Progress Data Integration in Healthcare A quick overview Martin van Middelkoop Business Development Manager October 2009

Mijn passie This is my hobby – flying Model airplanes. The upper picture shows speedy models which are used in pattern flying competitions - this is my regular plane which I fly every week end when weather allows. Currently I am building a F4U Corsair “warbird” – in 1940, with a maximum speed of 425 Miles per hour in level flight and , this plane was the first to exceed a speed of 400 Miles per hour, thus making it the fastest plane around in the second world war. The plane was called “Wispering death” because of its characteristic sound and high speed.

Architectural Vision for Healthcare

Problem - Integration Technology Gap Number of Integrated Resources ESB Integration Infrastructure MOM Semantic Integration Queuing Data Integration Common Model Hub-and-Spokes Hand coding Years

Technology Vision for Healthcare Open Health Tools, Architectural Vision

Enabling Plug-n-Play in Healthcare

Progress Software GLOBAL INNOVATION MISSION EXPERIENCE Headquarters: Bedford, MA Offices: 90 Worldwide Employees: 1,600 Revenues: $512 million NASDAQ: PRGS Founded: 1981 GLOBAL Deployed at 120,000 customer sites in 140 countries 2,000 Partners deliver 5,000 unique business applications Over 600,000 new users acquire Progress-based technology annually To deliver superior software products and services that empower our partners and customers to dramatically improve their development, deployment, integration and management of quality applications worldwide. INNOVATION #1 Enterprise Service Bus – Sonic ESB Gartner Dataquest Market Leading Event Processing Platform – Apama Bloor Research Award winning Semantic Data Integration Product – DataXtend SI Telstra, Telecom Italia, BT, DT Leading Business Transaction Assurance Product - Actional MISSION EXPERIENCE First let’s very quickly take a look at Progress from the view of our Corporate presentation… We have great things to say about Progress … Changes scope of opportunity Changes our value to the ultimate customer: End User NOTES: Revenue is “analysts estimates” for 2005 fiscal year, which ends Nov 30, 2005. FOCUS: The Application Infrastructure term comes from our boilerplate and paragraph is from our 2005 Annual Report. GLOBAL PRESENCE: This is from 2005 PSC factoids INNOVATION: PROGRESS SOFTWARE CORPORATION CAPTURES THREE INFOWORLD INNOVATOR AWARDS ‘Groundbreaking Individuals’ Bill Cullen, Mark Palmer and Jonathan Robie Honored for Bold, Innovative Breakthroughs and Named to Innovators Hall of Fame; Innovator 2005 awards by InfoWorld Media Group, a division of IDG, the world’s leading technology media, research, and event company. Bill Cullen of Sonic Software, Mark Palmer of the Progress Real Time Division and Jonathan Robie of DataDirect have been recognized for their vision and expertise that is “directing the future of enterprise technology and having a significant impact on the evolution of the tech world.” All three executives will be added to InfoWorld Media Group’s Innovators Hall of Fame. Progress-Based Forestry Application from DABAC for Cambien Forstebetriedbe Wins Computerworld Honors Award for Innovation in Manufacturing DABAC – Progress-based application for the forestry industry – tagging lumber and reducing shrinkage through the use of RFID – using OpenEdge, Sonic and ObjectStore to meet RFID challenges. Real time data management in the Timber Tracking, which has never dealt with real time event data before! DABAC leverages a Progress-based ERP application from Progress Epicor and ObjectStore to pilot RFID inventory tracking for the lumber industry. OpenEdge provides the development platform and database, ObjectStore provides mass data collection, the Sonic ESB is the communication backbone. Her Majesty The Queen today announced the 2005 winners of The Queen’s Awards for Enterprise, the UK’s leading accolade for business success that is now in its 40th year. There are 137 Awards, the highest total for 10 years. * Innovation Award went to Visualfiles Limited, Leeds: innovative software products for the legal profession Visualfiles Ltd, established in 1985, wins the Award for the development of innovative software products for the legal profession. The most recent product, which is web-enabled, facilitates the centralised management of files and procedures as well as document assembly, tracking and storage. The products bring benefits to clients, such as solicitor firms, in the forms of increased caseload capacity and fast case turnaround and thus increased revenues at reduced costs. Through continuous innovation and development, the company has maintained its market-leading position. July InfoWorld, ESB product review ranked Sonic #1 ESB software Also, CMP Media’s Network Magazine Innovation Awards Recognize Sonic Software for ‘Most Influential Infrastructure Software’ — Sonic ESB® Recognized for “Greatest and Most Immediate Impact” on Infrastructure Software Market and Foundation for Service-Oriented Architecture (SOA) 7

