Integration models

Pensieve sits beside an incumbent system, runs as the whole platform, or moves between the two in phases, and each shape can also feed the hospital's own data platform. This page describes each model, what runs where, which system keeps each record and what the hospital provides.

The models side by side

The shape follows from one decision per domain: which system keeps registration, admissions, orders and billing. That decision sets the feeds the bridge carries. The table compares the four models on the questions that decide a deployment.

Beside an incumbent system

An incumbent HIS or EHR keeps the domains the hospital leaves with it, such as registration, admissions or billing, and stays their system of record. Pensieve runs the clinical record, orders and results, and holds a following copy of each domain the incumbent owns, refreshed as the incumbent's messages arrive.

The incumbent's admit, transfer, update and discharge messages and the laboratory's results arrive through the bridge over HL7 v2 or FHIR. Each becomes a typed fact for Gate, Atlas or Forge. Orders leave through the governed outbound path, and an incumbent that takes FHIR receives Pensieve's patient and encounter changes over a direct connection, as a Patient with its Encounter.

Vault runs in whichever of the three billing modes fits the domains the incumbent keeps. The hospital provides a host for the bridge, an interface specification and sample messages for each feed, and a decision on which system holds each domain. How that decision works is set out in system of record and coexisting with an existing system.

As the whole platform

Pensieve runs every function from registration to billing. Gate registers and admits, Atlas holds the record, Forge places and tracks orders, and Vault bills and keeps the books.

The bridge then carries only the departmental systems the hospital keeps: a laboratory information system over HL7 v2, and analysers over ASTM where no laboratory system sits between. For imaging it carries the study references and worklist entries, while the studies travel from the imaging source to the Pensieve imaging store on their own path. National, payer and provider services are reached from the platform, as in every model.

Pensieve is the system of record for each domain it runs, and the laboratory system or analyser stays the source of the raw result it produces. The hospital provides a bridge host for the departmental systems it keeps, and its own registrations and accounts for the national, payer and provider services it uses.

A phased move

A phased move starts beside the incumbent and moves domains to Pensieve one at a time, towards the whole platform. Each step is a set of connection changes, and billing moves by switching the site's billing mode. For each move, the hospital provides sample messages for the connections that change and decides which domain moves next.

1. 1

   Prove the new path

   Each connection the moving domain needs passes a dry run on a sandbox site before it is activated, as proving an integration describes.

2. 2

   Start the work in Pensieve

   The hospital reassigns the domain's system of record to Pensieve in Westron, as system of record describes, and staff begin its work in the Pensieve tool that owns it.

3. 3

   Retire the incumbent feed

   The feed that carried the domain from the incumbent is retired by a clean disconnect, as running an integration describes.

4. 4

   Switch the billing mode

   The site's billing mode changes, and a switch is refused while a payment is pending. Every money record keeps the billing mode it was raised under, and each switch is recorded.

Feeding the hospital's data platform

The hospital's warehouse takes its data from Pensieve through export. The self-service export in export and exit carries whole records, and the analytical exports Falcon produces on the platform are de-identified by default. The hospital provides the warehouse, and its own users run the export.

Analysis that needs current data runs inside Falcon, under the same read checks as any tool. An outside warehouse or BI tool has no live connector, replication feed or SQL access, so export is its route to the data, as analytics and data out describes.

Common confusions

Read how an incumbent's feeds connect in hospital information systems, and how the billing modes meet an outside finance system in tax and finance systems.