CONNECT 4.0 Enhancing Health Information Exchange for Interoperability Success

1. CONNECT 4.0Enhancing Health Information Exchange for Interoperability Success February 12, 2013

2. Introduction Greg Turner CONNECT Product Manager Brian Humphrey CONNECT Architect

3. Webinar Technical Details During discussion time, “raise hand” to speak What is the largest file size I can stream usingCONNECT 4.0? Type questions in advance; click send Questions + answers appear in chat window

4. What is CONNECT ? 4

5. What is CONNECT? CONNECT is a software platform that supports health information exchange CONNECT uses Nationwide Health Information Network standards and governance to ensure HIEs interoperate with other current and future exchanges CONNECT is a low cost open source solution that is designed to be flexible to support an evolving health data exchange environment

6. Why CONNECT? CONNECT can be used to: • Set up a health information exchange within an organization • Set up a Direct health information service provider (HISP) • Tie a health information exchange into other HIEs including the eHealth Exchange, CMS esMD or Direct • Support patients by providing the technology that allows them to electronically “carry” their health record as they traverse the healthcare system. • Support providers by enabling a more complete picture of a patient’s medical record increasing quality of care

7. CONNECT Building Blocks CONNECT sits between the HIE implementation system, or EMR, and “exchange partners” CONNECT sends and receives NwHIN Exchange and NwHIN Direct messages to other practices, hospitals, and HIEs A CONNECT adopter is required to create or implement services called adapter services that allow for processing the messages to and from CONNECT CONNECT provides reference adapters that include sample code on how to connect back-end systems to CONNECT using adapter services

8. Government Agency Document Repository Policy Engine Master PatientIndex (MPI) System Regional Health Information Organization Health Information Exchange Disease Oriented Care Network Document Registry System Hospitals, physicians, practices EMRor HIE System EMR or HIEAdapter ServiceCreates/sends messages to CONNECT and receives/processes and responds to messages from CONNECT NwHIN Exchange

9. CONNECT 4.0 Direct Overview Government Agency Any mail server Regional Health Information Organization Health Information Exchange Disease Oriented Care Network Hospitals, physicians, practices EMRor HIE System EMR or HIEAdapter ServiceCreates/sends messages to CONNECT and receives/processes and responds to messages from CONNECT NwHIN Direct

10. CONNECT is Open Source Software • Open source license • Open release planning, sprint review and planning sessions • Community contributions welcomed • Bug reports + fixes • Features requests + implementations • Testing and requirements • FHA-sponsored Product Management, Curation, Development

11. CONNECT 4.0 Release Overview 11

12. CONNECT 4.0Release Features • Increased throughput targeting increased numbers of PD, QD, RD, AD, and DS transactions • Exchange and process large payload sizes of up to 1 GB • Run CONNECT on additional application servers such as IBM WebSphere and Oracle WebLogic to meet their environment needs • More comprehensive event logging and metric data • Ability to determine the state of a transaction across messages in order to better review and analyze the operation of CONNECT and adopters’ trading partners • Minimize deployment load by supporting a lightweight gateway which allows smaller server footprint and use of system resources • Support Direct messages to allow for greater adoption and exchange

13. #1 – Increase Throughput for CONNECT FEATURE BENEFITS More efficiency of gateway at higher volumes Support more widespread or national rollout plans for health data exchange Better utilization of adopter infrastructure 1600 messages/minute Increase throughput, targeting increased numbers of PD, QD, RD, AD and DS transactions Test Plan and Test Report https://developer.connectopensource.org/display/CONNECT40/Performance+Testing

14. #1 – Increased Throughput for CONNECTIncreasing CONNECT’s throughput and efficiency Achieving Gains • Reduction in memory usage • ApacheCXF & OpenSAML • Reduced number of static classes • Fewer number of Webservices running • Removed redundant and duplicative code flows *These numbers are based on the same testing methodology performed during the CONNECT benchmark testing for release 3.3.

