Park Nicollet Health Services operates a major hospital and 25 neighborhood clinics in Minnesota. In 2006, the company’s move to a standards-based integration architecture was behind schedule due to technical problems with its existing application-integration solution. After evaluating competing technologies, Park Nicollet chose Microsoft® BizTalk® Server 2006 R2, part of the Microsoft Application Platform, as the core of its Enterprise Service Bus. With native support for electronic data interchange, BizTalk Server 2006 R2 can manage many of the company’s business processes faster and more reliably. In-house development experts work more efficiently by taking advantage of the software’s tight integration with the Microsoft .NET Framework. And Park Nicollet expects the number of Health Level 7–based transactions the system processes each day to increase from 1.5 million to 3 million.

By replacing our integration engine with BizTalk Server, our IT options expand exponentially: Not only do we have BizTalk Server features, we also have the whole .NET Framework environment available to us.  David Vensland Manager of Integration Services Park Nicollet Health Services

Situation

Park Nicollet Health Services is an integrated care system that includes Park Nicollet Methodist Hospital and 25 clinics. Based in St. Louis Park, Minnesota, Park Nicollet has more than 8,200 employees in clinical and administrative positions, including approximately 645 doctors.

When Methodist Hospital and Park Nicollet merged in 1993, the Integration Services team of the IT department was faced with having to integrate dozens of different systems—including GE LastWord and IDX Billing and Accounts Receivable—and applications from Cerner and Spheris. The systems processed thousands of transactions each day. To exchange information with each other, most of these systems rely on electronic data interchange (EDI)―mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)―and on Health Level 7 (HL7). EDI is a collection of standards for message syntax, protocol, and transport, and HL7 is a standard data exchange protocol used in the healthcare industry.

To support more efficient and flexible IT operations, Park Nicollet wanted to transition to an Enterprise Service Bus (ESB) model as a pathway to adopting a service-oriented architecture (SOA). ESB is messaging middleware that uses XML, Web services, and standardized rules to help business applications interoperate. Implementing a SOA helps integrate heterogeneous, distributed IT components into a simplified and highly flexible set of IT resources.

In 2004, the company chose Integration Composite Application Network (ICAN) Suite by SeeBeyond Technology Corporation as part of a more standards-based integration strategy, augmenting its older integration solution, DataGate (also by SeeBeyond). Park Nicollet chose the newer software in part because, unlike DataGate, it was based on a recognized standard development technology (Java Platform, Enterprise Edition). However, several technical problems occurred during the ICAN upgrade project, including difficulty implementing the software’s EDI functionality.

In 2006, Park Nicollet began looking for a new solution to integrate its applications and business processes. The company determined that in addition to supporting industry-standard development technology, the solution should provide centralized integration with comprehensive data monitoring, promote SOA design principles, and fully support enterprise-class Web services. Additionally, Park Nicollet wanted high reliability, straightforward deployment, and responsive, expert technical support.

Solution

After studying competing products, Park Nicollet sent a request for proposal (RFP) in February 2007 to several vendors and in June 2007 chose Microsoft® BizTalk® Server 2006 R2. The Integration Services team ranked the vendors on a variety of criteria and selected BizTalk Server for several reasons: First, Microsoft products and technologies provide the foundation of the company’s IT infrastructure, which is based on the Windows Server® 2003 Enterprise Edition operating system. Second, the company’s developers have expertise in the industry-standard Microsoft .NET Framework, which BizTalk Server fully supports. Third, the company was impressed with the responsive technical support that Microsoft offers. “The really phenomenal support that we have received with other Microsoft products was a huge deciding factor for us,” says David Vensland, Manager of Integration Services at Park Nicollet Health Services.

Additionally, Park Nicollet had experience with BizTalk Server 2006 and expected that the new version would also work well in the company’s IT environment. In March 2006, the year before the RFP, Microsoft had visited the company to demonstrate how EDI integration could work with the company’s electronic medical records (EMR) system using BizTalk Server 2006 and its separate EDI base adapter. This proof-of-concept demonstration was successful, and it effectively resolved the previous difficulty with EDI-formatted messages. Further, the EDI fix had required only one week for Microsoft to implement.

Right now, we process about 1.5 million transactions a day, and we expect the new BizTalk Server environment to handle 3 million as we extend our EMR implementation.  David Vensland Manager of Integration Services Park Nicollet Health Services

In August 2007, after using the Microsoft ESB Guidance and other resources for planning, Park Nicollet began replacing DataGate and ICAN with BizTalk Server 2006 R2 as the main integration engine for the company’s ESB. The Integration Services team will also upgrade its EDI integration component from BizTalk Server 2006 to BizTalk Server 2006 R2 in the near future, but for now the team is focusing on migrating HL7-based businesses processes.

The new solution includes the following components:

• Microsoft BizTalk Accelerator for HIPAA to help meet HIPAA transaction requirements
• Microsoft BizTalk Accelerator for HL7 to rapidly integrate HL7-based applications and share patient information within and between healthcare organizations
• Microsoft BizTalk FTP Adapter to exchange files between BizTalk Server and server computers that use the File Transfer Protocol
• Microsoft Visual Studio® 2005 Team Edition for Software Developers development system to create and customize applications
• Microsoft SQL Server® 2005 database software to store BizTalk Server transaction data

After the HL7 pieces are live, Park Nicollet will use BizTalk Server Business Activity Monitoring tools to monitor relevant business metrics. It also plans to use Microsoft Visual Studio 2005 Team Foundation Server to support collaborative development projects through a centralized data warehouse of real-time project intelligence and history.

