Web Services Expedite Lab Reports, Help Physicians Enhance Patient Care
Capgemini collaborated with Microsoft to create a .NET solution for PACLAB allowing health care workers to access patient lab reports.
PACLAB Network Laboratories provides medical laboratory services to physicians, clinics, and large hospitals in Washington State.
To improve its position in this competitive business, PACLAB wanted a system that would enable large health care organizations as well as individual physicians and clinics to access patient lab reports, regardless of where the testing was performed within the PACLAB system.
PACLAB worked with Capgemini, a Microsoft ® global alliance partner, to create a Microsoft .NET–connected solution that uses Web services to query databases in various health care organizations in order to provide a complete, unified picture of a patient’s test reports.
The result is faster access by physicians to lab results, reduced potential for overlapping or redundant tests, potentially quicker diagnoses, and better service to patients.
Situation
PACLAB Network Laboratories provides medical laboratory services to physicians, clinics, and large hospitals in Washington State. The organization, a partnership of six of the region’s most established health care providers, pools those providers’ resources into Washington’s only statewide laboratory system.
Since 1996, PACLAB has steadily developed its business and currently provides about 30 percent of all outpatient medical laboratory services in the western part of the state, which includes the Seattle metropolitan area.
However, PACLAB has encountered obstacles to its growth due to the complexity of providing a secure, easily managed flow of laboratory information between organizations that maintain their own internal IT systems. Even with their participation in the PACLAB network, hospitals and physicians frequently faced challenges such as delays in receiving lab reports, an inability to know for certain whether or when patients had tests performed in other health care facilities, and the potential of unnecessary costs caused by overlapping or redundant testing.
PACLAB management wanted to use new technology to improve the quality and efficiency of patient care by integrating inpatient and outpatient laboratory data and making that data available online to authorized health care providers, regardless of their IT system or hospital affiliation.
Solution
Working with Capgemini, a Microsoft ® Certified Partner and Microsoft Global Services Partner of the Year for 2003, PACLAB implemented an
The design and development of the LabsNow pilot project took about two months, with Microsoft Consulting Services and Capgemini collaborating with PACLAB on the design of the solution. The development effort involved Capgemini and Microsoft technology teams, health care experts, testers, and project management staff, who were all focused on ensuring a high rate of adoption among the LabsNow participants. System wide development took about six months.
In developing the solution, the Capgemini and PACLAB development teams employed the Microsoft Visual Studio ® .NET development system—including the Visual C# ® development tool, ASP.NET, and ADO.NET—along with Microsoft SQL Server TM 2000 and the Windows ® 2000 Advanced Server operating system, which provided the teams with a tightly integrated development environment.
The solution also uses SeeBeyond Technology’s E-Gate integration engine and Madison Information Technology’s AlignDex enterprise master patient index. To more easily incorporate SeeBeyond and Madison, PAML created custom “Web service wrappers” for the applications using Visual Studio .NET. Other PACLAB partners have used Microsoft BizTalk ® Server 2002 for enterprise application integration.
“Although other solutions can provide this capability to physicians, the use of Web services in LabsNow means that it is a much simpler, secure, flexible, and more cost-effective solution for participating hospitals,” says Stewart Adelman, General Manager of PACLAB in Bellevue, Washington. “LabsNow is able to transparently request, combine, and filter patient information from multiple distributed data sources, then present that information to health care professionals in an understandable and clear-cut manner.”
Benefits
The LabsNow solution enables hospitals to manage patient data more efficiently and integrate more easily with doctors’ offices and other health care organizations. It also gives physicians the ability to get a complete, accurate, up-to-date, and consolidated view of patient data. This, in turn, helps health care professionals enhance patient care with more informed and timely services.
Patient Data Accessed Faster
Traditional methods of producing and obtaining lab reports on patients involve paper-based processes, which are slow and can produce errors and redundancy. For example, if a patient has some blood work done by his or her local doctor in April, then is admitted to a hospital in June following an accident, the hospital physician examining the patient may not be aware of, or have easy access to, the earlier lab test results.
