InterSystems Virtual Summit 2020: Day Two Keynote Recap

Day One Summary	Day Two Summary	Day Three Summary

2020 marks the first year ever of InterSystems’ Global Summit going virtual! Join us from October 20th to November 5th as we recap various sessions of this year’s event. Today’s theme is around the three elements needed to be an agile enterprise: responsive partnerships, flexible technology, and healthy data.

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Our Vision for Support: A Responsive Partner

Challenges and disruptions are best handled by relying on trusted partners to navigate effective ways through them. John Paladino, Head of Client Services at InterSystems, reminded viewers that InterSystems continues to be such a partner for its customers and that it is his job to deliver successful technology to help solve real-world problems as they emerge.

Paladino explained that agility requires three things:

• Responsive partners who help you deal with change and fix problems
• Flexible technology that lets you create new products and services quickly
• Healthy data that is clean, available, and ready to guide decisions

InterSystems’ Worldwide Response Center is a key partner for InterSystems customers. The InterSystems team is accustomed to responding to crises with customers on a routine basis and will be available to customers for the next one. Paldino stressed that the right partner would most certainly outlast any individual technology. Companies should choose their partners for the long-haul.

Paladino shared a few examples of major crises during his career and InterSystems’ ability to respond. These included 9/11 in 2001, Hurricane Katrina in 2005, and the 2010 Chile earthquake. In each case, InterSystems was prepared to respond and support customers, victims, and communities.

COVID-19, though, is different. This situation requires partnerships that are built on knowing and collaborating with other people, meaning being willing to ask questions, admit mistakes, and engage in problem-solving over time as equals—with passion and focus. Passion and focus earn trust, and trust is key to rapid responses.

InterSystems has held the belief that a positive, can-do attitude is essential to an effective response. There has been a willingness to disregard what seems impossible and apply passion and focus anyway to find a solution. It is with that intensity that InterSystems is prepared to support its customers now and through whatever the future will bring.

Whatever the next crisis is, Paladino says, “Bring it on. We’re ready and will be right by your side.”

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Technology, Ambition, & Breaking Down Barriers

In this session, Dr. Paul Tibbits spoke about how the VA is making investments to streamline, expand, and modernize the infrastructure used to serve veterans now and into the future. The goal is to make life more convenient for VA staff and patients. Much of the work involves focusing on more efficient use of the resources available to VA staff. Making better and more refined use of technology leads to a better experience for both staff and those they serve.

Dr. Tibbits leads the newly created Office of Technical Integration at the VA. The department’s mission is to fulfill President Lincoln’s promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans.

The VA is the second-largest federal agency in the U.S. with over 400,000 employees across the U.S. and abroad that supports 19.2 million veterans and operates 171 VA medical centers and over 1,200 outpatient facilities. Currently, the VA has prioritized 45 major projects to bolster its cybersecurity and privacy posture.

As many organizations carry out digital transformation strategies today, the VA is doing the same. It has established four guiding principles, which are transparency, accountability, innovation, and teamwork. The VA also developed five imperatives or goals:

• Exceptional Customer Service
• IT Modernization
• Strategic Sourcing
• IT Workforce Transformation
• Seamless and Secure Interoperability

In order to achieve these imperatives, the VA has defined the following six focus areas:

• Manage Data
• Migrate to the Cloud
• Improve Cybersecurity
• Digitize Business Processes
• Decommission Legacy Systems
• Recruit and Retain a World-Class IT Workforce

The VA established the Office of Technical Integration approximately a year and a half ago, which formed due to a recognized need for coordination to not rely entirely on fitting somewhere into a CIO’s schedule. The Office employs an agile approach and sees itself in the middleware or “white space” between systems as a facilitator and convener to convert that white space into “managed space.”

Dr. Tibbits described the role of the Veterans Data Integration and Federation (VDIF) program in centralizing and streamlining connections with partners. To improve the effectiveness of the VA’s solutions, Dr. Tibbits and the Office are striking a balance between the need to support disparate systems and the desire to simplify and, ideally, “build once, use many.”

The core of the new architecture is HealthShare and enables a unified care record, coupled with the extended benefits of a cloud-based IRIS Data Platform.

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Our Vision for Healthcare: Healthy Data and Beyond

Don Woodlock, Head of Healthcare Solutions at InterSystems, opened his presentation by asking the audience what they thought the most powerful tool has been to fight COVID-19. Answers might include ventilators, personal protective equipment, or perhaps treatments like Remdesivir. From Woodlock’s perspective, the most powerful tool so far has arguably been data.

Data has been essential to understanding who has COVID-19, determining testing volume, test results, new case rates, geographic origins of cases and hot spots, and has been used to inform decisions about closing or re-opening at the state and local level across the country.

Woodlock believes that the healthier and more accurate data is, the more understandable and useful it will be, and InterSystems is committed to helping customers pursue this healthy data. To help define this term, Woodlock said that healthy data is accessible, usable, and ready for action. Specifically, the data isn’t stuck in siloed systems. It is defined, clean, and trustworthy, and it is ready to be used immediately in the hands of those who need it in making decisions (including machine learning algorithms, reports, or dashboards).