Because BizTalk Server is its mission-critical integration engine, the company is also taking advantage of Microsoft Services Premier Support to provide around-the-clock production support.

Benefits

By deploying BizTalk Server as the cornerstone of its Enterprise Service Bus implementation, Park Nicollet has improved the efficiency of its integration efforts, made better use of IT labor resources, increased system reliability, and reduced turnaround time for insurance eligibility requests. The company is also receiving superior technical support.

Improves System Reliability and Business Agility

Park Nicollet has designed its new integration environment using BizTalk Server to promote higher availability. “Before, a single hardware malfunction could bring down the whole application-integration system until it was fixed,” says Vensland. “That's something we wanted to avoid in the new environment: it has to be rock-solid. With BizTalk Server2006 R2, we can more easily cluster servers, so if one goes down, the others pick up where that one left off.”

Whenever we call Microsoft Services Premier Support, we reach someone who really knows about the relevant BizTalk Server module in depth, so we usually get an incredibly fast response.  David Vensland Manager of Integration Services Park Nicollet Health Services

Typical of companies that implement EMR systems, Park Nicollet plans to use BizTalk Server to process a dramatic increase in business-process transactions. For example, one HL7 transaction might schedule a patient for an appointment, and that transaction will automatically start a series of other HL7 transactions to handle processes that track and support the services the patient receives. “Our growth potential is almost unlimited because with BizTalk Server 2006 R2, we can scale horizontally,” Vensland continues. “We’re going to start with two servers, and if they can’t handle the HL7 load, we’ll add a third. As the HL7 environment grows, we’ll add more. Right now, we process about 1.5 million transactions a day, and we expect the new BizTalk Server environment to handle 3 million as we extend our EMR implementation.”
 
In addition to handling a 100 percent increase in the number of transactions over the next five years, flexible scaling with BizTalk Server will help Park Nicollet increase its business agility. For example, Park Nicollet can add clinics or hospitals with relatively minor integration effort. And the Integration Services team can add services such as Web-based interfaces as part of the SOA. “As we expand to include Web services orchestration, we’ll simply add servers that can handle those processes as well,” says Vensland.

Offers Responsive, Expert Technical Support

During the proof-of-concept demonstration of BizTalk Server 2006, Park Nicollet got a glimpse of the quality of support that Microsoft Services can deliver. Vensland says, “Microsoft helped us set up our EDI criteria with BizTalk Server 2006 and had the system up and running within a week—something we hadn’t been able to do for years with our previous solution.”

That positive experience has continued during the deployment of BizTalk Server 2006 R2. Compared with the 136 open support issues that it had at one time with the previous solution, Park Nicollet has had only three support issues with BizTalk Server. And when the company does need help, expert answers are delivered promptly. Vensland continues, “Whenever we call Microsoft Services Premier Support, we reach someone who really knows about the relevant BizTalk Server module in depth, so we usually get an incredibly fast response. For our two EDI-related support issues, we got a resolution within one day. The third issue was very complex and took longer, but Microsoft worked with us until we got it fixed. The relationship that we have with our local Microsoft support team has been really productive.”

Cuts Insurance Process Time in Half and Lowers Costs

Park Nicollet plans to take advantage of native EDI support in BizTalk Server 2006 R2 shortly after the new software is deployed. Until then, the company will continue relying on BizTalk Server 2006 and the EDI base adapter. This interim step has helped the company use EDI integration to streamline services and lower costs by, for example, reducing the amount of work handled by third-party vendors.

Park Nicollet previously had to outsource the services related to checking patients’ insurance eligibility by delivering batch files to an external vendor each day. Now, the company can use EDI functionality in BizTalk Server to handle part of this process by transmitting the patient’s insurance information over a secure connection to a clearinghouse that responds almost immediately. Vensland says, “Using BizTalk Server 2006 eliminated a whole day from the process that checks insurance eligibility—from next-day service to same-day service—time that our staff can use to help patients resolve eligibility issues.”

Uses IT Labor Resources More Efficiently

With BizTalk Server 2006 R2, the Integration Services team can align its development efforts with the rest of the IT department, which was already using Microsoft development tools. “One of the most important things we wanted to accomplish with this project was to promote using industry standards enterprisewide,” says Vensland. “By replacing our integration engine with BizTalk Server, our IT options expand exponentially: Not only do we have BizTalk Server features, we also have the whole .NET Framework environment available to us. Our company has another team that develops .NET-connected applications, and now we can draw on its members’ expertise. And they can tie into our environment to enhance their applications as well. Before, our team was a separate entity. Now, thanks to BizTalk Server, we can create better solutions through collaboration.”

For More Information

For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234 in the United States or (905) 568-9641 in Canada. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to:
www.microsoft.com

For more information about Park Nicollet products and services, call 800-862-7412 or visit the Web site at:
www.parknicollet.com 

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Document published May 2008