2. What does Cloud9 do?
● Provides Next Generation Solutions for the Healthcare Enterprise.
● Cloud9 specializes in Solutions for large scale Multi Disciplinary
Healthcare Delivery Enterprises.
● Designs, develops and delivers, clinical, connectivity, financial,
administrative and transactions systems for:
● Hospitals
● GPs, specialists, aged and community care providers
● Home care
● Government and private healthcare funders
● Delivers Information ( Clinical, Financial and Administrative ) to assist
in patients care to all stakeholders
● Provides the Next Generation of Healthcare solution to move
Clinicians to evidence based medicine
3. Business Strategy
● Our business plan lays out the strategy for the creation of a Healthcare
Information, Communication, Technology and outsourcing business
that will be delivering recurring revenues of over USD$50million within
5 years and an enterprise value of USD$200million
● To be the leader in our chosen markets
● To deliver systems at a lower price point to the whole health
community
● To demonstrate the use of data…. To motivate and provide the tools
that will allow all our healthcare professionals to move from opinion
based medicine to evidence based medicine
● To demonstrate how technology can be used to deliver greater number
of services to the community for the same spend
6. Strategy behind Plan
● The plan is to turn the traditional health IT strategy on its head where
the focus is traditionally on a fragmented under funded, politically grid
locked hospitals to a regional or nationwide health information system
based on primary and community health institutions and where the
hospital is just another node where healthcare is delivered
● New target markets will include NGO’s, Local Government, Regional
Governments and the Health Funders
● To position ourselves to capture opportunities in the traditional and
emerging healthcare market place including;
● Community care
● Elderly care
● Payor markets
7. Business scope
● Key Market Segments
● Community (includes traditional GP) , Aged Care &
Consumer/Citizen. This includes a personal patient record
accessible (any where, anytime, on any thing ) by the citizen in
partnership with their healthcare provider
● Regional healthcare (including community and aged care) delivery
● Hospital networks, Community networks and Aged Care networks
● Insurance, payment and POC mechanisms
● Pharmaceutical management (including clinical trials) and delivery
systems through to the end user
● Population Health and chronic disease management
8. Remarkable Progress
In only 14 months…
● Clarity –
● Completed Phase 1 of product development and secured 4,500 new
Subscribed users which will be coming onto our new platform:
● We inherited an existing footprint in Primary Care (Monet)
● We would develop a new code base that gave us extended
capability – with at least the same functionality as Monet
● Development of Practice Management & Patient Administration
● Development of Clinical
● Development of full PAS functionality
9. Remarkable Progress
In only 19 months…
● The Spine…
● a platform providing a comprehensive set of tools that fully
addresses the administrative and clinical information managements
requirements of citizens, patients, healthcare professionals,
researchers and health funders:
● It includes:
– A federated governance model including:
● Process integration
● Organizational integration (including an EMPI)
● Imbedded Systems integration and supporting components
● Distributed public key infrastructure
10. Remarkable Progress
The Spine – transformational nature
● CDR – based on a health record architecture (HIPPA accredited)
● providing information at the point of care
● facilitating access to information for research into new treatments ;
and
● allows information to be fed back , in an interactive learning
environment, to improve the safety and effectiveness of treatments
● Universal discovery system
● Designed to co-exist with existing systems and absorb them over time,
reduces the disruption to the organisation
● Provides lower cost of ownership
11. Remarkable Progress
● Developed Synchronicity
● Cloud based integration and interoperability platform
● Integration Event Processing, incorporating CEP
● Very high performance transaction processing
12. Looking to the next 12 months
● Using the same proven formula, we’ll focus on extending our product
portfolio further into the continuum
● HIS
● LIS
● RIS
● Pharmacy
● Ambulance/ Mobile emergency
● Telehealth and Air Ambulance
● PPR
13. Outlook
Quality and engaged Partners
● Sonic – A$7b company. Continue to consolidate relationship, out
sourcing and new business opportunities
● IPN Australia's largest operator of medical practices, over 212multi
disciplinary medical centers. Cover over 9.5 million patient
consultations, 2,100 general practitioners and 2,500 healthcare
professionals. – continue roll out of Clarity and new business
opportunities
15. Spine
● Provides a comprehensive set of tools that fully address the
administrative and clinical information management requirements of
citizens, patients and healthcare professionals
● Provides complete support for end-to-end care, removing barriers
between care settings
● Supports healthcare outside of the hospital, clinic and surgery and into
the home
● Design to co-exist with existing system and absorb them
● Enables systems to be upgraded and replaced incrementally
● Easy adaptation to user/ country specific needs
● Scalability
16. Spine Manages the 3 dimensions
of Healthcare delivery
● The personal health dimension supports individuals in managing their
own wellness and healthcare decision-making. It includes a personal Practitioners
Pathology
health record that is created and controlled by the individual or family,
Laboratories
plus non-clinical information such as self-care trackers and directories of Medical
Specialists
healthcare and public health service providers.
