Presenter(s):

Marilee Benson
VP of Sales, Mirth

Topic
Mirth 101 Solutions Introduction

Level
100

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 Things our lawyers make us say...

Neither NextGen Healthcare nor any presenter at the ONE

User Group Meeting is engaged in rendering legal or other
professional advice and this presentation is not a substitute
for the advice of your attorney, accountant and/or other
professional advisor.

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 Session Guidelines

Silence all cell phones

Questions will be addressed at the end of the
presentation
Refrain from personal discussion

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Whats all the smiling about?

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Why are NextGen Clients using
Mirth?
Desire enhanced interfacing 35+ NextGen
capabilities
Solving problems related to
clients are
having providers using multiple also Mirth
EMRs Commercial
Solving MU Qualification
challenges
Clients
Managing care transitions
Participating in value based
payment models

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 The Challenges of Interoperability

What Where How Frowns

Complexity of Data Environments Workflow

Structured: State/Private HIE Outside of the EHR
HL7 Hospitals Integration with
C-CDA HISP clinical workflow
CCD/CCR eHealth Exchange 3rd Party portals
IHE Registries Document
SNOMED-CT Labs management
ICD-9/10 Limited data import
Unstructured data Financial / Business
Images Protective business
Narrative notes practices
PDFs Technology costs

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 Overcoming the Challenges of Interoperability

What Where How Mirth Smiles

Complexity of Data Environments Workflow

Structured: State/Private HIE Outside of the EHR
HL7 Hospitals Integration with
C-CDA HISP clinical workflow
CCD/CCR eHealth Exchange 3rd Party portals
IHE Registries Document
SNOMED-CT Labs management
ICD-9/10 Limited data import
Unstructured data Financial / Business
Images Protective business
Narrative notes practices
PDFs Technology costs

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 Data Translation & Routing

What Complexity of Data

Structured:
HL7
C-CDA
CCD/CCR
IHE
SNOMED-CT
ICD-9/10
Unstructured data
Images
Narrative notes
PDFs

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 Patient Identity Management

Where Environments
State/Private HIE
Hospitals
HISP
eHealth Exchange
Registries
Labs

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 Health Information Exchange

Workflow
How Outside of the EHR
Integration with
clinical workflow
3rd Party portals
Document
management
Limited data import
Financial / Business
Protective business
practices
Technology costs

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 Community Wide EMR-Agnostic
Care Management

Workflow
How Outside of the EHR
Integration with
clinical workflow
3rd Party portals
Document
management
Limited data import
Financial / Business
Protective business
practices
Technology costs

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 Mirth Suite of Products

Mirth Connect
Data Integration Engine
Mirth Results
Central Data Repository & Provider Portal
Mirth Match
Enterprise Master Patient Index
Mirth Analytics
Data Warehouse & Reporting
Mirth Mail
Secure Direct Messaging & Provider Directory
Mirth Care
Chronic Disease Management and Care Coordination

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 Direct Messaging,
HealtheWays
DirectTrust HISP
IHE Exchange
Provider Directory

Mirth
Care Mirth
Mail

Mirth Mirth Mirth

Match Results Analytics

Mirth Connect Mirth Appliance

Mirth
Ready-to-Run Platform
SignOn for Mirth Application

Disparate EHR Systems

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Mirth Suite
Hospital RX History
Data flow System Imaging
Vendor A Registry VA/HIE Query 3rd Party
Query BI Tool
eHealth
IHE Exchange Web
Exchange
(XDS.b) services

Mirth Match Mirth Results Mirth Analytics

EMPI CDR w/Provider Portal Data Warehouse
Establish Patient Aggregate, Normalize Patient Get data BI ready
identity Data

Results &
Mirth Appliances Alerts
Ready-to-Run Platform Mirth Mail Notifications
for Mirth Application Mirth Connect Integration Engine Direct (HISP) Platform via:
-Fax
*Message Data -Direct
Push or Pull -HL7
-Custom
Hospital Physician Physician Physician
System Practice Practice Practice
Vendor A Vendor B Vendor C Vendor D

*HL7, X12, Flat files, Batch, CCD,

Consolidated CDA, and EHR Integration
 Mirth Connect

Health Information Systems

Lab Pharmacy Radiology Clinic Hospital

Different Protocols Incompatible Data

Diverse Connectivity
Mismatched Versions Lack of Control
Expense of Proprietary Lack of Flexibility
Solutions
HIPAA Privacy & Security

applications, protocols, connectivity, etc.

