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Webinar: Electronic Health Records (EHRs) and MongoDB - Advancing the Data Platform for the Future
NewWave Telecom & Technologies, Inc.            www.newwave-technologies.com




                                       Agenda
 •    Who is NewWave?
 •    Why Mongo?
 •    How NewWave Uses Mongo
 •    NewWave’s Road Map
 •    Questions?
NewWave Telecom & Technologies, Inc.                                      www.newwave-technologies.com




                            Who is NewWave?
                                       —  Established provider of innovative IT services,
                                           solutions and support since 2004.
                                          —  SEI CMMI Maturity Level II Company
                                          —  8(a) Small Business, MBE Certified
                                          —  GSA IT Schedule 70 & 8(a) STARS II
                                       —  Outstanding history in supporting Federal
                                           Healthcare Programs for years
                                       —  Reputation for providing commercial and
                                           federal government clients reliable, cost
                                           effective technical solutions
NewWave Telecom & Technologies, Inc.                                   www.newwave-technologies.com




                       NewWave Customers
                                       Federal Emergency Management Agency (FEMA)
                                          •  Workman Compensation Claims Management



                                       Department of Health and Human Services
                                          •  Center of Medicaid and Medicare Services (CMS)
                                              •  Quality Net Identity Management (QIMS)
                                              •  Data Management (DM) IDIQ
                                                   •  Electronic Health Records
                                              •  Research, Data and Information System
                                                 (RDIS) IDIQ
                                                   •  Data Collection Task
                                                   •  MCSIS – Information Sharing System
NewWave Telecom & Technologies, Inc.                   www.newwave-technologies.com




                               Current Projects
 Provider Screening Challenge (Crowdsourcing)
           “To develop a multi-state, multi-program provider screening
             application capable of risk scoring, credential validation,
             identity authentication, and sanction checks, while lowering
             burden on providers and reducing administrative and
             infrastructure expenses for States and federal programs”

        •  To operate in a cloud-based environment
        •  Federal Healthcare is looking for “reliable, scalable, and
           cost-effective” software to improve screening of
           providers across state and program lines
NewWave Telecom & Technologies, Inc.               www.newwave-technologies.com




                                  Innovation Lab
NewWave Telecom & Technologies, Inc.                    www.newwave-technologies.com




                               Current Projects
 Transformed Medicaid Statistical Information
 System

           “Evaluate the final multi-state, multi-program provider
           screening application capable of risk scoring, credential
           validation, identity authentication, and sanction checks
           technical solution and provide information technology (IT)
           technical assistance for States implementing and piloting this
           solution”

        •  To provide IT technical assistance (TA) including
           working with states as it relates to their state system
           requirements, IT system builds, and associated
           interfaces
Pre-Mongo Physical Architecture –
         Electronic Health Records
                     Load	
  Balancer	
  



   IBM	
  	
                                   IBM	
  
HTTP	
  Server	
                            HTTP	
  Server	
  
                                                                 •  Traditional Architecture
                                                                 •  Not easily scalable
                                                                 	
  
WebSphere	
                                 WebSphere	
  




                     Oracle	
  DB2	
  
                        Oracle	
  
                      Oracle	
  DB2	
  
                         DB2	
  
NewWave Telecom & Technologies, Inc.                               www.newwave-technologies.com



Health Information Technology and the Big Data
                                       The need and the trends

          “If US healthcare were to use big data creatively and effectively to drive
          efficiency and quality, the sector could create more than $300 billion in
          value every year. Two-thirds of that would be in the form of reducing US
          healthcare expenditure by about 8 percent.” - McKinsey

  —  Making data available in real or near-real time
  —  Processing data without much moving around
  —  No need to replace with bigger and powerful servers; just add nodes to the
      existing infrastructure


             …and so MongoDB
NewWave Telecom & Technologies, Inc.                      www.newwave-technologies.com




                                       Why Mongo?
 File Storage:
 •  GridFS                                     Cost	
  
 ETL Data:
 •  Built-in aggregation framework for
    simple applications
 •  Integrates with Hadoop for complex
    data aggregation using Map/Reduce
 Versatility:
                                                                      Compa5bility	
  
 •  Cloud-friendly
 •  Java-friendly                                                     Performance	
  
 Schema-free:
 •  Agile                                                             Availability	
  
Why Mongo Over RDBMS?
	
  
	
        ü  Design-as-you-go
	
  
{	
  
        	
  “_id”	
  :	
  ObjectId("4efa8d2b7d284dad101e4bc9"),       ü  Agile Methodology
              	
  “providerName”	
  :	
  	
  “Dave	
  Dawson”,	
  
        	
   	
  “specialty”	
  :	
  “	
  Internal	
  Medicine”	
  
}	
  
{	
  
        	
  “_id”	
  :	
  ObjectId("4efa8d2b7d284dad101e4bc9”),	
  
        	
  “providerName”	
  :	
  	
  “Steve	
  Towson”,	
  	
  
        	
  “specialty”	
  :	
  “	
  Physical	
  Therapy”,	
  
        	
  “fileName”	
  :	
  “	
  xray.jpg”	
  
}	
  
	
  
	
  
	
  
	
  
Why Mongo Over RDBMS?	
  




