hipaa-strength enterprise portals examples and architecture steve flammini chief technology officer...
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HIPAA-strength Enterprise PortalsExamples and Architecture
Steve FlamminiChief Technology Officer
Partners HealthCareBoston, MA
Overview• Who is Partners HealthCare?• Approach• Enterprise Portal Examples• Architecture• Conclusions
Partners HealthCare System• Created in 1994 through affiliation of
Massachusetts General and Brigham & Women’s Hospitals
• Patient care– Two academic medical centers
– Four community hospitals and two specialty hospitals
– Joint cancer care venture with Dana Farber
– Mental health network
– Non-acute care network
– Network of more than 1000 primary care physicians and 1200 community specialists
– Total of more than 5000 physicians serving 2.2 million patients in Eastern Massachusetts
Partners HealthCare System• Research
– Largest non-university based non-profit private medical research enterprise in United States
• Education– Principal teaching affiliate of Harvard Medical
School
• Revenue– $4.0 billion – $760 million in research expenses
Kensington, NH
Hampton Falls, NH
Seabrook, NH
Hampton, NH PCHI Regional Organization
Primary Service Area
Currently No Coverage
Secondary Service Area
Revised 9-00
Dorchester
HydePark
WestRoxbury
ChestnutHill
Brookline
JamaicaPlain
Roxbury
BrightonAllston
Watertown
Belmont
CambridgeSomerville Charlestown
EastBoston
Chelsea
Woburn Saugus
Melrose
Stoneham
North End
South End
West End
South Boston
Back Bay ‘east’Back Bay ‘west’
Revere Malden
Rockport
Gloucester
Ipswich
EssexHamilton
ManchesterBeverly
MarbleheadSalem
Danvers
Nahant
Swampscott
Peabody
Lynn
North Andover
Boxford
TopsfieldMiddleton
Hull
Wenham
Cohasset
Scituate
Marshfield
Hingham
NorwellWeymouth
Braintree
Dorchester
Milton
Duxbury
Plymouth
Kingston
Carver
Plympton
Halifax
Middleboro
Bridgewater
EastBridgewaterWest
Bridgewater
Pembroke
Hanover
Rockland
Abington
HansonWhitman Brockton
HolbrookAvon
Randolph
Easton
WarehamRochester Freetown
Acushnet
Lakeville
TauntonRaynham
Norton
Dighton Berkley Seekonk
Rehoboth
Attleboro
NorthAttleboro
Mansfield
Swansea
Som
erse
t
FallRiver
Westport
New Bedford
Dartmouth FairhavenMattapoisett
Marion
Falmouth
BourneSandwich
Mashpee
GayHead
Chilmark
WestTisbury
Edgartown
Oak BluffsTisbury
Nantucket
Barnstable Yarmouth
Dennis
HarwichChatham
Brewster
Orleans
Eastham
Wellfleet
Truro
Provincetown Foxboro
Plainville
WrenthamBellingham
FranklinNorfolk Sharon
Walpole
Stoughton
CantonNorwood
MedwayMillis
Medfield
DoverSherborn
Holliston
Hopkinton Ashland
NatickFramingham
Southborough
WestwoodDedham
Needham
Weston Wayland
Westborough
NorthboroughMarlborough
BerlinHudson
Bolton StowMaynard
Boxborough Acton Concord
Lincoln
BedfordLancaster Harvard
LunenburgShirley Ayer
Groton
Littleton
Westford
Carlisle
Billerica
Chelmsford Tewksbury
Waltham
Lexington
Burlington
Wilmington
NorthReading
Wakefield
Lynnfield
Andover Dunstable
TyngsboroDracut
Lawrence
Lowell
Portsmouth,RI
QuincyMattapan
Sudbury
Winthrop
Warren,RI
Bristol,RI
Little Compton
RI
Tiverton,RI
Reading
Medford
Winchester
Everett
Arlington
Merrimac Valley
Rte 2 West
Metro West
Neponset Valley
Boston SouthSouth ShoreTri County
North Bristol
Plymouth
Cape & Islands
Fall River
New Bedford
Partners - BWH
Metro North
Partners - MGH
North Shore
Cape Ann
Regional ServiceOrganizations:
North Central
Near North
Cambridge/Somerville
Newton-Wellesley
Newton
Northeast
Wellesley
Greater Lowell
Georgetown
West
Newbury
Rowley NewburyGrovelan
dMethuen
HaverhillNewburyport
Amesbury SalisburyMerrimackPlaistow, NH
EastKingston, NH
Approach• Internal Development of Enterprise-Class
Systems• Enterprise Apps must be ‘portalized’• Multi-Tier Architecture, Emphasizing
Abstraction between data, presentation, and logic. (Loose Coupling)
• Increasing role of XML / Web Services in Service-Oriented Architecture
• Back-End Integration / Aggregation of Legacy Systems
• Foundational Enterprise Elements: Directories, EMPI, CDR, CPR
Approach• Extranet Security Architecture
– HTTPS– Multiple Authentication Factors– Roles-based access structures– Audit Trails
Enterprise Portal Architecture
PCHInet
Provider
RPDR
MedicalReferences
CPM QM
EMPI
eConsultReferralView
Images4-NextLMR
Order Entry
Labs
Clinical DataRepository
Directories
LMR Data
Clinical Images
IDX
NSMCPCHIMcLean
DFCI
MGH BWHNWH Faulkner
Spaulding
IDXMeditech PCIS BICS SMSHomecare
PHCGSVNA
Example: CPR / PACS interoperabilityCPR Database servers
App Servers Web Servers
Image serversRadiology App Servers
XML query/response
RadiologyWeb Servers
Computerized Patient Record
Simplified Application Platform Overview
Database Server TierApplication Server Tier
(MiddleWare Services)
Presentation Tier
(GUI)
Multi-Tier App Environment
DB Servers /
Legacy Platforms
App ServersPresentation
Web Servers
Content
Switches
CISCO CS11050
HT
TP
S, T
CP
/IP
IP / V
LA
N
ISA
PI, IP
, XM
L
XM
L, pooled IP
, proprietary
Conclusions• Agile, multi-tier architecture is essential for
portalization.• Enterprise Portals consist of only web-
enabled apps.• Portals will deliver to multiple classes of end
user devices. • Robust Architecture for Secure Extranet
Access.• Emphasis on Integration Elements:
Directories, CDR, EMPI, CPR