Sydney IVF faces the common challenge of needing to support a number of best-of-breed applications. The organisation recently selected a commercial fertility management system to consolidate a number of in-house systems. This application manages patient information which is an important input into Sydney IVF's billing process. To support the billing process the fertility management system needed to integrate with Navision, an existing financial software system.
After meeting with the suppliers of its existing software solutions, Sydney IVF realised that they could not easily and cost-effectively provide integration between the applications. Nor could they provide all the functionality required for Sydney IVF's customer billing process.
Sydney IVF turned to Global Integration, an InterSystems services partner, for an alternative solution. Within three months, using InterSystems Ensemble, Sydney IVF created a truly integrated information environment with a single patient identifier supporting a single view of the customer journey.
Central to the new environment is a patient identification system implemented in Ensemble that maintains a master copy of customer information, including demographics from central patient registration. Ensemble also manages the exchange of information between different systems, ensuring they remain in synch. Information exchange is performed via HL7 (Health Level 7), a clinical messaging standard supported in various forms by most of Sydney IVF's software suppliers, and via XML (eXtensible Markup Language) where HL7 is not supported.
Integration between applications with a single patient identifier has enabled Sydney IVF to implement a new team-based approach which improves customer care. "Having a single view of the patient has facilitated the restructuring into teams that are more closely aligned to the patient," said Michael Ashby, Sydney IVF's CIO. "We can now ensure that the same nurse, scientist and doctor follow a customer all the way through their treatment. Previously, there were barriers to getting a patient focus, including different databases and manual handoffs between departments."
Using InterSystems Zen™ technology, which enables the rapid creation of rich Internet applications, Sydney IVF developed a new composite application for customer billing which has extended and enhanced its existing systems to automate the billing process.
"This is seen as the biggest project and the biggest change to the organisation in 30 years," said Ashby. "We have moved people from back-end support functions to front line patient interactions."
The new systems have significantly improved operational efficiency. Twenty back-end support staff positions - 12 of them in customer billing - were no longer required, reducing costs. At the same time, 30 new roles were created, including 12 patient support co-ordinators, boosting productive capacity.
"While it is too early to assess the bottom line improvements, as the system has been in place for less than 12 months, it is significant to note that the month immediately following the implementation saw the highest volume of IVF patients in the history of the company," said Ashby. "The number of IVF cycles in the six months June to December 2009 was over and above any previous record and the ability of the new systems to process this is an indicator of the stability, scalability and flexibility of the applications."
The integrated information environment underpinned by Ensemble has also improved the organisation's business agility, removing internal constraints to growth and improving its ability to quickly adapt to external changes.
"The company's growth would have been impeded with the existing disparate information systems," said Ashby. "The different departments were all treating the one patient but there was a lack of consistency of information and each had their own patient number."
When Medicare recently changed its pricing, billing rules and item numbers, Sydney IVF was easily able to adapt to the changes. "We were able to design the changes within a couple of days," said Ashby. "What took longer was how we were going to interpret the new Medicare rules, which were a significant change for the industry. For last six months we have been tweaking the rules and the billing and it has been relatively easy to do. We would have saved 3-4 weeks of full-time work."
Having created a more flexible information environment and a single patient identifier, Sydney IVF is now extending its systems to improve the level of information it provides to the external specialists who use its facilities.
Using Ensemble, services partner Global Integration is developing a doctor's portal so specialists can enter patient demographics and treatment plans, and monitor test results. Phase one of the project will see the portal implemented via a Web interface, with a second phase providing direct integration to the doctors’ practice management systems.
"We want to make it easier for specialists to work with us than with anyone else," said Ashby. "We currently give access to some doctors via Citrix but they have their own systems that they would prefer to use," said Ashby. "The first step will be to give them a portal but ultimately information will go straight into their systems via secure messaging and they can take action in their own system. They love the idea."
InterSystems Corporation is the worldwide leader in software for connected healthcare. With headquarters in Cambridge, Massachusetts, and offices in 24 countries, InterSystems provides advanced software technologies for breakthrough applications. InterSystems Ensemble® is a seamless platform for integration and the development of connected applications. InterSystems CACHÉ® is a high performance object database that makes applications faster and more scalable. InterSystems HealthShare™ is a platform that enables the fastest creation of an Electronic Health Record for regional or national health information exchange. InterSystems DeepSee™ is software that makes it possible to embed real-time business intelligence in transactional applications. InterSystems TrakCare™ is a connected healthcare information system that is Web-based and rapidly delivers the benefits of an Electronic Patient Record. For more information, visit InterSystems.com.