ü  For Applications requiring high performance and
    scalability without compromising on functionality
NewWave Telecom & Technologies, Inc.                        www.newwave-technologies.com



                       How We Use Mongo?
 •  Storing Electronic Health Records
 •  Mongo provides a convenient, powerful and                        NETEZZA
                                                                    TERADATA
    robust way to store structured/unstructured                       Oracle
    data                                                               IBM

 •  Leverage the use of GridFS to store large
    files, that are stored as chunks.
 •  Integrate with Hadoop and “BI tool” to                            Hadoop
    analyze data from local and external stores
    using Map/Reduce framework in Mongo.


                                        Electronic	
  
                                       Health	
  Data	
             MongoDB
                                                                     MongoDB
                                       ApplicaWon	
                   MongoDB
NewWave Telecom & Technologies, Inc.                                                                  www.newwave-technologies.com



     Architecture                                                      HTTP	
  
      Diagram
           FTP	
                                            Spring	
  Security	
  
                                                              HTML	
  5	
  
           File	
                                                 JQuery	
  
                             Camel	
  
                                                                                                                       Spring	
  
                                                                                                       Spring	
      Framework	
  
                                            Ac5vi5-­‐BPM/	
                                           Security	
  
           JMS	
                               Drools	
  
                                                                         Open	
  Geo	
  
                                                                                     	
  
                                         Spring	
  Data	
  	
                  Elas5c	
  Search	
  
          SMTP	
                                                                     	
  


                                  	
  
                                Ac5ve	
  
                                                                   MongoDB	
                            GridFS	
  
                                 MQ
                                    	
  


                                                                    Hadoop	
  
NewWave Telecom & Technologies, Inc.                                www.newwave-technologies.com

                            EHR Requirement:
                               Efficient Data Exchange
                                          The Need
 FTP	
                                       •  Exchange data smoothly and securely among
                                                different actors
 File	
                                      •  Guaranteed interoperability
                       Camel	
            The Solution : Apache Camel
                                             •  Patterns to implement routing and mediation rules
 JMS	
  
                                                in Java via Spring based XML
                       Spring	
  Data	
      •  Uses URIs to work directly with any kind of
SMTP	
                                          Transport or messaging model ( FTP, File, JMS
                	
                              etc.)
              Ac5ve	
                        •  Provides Business Activity Monitoring (BAM)
               MQ                MongoDB	
   •  Convenient storage of ETL data to Mongo
                  	
                         •  Parallel processing and ordering of messages for
                                                throughput and load balancing
NewWave Telecom & Technologies, Inc.                                             www.newwave-technologies.com


                            EHR Requirement:
                               Spatial Data and Search
                                        The Need:
                                           •     Data Integration and spatial visualization
                                           •     View epidemiological region
                                           •     Demographic analysis
                                           •     Allow users to search health records efficiently
                                        The Solution:
               HTTP	
                       •      OpenGeo Suite
                                                    •    MongoDB – WMS and WFS data
                                                    •    “Object Embedding” in OpenLayers
        Spring	
  Security	
                        •    HTML5, JQuery and OpenLayers for desired map
            HTML	
  5	
                                  view
                                                    •    Google’s geocoder for locating addresses
              JQuery	
  
                                            •      Elastic Search
Elas5cSearch	
            OpenGeo	
  
                                                    •    Modeled with document oriented DBs
                                                    •    Distributed based search support
                                                    •    Elastic search engine on top of Apache Lucene
           MongoDB	
  
NewWave Telecom & Technologies, Inc.                                        www.newwave-technologies.com


                              EHR Requirement:
                                          Rules Engine
                   HTTP	
               The need:
                                          •    Automate workflows of administrative processes
          Spring	
  Security	
            •    Increase business agility
              HTML	
  5	
                 •    Automate activities
              JQuery	
                    •    Lower modification expenses on business logic
            ActivitiBPM/
               Drools                   The solution:
             Spring	
  Data	
              •  ActivitiBPM/Drools and Spring-data-mongo
                                                 •    Capable of processing large volumes of data
         	
                                      •    Mongo for rule repository and storing user
       Ac5ve	
                                        documents (e.g. prescriptions)
        MQ             MongoDB	
  
