The world of super integration

This article appears in the issue April 2007 [Volume 16, Issue 4]
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Last summer, in a very quiet acquisition, Microsoft purchased a health intelligence software product called Azyxxi, which was the brainchild of Dr. Craig Feied, Dr. Mark Smith and Fidrik Iskandar of MedStar Health. That acquisition by Microsoft underscores the importance of “smart systems integration,” a phrase I use to describe “systems of systems” that perform exceptionally well together, are highly reliable and really change the way people work. I’ve had the good fortune to meet with and get to know the Azyxxi development team over the past couple of years, and they definitely have something to teach us all about integrating knowledge management systems.

Azyxxi, a name chosen so that it would never be confused with any other product or company, was designed to integrate the multiple heterogeneous software systems (including knowledge management technologies) that have grown up over time within hospitals and large medical establishments. The point of Azyxxi is to provide doctors and medical practitioners with as much information about a patient as quickly as possible in order to improve medical outcomes. Azyxxi was designed for one simple reason, to save lives, and it is exceptionally good at that task.

In the mid-1990s, Feied and Smith were working at Georgetown Medical Center in Washington, D.C., a MedStar hospital, and were asked to move over to the Washington Hospital Center to solve some serious problems in its Emergency Medical Department. The Washington Hospital emergency room was experiencing major issues with patient throughput, treatment times and outcomes. At that time, the emergency room was able to treat 35,000 patients a year at most, and patient waiting times for processing and treatment could run as long as six to eight hours.

Today, with the help of Azyxxi, patients are processed within minutes of arrival, and the emergency room treats over 70,000 patients a year. The secret is the super integration of heterogeneous hospital information systems that Feied’s team enabled, using Microsoft’s integration tools and relational database management systems. Azyxxi ties together hundreds, if not thousands, of unrelated systems using a wide variety of data types in order to provide an immediate, updated composite portrait of the patient’s healthcare history. Amazingly, Azyxxi went live in late 1995 and has remained fully operational for the past 12 plus years without interruption.

Azyxxi is a great example of the wonderful systems integration tools available today that can deliver comprehensive, extendable and reliable integrated solutions. In its latest instantiation, the Azyxxi software uses Microsoft’s .NET software integration tools. The .NET software ties together relational databases, imaging software, medical telemetry systems, paper scanners and optical character recognition services, communications packages and a variety of KM tools that provide data metatagging, search engines, analytics and, of course, a user interface that people love.

All of Azyxxi’s components are integrated using powerful middleware software that allows the creation of standard approaches and tools to interface with the myriad software and hardware systems found in hospitals. Azyxxi is a good example of the type of integrated enterprise software systems that IT managers in the business world need to build to make use of the wide variety of information and knowledge management tools, data types and data sources that are available today.

Microsoft’s .NET development tools are but one example of the kinds of super integration technologies that are available for use in building integrated “systems of systems.” There are tools from companies like webMethods and BEA  that use enterprise Java technologies. TIBCO, IBM, Oracle/PeopleSoft, SAP and other software and data integration vendors sell a variety of different integration tools that support a variety of software development languages and technology approaches, which make it possible for enterprise IT managers to build complex and highly reliable integrated solutions.

There are also a growing number of emerging open source and commercial technologies for rapid scripting of Web applications including: Ruby on Rails, PHP, Python, Cold Fusion, JavaScript and others. Those tools are providing developers with unprecedented ability to rapidly integrate different information technologies into sophisticated Web applications.

The tools are on a level of sophistication with object-oriented Enterprise JavaBeans or C# programming languages, but without the often complex or cumbersome engineering quality controls needed for those kinds of tools. The emerging technologies lead to integration projects that deliver real value in a fraction of the time required by more traditional enterprise or Web development tools. While programming is still programming and good engineering approaches, common standards and sound quality assurance practices are necessary, the new Web scripting tools really do offer much faster systems integration outcomes than traditional programming tools of the past.

There is also an emerging revolution in the availability of new integration tools to deliver smart Web-based user interfaces. IT managers working within the business intranet, extranet or commercial Web-oriented software development industry (which is almost anyone developing software these days) should make an effort to become well versed in the newly emerging technologies for building rich Internet applications (RIAs).

Developers have an increasingly large stable of new commercial and open source technologies and products they may use to deliver intelligent, contextually powerful applications to the Web browser. That allows RIA applications the richness, ease of use, sophistication of design and complexity traditionally the realm of Windows or MAC graphical user interfaces common to client/server applications.

The technologies used to deliver those kinds of RIA applications include products based on asynchronous JavaScript and XML, such as General Interface (a TIBCO company), BackBase or JackBe. They also include products like Adobe’s Flex and ActionScript or OpenLaszlo, which allow RIAs to take advantage of the now ubiquitous Adobe Flash Player. Those technologies add tools that allow programmers to develop really smart client applications in the Web browser that are every bit as sophisticated, comprehensive, usable and cool as traditional Windows or MAC

Over the past few years, I have had the opportunity to invest in a variety of different point solutions that clearly fall into the knowledge management information technology area. They include image, audio and geospatial search engines and multilingual entity and entity relationship extraction
software, machine translation and transliteration systems and a variety of graphical data visualization tools.

Most of those technologies operate quite well as standalone point solutions to solve a specific business problem. However, I

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