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Innovatives Healthcare-IT-Management mit LORENZO
Microsoft Hospital Solution Days
Bad Homburg, 17. Oktober 2005
Dr. Dominik DeimelClinical Director iSOFT
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Agenda
Vision
Internationalität
Partner
Die Firma iSOFT
LORENZO Produktkonzept
LORENZO Technologie
LORENZO Stärken
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iSOFT entwickelt Software Systeme
für das Gesundheitswesen.
Wir stellen weltweit führende IT
Systeme für das Gesundheits-
wesen zur Verfügung.
LORENZO ist die Next Generation
Lösung zur Vernetzung aller
Beteiligten der Health Economy.
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Marktführerschaft für IT-Systeme im Gesundheitswesen
Kunden
• 1.700 Krankenhäuser
• 6.000 Niedergelassene Ärzte
• 22 Länder in fünf Kontinenten
• > 700 Kunden in Deutschland
Mitarbeiter
• 2.748 Medizinische IT Experten
• 1.000 Technische Entwickler
• 400 Mitarbeiter im deutschsprachigen
Raum
• 2 Entwicklungszentren in Indien
Kunden & Mitarbeiter
Gelistet am London Stock Exchange
Viertgrößter Software und Computer
Anbieter am London Stock Exchange
Marktkapitalisierung: > 1 Mrd. EUR
Unternehmensgröße
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Internationale Ausdehnung
England
Ireland
Wales
ScotlandNorway
Germany
Netherlands
Switzerland
Canada
Hong Kong
Australia
New Zealand
Singapore
Malta China
South Africa
AustriaHungary
Poland
Russia
RomaniaGreece
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Globale Partnerschaften
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Agenda
Produktstrategie
Eigenschaften
Grundsätze
Die Firma iSOFT
LORENZO Produktkonzept
LORENZO Technologie
LORENZO Stärken
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Skalierbar für lokale, regionale und nationale Gesundheitseinrichtungen
Bedarfsgerechte Plattform, angepasstes Kosten-Modell
Standardisiert
Investitionsschutz von bestehendem Wissen, Daten und Infrastruktur
Auf Terminologie basierende Regeln
Integrierte Workflow Engine
Stabile, intelligente Unterstützung von Business Process Modelling
Medizinische Forschung
Choreographie
Universale Akte
Wissen
Flexibilität
Grundsätze
Form, Funktionalität, Nutzen
Erforderliche EigenschaftenMarktanforderungen
Umstrukturierung des Gesundheits-wesens und steigende Kosten
Breite Unterstützung für Ärzte und medizinisches Personal
Sicherheit für bereits getätigte IT-Investitionen
Einbeziehung des Bürgers
Der Markt definiert die erforderliche Lösung
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Was ist LORENZO?
LORENZO ist eine zukunftserprobte Lösung für das Gesundheitswesen, die alle Anforderungen von Bürgern, Patienten und Mitarbeitern im Gesundheitsweisen an ein administratives und klinisches Informationsmanagement abzudecken vermag.
LORENZO hilft dabei, die Organisationsstruktur von Einrichtungen und Kliniken nachhaltig zu verbessern sowie Qualität, Effizienz und Konsistenz im Gesundheitswesen zu fördern.
Ein Produkt, viele Lösungen
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LORENZO Lösungskonzept
Zukunft
Morgen
Heute
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LORENZO – Lebenslange Patientenakte
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Nutzung von Standard - Technologie
LORENZO Technologien
Sicherheit, Interoperabilität, Verlässlichkeit, Skalierbarkeit
Unterstützung von WEB-Services zur Integration in die
jeweilige Umgebung
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Ausgelegt auf Ablaufsteuerung
Optimiert für Performance
Forderung nach Integration nicht
vordergründig
25 Jahre bestehen auf
technologischen Kompromissen
Gartner: 40 % der IT Ausgaben sind
rückwärtsgerichtet
bisherige IT-Struktur
Ausgelegt auf Integration
Optimiert für moderne EDV Prinzipien
– Web, Mobilität, Individualität,
Zusammenarbeit
Unterstützt und ermöglicht moderne
Konzepte für virtuelle Organisationen
Unterstützt die Anwender, fördert
Workflow und Prozessoptimierung
Service-orientierte Architektur (SOA)
Architektur – Bestehende Industriestandard nutzen
“Es sind nicht die Stärksten, die überleben, auch nicht die Intelligentesten, sondern diejenigen, die sich am besten anpassen können.