That could result in an incomplete diagnosis, a misdiagnosis, or possible errors in prescribing medication. Using LabsNow, the hospital physician can access all of the patient’s lab records within minutes, which can enable a faster and more accurate diagnosis.
“Today, a patient’s lab report is typically in paper form,” says Ashif Jiwani, Capgemini’s Senior Manager for Microsoft-based health care solutions. “Patients and doctors may wait days to receive results, which can increase the risk of misdiagnosis or mistreatment of a patient. Additionally, this can exacerbate inefficient reimbursement processes, which can result in duplicate lab testing and added costs.
“With LabsNow, physicians no longer need to go through separate channels to build a view of a patient’s lab tests,” Jiwani says. “The LabsNow solution does that for them, freeing up their critical time by supplying accurate patient data very quickly. The result is more efficiency for doctors and better care for patients. This was made possible by the tightly integrated components of the Microsoft .NET Framework and Visual Studio .NET, including the native support for Web services that enabled the rapid creation of a sophisticated solution.”
Organizations Keep Control of Data
The LabsNow solution also removes another barrier to sharing data between health care organizations: organizational concerns about loss of control over patient data.
“When we were evaluating how to create a system for sharing lab results, it came down to two possible scenarios,” says Adelman. “One of them was to create a massive database that would hold all patient data from all participating clinics and hospitals. The problem with this approach is that health care organizations are afraid of losing control over patient data and will either refuse to participate or will only provide limited amounts of information, which reduces the effectiveness of the solution.”
But with the Web services–based solution, Adelman says, hospitals, clinics, and physicians can retain control over their data while providing full access to that information when it is needed elsewhere. LabsNow also helps participating organizations retain competitive advantages yet leverage outside resources. For example, one participating hospital may be the only one with specialized equipment for performing a certain type of test. By being part of the LabsNow network, it can offer—and charge for—highly specialized testing services while gaining access to other services provided by partner organizations, including PAML. This is a key benefit because health care organizations go through economic cycles and are forced to reduce overhead or merge resources with other organizations to remain financially viable. The LabsNow solution is also one of the first production implementations of Web Services Enhancements for Microsoft .NET (WSE), an add-in for Visual Studio .NET that provides developers with advanced Web services capabilities, including enhanced options to build robust Internet-based security standards into Web services.
Additionally, the solution uses secure methods of transmitting information and is compliant with the U.S. Health Insurance Portability and Accountability Act (HIPAA), which imposes stringent privacy and security rules governing the confidentiality of patient records. “And because participating member organizations still own the data,” Adelman says, “they can choose what information they want to share. So, for example, if they have a celebrity patient, they may not want to share those records, and they will often keep tight control over information on psychiatric patients.”
Microsoft .NET Provides a Readily Adopted Solution
The LabsNow system is based on a three-tier architecture with published interfaces that enable integration into a variety of IT systems. This ease of integration encourages and promotes broad and quick adoption within the health care community. Participating hospitals can use the portal front end that Capgemini developed or just use their own portal technologies and call the published Web services provided by LabsNow.
“Rather than force us to rip out and replace our current technology, LabsNow gives us true integration with our current systems and allows our doctors to assemble medical records on the fly,” says Bruce Elkington, Vice President of Information Technology for Franciscan Health System, a participating organization based in Tacoma, Washington.
When a physician accesses the LabsNow portal, a Web service uses Improved Service Delivers a Competitive Advantage Adelman says that with the Microsoft .NET–connected, Web services solution, PACLAB is able to deliver a level of service that national laboratory service providers can’t match.
“This solution provides PACLAB and the participating organizations with the competitive advantage of having direct hospital connections to labs in the field,” he says. “LabsNow can provide both the inpatient and outpatient data for a consolidated, unified record of a patient’s tests.
“Advances in information are core to our strategy,” Adelman continues. “With Capgemini and the Microsoft .NET Framework, we have delivered an innovative Web services solution that gives hospitals unprecedented capability and flexibility in managing and accessing patient lab data. Hospitals can adopt the LabsNow solution quickly, without changing any of their back-end data storage systems.
Physicians can easily obtain a complete view of a patient’s lab data in real time—regardless of where that data is generated and stored—allowing them to provide more informed and timely care.”