The flagship product of GMZ—Patient Management and Care Software or PVVS—links doctors, hospitals, and nursing services across southeastern Germany. The PVVS web application helps these providers manage the data of 30,000 patients and bill health
insurance companies. To support the company’s growth, GMZ needed to improve the performance of PVVS and scale it to support twice as many simultaneous users while maintaining rapid response time. To achieve this goal, GMZ and its IT partner I-Motion engaged
Microsoft Services Premier Support for Developers to optimize the company’s web platform by redesigning it in a test environment that simulates real-life conditions. This included a code review, additional software development, and training for GMZ and I-Motion
developers. The result was a 120 percent increase in the web platform’s performance and more reliable service for GMZ customers.
Founded in 1998, GMZ has dedicated itself to helping healthcare providers in Germany offer better service to their patients. Using the company’s flagship product—Patient Management and Care Software, or PVVS as it’s abbreviated in German—providers reduce
time spent on day-to-day administrative tasks. These include creating medical reports, maintaining patient documentation, managing electronic patient data, and billing for medical services. The result is more time available for medical care.
GMZ links physicians, nursing service providers, and hospitals located in and around Munich, Garmisch-Partenkirchen, Mühldorf an Inn, Neuötting, Waldkraiburg, and Weilheim. Through the centrally hosted PVVS web application, healthcare providers can manage
and exchange the medical data of nearly 30,000 patients and bill health insurance companies. GMZ also plans to integrate pharmacies into its network and to allow patients to access their records online. “Traditionally, every medical service provider has had
to keep its patient data in its local IT system and send it to a clearing center for billing,” explains Dr. Elmar Schmid, Chief Executive Officer of GMZ and a General Practitioner in Munich. “Information is moved between physicians and hospitals, for example,
using printouts or faxes. PVVS greatly streamlines this process.”
||Testing Services of Premier Support for Developers helped us improve the performance of our PVVS medical services web application by 120 percent.
| Dr. Elmar Schmid
Chief Executive Officer, GMZ
PVVS was developed by GMZ along with its IT partner I-Motion. Microsoft Partner Network member I-Motion develops, installs, and operates communication solutions for the German healthcare industry. Over the years, the companies have improved PVVS, which is now
based on Microsoft Silverlight, the Windows Server 2008 R2 operating system with Microsoft Internet Information Services 7.5, Microsoft SQL Server 2008 R2, and the Microsoft .NET Framework 4. The application’s graphic user interface is built on Windows Presentation
Foundation, a key component of the .NET Framework. “It was very important to us that any changes made to patient data should be visible in real-time through an intuitive graphical interface for every logged-in client,” emphasizes Schmid. This prevents double
entries when two or three users are working on one document at the same time.
At the end of 2011, GMZ and I-Motion tested PVVS live with 200 users. During this process, the companies identified problems with the application’s form management system and slow performance that would hinder scalability. With the growing popularity of
PVVS, GMS also wanted to improve functionality to simplify processing medical reports, billing, and budgeting. But most of all, it had to resolve the performance hurdles, which was key to supporting expected business expansion. “At that time, we had little
experience with scalability issues,” says Robert Wölzlein, Chief Executive Officer of I-Motion. The companies needed expert help to significantly upgrade PVVS to handle the increased customer volume.
On the recommendation of I-Motion, GMZ engaged Microsoft Services Premier Support for Developers to test the scalability, performance, and stability of PVVS and to evaluate the application’s overall architecture. Premier Support for Developers helps
an organization’s development team by giving it access to experienced Microsoft resources and a full suite of Microsoft services designed to both accelerate project results and reduce risks across the entire software development life cycle. Specifically, GMZ
was eager to take advantage of the program’s individual workshops on technologies and products, prototyping, testing under various scenarios, and architecture and code reviews, as well as 24-hour technical support.