Adding value to any infrastructure Application Platform Governance & Management Event Processing Enterprise Service Bus Data Services Data Access Transition In: Bring focus back to generic technology needs and specific product offerings Main Purpose: Demonstrate depth of coverage in fundamental areas and associate product names with those areas Key Points: ESB, SI, and SOA Management are fundamental areas for successful SOA We have great products in each of those areas We recognize that requirements go beyond those fundamental areas We have products in those areas as well Animation Instructions: As the slide comes up, it re-establishes EI’s position in what we consider the three fundamental elements of SOA integration: ESB, Semantic Integration, and SOA Management. But it does not tie this directly to products. In fact, this is the first times that direct product names come in. Reinforce the need for these technologies, then <CLICK> to associate products with each of those technology needs. At that point stop and recognize that there are needs beyond these three fundamentals. Again, the needs come up without product names so that they can be briefly acknowledged. The next <CLICK> will bring in product names, where we can establish in the prospect’s mind that we have products in these other areas as well. Sample Script: We’ve talked today about the importance of key enterprise infrastructure components for SOA. <CLICK> Progress has industry leading products in each of those three categories, and we can provide you great detail about each. It is important to recognize that each of these best-in-class products can work standalone or in concert with our other products. Each is designed for its specific purpose and designed to work in a heterogeneous environment. <CLICK> But it doesn’t end there. Business need an array of technologies and products to fill out their entire computing environment. <CLICK> Progress has similar best-in-class products in each of these areas – from event processing to mainframe connectivity and other areas related to data access and business applications. In fact, the Progress portfolio is a great place to shop for any business looking to create agile, scalable SOA environments. But that’s a story for another day. Transition Out: Opening up the product “window” for the prospect is a setup for showing the depth and breadth of customers on the next slide. Notes: DO NOT attempt to position this slide as a suite or a platform or you will negate all of the hard work you just did to establish the importance and accuracy of our vision of the SOA space and best-in-class!!! This slide is not for talking about the other products – this is an intro. Leave the product discussions to other decks. Mainframe Connectivity 8

Technology Map Actional OpenEdge Apama Sonic FUSE Application Platform Apama Governance & Management Event Processing Enterprise Service Bus Sonic FUSE Data Services Data Access Transition In: Bring focus back to generic technology needs and specific product offerings Main Purpose: Demonstrate depth of coverage in fundamental areas and associate product names with those areas Key Points: ESB, SI, and SOA Management are fundamental areas for successful SOA We have great products in each of those areas We recognize that requirements go beyond those fundamental areas We have products in those areas as well Animation Instructions: As the slide comes up, it re-establishes EI’s position in what we consider the three fundamental elements of SOA integration: ESB, Semantic Integration, and SOA Management. But it does not tie this directly to products. In fact, this is the first times that direct product names come in. Reinforce the need for these technologies, then <CLICK> to associate products with each of those technology needs. At that point stop and recognize that there are needs beyond these three fundamentals. Again, the needs come up without product names so that they can be briefly acknowledged. The next <CLICK> will bring in product names, where we can establish in the prospect’s mind that we have products in these other areas as well. Sample Script: We’ve talked today about the importance of key enterprise infrastructure components for SOA. <CLICK> Progress has industry leading products in each of those three categories, and we can provide you great detail about each. It is important to recognize that each of these best-in-class products can work standalone or in concert with our other products. Each is designed for its specific purpose and designed to work in a heterogeneous environment. <CLICK> But it doesn’t end there. Business need an array of technologies and products to fill out their entire computing environment. <CLICK> Progress has similar best-in-class products in each of these areas – from event processing to mainframe connectivity and other areas related to data access and business applications. In fact, the Progress portfolio is a great place to shop for any business looking to create agile, scalable SOA environments. But that’s a story for another day. Transition Out: Opening up the product “window” for the prospect is a setup for showing the depth and breadth of customers on the next slide. Notes: DO NOT attempt to position this slide as a suite or a platform or you will negate all of the hard work you just did to establish the importance and accuracy of our vision of the SOA space and best-in-class!!! This slide is not for talking about the other products – this is an intro. Leave the product discussions to other decks. Mainframe Connectivity DataDirect ObjectStore DataXtend Orbix Shadow 9

The Progress ecosystem A sample of Progress’ OEM customers 9 of the top 10 app infrastructure vendors 8 of the top 10 system infrastructure vendors 8 of the top 10 packaged application vendors PURPOSE Neutralize AmberPoint’s pitch about their partner ecosystem. Offset concerns about sonactional

Our strategic partnership with EMC uses many parts of Progress portfolio Healthcare is an important, growing market Both working closely with healthcare standards bodies and integration groups (e.g., HL7, IHE) to address the challenges of information management and integration in healthcare. EMC and Progress are working together to identify and advance the capabilities of integration technologies that will be critical to the future of healthcare IT (e.g., Web Services, ESBs, and RESTful Web Services).

