The client is a German company that provides home care services for sick patients. It already has several branches and continues to expand. The medical staff helps to continue specialized therapy after discharge from hospitals, monitors the treatment course and serves as coordinators between hospitals, rehabilitation organizations and insurance companies.
Detailed information about the client can not be disclosed under the terms of the NDA.
PROBLEM AND OBJECTIVE
The company's employees help patients who need permanent care on a daily basis. Based on their data (personal information, contacts of relatives or guardians, type of insurance, examinations, and other documentation), a kind of electronic medical record is created.
The creation and implementation of an electronic medical record is a global standard. However, the implementation of the transition to the centralized exchange of information in the electronic form project is often slow and has its own difficulties.
The key problem on this project was the constant loss and leakage of patient data, as well as their medication orders. This type of problem was accompanied by a lack of ability to quickly access the system.
The request for support and stabilization of this system was related to constant service failures.
The challenge was to ensure stabilization and improvement of the system for the timely and proper care of patients with chronic diseases or who had undergone surgery.
By optimizing internal processes, settling interdisciplinary interaction between all involved actors and ensuring the timely supply of all necessary medications and equipment, we help the customer improve his patients' quality of life
What Was Done
At the time the Innowise Group specialists were involved, there was a certain instability in the functioning of the system, there were constant server crashes, errors in data synchronization, which largely prevented the overall functioning and could not be fixed by the IT department of the company, which became the reason for the client to turn to a third party contractor.
From the very start of the project, our team has been introducing new features and working to stabilize the system.
For example, one of the newest features is the ability to assign the status of a patient, his therapy plan and order as "primary care" and, after three months of care, automatically "follow-up care". The status of orders created during the first three months of care does not change.
As for the orders themselves, their current status (in processing, in delivery) is displayed via API in real time. This is done directly from the DHL service up to four times a day.
The team also developed a routing matrix, which gives the ability to specify days of the week and time of delivery for the orders deliveries to be made.
New features have also been added for the patient's account. Now the caregiving specialist can not only add a new therapy or care for wards, but also specify the status of his or her televisit (active, inactive) and disable or delete caregiver and relative contacts from the patient's record. Moreover, more than one healthcare worker can be assigned to a patient. Depending on the course of treatment, these can be medical workers of different specialties. The system can specify responsibilities (temporary and permanent), as well as the assignment of a chief patient care specialist. In this way, treatment and patient care can be approached more comprehensively and precisely.
Among other things, our team has given the client the option to switch to IP telephony for sending faxes. The new service sends faxes via sipgate, which makes the process faster and more efficient.
Another useful innovation is the ability to get acquainted with updates when logging in. This allows to understand the purpose and use certain functions in the right way.
- Server: .NET Framework, MS SQL, MongoDB
- Client cabinet: .NET Framework, MongoDB, WPF
- WebAkte: .NET Framework, MS SQL, ASP.MVC
- QA: Postman
- Platforms: web, desktop (Windows)
At the moment when the cooperation started, the company's software had already been about 8 years old and the connection with the initial team of software developers had been lost. Therefore, the first phase of the project required the Innowise Group team to apply reverse engineering methods, including the use of German-speaking business analysts for processing the accumulated software documentation.
The result of the first month of work of Innowise Group specialists was stabilization of the system by means of improving the code and completing the following technical stages:
- Migrating to the 64-bit version of the application;
- Improving the logging system;
- Integrating a log analysis tool, which allows for monitoring the system's behavior, tracking errors, and collecting statistics for detection of bottlenecks;
- Detecting and fixing issues related to the creation of temporary files in the implementation of the communication mechanism;
- Increasing the level of security of the storage of "sensitive data" in the configuration files.
It should be noted that this approach did not require stopping the work of the system and was held in a normal mode without any inconvenience and financial losses to the customer.
Further stages of work were aimed at significant modernization of the system. By our efforts, the reliability of the system was ensured, including the safety of the data stored in it (for example, personal data of patients).
As part of the solution to these problems, the following measures were taken:
- The incorrectly entered patient data has been found and corrected;
- Hierarchy of clinics has been implemented, allowing the physician to have access to patient data from different branches of the same clinic;
- Order identification has been added to make it easier to work with orders;
- A new way to create an order has been added;
- New values have been added to the directories;
- The filters have been improved;
- The defects in various forms have been fixed;
- The forms and document templates have been improved in accordance with the customer's current needs;
- The validation of the fields has been changed according to the current needs of the customer.
At the moment, the cooperation between Innowise Group and the customer's company is successfully continuing and developing. We steadily get new tasks from the customer, including upgrading and improving the functionality of the desktop and web applications, updating the UX / UI of the application, developing a mobile version from scratch, as well as the tasks of updating and upgrading the existing website of the company.
Thanks to the flexible Scrum methodology, the client has the ability to daily monitor the work progress, frequent demonstrations of new functionality and the ability to make adjustments to the terms of reference, as well as more flexible control over the budget.
JIRA was used as a tracker, since the customer had already worked on other projects in this system.
- 1 Business Analyst (4 hrs/day);
- 1 Project Manager (8 hrs/day);
- 3 Developers (1 Lead, 2 Middle developers (8 hrs/day each);
- 1 Tester (4 hrs/day).
Thanks to the work of the Innowise Group team, the updated system allows to rapidly record the patient's examination plan. This significantly reduces the time spent by medical staff, and specialists can devote the minutes they save to other patients.
The results of examinations and tests are always at the fingertips, just by logging into the application. This kind of electronic chart cannot be lost or erased because the database keeps the history of all changes.
Data from the card can be downloaded and printed or archived when not needed, and then restored. Rapid access to accurate data has reduced medical errors and provided more accurate patient care. Accurate and complete medical information about the patient's health additionally eliminates the possibility of inappropriate use of medications.
In real time, treating physicians can see a patient's current medical history, examination and test results, and can assess and adjust the treatment dynamics. The system provides automatic reminders for patients' medical tests and shows the progress of their condition. Just as quickly, medical professionals can arrange the necessary medications and have them delivered to the patient.
Sustained support and bug fixes in the system prevent errors in medication and equipment ordering, delivery and billing. The team is constantly making changes and improving the user side of the application, the UI.
As for the patients themselves, there is now no need to visit the clinic to get a statement or an prescription for medications. All that is needed is to sign the necessary documents in an electronic format and print them out.