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

Email

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