InterSystems Lets Pronger Smith Medical Easily Connect with Health Exchange 
Pronger Smith Medical Care is using InterSystems Ensemble seamless platform for integration and the development of connectable applications to simplify the way it interacts with a major health information exchange. Ensemble has saved thousands in integration expenses and the new system lets its two-member IT team build new integrations in as little as 10 minutes.
Pronger Smith Medical Care is using InterSystems Ensemble seamless platform for integration and the development of connectable applications to simplify the way it interacts with a major health information exchange. Ensemble has saved thousands in integration expenses and the new system lets its two-member IT team build new integrations in as little as 10 minutes.
Pronger Smith, which serves Chicago’s south side, was looking for an enterprise integration solution to help handle the integration requirements it would meet when joining a regional health information exchange (HIE) that used a Blue Cross Blue Shield electronic health record format, according to Pronger Smith CFO Bill Flamm.
By joining the regional HIE, Pronger Smith could share information with other exchange members and improve patient care. “Joining the HIE breaks us out of our standalone silo and helps ensure that physicians have the complete range of patient data needed to reduce the potential for error and to enable optimal care delivery,” Flamm said in a statement.
Pronger Smith also was looking for integration features to allow it to extract HL7 messages from its legacy EHR system and deliver them to the HIE’s medical record system.
Ensemble’s support for HL7 includes: Support for HL7 version 2.X and 3; pre-configured and customizable HL7 message router and schemas; an embedded database to guarantee message delivery; a rules engine to enable changes to running HL7 interfaces without programming; and an HL7 Sequence Manager to ensure messages are routed in the sequence established by the sender.
Beyond HL7 support, another major reason Pronger Smith elected to go with InterSystems Ensemble was its simplicity, and the Ensemble’s ability to help the medical care group’s small two-person team learn what processes and components were needed and how to quickly deliver them, according to Pronger Smith’s network system manager Craig Cypress.
“The initial proof-of-concept project provided good insight in what we had to learn,” Cypress said in the statement. Pronger Smith’s two-person team was able to build and implement application interfaces on a production basis after only two weeks, he added.
“Now that we’ve been trained and have experience working with Ensemble, it sometimes requires less than 10 minutes to build an interface maybe an hour if the interface is complex,” Cypress said.
Generating application interfaces with in-house staff on the Ensemble platform has already saved the company tens of thousands of dollars, Cypress said. Those benefits came as Pronger Smith completed its project to use Ensemble’s interfaces to provide connectivity between its legacy EHR and the regional HIE.
As a result of this HER-HIE connectivity, the medical care unit can integrate its systems with other products and apps.
Inside InterSystems’ Object-Based Integration Architecture
Architecturally, InterSystems Ensemble is a seamless platform for integration and the development of new connected applications. It also provides an ESB or SOA infrastructure.
Ensemble uses a combination of a powerful object model and abstraction technology to simplify the ability to create integratable composite applications. Ensemble comes with a high performance, highly scalable and SQL-compliant object database, which can handle thousands of simultaneous users and terabytes of data. All elements of Ensemble are modeled as object classes within this database.
This object-based approach allows Ensemble to provide consistent messaging, business rules processing, workflow, alerting, and real-time business activity monitoring across all the disparate systems involved. Ensemble’s object model supports applications, services, data sources, business rules, and other components via Ensemble’s advanced abstraction facility. By abstracting functionality of these resources in object classes, Ensemble can integrate all of them with one another.
This architecture is at the core of what InterSystems calls “Ensemble’s single stack” architecture, which avoids the need for IT to integrate separate development and integration tools,
On this point, to make future integrations easy, Ensemble stores the classes in its database and can present them in any form needed by other parts of the integrated system, including COM, .NET, ODBC, Java, JDBC, EJB, XML, and SOA/web services.
Further, for management and auditing, the Ensemble database serves as a repository for every message generated. So, messages are never lost, and an interrupted business process can be restarted from the point of interruption. Ensemble also provides sophisticated transactional bitmap indexing that enables real-time updating of, and access to, the message repository. Ensemble also supports WS-Security and other compliance standards.
Other notable InterSystems’ Ensemble messaging includes:
- A high-performance messaging engine that persists every message flowing through all integrated system
- High-speed, highly reliable publish/subscribe, event-driven, and content-based routing via a simple rules engine that non-programmers can use
- An extensive adapter library (including adapters for HL7 and X.12), along with the ability to quickly and easily build custom adapters
- An extensible framework to connect to a wide range of applications, services, data sources, and technologies – out-of-the-box
- Bi-directional support for standard messaging formats (XML, ebXML, SOAP web services, and vertical standards for healthcare, financial services, teleco and others)
- End-to-end management, including Visual Trace for rapid troubleshooting and message inspection
- A rapid development environment to easily extend existing adapters to new sources
- A graphical interface to an XML-based data transformation language that facilitates “drag-and-drop” transformations between different data formats and message types
- A graphical display that traces (historically and in real-time) every message generated by integrated system.
The recent InterSystems’ Ensemble project has “perfectly positioned” Pronger Smith to move forward with other patient care integration projects, Flamm said.
“There is ongoing emphasis on being able to share information and smoothly integrate health care systems,” Flamm said in the statement. “Meaningful Use and the establishment of Accountable Care Organizations, for example, are based on the ability to share information among multiple organizations.
