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Cedars-Sinai

Los Angeles-based Cedars-Sinai Medical Center is one of the largest non-profit academic medical centers in the United States. Approximately 2‚000 physicians in virtually all medical specialties serve Cedars-Sinai’s patient population. Known as a leader in its use of advanced technology and in quality healthcare delivery‚ Cedars-Sinai ranks among the nation’s best in U.S. News & World Report’s 2010 “America’s Best Hospitals” guide.

Cedars-Sinai made the decision to switch from its SeeBeyond eGate interface engine to more powerful and more reliable software. It needed a product that could support its vision of a “single system environment” for its clinical IT platform‚ which over time had grown to 412 clinical applications‚ including 17 electronic medical record systems (EMRs). This vision included a plan to replace these EMRs with a single EMR from Epic Systems‚ and to integrate it with internal and external applications for a seamless user experience. To make this vision of connected healthcare a reality‚ Cedars-Sinai needed an advanced integration platform with the ability to:

Interfacing has changed. It’s now more about outcomes and effective use and sharing of information than just about moving data from one application to another. The robust information management provided by Ensemble is as important to us as the details of what we’re sending.

Darren Dworkin, CIO
Cedars-Sinai Medical Center

  • Support more standards than just HL7
  • Connect physicians and public health organizations outside the hospital to its internal resources
  • Extract and integrate data from sources such as medical devices
  • Transform documents and terminology‚ not just messages
  • Centralize its data management activities
  • Aggregate data for a holistic patient view
  • Provide the right information at the right time‚ wherever it’s needed

After an evaluation of several leading integration products‚ Cedars-Sinai chose the InterSystems Ensemble® rapid integration and development platform to replace eGate. “Interfacing has changed‚” notes Darren Dworkin‚ Cedars-Sinai CIO. “It’s now more about outcomes and effective use and sharing of information than just about moving data from one application to another. The robust information management provided by Ensemble is as important to us as the details of what we’re sending.”

Integration‚ beyond interfacing

Before adopting Ensemble‚ Cedars-Sinai supported nearly 500 eGate interfaces (real-time and batch) between all of its systems. Ensemble’s rapid development environment was crucial in ensuring that the eGate interfaces could be replaced quickly‚ without delaying the EpicCare deployment‚ and without impacting hospital workflow. “What we were attempting was like changing the engines on an airliner while it’s in flight‚” explains Dworkin. “Our interfaces are that crucial to the operation of our institution.” All Cedars-Sinai interfaces now run on Ensemble‚ which is prCedars-Sinai uses Ensembleocessing an average of 6 million HL7 messages per day‚ plus non-HL7 messages such as X12 and custom formats.

As the organization moves forward Ensemble is the foundation for breakthrough integration work. “We’ve moved beyond just picking up data at point A and safely delivering it to point B‚ without any transformation or use that affects the user‚” says Dworkin. “The reality is that now we’re saving that data‚ transforming it‚ interpreting it‚ and creating new information based on it.” Ensemble’s embedded InterSystems Caché® database and its automatic persistence of messages provides the foundation for a rich information environment that is helping Cedars-Sinai improve care and business performance.

Integration across boundaries

Key Benefits

  • Platform for connected healthcare
  • Robust information management
  • Health information exchange


With the rising importance of health information sharing across organizational and geographic boundaries‚ the need to support more standards and profiles than just HL7 has become a necessity. “HL7 is not the only standard important in healthcare IT‚” explains Dworkin. “Now it’s as much about Web services‚ SOAP‚ X12‚ CCD‚ IHE‚ HITSP and other standards and profiles‚ as it is about HL7.”

Ensemble supports these and other standards‚ making it possible to address the widest range of integration tasks with a single product and a single graphical user interface. “By enabling us to do as much of our work as possible inside the integration platform‚” says Dworkin‚ “Ensemble helps us limit the number of moving parts for an easier-to-manage and more reliable system.”