Emergency Depts
● The healthcare provider dimension promotes quality patient care by Operating Theatres
providing access to more complete and accurate patient data on the Intensive Care Units
spot, around the clock. It encompasses such information as provider
notes, clinical orders, decision-support programs, digital prescribing Acute Wards
programs, and practice guidelines.
Sub-acute Wards
● The population health dimension includes information on both the health
of the population and the influences on it. The population health Community Health
Programs
dimension makes it possible for public health officials and other data
users at local, State, and national levels to identify and track health Hospital in
The Home
threats, assess population health, create and monitor programs and
services including health education campaigns, and conduct research.
18. The Spine Engine
● SOA Fabric Layer
● Federated Governance Model
Based on Distributed Public Key
Infrastructure (PKI).
● Central registry to store all
services, associated metadata,
plus business and technical
policies.
● Directory services (UDDI) that
accurately certify, identify, and
categorize clients (white pages)
and providers (yellow pages) of
health care services.
● Federated identity, verification,
and authorization with biometrics.
19. Supports Federated model of care delivery
Practitioners
Pathology
Laboratories Pathology
Medical
Specialists Laboratories
Medical
Specialists
Emergency Depts
Operating Theatres Emergency Depts
Intensive Care Units Operating Theatres
Intensive Care Units
Acute Wards
Acute Wards
Sub-acute Wards
Sub-acute Wards
Community Health
Programs Community Health
Programs
Hospital in
The Home Hospital In
The Home
Connectivity Bus
20. Spine - Registry(s)
Person Registry
WS WS
WS WS
WS
A Person Registry is a federated collective of Nervos nodes housing clusters of objects
representing person’s demographics and biometrics information. Person object clusters are
interfaced via services which are handled by the platform Web Services subsystems. Intrinsically,
they are subjected to the federation’s access control and identity management policies and regulations.
21. Person Registry
Patient Registry Financial Registry Military Registry
A Person Object is the common denominator for organizing various registries into a collective.
The object knows where role-based information about its subject (person) exists.
22. Person Registry
Patient Registry
Patient Registry
Patient Registry
To insure scalability and respect ownerships, different person objects are mapped to different patient
registries. The mapping is transparent to any business model use-case scenarios or workflow since the
responsibility is handled by the person object themselves.
23. Person Registry
Patient Registry
CDR CDR CDR
Clinical Data Repository
A patient object much like its predecessor (person object) can take on the responsibility of maintaining
the whereabouts of its subject health related data. Again to insure scalability and ownerships, the objects
are housed in one or many distinct yet federated cluster nodes.
24. Person Registry
Patient Registry
CDR
Clinical Data Repository
CCR Document CCR Document CCR Document CCR Document CCR Document
Timeline
The CDR accumulates snapshots of clinical documents in CCR object model under one patient as
they are posted by the registered clinicians. The results is a comprehensive chronologically ordered continuity-of-care
health records of participating patient population. In this registry each patient would have many cluster of CCR objects
in a read-only status. Objects are generally owned by the submitting entity.
25. Cloud-based e-Health Clinical Data
Repository
A Very First Nationally Scoped
Federated-Data-Warehouse
For Continuity of Care Records
27. Clarity Platform
● Is the implementation of a well-established, enterprise/ nation-wide level,
health informatics infrastructure coupled with the standardized point-of-
care clinical, financial and administrative applications to significantly
improve healthcare delivery whilst providing the ability to manage costs.