From the customer’s point of view, Woodlock believes that organizations must be able to capture and normalize data without turning everyone into data clerks doing manual tasks; it must be automated. And since patient health is not episodic or transaction, information needs to be aggregated and made available in a longitudinal format.

Every organization is different. However, though each organization has its own goals and priorities, they must have the tools and systems to innovate as markets and environments continue to change. In response to those needs, InterSystems is investing in technology and support systems that allow each customer to solve their unique problems as flexibly as possible, empowering customers to build their own solutions to more precisely meet local or organization-specific needs.

Woodlock described some of the ways InterSystems has responded to customers’ needs during this pandemic as an example of flexibility and adaptability. These include six major releases since January 2020 for TrakCare and HealthShare, which is more than ever before in such a short period of time.

InterSystems is also very excited about the FHIR standard and providing enhanced support for customers looking to take advantage of this technology, not only from a built-in, off-the-shelf perspective but also in terms of enabling customers to do more with FHIR on a self-service basis.

Woodlock announced a few key collaborations, including integrating TrakCare into Apple Health, as well as capturing Skype IDs in TrakCare as part of the registration process. Once captured, automatic scheduling of virtual visits is enabled, integrating with MicrosoftTeams to deliver interactive alerts with links to patient-specific information. TrakCare also integrates with “NORA,” an innovative chatbot solution built by Northwell Health to enable clinicians to request patient information or set a reminder in an automated way that feels like interacting with a person or virtual assistant through chat.

Other important announcements included a HealthShare CMS Solution Pack to help customers accelerate compliance with the Patient Access and Interoperability Rule (coming January 2021), COVID-19 specific standard dashboards as templates in HealthShare Health Insight, HealthShare Managed Connections as a service to help customers onboard participants, and integration with Commonwell and CareQuality, representing thousands of sites to connect with and millions of patient records.

Woodlock concluded his session by reminding viewers of upcoming sessions and encouraged attendance throughout the remainder of Virtual Summit 2020. Oh! And a guitar solo! Thanks, Don.

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Solving the Genomic Data Challenge with HealthShare

UC Davis Health is an academic medical center located near Sacramento, California, with 627 beds, 78,000 ED visits per year, and $2.6 billion in revenue (2017). The health system shares an EHR (Epic) with Marshall Medical Center.

HealthShare is used to deliver an integrated solution providing clinical access to discrete data with external linking (in context) within the EHR’s frame. Prior to the implementation of their new solution, UC Davis Health received inbound genomics reports in formats (paper and fax) that had to be scanned in, which led to delays in making the information available to clinicians. In addition, the reports were sometimes not visible or easy to locate, rendering them obsolete for direct patient care and planning.

The health system partnered with J2 Interactive to create a solution that brings these reports into HealthShare and displays them within Epic, making the information real-time, visible, and useful for clinicians.

In UC Davis Health’s move toward precision medicine, the older process of scanning documents into Epic’s Media tab did not feel “precise.” The data was not searchable and was not in clinicians’ line of sight as they were treating patients.

The new solution not only supports this specific use case for genomic reports but also provides a multi-use portal that can be used for other projects in the future to work with data through HL7, IHE profiles, FHIR R4, or other document or data types.

Inside the Epic user interface, a new Genomics “button” is presented to clinicians in multiple ways, such as a favorite in the provider’s activity list. Clicking on the Genomics button launches HealthShare in the Epic window and remains connected to both systems.

If a report is available and selected, multiple tabs are available for the clinician to use:

• Tab 1 – Genomic Results
• Tab 2 – Therapies
• Tab 3 – Clinical Trials
• Tab 4 – Variants of Unknown Significance

The viewer also includes links to more details for the citations listed in a report and displays information about possible treatments and clinical trials available. Clinicians can review this information sourced from the genomics report vendor and discuss a patient’s options.

A key feature of this solution is the availability of the original report in PDF format in addition to the parsed and displayed discrete data (XML). These PDF versions are available to clinicians as a trust-building element. Providers know they can always view and use the original for verification purposes or to see the information in a format that a provider might prefer from past experiences.

The discrete data is broken down and then displayed for providers in a walk-through format similar to a flowsheet. The project has converted static and less visible high-value information that sat outside of clinician’s workflows into an easy-to-use and meaningful augmentation of critical patient information at the point of care. In addition to supporting direct patient care, UC Davis Health de-identifies the discrete data they receive and uses it for value-add research projects.

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Our Vision for Data Platforms: Resiliency by Design

Gnau started off his presentation by explaining that disruptions occur fairly regularly over time and should be expected. This regularity means that companies must build solutions with frequent seismic changes in mind to ensure they can spend more time in the future managing their businesses and less time evaluating new or replacement platforms to meet their needs.

