"The Postmodern Electronic Health Record" Presentation by Tomaz GORNIK, CEO, Marand

1. The$
Postmodern$
Electronic$
Health$Record
www.marand.com
Tomaž,Gornik,
CEO,%Marand%
Co,chair,%openEHR%Founda6on%
Coordinator,%Slovenian%ECHA%Ecosystem%

2. www.marand.com
HEALTHCARE$IS$CHANGING
2
NATURE,OF,
ENCOUNTER
PATIENT,
LOCATION
CLINICIAN,
LOCATION
AUTOMATED$
COGNITIVE$
PROCEDURES
PHYSICALLY$PRESENT$
CONNECTED$
REMOTE$
NOT$INVOLVED
HOSPITAL$
CLINIC/PRACTICE$
HOME$
ANYWHERE

3. www.marand.com
WHAT$DO$USERS$WANT?
• an$experience$using$tools$and$apps$that$
they$are$used$to$in$their$daily$lives:$
• fit,for,purpose$apps$
• secure/access$anywhere,$anytime$
• electronic$communication$with$team$
and$patients$
• to$spend$more/time$actually$talking$with$
patients
3

4. www.marand.com
WHAT$DO$PATIENTS$WANT?
• the$same$experience$using$tools$and$
apps$they$are$used$to$
• secure$access$to$all/data$from$cradle/to/
grave$
• confidence$that$care$providers$have$
access$to$accurate$and$relevant/data$
• ability$to$keep/track$of$health$at/home$
and$share$this$data
4

5. www.marand.com
CURRENT$SYSTEMS
• Lack/of/interoperability$between$vendors,$
technologies,$applications$
• Difficult$implementation,$high/cost$$
• Out,dated$interfaces,$bad/design,/missing$
functionality,$time/consuming/
• Quality$of$data,$errors,$data$difficult/to/find$
• Lack/of/mobility,$support$for$devices
5

6. www.marand.com
"Traditional+monolithic+ERP+solutions+using+a+
closed,business,architecture+were+designed+
to+support+the+process+improvement+needs,of,
the,past+(such+as+transactional+efficiency+and+
data+integrity).”+
O$Gartner,$2015
6
EXAMPLE:$ERP
Gartner MONOLITHIC$SYSTEMS$DESIGNED$FOR$NEEDS$OF$THE$PAST

7. www.marand.com
“They+cannot,enable+the+open+and+agile+needs+of+
business+to+succeed+in+a+digital,economy+that+
demands+new,products+and+services+and+the+
ability,to,respond+to+new+business+moments.”++
A+Gartner,$2015
7
EXAMPLE:$ERP
Gartner MONOLITHIC$SYSTEMS$CAN’T$COPE$WITH$NEW$DEMANDS

8. www.marand.com8
ERP$EVOLUTION:$BESTOOFOBREED
HR
(Package)
Order,
Management
Manufacturing,
(Mainframe)
GL,,AP,,
FA
(Package)
Payroll
(Outsourced)
Collections/AR
(Custom)
PREO1997
BEST,OF,BREED
NO/CORE/ERP/
MULTI&VENDOR
FUNCTION,ORIENTED

9. www.marand.com9
ERP$EVOLUTION:$MODERN
HR
(Package)
Order,
Management
Manufacturing,
(Mainframe)
GL,,AP,,
FA
(Package)
Payroll
(Outsourced)
Collections/AR
(Custom)
AR AP GL
FA Inventory Payroll
Order,
Managmt
HR
Manufact
uring
ERP/SUITE
PREO1997
BEST,OF,BREED
1998O2014
MODERN/ERP
NO/CORE/ERP/
MULTI&VENDOR
FUNCTION,ORIENTED
CORE/ERP/
SINGLE/VENDOR
DATA,ORIENTED

10. www.marand.com10
Collections
AR
NO/CORE/ERP/
MULTI&VENDOR
FUNCTION,ORIENTED
ERP$EVOLUTION:$POSTMODERN
ETRecruit
GL
AP
FA
Inventory
Payroll,
Order
Management
Manufacturing
HR
(Package)
Order,
Management
Manufacturing,
(Mainframe)
GL,,AP,,
FA
(Package)
Payroll
(Outsourced)
Collections/AR
(Custom)
CORE/ERP/
SINGLE/VENDOR
DATA,ORIENTED
CORE/ERP/
MULTI&VENDOR
PROCESS,ORIENTED
Payroll
(Outsourced) HR
CRM
Talent
Management
AR AP GL
FA Inventory Payroll
Order,
Managmt
HR
Manufact
uring
ERP/SUITE CORE/ERP
PREO1997
BEST,OF,BREED
1998O2014
MODERN/ERP
2015$O$
POSTMODERN/ERP

11. www.marand.com
POSTMODERN
• Multi,vendor$components/
• New$deployment$models$(hybrid,$cloud)$
• New$technology$
(Mobile,$Big$Data,$IoT,$InOMemory,$Process,$Rules)
• Improved$usability$and$user$adoption$
• Agility$and$flexibility/(less$lockOin)$
• Cost$effectiveness$
• Differentiation$and$innovation
11
USES
ENABLING