– Charles Darwin
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Service-orientierte Architektur
Die führenden Technologie- und Software-Anbieter entwickeln SOA – Strategien und Architekturen
• Microsoft via (http://msdn.microsoft.com/architecture/)
– .NET SOA support
– Metropolis (Enterprise Architecture)
• Oracle via (http://www.oracle.com/soa)
– Oracle Information Architecture (OIA)
– Oracle Fusion Architecture
• HP via (http://managementsoftware.hp.com/products/soa/index.html)
– HP SOA Envisioning
– HP SOA Manager
• IBM via (www.ibm.com/soa)– Websphere
LORENZO basiert auf iSOFT Service Oriented Architecture
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LORENZO – Service Orientierte Architektur
Präsentation
Integration
Datenbank
Bu
siness
Services
En
terp
rise
S
ervi
ces
Sicherheit
User interface, web services, contextmanagement, device specific rendering
Security (Authentication, Authorisation),System Event Management
Domain Objects, Workflow, TerminologyService, Decision Support Service,Medication Management Service,
Clinical Record Manager
Audits, Scheduling, Batch Processing,State Management
Transaction Management, ServiceAdapters, Service Hubs
Data Access, Data (Live,Meta and Reference)
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Integrierter Ansatz für das Gesundheitswesen
LORENZO Services Grundlegende Dienste für die Bereiche Diagnostik,
Anforderung, Medikation, Verwaltung, Klinische Prozesse
und Abrechnung
LORENZO Technologien
Sicherheit, Interoperabilität, Verlässlichkeit, Skalierbarkeit
Unterstützung von WEB-Services zur Integration in die
jeweilige Umgebung
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LORENZO Service-Landkarte
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Flexibilität in der Lösung
LORENZO Lösungen
Benutzerfreundliche Oberfläche
Anbindung einer großen Bandbreite von Endgeräten
durch konsequente Designarchitektur
LORENZO Services
Grundlegende Dienste für die Bereiche Diagnostik,
Anforderung, Medikation, Verwaltung, Klinische Prozesse
und Abrechnung
LORENZO Technologien
Sicherheit, Interoperabilität, Verlässlichkeit, Skalierbarkeit
Unterstützung von WEB-Services zur Integration in die
jeweilige Umgebung
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LORENZO – globale Lösungen für die Health Economy
Meine Gesundheitsakte
Meine Medikation
Mein Gesundheitsorganisation
Meine Termine
Meine Gesundheitsportal
Meine Gesundheitsmanagement
Nationale Gesundheitsakte
DMP Programme
Gersundheitsvorsorge
Screeningverfahren
Gefängnis
Armee
Epidemiologie
Unfallchirurgie / Notfall
Nephrologie
Psychologie
Kinder und Jugend-Psychiatrie
Erwachsenen Psychiatrie
Sprachtherapie
Psychotherapie
Pysio- / Ergotherapie
Gynäkologie
Geburtshilfe
Pädiatrische Onkologie
Endoskopie
Chirurgie
Palliativmedizin
Onkologische Vorsorge
Onkologie
Chemotherapie
Strahlentherapie
Kardiologie
Ophthalmologie
Intensivmedizin
Neonatal Medizin
Zahnmedizin
Kinderheilkunde
Koloskopie
Kardiologische Vorsorge
Herzchirurgie
Neurochirurgie
Neurologie
Geriatrie
Orthopädie
Endokrinologie
Hals-Nasen-Ohrenheilkunde
Ambulanzmanagement Krankenhaus
Stationsmanagement Krankenhaus
Rehakliniken
Arztpraxis
Häusliche Pflege
Psychiatrischer Dienst
Sozialdienst
Notfall- / Feuerwehr
Zentrale Notfall-Einrichtungen
Abrechnung (DRG, § 301, § 302, KV, BG, Privat-Liquidation)
Anlagen-BuchhaltungFinanzwesen / Controlling
Private Krankenversicherung
Krankenhaus Apotheke
Apotheke
Zentral-Apotheken
Labor
Biochemie
Hämatologie
Immunologie
Transfusionsmedizin
Mikrobiologie
Zytologie
Histologie
Bildgebende Radiologie
Interventionelle Radiologie
PACS
Radiologie Management
Pathologie
Audiologie
Optometrie
Neurophysiologie
Krankenhauskonzerne
Qualitätsorientierte Rechnungsstellung
Gesundheitsstrategieplanung
Rheumaliga
Dialysegruppen
Diabetiker
Schilddrüse
Herzliga
Blutdruck
Asthma
Koronare Herzerkrankungen
Regionale Gesundheitsversorgung
Nationale Gesundheitsversorgung
Mobile Pflegedienst
Hausbesuche
Hausarzt
Klinische Statistik
Klinische Forschung
Epidemiologie
Lösungen für regionale + nationale Gesundheitsorganisationen
Lösungen für Selbsthilfegruppen
Lösungen für spezielle Fachrichtungen
Lösungen für Gesundhietsverorger
Lösungen für lokale Versorgungeseinrichtungen
Lösungen für diagnostische Einrichtungen
Lösungen für öffentliche Einrichtungen
Lösungen für Pharmazie und Forschung
Lösungen für Therapeuten
Lösungen für Konzerne
Lösungen für den Bürger
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Agenda