InterSystems’ view of resiliency involves accommodating rapid and frequent pivots, encouraging distributed self-service options, and being able to absorb unplanning spikes in volumes or types of data. Successful companies need to examine their operations to identify manual data entry and related non-scalable processes and replace them with automation.

Such companies will also need to invest time and attention in running scenarios, akin to what IT organizations do for business continuity and disaster recovery planning. Gnau’s message is that scenario iterations help identify potential points of weakness or disconnects that could be problematic in a future crisis.

Gnau also believes that building AI into solutions can help organizations stabilize themselves and adapt more quickly as disruptions emerge. Having tools and evaluation processes in place before the next event can help to “train” these technologies to adjust automatically.

Gnau advised viewers to be selective and choose long-term partners, not just vendors. This selectiveness is important during disruptive times because partners will be far more likely to be invested in your organization’s history, future, and success in navigating the current disruption.

These factors were considered in InterSystems’ design of the IRIS Data Platform, which connects disparate data sources and silos using machine learning-enabled applications. InterSystems has recognized an increasing number of organizations embracing and adopting AI and ML technologies, increasing demand for access to data and analytics, and an increasing number of migrations to the cloud.

InterSystems is investing in the following five areas to ensure they stay ahead of the types of shifts just described:

• Advanced analytics and AI—Machine learning will be integrated for broader use beginning this month, including models that customers can use.
• Speed, scale, and security—InterSystems has already demonstrated significantly faster response times, which will be essential as more devices connect in the coming months and years and volumes of data transactions are expected to multiply.
• Cloud and DevOps—This includes managed services for the cloud and IRIS FHIR Accelerator Service to support developers in more rapidly building, testing, and deploying their own solutions.
• Interoperability and IoT—Including the InterSystems API Manager, Kafka support, and OPC-UA adapter.
• Developer experience—Investments in VS Code IDE and support for most native languages that developers prefer or are best suited to a local solution.

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Financial Services: Adaptability in Times of Uncertainty

Michael Hom of InterSystems’ Financial Services division led a panel of experts in today’s final keynote presentation.

Marinela Tudoran began the session by describing Credit Suisse’s response to COVID-19. In her view, Credit Suisse was well-prepared to respond quickly, in part due to lessons learned from the 2007-2008 market crisis, investments the company made in flexible and robust technologies, and a workforce that was already quite familiar with remote work options.

These factors led to the company’s plans of moving 95% of their workforce to remote working over the course of a weekend. The most significant challenges with this switch seemed to have more to do with supporting clients who were not similarly positioned or experienced and had difficulty adjusting to remote workflows and communications.

Tudoran also felt that the company’s migration to the cloud was instrumental in their ability to scale and adjust to volume fluctuations intelligently. For Credit Suisse, it is also important to note that many individuals working remotely require powerful systems in their homes to do their jobs and have real-time access to market signal information. This requirement will certainly be a consideration for companies in similar fields, where planning ahead of time and making such investments well in advance of any disruption is critical.

Alex Conceicao offered an overview of Brazil’s banking system and highlighted the central bank’s schedule of moving to open banking and connecting approximately 1,000 banks in the near future. The original plan was for banks to connect to one another. However, due to costs, logistics, timelines, and maintenance, banks have begun to rally around the idea of standing up a national hub that supports connectivity between any number of institutions with a single connection for each bank. Privacy and policy questions remain, but this is the technological blueprint for the country at this time. Plans are expected to play out in 2021.

Jittu Lulla, Wealth Architect at Broadridge, shared his company’s approach to organizing data to support analytics. The essential process has focused on ensuring that data is strongly governed from the time it arrives, is cleaned, then stored in a data lake. The company’s data is stored with metadata that helps the company use and aggregate data efficiently to support quick insight delivery. Lulla described the components of normalizing data, organizing it in a logical manner, creating APIs to access it easily, and applying robust security and control as a “data fabric.”

Tudoran described Credit-Suisse’s use of machine learning approaches to proactively identify internal and external points of failure and help predict problems occurring within their own systems as well as on behalf of their connected partners. They have been able to alert trading partners ahead of time when they detect activity that might indicate a potential system failure.

One example of the use of data in Brazil is security device information and surveillance. Conceicao presented Brazil’s endeavors to share and analyze data from approximately 90,000 security cameras and devices to pinpoint security breaches and threats at physical bank locations. This effort is an attempt to be more proactive in reducing risks and disruptions.

The panelists ended the discussion by providing advice to viewers about some of the best things companies can do to prepare for the next major crisis. Ideas included: improving and thinking through flexible communication solutions and policies, especially as communication needs change by time of day or by division; offering your company’s expertise and solutions to partners that might pose a risk if they are not operating at the same level of readiness as your organization, and making a commitment to move to the cloud.

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Day One Summary	Day Two Summary	Day Three Summary

Thank you for joining us for today’s recap. J2 has been a trusted InterSystems Implementation Partner since 2004. Learn more about us and our involvement in InterSystems Virtual Summit 2020.