15. #2 – Large Payload Support FEATURE BENEFITS Increased ability to support the data exchange needs of more adopters Enable additional use cases that require the exchange of larger file sizes Positive impact on performance of gateway when handling larger payloads Provide the ability to exchange and process large payload sizes of up to 1 GB

16. #2 – Large Payload Support Large Payload (Combinations of Messages with payloads totaling 1 Gigabyte) *Seconds

17. #3 – Support for Multiple App Servers FEATURE BENEFITS More deployment options Remove any tech stack waivers Model for the community to add support for other app servers Adopters can use their preferred app servers and take advantage of internal sys admin expertise for things like security, scalability, etc. Run CONNECT on additional application servers such as WebSphere and WebLogic to meet expanded environment needs

18. CONNECT Deployment Diagram

19. #4 – Event Logging FEATURE BENEFITS Allows adopters to better understand usage and performance Supports better planning and management of deployment Provides opportunity for automated monitoring Provides opportunity for dynamic scaling based on load Provide more comprehensive event logging and metric data (counts and duration) using improved logging in CONNECT

20. #4 – Event Logging Goals and Data Points • Two formal high level business goals: • CONNECT provides the ability to count and produce durations for the following values: • Number of a given transaction type (PD, QD, RD, etc.) • Number of a given transaction group • Number of transactions from a specific gateway • Total duration for given transaction type • Total duration for a given transaction group • CONNECT can track and report on the following data points: • Error • Performance • Transaction Type • Payload • Error Messages log (without PHI data)

21. #5 – Transaction Logging FEATURE BENEFITS Provides a more holistic view of a complete transaction with any given exchange partner Increased insight for troubleshooting and issue resolution More input for transaction management and planning Provide the ability to determine the state of a transaction across messages in order to better analyze the operation of CONNECT and adopters’ trading partners

22. #5 – Transaction Logging Transaction Logging Example Database and log output for a related transaction chain (Patient Discovery, Document Query, and Document Retrieve messages as a single transaction) Note that there are two transaction entries logged for each service The response Nhin message ID was logged based on its RelatesTo message ID

23. #6 – Lightweight Gateway FEATURE BENEFITS Adopters with capable back-end systems can have a more lightweight deployment footprint Allows for more economical allocation and use of infrastructure resources Paves ground for community-contributed adapter layers – to EMRs & etc. Minimize deployment load by supporting a lightweight gateway which allows smaller server footprint and use of system resources and allows the adopters to maximize the use of custom-built adapters

24. #7 – Direct Integration with CONNECT FEATURE BENEFITS Tool for Meaningful Use (Stage 2) Provides a means to support both NwHIN Exchange and Direct spec transactions through one deployment Offers a built-in growth or migration path for additional use cases Supports expanding federal, commercial, and state and regional HIE needs Include ability to support Direct messages to allow for greater adoption and exchange

25. Direct Deployment

26. Upcoming Events 4.0 February 11, 2013CONNECT Release 4.0 February 19, 2013 (2pm ET) CONNECT 4.0 Technical Deep-Dive webinar https://www1.gotomeeting.com/register/749358937 February 25, 2013 (10am ET)Next Sprint Review + Planning meeting March 4 -7, 2013 HIMSS Interoperability Showcase demo Spring 2013 (date to come, D.C. area)CONNECT User Group Meeting

27. Join Us for Sprint Review + Planning Join us for sprint review and planning sessions, every other Monday, 10am-noon ET. The CONNECT product team will share the work of the last sprint for community review and feedback. We’ll then transition into a high-level planning session to set the themes for the coming sprint, in the context of the product roadmap. Community input and insights are welcome, so please join us! The meeting will start with a review of the work accomplished during the past sprint which leads into a planning discussion for the upcoming sprint, we flow from one topic to another based on content, questions and conversation. Sprint Review + Planning: Every other Monday 10am-12pm ETTel: 646-216-4772 866-946-0485 Participant Code 922 914 63Web: https://arkadin.webex.com/arkadin/j.php?J=703876882 (meeting id 703 876 882)

28. More Details on CONNECT Release info: Requirements artifacts: GitHub: JIRA: Forums: https://developer.connectopensource.org/display/CONNECT40 https://developer.connectopensource.org/display/CONNECTWIKI/Requirements+Artifacts https://github.com/CONNECT-Solution/CONNECT http://issues.connectopensource.org http://www.connectopensource.org/developer-resources/forums/developer-forum

29. Useful Links Community Resources: www.connectopensource.org https://developer.connectopensource.org mailto:connect@hhs.gov Contributing code:https://developer.connectopensource.org/display/CONNECTWIKI/Contributing+Code Sprint info:https://developer.connectopensource.org/display/NHINProgress/Progress+Summary+Page

30. Questions and Discussion 30

31. Webinar Technical Details During discussion time, “raise hand” to speak What is the largest file size I can stream usingCONNECT 4.0? Type questions in advance; click send Questions + answers appear in chat window

32. Thank you for watching! Please post questions to the community forums on connectopensource.orgor email to connect@hhs.gov