Building 'the glue' for the Electronic Health Records (EHR) by linking systems essential for business and clinical operations smoothly scale from modest beginnings to beyond 6,000,000 HL7 messages per year.
With 2,200 staff caring for 45,000 inpatients and 155,000 outpatients annually, the Sydney Adventist Hospital (“The San”) is one of the largest and busiest private hospitals in New South Wales.
Until 2010, The San had a number of direct interfaces between The San applications running on the Microsoft platform and a range of third party systems. These systems provided functions such as Patient and Nurse Management, Pharmacy, Pathology, Inventory, Radiology, Theatres and Cardiac Catheter Lab.
The nature of the infrastructure made diagnosis of integration issues challenging. Furthermore, the integration architecture could not be readily scaled to support the increasingly complex information exchanges, workflows and message volumes that were expected to arise from The San’s investment in the electronic health record.
MOQdigital were engaged to develop an architecture that would solve the immediate problem while also providing a platform that would augment The San’s ability to manage the majority of their integration requirements and further develop their HL7-based services. A solution was proposed that had BizTalk at its heart, and could address the major business problem in terms of a richer HL7 environment with centralised and proactive monitoring.
MOQdigital quickly delivered a comprehensive proof-of-concept solution, based on the above, and with new interfaces to selected 3rd party products. Following the pilot phase, MOQdigital provisioned an architecture for a complete solution comprising Developer, Test and Production environments. The overall structure also described the protocols for the generic BizTalk interface and the associated development processes. Once these core elements were in place, it became much easier to develop new interfaces based on those already in place, including leveraging BizTalk’s broadcast messaging capabilities.
In addition to providing technical leadership, MOQdigital developed an enhanced monitoring capability. With an emphasis on quality of information, the objective was that problems could be anticipated before they would arise, or could be diagnosed more reliably. The effects of this initiative were that the business users were insulated from technology issues, and there was quality data available for capacity planning at The San. In addition, the IT support personnel had fewer out-of-hour calls, and could spend more time managing and less time firefighting.
Working closely with The San’s experienced development team and health informatics project manager from EpiSoft, MOQdigital developed and enhanced monitoring capability as well as providing outstanding technical leadership in solution architecture development. “This is a very comprehensive example of how integration directly impacting front line patient care can be delivered using Microsoft BizTalk Server. With an increasing focus on health information exchange in the national health reform process, the progress that The San and MOQdigital have made is compelling in terms of its clinical and business impact.” Dr Simon Kos MBBS, Clinical Advocate, Microsoft Australia.