Die Firma iSOFT
LORENZO Produktkonzept
LORENZO Technologie
LORENZO Stärken
Standards
Bestehende Technologien
Zukünftige Technologien
Entwicklungsumgebung
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LORENZO Technology
Nutzung etablierter Standard-
Technologien (z.B. SOA, .NET)
Unterstützung unterschiedlicher
Endgeräte: digitales TV, Tablet-PCs,
PDA, Handy
Sicherheit – Zugangskontrollen,
Unterstützung moderner Sicherheits-
Standards
Hohe Integrationsfähigkeit
Skalierbarkeit
Investitionsschutz
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Standards
Business process execution language for WS (BPEL4WS)• http://www-106.ibm.com/developerworks/library/ws-bpel/
XML• http://www.w3.org/XML/
Security assertion mark-up language (SAML)• http://www.oasis-open.org/committees/tc_home.php?wg_abbrev=security
SOAP• http://www.w3.org/TR/soap/
WSDL• http://www.w3.org/TR/wsdl
WS*• http://www.w3.org
HL7V2.x, HL7V3• http://www.hl7.org
EDIFACT• http://www.unece.org/trade/untdid/welcome.htm
RETE Algorithm• http://www.informatik.uni-trier.de/~ley/db/indices/a-tree/f/Forgy:Charles.html
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Produkt-Plattformen heute
Clients • Microsoft Internet Explorer 6
• Standard PC mit Microsoft .NET 1.1
Applikation• Windows 2003 Server SP1
• Microsoft .NET Framework v1.1
• Microsoft IIS v6 (Internet Information Server)
• Microsoft Enterprise Instrumentation Framework v1.0 (Logging & Instrumentation)
• SMTP
• Web Services Extensions 2.0 (WSE2.0)
• MSXML v4 & MSMQ v3
Datenbank
• Microsoft SQL Server 2000 & reporting services
• oder ORACLE 9i
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Geplante und potentielle Technologien
Technologien
• Microsoft (Whidbey, Indigo, Longhorn, SQL Server 2005, IE 7)
• 64-bit & 64-bit Erweiterungen
• Oracle 10g RAC
Innovationen• Mobilität – neue Client-Ansätze (PDA, SDA, Handy)
• Integration moderner Medizintechnik – Medikamenten-Automation, digitale Mikroskopie, Blutzucker-Messgeräte, OP-Roboter
• RFID – mobile Patienten- und Ressourcen-Identifikation
• Biometrische Authentifizierung (Patient und Personal)
• Biometrie– Handschrift, Sprache, Stimme, Finger-Print
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LORENZO Entwicklungs-Tools
Platform
Microsoft SQL Server 2000Oracle 9i
Microsoft Windows XPMicrosoft Internet Explorer
i.TIME, Microsoft Project 2000
Office Productivity
Microsoft Office 2003Microsoft Exchange 2003
InstallShieldTelelogic CM Build
Configuration Management
Microsoft Visual SourceSafeTelelogic DOORS
Telelogic CM Synergy
Issue Tracking Tools
iASSISTTelelogic Change Synergy
Crystal Reports
Reporting Tools
Project Management
Build & Deployment ToolsRational RoseERWIN
Microsoft Visio
Microsoft Visual Studio.NET XML SpyFxCop
Mercury Test DirectorMercury LoadRunnerMercury WinRunner
Mercury QuickTest ProSimuloader
RobohelpHTML Help
Adobe Acrobat
Macromedia DreamweaverMacromedia FlashAdobe Photoshop
Programming Tools
Authoring Tools
Web Design Tools
Testing Tools
Modeling Tools
Microsoft Windows Server 2003Microsoft IIS
RDBMS
Microsoft BizTalk 2004 / SeeBeyond eGate
Integration
Client
3rd Party Reference Databases
HLi Cyber LE
Issue TrackerMicrosoft Sharepoint Team Services
Team Communication Tools
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Agenda
Die Firma iSOFT
LORENZO Produktkonzept
LORENZO Technologie
LORENZO Stärken
Business Process Modelling
Terminologie
Wissensbasierte Dienste
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Zusammenspiel der Komponenten
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Business Process ModellingLORENZO Prozess-Ablauf
1
2
3
4 6
75
9
8
Jeder Arbeitsschritt wird als „Care Activity” definiert
Jede „Care Activity“ kann in jedem Prozess verwendet werden (Wiederverwendbarkeit)
Eine Zusammenfassung von „Care Activities“ wird als „Overall Care Activity (OCA)“ bezeichnet
Zwischen OCAs wird nach dem „Baton passing“ Prinzip verfahren
Der Workflow ist regelbasiert
Alle Arbeitsschritte landen in einem „Eingangskorb“ eines Teams/Users
Die Übergabe ist bezogen auf:• User und Teams
• Rollen
• Rechte und Geschäftslogik
Unterstützung von Standards• BPEL (Engine)
• BPMN (Modeller)
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LORENZO ProzessmodellierungDer User kann die Behandlungsaktivitäten direkt per drag & drop graphisch darstellen
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LORENZO Regel-AssistantWenn ‘LikeDiabetes’ = ‘Ja’ ist, erfolgt eine Benachrichtigung an die Pflegekraft.