● The Clarity Platform facilities external interoperability whilst resolutely
embracing the concept of enterprise / nation-wide health information
exchange
● The Clarity Platform provides information at the point-of-care where
patients are treated; facilitates access to information for research into new
treatments; and allows information to be fed back, in an interactive
learning environment. Thus replacing opinion-based-decision making with
evidence-based decision making.
28. Clarity Platform
Our Clinical goal:
● to provide systems that allow the clinician to move from opinion based
medicine to evidence based medicine where the clinician has the ability to
form a diagnosis on the basis of current worlds best practice and
treatments of illness allowing for better patient outcomes. Against the
current reliance on opinion formed on the basis of the clinicians reliance
on past experience and the (impossible) ability to keep up to date with
literature
Move from opinion based medicine to evidence based medicine
29. Clarity Platform
Clarity for the Clinician
● Clarity allows the clinician (to consistently) pick the right combination of
tools to innovate and improve efficiency of his practice.
● Incorporating registration, scheduling (rescheduling) the clinical
dashboard for full clinical notes (structured and templates for free text) ,
observations, letters, referrals, guidelines, multi disciplinary care plans,
medication management, active monitoring for clinical risk, task
management, distributed to-do-list with escalation reminders and
automatic completion flow management and work flow automation,
results tracking, order entry & sets and tracking
● The Clarity decision support engine monitors all data flowing through the
system and can trigger alerts and notifications
30. Clarity Platform
Clarity for the Clinician (continued)
● Supports healthcare outside of the clinic and surgery and into the
citizens home including community and care settings
● Supports care delivery through identifying patients who interact with
multiple parts of the health care system to monitor equity of access
and care provision
● Supports more efficient commissioning of services and payment by
results and audit of clinical practice
31. Clarity Platform
Clarity for the administrator
● Clarity provides comprehensive data-driven care management services
with minimal technology overhead. Each patient encounter transparently
percolates and spreads from the point-of-care solution, merges with other
enterprise data and eventually finds its way back to the participating
stakeholders resulting in an evolving and sustainable knowledge network,
whether clinical, financial or administrative.
33. What is Synchronicity?
● Synchronicity is an event driven, service-oriented, integrated
platform for the development, deployment and management of
processes for the integration of applications.
34. What can you do with Synchronicity?
Application Data Process Composite Enable an
Integration Migration Automation Applications SOA
Synchronicity
Others…
35. Parts of Synchronicity
● Synchronicity Studio
● the tools for designing, developing, testing and deploying
Synchronicity Processes
● Synchronicity Runtime
● the container into which Synchronicity Processes are deployed
for execution.
● Synchronicity Management
● a web site that allows support staff to administer, manage and
monitor both Synchronicity runtimes and their deployed
Synchronicity Processes
36. External Applications External Applications External Applications
Service and Service and Process Composition,
Process Management Configuration and Development
Synchronicity
Synchronicity A message
with content
A message
with content
A message
with content
Bus
to fit into to fit into to fit into
this box for this box for this box for
display display display
purposes purposes purposes
only only only
Synchronicity Message Parsing Content Based
Message Transform Logging and Trace
(One to One, One to Services
Services (Text, CSV, HL7, EDI, Routing
Many, Many to One, (Audit, Event, Trace
Custom..) (Dynamic VML)
Many to Many) and Debug)
Transaction Unified Security Management
Service / Process
Management (Transport, WS- Services
Execution
(XA and Local) Security and Access) (JMX, XMPP)
Unified TCP/IP HL7 HTTP/S JDBC
Connectivity XMPP Web Services FTP/S Log Files
File JMS SMTP, POP3, IMAP Others..
External Applications External Applications External Applications
37. Synchronicity Processes
● Workflow definition of the steps necessary for an integration use-
case.
● Implements the logic of an interaction
● which usually involves the parsing, conversion, transformation,
manipulation of data either passed to the process or obtained
by the process interacting with external resources, systems or
applications.
38. Synchronicity
Integration Event Processing (IEP)
● IEP is a new way to look at traditional data
integration. Rather than simply mechanizing the
process of moving data from Point A to Point B, IEP
adds a new layer of sophistication by analyzing data
while in transit.
● Allows real time analysis and intelligent decision-
making.