                                                 •    Rule 1: rule based services (e.g. calculating
           	
  
                                                      premiums and refunds)
 ü       New Diseases
 ü       New or modified laws on the            •    Rule 2 : complex decision activities and content
          health insurance market                     based routing decision (automated or manual or
 ü       New insurance products                      both)
 ü       New business model                     •    Rule 3: Work item allocation for manual
                                                      processing steps (e.g. fraud detection)
NewWave Telecom & Technologies, Inc.                            www.newwave-technologies.com




                       Physical Architecture
 •    Expect high volumes of users and patient                Load	
  Balancer	
  
      information
 •    Sharding, an efficient and inexpensive
      option
 •    Store metadata in Config Servers            Nginx	
                            Nginx	
  




                                                   JeYy	
                             JeYy	
  


                                                                 MongoS	
  


                                                 Mongod	
                            Mongod	
  
                                                                Mongod	
  
NewWave Road Map


NewWave Telecom & Technologies, Inc.   www.newwave-technologies.com
NewWave Telecom & Technologies, Inc.                                            www.newwave-technologies.com




Multi-Cloud                                                              SaaS

Environment
                                                                                      PaaS




                                                    Hybrid	
                                      IaaS

                                       Public	
                  Private	
  
NewWave Telecom & Technologies, Inc.                                    www.newwave-technologies.com




                          Mongo for Social Media
   	
  	
  
                  “Sixty Percent of surveyed physicians and 65 percent of surveyed
                  nurses are interested in using social networks for professional
                  purposes” - Manhattan research Taking the Pulse, v9.0.



              Use Case:
              •  EHR application relies on social media for
                 trend detection and intelligence gathering –
                 natural disaster detection or flu outbreak
                 tracking                                                Twitter caught the
                                                                       2010 cholera outbreak
              Why Mongo??                                                     in Haiti
              • Integration with Spring Social
              • Mongo 2.2’s powerful aggregation framework
              • Built-in Map/Reduce framework
              • Sharding and replication capability
QUESTIONS??	
  




                  Linkedin.com/company/newwave_technologies   @NewWave_Tech

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Webinar: Electronic Health Records (EHRs) and MongoDB - Advancing the Data Platform for the Future