Legacy
Reporting Web Services Database
Applications

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 Mirth Connect

Health Information Systems

Lab Pharmacy Radiology Clinic Hospital

Routing Extensible
Filtering Powerful
Transformation Flexible
OSS Based Reliable

applications, protocols, connectivity, etc.

Legacy
Reporting Web Services Database
Applications

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Mirth Connect Administrator Dashboard

Channel Status Connection Status

Message Counts Connection Log
 Channel Pattern Flexibility
Integration Broadcast Router Chaining

S S S S
S

F F F F F F
F

T T T T T T
T

D
D D D D D D D D D D
 Mirth Connect Administrator

Create Mirth Channels to

define data interfaces using
the included Mirth Connect
Administrator.

S Source Connector inbound data

F Filters message flow & routing

T Transformers extract & reformat

D Destination Connectors outbound

data, one or more
S

F F F

T T T

D D D
 Channel Architecture

Source Connector

Channel
Conversion to XML
Message data accessible
using JavaScript and E4X. Filters and Validation
This is known as the
transformed version of
the message. Transformers

Conversion from XML

Destination Connectors
 Mirth Connect 3.0
Advanced Alerting Module

Fine Grained Monitoring

Message Thresholds
Escalation Levels
Do-Not-Disturb Periods
Free to Mirth Connect
Platinum Customers

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 Mirth Connect
Open Source versus Commercial

Mirth Connect Open Source is available free for download

Only community support available
Does not include commercial plugins

Mirth Connect Commercial Licenses

3 Levels of Mirth Commercial Support Available
3 Levels of Plugins (advanced features)

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 Mirth Connect Options

Silver Annual Subscription - $5,000 Annually

Email support from Mirth
Limited to 10 support tickets during business hours
3 plugins
SSL, Channel History, Message Generator
Licensed per instance of Mirth Connect

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 Mirth Connect Options

Silver Platinum Subscription - $30,000 Annually

24 X 7 Support via Phone and Email
Unlimited tickets, 1 hr. response SLA
11 plugins
Advanced Alerting, Roles Based Access, LDAP, Email
Reader, CDAPI

Licensed per instance of Mirth Connect

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 Mirth Appliances

Mirth Products can be deployed using

one of three convenient deployment
options:
1. Mirth Physical Appliances in your
data center;
2. Mirth Virtual Appliances running on
a VMware or Xen-based virtual
infrastructure in your data center or
using a third-party hosting provider;
3. Turn-key Mirth Hosted Appliance
service managed by the expert
engineers on Mirths Operations
Team.
Select the standard approach that best
fits your needs, or talk to Mirth about
your unique requirements.

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 Mirth Hosting Internet
Architecture
Mirth designed and hosted Pfizers InformaCare Firewall Firewall
infrastructure from 2000 to 2010
Mirth application hosting since 2008
100% focused on hosting Mirth healthcare Switch Switch
software

BLADES
SERVER
Hosting 270 servers in Denver, CO (Primary)
BladeServer Chassis
DR Site is in Irvine, CA
SLA of 99.9 uptime%
SSAE16/SOC 2 Type II and SOC 3 certified data Clustered StorageServer
centers
VMWare Mirth Appliances Primary Redundant
Encyption-At-Rest Upgrade coming

DISKS
Primary Disk System

Backup Integrated StorageServer

DISKS
IRVINE, CA DENVER, CO Backup Disk System
 Mirth Appliance Features
PostgreSQL Database built-in
Web-based management interface
Direct console interface with shell access
Built in SFTP server
VPN server for remote client access
SSL support for inbound and outbound
connections
Integrated certificate authority
Automatic software updates
Backup and recovery
Scheduled backups
Connect to network drives
Clustering support with automatic failover
(Mirth Connect)
SupportNet for remote support

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 Mirth Match EMPI

Enterprise Master Patient Index (and other MDM use

cases)
Handles typos, misspellings, transpositions, aliases
Probabilistic Matching
API Available to Register and Search
Data Stewardship for uncertain cases (Work Queue)
Highly Configurable Matching Algorithm