12. www.marand.com12
WHAT$ABOUT$HEALTHCARE?
APPLICATION$A APPLICATION$B APPLICATION$C
PAST VENDOR$DEPENDENT,$PROPRIETARY$DATA

13. www.marand.com13
VENDOR$DEPENDENT,$PROPRIETARY$DATA
PAST
APPLICATION$B APPLICATION$C
DATA$MIGRATION
CONVERSION,
EVERY,7–10,YRS
DATA$LOST
CONVERSION,
EVERY,7–10,YRS
DATA$LOST
APPLICATION$A

14. www.marand.com14
SOLVED$FOR$IMAGES$AND$DOCUMENTS$
PRESENT
IMAGES,
PACS
DOCUMENTS,
HL7$/$CDA
APPLICATION$B APPLICATION$CAPPLICATION$A

15. www.marand.com15
WHAT$ABOUT$STRUCTURED$DATA?
IMAGES,
PACS
DOCUMENTS,
HL7$/$CDA
PETABYTES,OF,NEW,
STRUCTURED,HEALTH,,
DATA,PER,DAY,(IN,US)3
PRESENT
APPLICATION$B APPLICATION$CAPPLICATION$A

16. www.marand.com16
VENDOR$INDEPENDENT,$OPEN$DATA
IMAGES,
PACS
DOCUMENTS,
HL7$/$CDA
STRUCTURED,
DATA
FUTURE
APPLICATION$B APPLICATION$CAPPLICATION$A

17. www.marand.com17
CLINICIAN,
PORTAL
APPS
DECISION,
SUPPORT
DEVICE,
CONNECTT
IVITY
PATIENT,
PORTAL
APPS DEVICES
CLINICAL,APPLICATIONS/SERVICES
MULTITVENDOR
PATIENT,FACING,APPLICATIONS,
MULTITVENDOR
Connectivity,&,Transformation,&,Routing,
Process,&,Orchestration,
Management,&,Monitoring,
Security,&,Privacy
POSTMODERN$EHR
MASTER,
PATIENT,
INDEX
TERMINOLOGY
PROVIDER,
REGISTRIES
DATA,
WAREHOUSE
SERVICE,BUS
HEALTH,INFORMATION,ACCESS,LAYER
DOCUMENTS
STRUCTURED+
DATA
IMAGES
CLINICAL,DATA,REPOSITORIES

18. www.marand.com
SIMI$
MOSCOW
18

19. www.marand.com
SIMI$
MOSCOW
CityOwide$Electronic$
Health$Record
Scope:
›,428,policlinic,insatuaons,
›,76,healthcare,centres,
›"12"million"pa,ents""
›"161"millions"visits/year"
›"130.000"system"users""
›"45.000"physicians"
›"1B"documents,"25"TB"of"data"
18

20. www.marand.com19
SIMI$
MOSCOW
CityOwide$Electronic$
Health$Record
Challenges:
›,Complex,environment,
›,MulaTvendor,socware,development,
›,Vendor,lockTin,and,risk,
›,Lack,of,interoperability
Clinical,and,analyacal,infrastructure,
providing,a,centralised,,vendorTneutral,EHR

21. www.marand.com20
SIMI$
MOSCOW
CityOwide$Electronic$
Health$Record
Solu_on:
›,Health,Data,Plaeorm,as,clinical,data,,,
,,repository,
›,Plaeorm,APIs,for,all,development,
›,openEHR,and,IHE,XDS,
›,IHE,XDS,for,electronic,document,sharing,
Clinical,and,analyacal,infrastructure,
providing,a,centralised,,vendorTneutral,EHR

22. www.marand.com21
SIMI$
MOSCOW
CityOwide$Electronic$
Health$Record
Benefits:
›,Common,data,plaeorm,for,all,applicaaons,
›,All,clinical,data,in,an,open,,structured,
,,format,
›,Technology,and,vendor,neutral,,less,lockTin,,
›,Powerful,querying,and,analyacs,
›,Deployed,in,a,private,cloud
Clinical,and,analyacal,infrastructure,
providing,a,centralised,,vendorTneutral,EHR

23. www.marand.com
SUMMARY
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24. www.marand.com
SUMMARY
• Healthcare is changing
22

25. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
22

26. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
• ERP went from BOoOB to Megasuite to Postmodern
22

27. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
• ERP went from BOoOB to Megasuite to Postmodern
• The same will happen with healthcare applications
22

28. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
• ERP went from BOoOB to Megasuite to Postmodern
• The same will happen with healthcare applications
• The future is multi,vendor
22

29. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
• ERP went from BOoOB to Megasuite to Postmodern
• The same will happen with healthcare applications
• The future is multi,vendor
• Vendor,neutral health data is a key asset
22

30. www.marand.com
SUMMARY
• Healthcare is changing
• Today’s monolithic applications can’t cope
• ERP went from BOoOB to Megasuite to Postmodern
• The same will happen with healthcare applications
• The future is multi,vendor
• Vendor,neutral health data is a key asset
• It’s time for Postmodern EHRs!
22

31. www.marand.com
Tomaž,Gornik,
CEO,%Marand%
Co,chair,%openEHR%Founda6on%
Coordinator,%Slovenian%ECHA%Ecosystem%
tomaz.gornik@marand.com%
The$
Postmodern$
Electronic$
Health$Record