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Effektive Nutzung des medizinischen Referenzwissens
Unterstützung von Terminologie (z.B. SNOMED CT) durch die LORENZO Terminology Engine
Interaktion mit strukturierter klinischer Dokumentation, Regeln und Wissensbasierten Systemen:
• Interpretation medizinischen Freitextes (z.B. „Wunde weiterhin reizlos“)
• Beschreibung von klinischen Kontexten unter Verwendung von Terminologie
LORENZO stellt Unabhängigkeit von der Referenz-Terminologie sicher
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Beispielhafte Nutzung von TerminologieBeschreibung einer Diagnose im Freitext
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Beispielhafte Nutzung von TerminologieAuswahl des entsprechenden Konzeptes
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Beispielhafte Nutzung von TerminologieAutomatische Anzeige verfügbarer Formulare
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Beispielhafte Nutzung von TerminologieAutomatische Anzeige verfügbarer Formulare
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Der Weg zur Evidence Based Medicine (EBM)
LORENZO bietet Ärzten und Pflegekräften medizinische Konzepte durch Integration globaler Standards (wie z.B. Map of Medicine)
Klinische Pfaden und Entscheidungs-Unterstützung
Darstellung verschiedener Optionen
Nutzen: Hohe Akzeptanz bei den Ärzten, Konsistenz bei der Anwendung von Behandlungsleitlinien
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Einbindung klinischer Prozess-Standards – PfadeMap of Medicine - National Libary for Health
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THIS DOCUMENT IS CONFIDENTIAL and intended solely for the use of the individual to whom it is addressed or any other recipient expressly authorised by iSOFT Group plc, in writing or otherwise, to receive the same. If you are not the addressee or authorised recipient of this document, any disclosure, reproduction, copying, distribution, or other dissemination or use of this communication is strictly prohibited.
Einbindung klinischer Prozess-Standards – PfadeMap of Medicine - National Libary for Health
40
THIS DOCUMENT IS CONFIDENTIAL and intended solely for the use of the individual to whom it is addressed or any other recipient expressly authorised by iSOFT Group plc, in writing or otherwise, to receive the same. If you are not the addressee or authorised recipient of this document, any disclosure, reproduction, copying, distribution, or other dissemination or use of this communication is strictly prohibited.
Schlüsselfaktoren für das innovative Healthcare-IT-Management mit LORENZO
LORENZO ist die durchgängige Next Generation Plattform für die Health Economy
Einheitliche Architektur
Umfassende Abdeckung der funktionalen Anforderungen
Funktionssicherheit
Aktive Mitwirkung in Standardisierungsgremien: IHE, DICOM, HL7, VHITG, u.a.
Integrationsstandards
Projekterfahrung in der Ablösung von Alt-Systemen (PDM, Leistungs-/Befunddokumentation)
Migrationserfahrung
Referenzierbarkeit der Lösung
Serviceorientierte Applikationsarchitektur Hochverfügbarkeit und lineare Skalierung
Hohe Verfügbarkeit
700 Installationen in Deutschland mit Schnittstellen Universitätsklinika: Aachen, Greifswald, Essen, u.a.
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THIS DOCUMENT IS CONFIDENTIAL and intended solely for the use of the individual to whom it is addressed or any other recipient expressly authorised by iSOFT Group plc, in writing or otherwise, to receive the same. If you are not the addressee or authorised recipient of this document, any disclosure, reproduction, copying, distribution, or other dissemination or use of this communication is strictly prohibited.