Misys Healthcare Systems

Team Uses Powerful Tools to Build Innovative Web-Based Medical Records Application

For more than a decade, Misys Healthcare Systems and Veracity Solutions have partnered to develop innovative applications that meet the needs of healthcare providers while improving the quality of patient care. To help medical staff reduce manual, paper-based processes, Misys Healthcare Systems and Veracity Solutions collaborated to create FreeNatal, a Web-based application that provides prenatal care providers with an easy-to-use, secure interface for managing patients’ records. Using Microsoft® Visual Studio® 2008 SP1 and the Microsoft .NET Framework 3.5 SP1, eight members from the Misys-Veracity team created the application. By taking advantage of these powerful technologies, the team increased development speed by 60 percent, enabling accelerated market delivery and further strengthening their respective positions in the healthcare informatics industry.

With Visual Studio 2008 SP1, ADO.NET Data Services, and ADO.NET Entity Framework, we increased our development speed by an average of 60 percent. Galen Murdock, President and CEO, Veracity Solutions

Situation

The majority of physicians in the United States rely on paper-based charts to monitor the long-term treatment of their patients. The use of paper-based medical records poses several potential problems—both for care providers and for their patients.

Through the years, maternity care providers have relied heavily on faxing patient records from the provider’s office to the hospital. Because of this process, however, the patient’s prenatal record is unavailable at the time of delivery in approximately 15 percent of cases. In addition to being intrinsically inefficient, paper-based medical records compromise the availability of patient information. The need for on-demand access to patient information is especially critical for prenatal care providers, who treat their pregnant patients in multiple care settings.

Perceiving a strong market demand to improve this situation, leaders from Misys Health Care Systems set out to devise a solution. Misys Healthcare Systems develops and supports reliable, easy-to-use software and services that enable physicians and caregivers to more easily manage the complexities of healthcare. After evaluating the scope and requirements of the project, the Misys team engaged Veracity Solutions—a software development firm based in Utah. The two companies, which had worked together on previous projects, began collaborating on the development of a solution designed specifically for physicians who provide maternity care.

“Based on our research, we found that—in an otherwise highly electronic industry—there wasn’t a cost-effective, high-performance solution like this available on the market,” says Jacob Reider, M.D., Medical Director at Misys Healthcare Systems and Lead Clinician on the project. “We saw a great opportunity to deliver an easy-to-use, highly secure solution that meets the needs of the more than 90 percent of maternity care providers who still rely on paper-based records.”

Several important technical and business requirements guided the design and architecture of the application. Leaders from Misys Healthcare Systems and Veracity Solutions recognized the need to incorporate rigorous security features into the application to comply with federal government standards for patient privacy. They also knew that the application needed to be Web based to facilitate maximum accessibility and extensibility. In addition, they wanted to ensure that the application offered high performance and a rich user interface. Further, executives from both Misys Healthcare Systems and Veracity Solutions wanted to quickly develop the solution to capture an exceptional market opportunity.

Solution

Over the course of four months, an eight-person, agile team from Misys Healthcare Systems and Veracity Solutions worked to develop FreeNatal, a Web-based, electronic medical record application designed for physicians who care for and treat pregnant patients. To create FreeNatal, the team relied on Microsoft® Visual Studio® 2008 SP1. The team also took advantage of several technologies offered in the Microsoft .NET Framework 3.5 SP1, including the addition of the Microsoft ADO.NET Entity Framework and Microsoft ADO.NET Data Services. To meet the requirement for a highly responsive and interactive user interface, the team used Microsoft ASP.NET AJAX.

Fast Facts
Development team	1 project lead and development manager 1 lead developer 2 practicing physicians 1 senior developer 2 user-experience designers 1 tester
Time to complete	4 months
Developer tools	Microsoft Visual Studio 2008 SP1
Programming model	Microsoft .NET Framework 3.5 SP1 Microsoft ADO.NET Data Services Microsoft ADO.NET Entity Framework
Programming languages	C# Microsoft ASP.NET AJAX

ADO.NET Data Services gave us the ability to pull content dynamically from the server and also separate the markup from the data, which optimized performance. Gregg Jensen, Software Architect, Veracity Solutions

Increasing Development Speed
The Misys-Veracity team relied on several new features and improvements in Visual Studio 2008 to drive faster development. “There were a number of improvements in Visual Studio 2008 that helped us save time,” says Gregg Jensen, Software Architect and Lead Developer on the FreeNatal project for Veracity Solutions. “We relied heavily on JavaScript IntelliSense®, which was highly accurate in inferring variable types and automatically filling them in. This saved us a considerable amount of time over the course of the project.”

Focusing on User Interface Development
The .NET Framework 3.5 SP1 helped developers work seamlessly with both data and interface elements. In particular, the team took advantage of the ADO.NET Entity Framework, a modeling framework that lets developers quickly define a conceptual model of a database schema that closely aligns to a real-world view of information. After the team completed the database, developers quickly constructed an Entity Data Model using the Microsoft ADO.NET Entity Data Model Designer. “We generated all of our core objects right off the database in just a few clicks,” says Jensen. By abstracting and streamlining the process of generating data access code, developers focused on writing features designed to enhance the user experience. “We didn’t have to worry about the plumbing or the framework, so we could focus on creating the business logic that would meet the needs of the physicians who would be using FreeNatal,” explains Galen Murdock, President and CEO of Veracity Solutions. As illustrated in Figure 1, FreeNatal enables physicians to quickly access both summary and detailed patient information across a variety of easy-to-use interfaces.