  • 2. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Agenda •  Who is NewWave? •  Why Mongo? •  How NewWave Uses Mongo •  NewWave’s Road Map •  Questions?
  • 3. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Who is NewWave? —  Established provider of innovative IT services, solutions and support since 2004. —  SEI CMMI Maturity Level II Company —  8(a) Small Business, MBE Certified —  GSA IT Schedule 70 & 8(a) STARS II —  Outstanding history in supporting Federal Healthcare Programs for years —  Reputation for providing commercial and federal government clients reliable, cost effective technical solutions
  • 4. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com NewWave Customers Federal Emergency Management Agency (FEMA) •  Workman Compensation Claims Management Department of Health and Human Services •  Center of Medicaid and Medicare Services (CMS) •  Quality Net Identity Management (QIMS) •  Data Management (DM) IDIQ •  Electronic Health Records •  Research, Data and Information System (RDIS) IDIQ •  Data Collection Task •  MCSIS – Information Sharing System
  • 5. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Current Projects Provider Screening Challenge (Crowdsourcing) “To develop a multi-state, multi-program provider screening application capable of risk scoring, credential validation, identity authentication, and sanction checks, while lowering burden on providers and reducing administrative and infrastructure expenses for States and federal programs” •  To operate in a cloud-based environment •  Federal Healthcare is looking for “reliable, scalable, and cost-effective” software to improve screening of providers across state and program lines
  • 6. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Innovation Lab
  • 7. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Current Projects Transformed Medicaid Statistical Information System “Evaluate the final multi-state, multi-program provider screening application capable of risk scoring, credential validation, identity authentication, and sanction checks technical solution and provide information technology (IT) technical assistance for States implementing and piloting this solution” •  To provide IT technical assistance (TA) including working with states as it relates to their state system requirements, IT system builds, and associated interfaces
  • 8. Pre-Mongo Physical Architecture – Electronic Health Records Load  Balancer   IBM     IBM   HTTP  Server   HTTP  Server   •  Traditional Architecture •  Not easily scalable   WebSphere   WebSphere   Oracle  DB2   Oracle   Oracle  DB2   DB2  
  • 9. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Health Information Technology and the Big Data The need and the trends “If US healthcare were to use big data creatively and effectively to drive efficiency and quality, the sector could create more than $300 billion in value every year. Two-thirds of that would be in the form of reducing US healthcare expenditure by about 8 percent.” - McKinsey —  Making data available in real or near-real time —  Processing data without much moving around —  No need to replace with bigger and powerful servers; just add nodes to the existing infrastructure …and so MongoDB
  • 10. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Why Mongo? File Storage: •  GridFS Cost   ETL Data: •  Built-in aggregation framework for simple applications •  Integrates with Hadoop for complex data aggregation using Map/Reduce Versatility: Compa5bility   •  Cloud-friendly •  Java-friendly Performance   Schema-free: •  Agile Availability  
  • 11. Why Mongo Over RDBMS?     ü  Design-as-you-go   {    “_id”  :  ObjectId("4efa8d2b7d284dad101e4bc9"), ü  Agile Methodology  “providerName”  :    “Dave  Dawson”,      “specialty”  :  “  Internal  Medicine”   }   {    “_id”  :  ObjectId("4efa8d2b7d284dad101e4bc9”),    “providerName”  :    “Steve  Towson”,      “specialty”  :  “  Physical  Therapy”,    “fileName”  :  “  xray.jpg”   }          
  • 12. Why Mongo Over RDBMS?   ü  For Applications requiring high performance and scalability without compromising on functionality
  • 13. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com How We Use Mongo? •  Storing Electronic Health Records •  Mongo provides a convenient, powerful and NETEZZA TERADATA robust way to store structured/unstructured Oracle data IBM •  Leverage the use of GridFS to store large files, that are stored as chunks. •  Integrate with Hadoop and “BI tool” to Hadoop analyze data from local and external stores using Map/Reduce framework in Mongo. Electronic   Health  Data   MongoDB MongoDB ApplicaWon   MongoDB
  • 14. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Architecture HTTP   Diagram FTP   Spring  Security   HTML  5   File   JQuery   Camel   Spring   Spring   Framework   Ac5vi5-­‐BPM/   Security   JMS   Drools   Open  Geo     Spring  Data     Elas5c  Search   SMTP       Ac5ve   MongoDB   GridFS   MQ   Hadoop  
  • 15. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com EHR Requirement: Efficient Data Exchange The Need FTP   •  Exchange data smoothly and securely among different actors File   •  Guaranteed interoperability Camel   The Solution : Apache Camel •  Patterns to implement routing and mediation rules JMS   in Java via Spring based XML Spring  Data   •  Uses URIs to work directly with any kind of SMTP   Transport or messaging model ( FTP, File, JMS   etc.) Ac5ve   •  Provides Business Activity Monitoring (BAM) MQ MongoDB   •  Convenient storage of ETL data to Mongo   •  Parallel processing and ordering of messages for throughput and load balancing
  • 16. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com EHR Requirement: Spatial Data and Search The Need: •  Data Integration and spatial visualization •  View epidemiological region •  Demographic analysis •  Allow users to search health records efficiently The Solution: HTTP   •  OpenGeo Suite •  MongoDB – WMS and WFS data •  “Object Embedding” in OpenLayers Spring  Security   •  HTML5, JQuery and OpenLayers for desired map HTML  5   view •  Google’s geocoder for locating addresses JQuery   •  Elastic Search Elas5cSearch   OpenGeo   •  Modeled with document oriented DBs •  Distributed based search support •  Elastic search engine on top of Apache Lucene MongoDB  
  • 17. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com EHR Requirement: Rules Engine HTTP   The need: •  Automate workflows of administrative processes Spring  Security   •  Increase business agility HTML  5   •  Automate activities JQuery   •  Lower modification expenses on business logic ActivitiBPM/ Drools The solution: Spring  Data   •  ActivitiBPM/Drools and Spring-data-mongo •  Capable of processing large volumes of data   •  Mongo for rule repository and storing user Ac5ve   documents (e.g. prescriptions) MQ MongoDB   •  Rule 1: rule based services (e.g. calculating   premiums and refunds) ü  New Diseases ü  New or modified laws on the •  Rule 2 : complex decision activities and content health insurance market based routing decision (automated or manual or ü  New insurance products both) ü  New business model •  Rule 3: Work item allocation for manual processing steps (e.g. fraud detection)
  • 18. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Physical Architecture •  Expect high volumes of users and patient Load  Balancer   information •  Sharding, an efficient and inexpensive option •  Store metadata in Config Servers Nginx   Nginx   JeYy   JeYy   MongoS   Mongod   Mongod   Mongod  
  • 19. NewWave Road Map NewWave Telecom & Technologies, Inc. www.newwave-technologies.com
  • 20. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Multi-Cloud SaaS Environment PaaS Hybrid   IaaS Public   Private  
  • 21. NewWave Telecom & Technologies, Inc. www.newwave-technologies.com Mongo for Social Media     “Sixty Percent of surveyed physicians and 65 percent of surveyed nurses are interested in using social networks for professional purposes” - Manhattan research Taking the Pulse, v9.0. Use Case: •  EHR application relies on social media for trend detection and intelligence gathering – natural disaster detection or flu outbreak tracking Twitter caught the 2010 cholera outbreak Why Mongo?? in Haiti • Integration with Spring Social • Mongo 2.2’s powerful aggregation framework • Built-in Map/Reduce framework • Sharding and replication capability
  • 22. QUESTIONS??   Linkedin.com/company/newwave_technologies @NewWave_Tech