The following discussion focuses on the performance, uptime, stability, and manageability of Corepoint Integration Engine  running in a Windows environment.
On a visit to Cedar Rapids, Iowa, Corepoint Health Founder and CTO, Dave Shaver sat down to interview UnityPoint Health Technical Team Lead – Interoperability refers to the ability of two or more systems or components to exchange information and to use the information that has been exchanged., Joe Hamilton. Their conversation covered a variety of topics ranging from operating system performance, integration engine evolution, the growth and change of the healthcare industry, and ways in which engines and engine teams can impact patient care.
Part 1: Operating system considerations and platform performance
Part 2: A more productive team 
Part 3: Building and supporting interfaces 
Part 4: Impact of an integration engine on patient care 
Dave: So, we’ve talked a lot about infrastructure, and Windows, and Unix. And related opportunities for downtime and performance. And the overall implications of testing. Lots of topics we’ve talked about. Give us a sense of the size, and scope, and scale of the engines you guys are running. That kind of thing with your 11 team members.
Joe: So, we run two separate engines. We have bedside monitoring devices on an engine all by itself. There’s a hundred… Let’s see, around 125 interfaces on that engine. Very high volume. Very low complexity. So, we separated those off. Because those will tend to be … Any site that we get, typically, will have devices. And so, we want to keep those all in one place.
Running on the Windows platform. The great thing about what we have is we have it virtualized. So, that if we ever have a need to add processing power, or add memory, we can do it without a whole lot of effort. It literally is, throw more resources at it and it’ll work. And the same is true with SQL. The more memory you give SQL, the faster it’s going to get. The more it’s going to do. So yeah, I mean, it makes sense to have that Windows platform where it’s easy to grow and not have to worry about the consequences. Our previous product, we had downtimes once, twice a month, easy, with very little support from the vendor.
And, it was an interesting conversation to have when we were looking at Corepoint. Mainly because previous platforms ran on Unix base. Right, because everybody’s like, ‘you can’t use Windows. Windows isn’t stable enough to handle an engine. It’ll go down.’ On and on and on. Corepoint runs on Windows. Previous platform didn’t. We had a whole lot more downtime with the previous platform. We had a solid 15 months of uptime straight with Corepoint. And that includes taking maintenance on the Windows servers without a downtime. An experience that I never dreamed would actually come true. I’d hoped, granted, but in my 15 years of healthcare IT, I don’t think I’ve ever seen a system that’s as stable as what we’ve got now with Corepoint.
Beyond the Video
- Additional insights about previous integration engine vendor
- Highlights of experience with system maintenance & operation
- Rapid speed to productivity during transition
Joe: Going back to the old vendor, I remember specifically an experience where we had an engine downtime in the middle of the night, and we tried to call. Nobody answered. That’s the scariest thing in the world when you say, “What am I gonna do now? The engine won’t start back up. How am I going get this going when I can’t get vendor support to do it?” Very much a nightmare scenario. We were down that time for eight or nine hours. It was just a nightmare. During that time, our patients aren’t being served properly. They have to go back to paper. They have to call and fax results. All of the benefits that they get from us moving the data are gone.
Dave: On the efficiency front, on platforms, give some sense of the maintenance requirements, the monitoring requirements, the up and downtime requirements for your platform, which includes your operating system, your SAN, your servers, your VM environment, and your engine… Compare and contrast your prior engine, which ran on Unix, to where you are now with your Corepoint engine.
Joe: With Corepoint, obviously it runs on Windows. The disk is SAN based, just like it was on Unix. The difference being now that we run Windows virtual machines, so it’s supported by a team. At the root, the Unix was never down, but again, the Java was, and we were supporting that. Now, because we have the A2 technology (high availability)  of Corepoint, which allows us to have two engines running with basically a hot backup, if something happens to that primary engine, the secondary – the A2 partner – picks up and runs with it. We don’t experience any downtime. It’s all automatic. We’ve actually had some downtimes averted from infrastructure problems by that very thing.
So that’s probably the biggest thing. The fact that we had downtimes regularly with our previous engine… 11 people on my team could do nothing when it was down. Downtimes are very expensive from a labor perspective. Everybody’s sitting there wondering, “What do we do? Can’t do any work until that comes back up.” Very expensive. Minimizing downtime equals big savings to the organization.
Dave: Back to that patient focus, as a service to your customers, your providers, your lab technicians, your referring physicians, your community, your patients, as far as they’re concerned it doesn’t matter whether it’s Unix or Windows.
Joe: Correct. What they care about is, does the system work when I walk up to do my job? Put myself in the patient’s shoes. If I walk in, I just expect stuff to work. I don’t want to walk in and have the doctor say, “You know what, sorry, can’t treat you today because I can’t get to my information.” We’d never want that.
Dave: In your experience, what differentiates vendors? It’s fair to say, even as a guy that has spent 25 years in this industry working on integration for healthcare, most of the engines check all the boxes. What would you tell somebody that is looking at an engine and says, “Well, I like the Corepoint platform, but it runs on Windows, so that’s going to cause reliability problems.”
Joe: I think the best thing is to talk to people that are already using it. I know that vendors tend to say, “Why don’t you talk to some customers of ours?” And they’re going to pick people that are going to say the best things. But I also encourage any site that’s looking to say, “Can we have a copy and play with it?” I think that makes all the difference in the world. Or maybe say, “We have this complex workflow. How would you deal with it?” If the vendor says, “Gosh, I don’t have a clue. We’ll get back to you on that.” That’s a whole lot different answer than, “Yes, we can do it. There’s some sort of this, this, and this. I will have to double check to be sure.” And then following that up with saying, “Here’s how we would do it.”
I don’t know who sits in all of the vendor sales meetings, but for us the experience was very good. The folks that we talked to from Corepoint were able to say, “Here’s how we would do that.” And then being able to play around with the product and create something without having a lot of practice. We didn’t go through two, three classes before we first saw the product. When we acquired, merged with the other hospital, and they had the Corepoint platform, we were able to look at that engine and actually do things on it without ever having a bit of training. That says something to the ease of use, the usability of it. And that ease of use will translate to efficiencies, which means we can get more done in less time, with fewer people, which will better serve our customers and our patients.
Dave: I think about all of the UnityPoint IT folks, all of you running around and working on the servers and making sure it’s reliable. I think it’s interesting to compare and contrast. The same focus and quality you bring to the job in support of Corepoint, you tried to do the same thing with your prior engine, but you had very different experiences.
Joe: Very much so. I don’t think that we could guarantee quality. We certainly couldn’t guarantee uptime. The claim to fame for running on a Unix platform was Unix never goes down. Yeah, but that engine ran on Java on top of Unix, and Java goes down.
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