In early January 2012, experts from Microsoft Testing Services, provided by Microsoft Services Premier Support for Developers, thoroughly tested PVVS in a laboratory located at the Microsoft office in Unterschleißheim near Munich. The facility can configure
enterprise solutions in a variety of test environments on 700 current server systems with up to 25,000 virtual users working simultaneously. The test environments can also be accessed remotely. For GMZ, Microsoft staff recreated the PVVS production environment
and tested response time from the perspective of typical end users. The test’s starting point consisted of 100 users (a normal load) working simultaneously and accessing the GMZ wide area network (WAN) through connections such as digital subscriber line (DSL)
1500. (The lower bandwidth and characteristically increased latency period of the WAN connection significantly affect the response time of the application.)
Using their technical experience and profiling and analysis tools, Testing Services staff identified which application procedures required the most processing time, and they gradually increased the simulated load until a weak point (bottleneck) was reached,
causing stagnated system performance. “The tests revealed inhomogeneous and inconsistent CPU usage,” says Wölzlein. “This was a clear sign of a lack of stability of the system.” With the weak points identified, the Microsoft team worked with GMZ and I-Motion
developers to reduce the number of redundant queries or suggested more efficient .NET programming methods. These remedies were retested to document their effectiveness, including an overnight run to check whether the processor usage remained stable over time.
||We benefited from the knowledge transfer from Premier Support for Developers. We now have the tools and expertise necessary for better testing of our own applications.
| Dr. Elmar Schmid
Chief Executive Officer, GMZ
A debugging specialist also helped out with testing. “After just two hours, the Testing Services specialist from Premier Support for Developers discovered the cause of two memory leaks that were slowing down our application,” recalls Wölzlein. “He solved the
problem, and the application has been stable ever since.”
He adds, “Throughout application testing, we were able to refer back to the knowledge of Microsoft experts at any time. They helped us solve many problems.”
With the application redesign and testing complete, GMZ deployed its upgraded PVVS web application live in February 2012.
After engaging Microsoft Services Premier Support for Developers, GMZ was able to upgrade its most important software product, PVVS, and deploy it in a very short time. PVVS now boasts faster system performance and improved functionality. And thanks
to the training offered through the Microsoft program, GMZ developers can better maintain the application themselves. As a result, GMZ provides improved service to its customers.
Faster System Performance, Higher Availability
By recoding and correcting errors in key PVVS procedures, the application now runs much faster. “Testing Services of Premier Support for Developers helped us improve the performance of our PVVS medical services web application by 120 percent, and its
stability and availability are now better than ever,” says Schmid. Specifically, at the beginning of the tests, PVVS was able to serve 100 simultaneous users with only adequate response time. At the end of the upgrade project, the application could serve 220
users, representing a 120 percent increase in overall computational capacity, while reducing response time by 56 percent.
Better Trained, More Knowledgeable IT Staff
GMZ and I-Motion IT staff gained valuable training during the project. “We benefited from the knowledge transfer from Premier Support for Developers,” says Schmid. “We now have the tools and expertise necessary for better testing of our own applications.
In this way, we can now continue to optimize PVVS, in cooperation with I-Motion.” In addition to its Testing Services, Microsoft Services Premier Support for Developers also supported I-Motion and GMZ with code reviews, tips for high-availability of the hosting
solution, and more stable server operation, and it provided advice about improving code quality and automatic testing.
More Responsive Customer Service, Better Patient Care
With the upgraded version of PVVS, GMZ has met the needs of its expanded business. The application now successfully operates with twice the number of users that is used to. Consequently, more medical practices and hospitals can take advantage of the
benefits of PVVS. By easily and quickly accessing digital patient data, consultation reports, and treatment summaries, and by settling medical invoices directly with insurance companies, providers can handle more patients and improve service. “More doctors
are now saving a significant amount of time because, with PVVS, they no longer need to manually process so many medical reports,” explains Schmid. “In addition, patient treatment is improved because duplicate examinations are effectively prevented.”
Reflecting on the improvements to PVVS made possible by Testing Services of Premier Support for Developers, Schmid concludes, “More medical practitioners are now in a better position to work according to patients’ needs and to provide their services in a
targeted fashion. As a result, healthcare providers operate more efficiently and patients get better care.”
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