Enabling High Performance
Strong system performance and high data availability were important requirements for FreeNatal. The team wanted to enable physicians to quickly access information about a patient’s treatment history, allergies, and medications. Recognizing the need to incorporate highly flexible Web services that could build on the advantages offered by the ADO.NET Entity Framework, the team used ADO.NET Data Services, as illustrated in Figure 2. Because ADO.NET Data Services uses simple uniform resource identifiers (URIs) to access and manipulate data while enabling the separation of the data access and presentation code, it offers an easy and flexible way to deliver data over the Internet. “ADO.NET Data Services gave us the ability to pull content dynamically from the server and also separate the markup from the data, which optimized performance,” explains Jensen.

Figure 1. FreeNatal “Face Sheet” view.

Ensuring Rigorous Security
To keep medical records confidential, the Misys-Veracity team incorporated sophisticated security controls into the FreeNatal application. “Maximizing data security was definitely one of our biggest development priorities, given all the regulations that physicians need to consider,” says Murdock. The team took advantage of native capabilities in ADO.NET Data Services to create query and change interceptors designed to buttress standard authentication mechanisms, such as password authentication. “ADO.NET Data Services gave us fine-tuned control over what data in the system could be edited and what data was strictly read only,” says Jensen. “On every trip to and from the server, for both reads and writes, the system verifies the user only has access to the data that they’re authorized to see.”

Achieving Maximum Interoperability
The team wanted to provide physicians with a range of options to access patients’ records beyond the standard FreeNatal “Face Sheet” view. To achieve this, developers extended the application through a widget on NetVibes, a Web-based social utility that lets users customize their own portal pages. “The NetVibes widget demonstrates the ‘mashability’ of this application—the idea that you can manipulate the data and present it in several ways—but there’s nothing preventing us from making the information from FreeNatal available on just about any device,” says Reider. “The extensibility of FreeNatal means physicians can access vital information about the changing needs of their patients even if they don’t have access to their computer.”

The key driver behind the interoperability of FreeNatal is its use of ADO.NET Data Services. Because the services offered through this framework are based on standards, supporting a REST interface and using JSON, ATOM, and XML formats, the data can be delivered easily over the Internet to a range of applications.

Quite frankly, the Microsoft software and technology we used throughout this project made us look good—to the physicians who consulted with us and participated in the demos, to other potential customers, and throughout the industry. Galen Murdock, President and CEO, Veracity Solutions

Benefits

Using Visual Studio 2008 SP1, the ADO.NET Entity Framework, and ADO.NET Data Services, the joint development team from Misys Healthcare Systems and Veracity Solutions created a highly extensible and secure Web-based application. Because these technologies from Microsoft accelerated development, the team rapidly went to market with a solution that meets a critical market need. Both companies have gained from increased visibility in the healthcare informatics industry.

Sixty Percent Faster Development on Average
The Misys-Veracity team relied on support for JavaScript IntelliSense in Visual Studio 2008 SP1 and the automated code generation power of the ADO.NET Entity Framework to dramatically reduce development time. “Using JavaScript IntelliSense in Visual Studio 2008 SP1, we shortened development by 30 percent on the client side,” explains Jensen. In addition, the team used the ADO.NET Entity Framework to automatically generate data access code. This meant that developers could devote more time during the early stages of the development life cycle to optimize the FreeNatal user interface. “Because the ADO.NET Entity Framework helped us abstract a lot of our database and data access layer development, I’d estimate that we doubled our efficiency developing back-end components,” adds Murdock. “With Visual Studio 2008 SP1, ADO.NET Data Services, and ADO.NET Entity Framework, we increased our development speed by an average of 60 percent.”

Figure 2. FreeNatal application architecture diagram.

Optimal Performance and Security
The team took advantage of the stability and scalability of the ADO.NET Entity Framework and ADO.NET Data Services to gain optimal system performance. “Since the FreeNatal UI requires frequent, rich data exchange with the back end, the responsiveness of ADO.NET Data Services is one of the things that impressed us the most,” says Murdock. “This means that the physicians who use FreeNatal can move quickly through the system and access all of the information they need while remaining fully engaged with the patient.” FreeNatal combines high performance with a high level of data security. Using the built-in capacity in ADO.NET Data Services, the team created rigorous security controls to ensure that FreeNatal meets the highest standards for protecting patient privacy.

Rapid Response to Market Need
Because the joint team from Misys Healthcare Systems and Veracity Solutions achieved rapid market delivery of the FreeNatal solution, both companies have gained visibility as innovators in the healthcare informatics industry. “Quite frankly, the Microsoft software and technology we used throughout this project made us look good—to the physicians who consulted with us and participated in the demos, to other potential customers, and throughout the industry,” concludes Murdock.

Microsoft .NET Framework 3.5

.NET provides you with a comprehensive and consistent programming model and a common set of APIs across all tiers of your application. .NET helps you to build applications that work the way you want, in the programming language you prefer, across software, services, and devices. .NET helps developers move quickly from idea to the creation of rich, responsive applications that people want to use.

 

.NET Framework 3.5 SP1 expands and improves offerings in the .NET Framework and Visual Studio 2008. .NET Framework 3.5 SP1 introduces the ADO.NET Entity Framework and ADO.NET Data Services, which simplify data access code in applications by providing an extensible, conceptual model for accessing data from any source.

For more information about the .NET Framework 3.5, please go to:

www.microsoft.com/netframework

 

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 Misys Healthcare Systems products and services, call (800) 334-8534 or visit the Web site at:

www.misyshealthcare.com

 

For more information about Veracity Solutions products and services, call (801) 277-3070 or visit the Web site at:

www.veracitysolutions.com

 

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.