HIPAA-strength Enterprise Portals Examples and Architecture. Steve Flammini Chief Technology Officer Partners HealthCare Boston, MA

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1 HIPAA-strength Enterprise Portals Examples and Architecture Steve Flammini Chief Technology Officer Partners HealthCare Boston, MA

2 Overview Who is Partners HealthCare? Approach Enterprise Portal Examples Architecture Conclusions

3 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

4 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

5 Primary Service Area Secondary Service Area Currently No Coverage Kensington, NH Randolph Rehoboth Dighton Berkley Seekonk Swansea Warren, RI Bristol, RI Somerset Hampton Falls, NH Rockland Lakeville Hampton, NH Seabrook, NH Plaistow, NH West Newburyport Haverhill Newbury Groveland Newbury Georgetown Lawrence Dunstable Dracut North Boxford Ipswich Andover Andover Rockport Lowell Topsfield Hamilton Essex Groton Chelmsford Tewksbury Middleton Wenham Gloucester Lunenburg Westford North Shirley Ayer Billeric Reading Danvers Beverly Manchester a Wilmington Littleton Carlisle Reading Peabody Harvard Burlington Wakefield Salem Lancaster Boxborough Bedford Lynn Marblehead Acton Concord Swampscott Bolton Stow Lexington Maynard Lincoln Nahant Hudson Berlin Sudbury Waltham Marlborough Wayland Newton Northborough Weston Framingham Hull Wellesley Southborough Natick Dorchester Westborough Needham Quincy Ashland Dedham Milton Cohasset Hopkinton Sherborn Dover Westwood Hingham Braintree Scituate Holliston Medfield Norwood Weymouth Millis Canton Norwell Medway Walpole Holbrook Norfolk Sharon Avon Abington Hanover Marshfield Franklin Stoughton Bellingham Brockton Whitman Pembroke Wrentham Foxboro East Hanson Easton West Bridgewater Duxbury Plainville Mansfield Bridgewater North Halifax Kingston Attleboro Bridgewater Norton Plympton Attleboro Raynham Taunton Plymouth Tyngsboro Portsmouth, RI Methuen Tiverton, RI Little Compton RI East Kingston, NH Amesbury Salisbury Merrimack Lynnfield Rowley Middleboro Carver Freetown Rochester Wareham Fall River Acushnet Marion Bourne New Bedford Mattapoisett Dartmouth Fairhaven Falmouth Westport Gay Head Tisbury Oak Bluffs West Tisbury Chilmark Edgartown PCHI Regional Organization Sandwich Mashpee Woburn Winchester Arlington Stoneham Melrose Belmont Somerville Charlestown Cambridge Watertown North Allston Brighton Brookline Chestnut Roxbury Hill Jamaica Plain Dorchester West Roxbury Mattapan Hyde Park Barnstable Medford Provincetown Dennis Yarmouth Saugus Malden Revere Everett Chelsea Nantucket East Boston End Truro South End West End South Boston Back Bay east Back Bay west Wellfleet Eastham Orleans Brewster Chatham Harwich Winthrop Regional Service Organizations: Partners - MGH Partners - BWH Metro North North Central North Shore Cape Ann Merrimac Valley Rte 2 West Near North Cambridge/Somerville Metro West Neponset Valley Boston South South Shore Tri County North Bristol Plymouth Fall River New Bedford Cape & Islands Newton-Wellesley Northeast Greater Lowell Revised 9-00

6 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

7 Approach Extranet Security Architecture HTTPS Multiple Authentication Factors Roles-based access structures Audit Trails

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19 Enterprise Portal Architecture Provider PCHInet Directories Medical References Labs Order Entry LMR 4-Next View Images Referral econsult Clinical Images LMR Data EMPI RPDR CPM Clinical Data Repository QM Homecare Meditech IDX IDX PCIS BICS SMS PHC GSVNA NWH Faulkner Spaulding PCHI McLean DFCI MGH BWH NSMC

20 CPR Database servers Example: CPR / PACS interoperability App Servers Web Servers Computerized Patient Record XML query/response Radiology Web Servers Radiology App Servers Image servers

21 Simplified Application Platform Overview Presentation Tier Database Server Tier (GUI) Application Server Tier (MiddleWare Services)

22 Presentation HTTPS, TCP/IP Multi-Tier App Environment Content App Servers Switches Web Servers IP / VLAN ISAPI, IP, XML CISCO CS11050 DB Servers / Legacy Platforms XML, pooled IP, proprietary

23 Conclusions Agile, multi-tier architecture is essential for portalization. Enterprise Portals consist of only webenabled 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