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For the staff of Credit Valley Hospital in Mississauga, Ontario even a momentary glitch in the facility's information system could mean more than just a minor hindrance.
For instance a delay in radiation treatment could set back a series of other related tests and procedures.
"We operate in a 24-7 environment and delay impacts patients, some of whom have waited long to get treatment," said Avril Cardoso, manager, application services at Credit Valley.
According to a report from Cancer Quality Council of Ontario the average wait for radiation treatment in the province last year was about 33 days.
To enable better patient care, medical and support staff use a variety of clinical applications to access data such as patient demographic information and other components of the electronic health record stored in its hospital information system (HIS),
Seamless interoperability of HIS with the hospital's radiation treatment planning system is very important in preventing patient logjams.
Credit Valley uses a planning system called VARiS from the Varian Medical Systems Inc. based in Palo Alto, Calif. Medical Information Technology (Meditech) Inc. of Westwood, Mass, provides the information system.
The hospital transferred data between HIS and VARiS, Credit Valley using Microsoft BizTalk Server 2004 .
The hospital also used BizTalk Accelerator to provide the necessary schemas and validation rules for BizTalk to understand the health Level 7 (HL7) messaging standard used for electronic data interchange (EDI) in hospital environments.
With the opening last year of its Carlo Fidani Peel Regional Cancer Care Centre, Credit Valley found the need to upgrade its system to reduce downtime and improve the management of system errors.
After consulting, Cactus Commerce Inc., an e-business service firm based in Gatineau, Quebec, Credit Valley decided to upgrade to Microsoft's BizTalk Server 2006 and version 3.0 of Accelerator.
Cardoso said under the scheme, patients are registered in HIS. BizTalk 2006 picks up the information and sends the data to VARiS. Both systems send out a message acknowledging the receipt of information.
"The benefit to the oncologist is that they know the patient has arrived and they can see the patient's demographic information which is integral to the clinical decision-making process."
Cardoso said with BizTalk Server 2004, IT technicians found it difficult to pinpoint errors when the system fails to transmit data. "If a radiation oncologist called us to say they can't find a patient in the system, we really don't have a way to find out what the problem is."
Chris Brakel, e-business program manager for Microsoft Canada said the key advantages that Credit Valley found with the newer software were faster tracking capability and better systems diagnostic features.
"The IT staff noticed faster tracking capability that allowed them to chart hospital traffic and workflow," said Brakel.
He also said the BizTalk 2006 consolidated management functionalities in a console that provided a single interface for configuring, deploying and running applications across multiple servers. "Instead of requiring an IT administrator to search for problems, the console Group Hub pages display them in easily identifiable colour-coded indicators."
BizTalk 2006 automatically sends an e-mail or text message to alert administrators when the system fails to transfer patient data between applications.
"Rather than reacting to the complaints or calls of the hospital staff, our IT team can pick out the problem the moment it surfaces on the screen," said Cardoso.
"In an acute care environment, you want to know and fix a problem before the clinician discovers it so that workflow is not disrupted," she added.
To further streamline the process, Credit Valley recently launched a self-registration kiosk similar to those used in the US.
"The automated patient registration allows unit clerks to focus time on task associated with patient care," said Cardoso.
With the help of BizTalk, Credit Valley intends to roll similar kiosks in 20 other locations across the hospital.
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