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 Fellegi-Sunter Matching Module

Fellegi-Sunter Algorithm
Tuned and configured for a specific entity domain (e.g.
Patients, Providers)
Analysis workbench
Load 100K+ of real data, 2-3 weeks of tuning
Matching configurations
Trait value comparators for each trait you choose

30
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 Data Stewardship - Work Queue

List
View

Detail
View
 Results/Match Integration

Results uses Match to aggregate patient records from

different sources into a single view
By cross-referencing demographic info
Data flows from Results to Match
Results adds demographic data to Match automatically

32
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 Mirth Match/Results Architecture

EHR,
Clinic, or
Lab

Mirth Match Entity

ADT Domain
HL7
Hospital Clinic Lab
(Identifier (Identifier (Identifier
Domain) Domain) Domain)

Mirth Mirth
Connect Results
Patient Records Patient Records Patient Records
w/ Demographics w/ Demographics w/ Demographics
Web Services (Entities w/ Traits) (Entities w/ Traits) (Entities w/ Traits)

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 What is Mirth Results?

Clinical Data Repository

Patient Longitudinal Health Record
Provider Portal (VHR)
Payer Portal
Supports complex consent and confidentiality
ADT & Results Notification Platform
XDS Repository
Federated Exchange
3rd party System queries
Surescripts Med History
PDMP Programs
eHT Imaging
State Immunization Registry

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ConfidentialProprietary InformationFor use by authorized NextGen clients and employees only. Not for public distribution. Copyright 2014
 Provider Portal User Preferences

Portal end users

can customize the
Patient Chart view

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 Download/Shar
e CCDAs

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 Or
Download
/Share
Reports

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 The Invisible HIE Enabling Care Transitions

The Events Subscription Module allows the automatic,

behind the scenes rules based distribution of information to
the appropriate care team members.

For example, automatically forward a Direct Message to

the PCP when a patient is discharged from the Hospital
(with a CCDA).

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 The Invisible HIE Enabling Care Transitions

ADT message

Mirth Results CCDA

CDR Rules
Connect Engine
CCDA

Match

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 Mirth Mail Direct Secure Messaging

Optional DirectTrust HISP Services if Mirth hosts for you

Always branded for your organization
Pricing starts at 100 mailboxes
Annual Subscription or Perpetual License Options
Offers a Secure Web Client for providers/care team
members who dont have access to a Direct Enabled
EMR
If you are 100% NextGen organization, then:

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 WEBMAIL
CLIENT

PROVIDER Web
DIRECTORY Registration

ADMIN UI
 Mirth Analytics

Data Warehouse just for Mirth Results

Builds Snowflake Schema from de-normalized, coded data
from Mirth Results
Expedites creation of multi-dimensional data cubes used
to generate clinical and operational reports
Leverages 3rd party Business Intelligence tools like:
Pentaho (BI Tool) and iReports

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Dashboards Using Analytics Data

Pentaho
Dashboard
Report using
Mirth Analytics
 Mirth Care

Developed over 10 years in partnership with Pfizer

EMR Agnostic Chronic Disease Management Platform
For healthcare organizations that have dedicated Care
Management teams that are managing chronic illnesses
and need to work on a care management platform that
can leverage data across multiple EMR systems.

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 Mirth Care
Capabilities
Clinical Decision Support Mirth Care
Disease Registry
plugs into
Clinical
Assessments/questionnaires the Mirth
Fulfillment HIE Suite to
Patient Education facilitate
Medications data
Care Coordination
integration
Task Centric Workflow
Secure Messaging

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 Direct Messaging,
HealtheWays
DirectTrust HISP
IHE Exchange
Provider Directory

Mirth
Care Mirth
Mail

Mirth Mirth Mirth

Match Results Analytics

Mirth Connect Mirth Appliance

Mirth
Ready-to-Run Platform
SignOn for Mirth Application

Disparate EHR Systems

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 Any Questions?

Marilee Benson
VP of Sales
marileeb@mirthcorp.com

ConfidentialProprietary InformationFor use by authorized NextGen clients and employees only. Not for public distribution. Copyright 2014