Leveraging Business Transaction Performance in Patient Data Transmissions: A Study

With the quick progression of EMRs and RCMs, healthcare databases have become large, complex networks of electronic information. Ensuring data reaches its destination in a timely and accurate manner can be critical for the well-being of patients.

With the quick progression of EMR, RCM and other medical software platforms, the databases of healthcare organizations everywhere have quickly become large, complex networks of electronic information. From lab results to pharmacy orders, ensuring data reaches its destination in a timely and accurate manner can be critical for the well-being of patients.

For BJC Healthcare, one of the largest nonprofit health care organizations in the US, replacing its homegrown monitoring solution for the IBM WebSphere MQ environment would become crucial from both time and financial standpoints. BJC serves residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions with 13 hospitals and several community health locations. With such a wide base of patients, the data flowing through BJC’s IT infrastructure needs to be well-organized, accurate and accessible.

Patient-critical data contained on the servers included visit details; dates the patient was admitted, transferred or discharged; lab results; vital signs; radiology reports and medication information. WebSphere MQ is the communication middleware that moves data from source to process, leveraging individual queues to get the job done. But the queues have to be monitored—otherwise, failing queue managers and full queues won’t get the manual attention they require.

For example, the system might function to send a doctor-dictated letter through a specific transcription system, transmitting it using HL7 standards for healthcare-oriented computer systems. WebSphere MQ facilitates highly reliable delivery of the data put in the queue by an application, otherwise known as “store and forward.” Then, an application converts the data from HL7 to XML and moves it to a report queue, where it validates essential formatting and required tag elements. Based on the patient’s unique ID number, the application finds the right patient and moves to a queue that brings the message into the database, an outbound queue or an error queue (if the process fails).

The organization’s homegrown monitoring solution required components deployed on multiple servers and was becoming expensive to maintain. It needed maintenance and fine-tuning, eventually pushing BJC’s evaluation team, which included Technical Specialist Mike Tammenga, to look for an alternative program that would offer more robust functionality. After a lengthy evaluation process, Tammenga and his team finally found a viable solution.

“One of the first things we noticed about [the solution] is its simplicity to implement,” said Tammenga. “That, coupled with a few other primary factors, was a huge selling point for us.”

Tammenga says the other factors were price, scalability, performance, flexibility and comprehensive functionality. Based on the solution’s rules engine, the BJC IT team could define factors that would give the platform predictive capabilities so problems would be caught before they could blow up. The application performance management solution effectively monitors queues for BJC’s Electronic Data Management System (EDMS) and other healthcare applications that run on the organization’s servers.

But the benefits don’t end there, claims Tammenga. “In accordance with HIPPA regulations, [the solution] helps us with our regulatory and compliance issues by safeguarding data as it is transmitted.

“Compared to our old homegrown system, [the solution] has proven much easier to manage and far more cost-effective. It doesn’t require a lot of tinkering, alerts us when queue managers go down or queues fill up, and keeps the MQ environment running properly or alerts us when it isn’t.”

Tammenga added that the environment has been much more reliable since the addition of the new software platform and, perhaps most importantly, doesn’t require much maintenance.

Charles R. Rich has held many key positions over the last 28 years in the IT industry, including his current role as VP of Marketing and Product Management at Nastel Technologies.