Various products and solutions Captiva eInput PACS imaging/storage Documentum xDB + XML Store XForms engine, XProc engine Dynamic Delivery Services Virtual Patient Record

Virtual Patient Record

SOA for Healthcare

Data Integration Terminology

Cross-enterprise Data Integration Concepts Payments HL7 HL7 Government PHR CCR Record Locator Service Master Patient Index Security Semantic Integration HIPAA Health Plan, Claims Provider HL7 Primary Care Physician EMR NCPDP/X12 Pharmacy

Conceptual Enterprise Architecture in Healthcare Business Logic B2B Gateway HL7, CCR, CDA, DICOM, HIPAA, NCPDP, … Electronic Medical Records Web Portal XML XML HL7 Forms, emails, documents ESB HL7 PDQ, PIX, HL7 HL7 XML XML Patient Master Index COTS Applications ODS Data Warehouse Patient Admin

Data Integration Strategies Messaged Oriented Middleware ESB with Common Messaging Model Patient Locator Radiology Patient Locator Finances EMR Radiology EMR Finances Common Messaging Model Patients Pharmacy Emergency Data W/house Patients Pharmacy Emergency Data W/house Point-to-Point integration ESB with Point-to-Point integration Delete for LOB Audience [Inventory, Service Provisioning, CRM, Trouble Ticketing] Patient Locator Patient Locator Radiology EMR Finances Radiology EMR Finances Patients Pharmacy Data W/house Patients Pharmacy Emergency Data W/house Emergency 18

Evolving Approach to Data Integration in Healthcare (internal/global) A industry-standard HL7-based Information Model enables a large-scale data integration through common semantics Hospital Run-time Lab Design Semantic Data Integration B2B Gateway Data Services Business Processes Services Patients EMR Locator Common Messaging Model Delete for LOB Audience [Inventory, Service Provisioning, CRM, Trouble Ticketing] Patients Claims Emergency Government Physician EMR Patient Locator Finances Radiology semantics capture the formal meaning of data. It is achieved by mapping (or rationalizing) the data source schemas to the Information Model 19

Conceptual Data Integration Stack Business Architecture – business Dictionary, business Business Processes; SNOMED Information Model – business “lingua franca”; openEHR, HL7 RIM Semantic Mapping Information Architecture Data Integration Architecture – point-to-point, transformation hub, common model Data Architecture – format conversion, technical mapping Applications Java, C#, C++ J2EE, .NET Messages HL7, DICOM, CDA Web Services Data Services Databases

Types of Mappings Technical Mappings HL7 V2.3 HL7 V3.0 Common Messaging Model HL7 V2.3 HL7 V3.0 Semantic Mappings Information Model Common Messaging Model HL7 V2.3 HL7 V3.0

Data Integration in Healthcare

Classes of Data Resources in Healthcare Internal Human Readable PDF Excel Internal Machine Readable Non-XML Standards HL7 2.x COBOL Information Model HIPAA XML Fixed length Delimited Mixed DICOM HL7 3.0 openEHR EN 13606 XML Standards

A Typical Project Design-time Central Distributed Run-time Clinics Radiology DICOM Claims HIPAA Billing XML Lab1 HL7 v2.3 Design-time Central Information Model EMR HL7 Lab2 COBOL Patient XML Clinic1 HL7 v2.3 Emergency CSV Clinic2 HL7 v2.5 Pharmacy HL7 Clinics Labs Claims Radiology Pharmacy Emergency GW Distributed Run-time Bus EMR Patient Admin Billing

Common Data Integration Issues Speed and quality of transformation development Life-cycle – changes, merges, impact analysis, reports Collaboration between analysts and developers Non-standard formats “Just like that one, but a little bit different…” Obscure semantics “Which HL7 v3 structure does my element go to?” Message enrichment How does one generate and maintain message control envelopes?

Use-case Outline Use-case 1 – HL7 2.x to 3.0 mapping demo Use-case 2 – DICOM to HL7 2.x discussion Use-case 3 – COBOL to HL7 RIM mapping demo Use-case 4 – openEHR Information Model browser demo Points Information Model as a common Designed to handle size/complexity of models, formats, schemas and mappings Meta-data driven

Use-case 1 – Standard to Standard Conceptual HL7 RIM HL7 2.x HL7 3.0 In Semantic Integrator POLB_IN224200 POLB_IN224200 ORU_R01 ORU_R01

HL7 RIM Core

Navigating the Model

Guiding through the Structure and Documentation

Semantic Mapping to Information Model

Integrated Testing HL7 v2.5 ORU_R01 HL7 RIM HL7 v3 POLB_IN224200 Patient Info Patient Info Patient Info

Use-case 2 - Pathology of a Translation Information Model DICOM HL7 2.x Format Neutralization Format Neutralization Semantic Mapping Semantic Mapping

Custom Format Conversion

Formal HL7 Extension Mechanism HL7 Sample SEF Definition SEF – Standard Exchange Format Generated through visual UI Allows formal extensions of HL7 and X12 grammar

Creating Format Extensions

Use-case 3 – Legacy Connectivity Conceptual HL7 RIM COBOL Copybook COBOL Data

Use-case 3 – Legacy Connectivity Results

Use-case 4 – openEHR Information Model Browser

For more information Visit www.xmlconverters.com/solutions/healthcare Visit www.dataxtend.com Visit http://www.emc.com/solutions/industry/healthcare-life-sciences/index.htm E-mail me: Martin van Middelkoop mmiddelk@progress.com (up to November 30th, 2009) My US colleagues working on DXSI and HL7 are Bill Gino – bgino@progress.com Boris Bulanov – bbulanov@progress.com You can reach me after November 30th, 2009 at mgvanmiddelkoop@medischegegevens.nl