● Detecting trends, exceptions and errors hidden within
the data it transmits, Synchronicity offers a whole
range of new possibilities not possible with previous
systems
39. Complex Event Processing
● The Complex Event Processing (CEP) engine allows
sophisticated rule based handling of multiple events.
An exciting new technology, Complex Event
Processing consists of processing many events
happening across all the layers of an organization,
identifying the most meaningful events within the
event cloud, analyzing their impact, and taking
subsequent action in real time.
● CEP removes the need to continuously reference the
source systems. Without CEP, workflows can
breakdown and systems can hinder, rather than
enhance productivity.
● Complex Event Processing technology allows
numerous events to be evaluated and outcomes to be
derived non-deterministically.
40. Adaptable Workflow Engine
● A scriptable workflow engine provides asynchronous real-time
orchestration between multiple events based on a set of predefined
business rules. While data is being routed through the system, it is
also analyzed according to it’s content and context.
41. Adaptable Workflow Engine
● The workflow engine has the ability to make decisions
and take actions based on scripted rules. Synchronicity
can provide users with relevant feedback in real-time,
which is crucial in settings where care givers must make
decisions quickly. For example, when a physician orders
a lab test, the system can ensure that the same test has
not been recently conducted through another system,
thereby reducing the duplication of healthcare costs.
42. Synchronicity Runtime
● The Container for deployed
Mainframe processes
● Runtime available as
● Software only
Server ● Virtual Appliance
● Physical Appliance
● Virtually any operating system
Laptop ● Virtually any platform
● Configurable Footprint
PDA / Cellphone
Platform
43. Synchronicity Runtime – Process Network
● Multiple Runtimes and Processes can cooperate in an integrated
Network
Synchronicity Runtime
Server
Synchronicity Runtime
Synchronicity Synchronicity Runtime
Mainframe Process Laptop
Network
Synchronicity Runtime
Synchronicity Runtime
PDA / Cellphone PDA / Cellphone
44. Synchronicity Studio
● Integrated process design and
development environment
● Eclipse based tools
Design
● Integrates well with other
Eclipse tools
● Provides full ALM features for Test Develop
process design development,
debug, test and deployment
● Graphical process design tools
● Develop and deploy to a Deploy Debug
Synchronicity Process Network
45. Synchronicity Studio – Design
● Visual Process Design
● Use a diagram to layout the
workflow i.e. Model the
integration
● Transformation (Map) Design
● See how source data is
converted to target data
● Business Rules Design
● Visualize data to action mapping
● Abstract Process Design
● Bind process for multiple runtimes
46. Synchronicity Studio – Develop
● Model data
● Message structure definition
using standards (UML, XML etc)
● Connection Profiles Definition
● Connector and Listener
configuration
● Process Binding
● Add Models, Maps, Rules,
Connectors to process
● Team Working
● Share resources with others
47. Synchronicity Studio – Debug
● Debug Process in-situ
● Step-by-step debugging of
process, check workflow and
connections
● Debug Maps and Rules
● Set breakpoints, examine
variables to ensure Maps and
Rules work correctly
● Test Parsers, Maps, Rules in
each editor
● Ensure correct behaviour prior to
deployment
48. Synchronicity Studio – Test
● Send Test Data to Process
● Submit sample data to process
using test tools
● Monitor Events
● Examine events from remote
runtimes
● Analyze Trace Data
● Drill down into detailed process
trace data
● Monitor Telemetry
● Graphically display throughput
and other counters
49. Synchronicity – Console
● Process management and
monitoring
● Command and control for
processes
● Telemetry and Statistics
● View all monitored counters
50. Synchronicity – Console
● Send Test Data to Process
● Submit sample data to process
using test tools
● Monitor Events
● Examine events from remote
runtimes
● Analyze Trace Data
● Drill down into detailed process
trace data
● Monitor Telemetry
● Graphically display throughput
and other counters
51. Synchronicity – Console
● Visualize processes
● See the process and examine
activity
● Event and Trace log access
● Examine and access trace events
● Sequence diagrams
● Drill down into messages
52. Summary
● Sophisticated tools for complex integration tasks
● Model based development
● Expose integrations as a service
● Team working
● Scalable runtime – footprint and capability
● Remote deployment and management
