

Open Source SolutionsHealthcare and Open Source

Open Source Solutions MOSS Purpose

• Meaningful disruption

Generates Revenue Causes change to happen

Open Source SolutionsOpen Source Solutions – HealthcareObjective: 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 SolutionsUses Case Scenarios

• Ambulatory Specialist Referral

• Provider to Emergency Department Referral

• Unplanned Access to Patient Medical Summary

• Ante-Partum Care Delivery

Open Source Solutions

ClinicalHealth Record(Tolven - eCHR)

EMR(OpenMRS)

PreNatalEMR Plug-in

(Misys)

Clinical—ED(Hospital)

AmbulatoryCare (EMR)

IntegrationLayer

Consumer/Retail Layer

IHEPIX Manager

(Initiate)IHE Adapters

(Misys)

PatientHealthRecord(Tolven - ePHR)

In Development Existing

IHE XDS Registry/Repository

Infrastructure (IBM)

Interface Engine(WebReach - Mirth)

Ambulatory Specialist Referral

Open Source Solutions

ClinicalHealth Record(Tolven - eCHR)

EMR(OpenMRS)

PreNatalEMR Plug-in

(Misys)

Clinical—ED(Hospital)

AmbulatoryCare (EMR)

IntegrationLayer

Consumer/Retail Layer

IHEPIX Manager

(Initiate)IHE Adapters

(Misys)

PatientHealthRecord(Tolven - ePHR)

In Development Existing

IHE XDS Registry/Repository

Infrastructure (IBM)

Interface Engine(WebReach - Mirth)

Unplanned Access to Patient Medical Summary

Open Source SolutionsSCALE 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

XX X XX

experience, solutions, results 14

MOSS - Mission

Objectives

- Create broad-base adoption of the MOSS Platform

- Develop lower cost Health Information Exchange (HIE)

- Standard’s based

- Support Nationwide Health Information Network (NHIN) initiatives

- Improve healthcare delivery by increasing EHR adoption

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

Approaches

- Provide 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 NetworkOpen Source Solutions

16

PIX/PDQ Server - OpenPIXPDQOpen Source Solutions

experience, solutions, results 17

IHE Standards Based Healthcare NetworkOpen Source Solutions

Open Source Solutions experience, solutions, results

Open Source Solutions

IHE Profiles: Server ComponentsApril 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 SolutionsMOSS – (OHT) Roadmap

OHT Charter Project Approval December ‘08

Connect-a-thonFebruary ‘09

IHE Project harmonizationJanuary ‘09

Move OpenPIXPDQ to OHT March ‘09

IHE Client library harmonization 3Q 2009

HIMSS ShowcaseApril ‘09

Begin OpenPIXPDQ DevelopmentOctober ‘08

Begin XDS Development 2Q 2009

ATNA/CT/XCA

2009

Connect Gateway Code Review2Q 2009

Open Source Solutions

experience, solutions, results World Congress

20

Portal Decomposition

20

Viewer—Liferay

Misys SaaSMisys SaaS

Platform

Value-AddComponents &

Portal

E-

PrescribingE

ncounter M

gmt.

Docum

ent M

gmt.

Lab Orders

Mgm

t.

Scheduli

ng

Billi

ng

CRM

Reporting

Clinical Data Repository

PIX/PDQeMPI

XDS Registry& Repository ATNA

IHE COREMisys ConnectServer Platform:

SaaS

CoreOpen SourceInfrastructure

Clinical Groupware

Open Source SolutionsFundamentally Different EMR StrategyOutside-IN

EMR

EMR EMR

EMR

Afterthought

Open Source SolutionsMashable Universe StrategyINSIDE--OUT

MeaningfulUse as definedBy 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 businessAs-is To-be• Map requirements to technical utility• Introduce “best practices”• Create detailed milestone development• Recommend architectural 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 SolutionsThank you

Questions?

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