Ochsner Clinic Foundation

I. Project and Personal Information

a. Company and division name: Sybase
b. Web site URL:
c. Project designation
d. Brief explanation of the goals of the project:The goal was to develop a system to overcome a persistent three-week backlog for cardiovascular test results by eliminating dictation and converting the process into a system that captures data at the point of delivery and, ultimately, delivers reports faster.
e. Brief description of the business risks involved: Commiting development to a client/server architecture, commiting development to a narrow technology and Limited development team were the business risks involved.
f. Brief description of how the system helps users: Built with Sybase PowerBuilder®, Ochsner's cardiovascular information system (CVIS) allows clinicians to enter test and procedure results directly into a patient's record - solving the problem with dictation, generating reports in seconds, and eliminating a three-week laboratory backlog.

II. Organizational Objectives

a. What short- and long-term benefits did the organization achieve from the project? Did the solution meet the projected goals for saving time and money? How were benefits measured? Was the system missioncritical to the organization? Ochsner Clinic Foundation has reduced the amount of service claim denials by up to $400,000 per year, reduced transcription costs by $60,000, and removed a great deal of manual intervention from the process. Medical research data for the cardiology division is accelerated, with a now enormous database of clinically sound information, providing reliable answers to critical issues. Studies now encompass 40,000 records versus a previous 100. Ochsner's service levels have increased, and, largely due to referrals from physicians and patients, the cardiology unit's business has tripled in seven years with no backlogs.
b. Describe the business purpose of the new system: To provide medical and administrative staff with real-time access to patient data, support the organization's anticipated growth while improving patient care, and Eliminate the need for outsourced transcription services.
c. Describe the features of the new system:
  1. Point and click data gathering
  2. Interpretive report generation
  3. Comparative reporting
  4. Interface of finalized reports to system wide clinical workstation system
  5. Electronic data integration with echocardiographic scanning devices
  6. Generation of medical billing
  7. Over 4000 data points, including , yearly updated date of death
d. Explain the functions of the new system: The system’s functionality allows physicians to generate cardiology test and procedure reports immediately after revieweing test data or completing a procedure. Confirmed report can then be published electronically for requesting physician’s review. Billing data is also generated and furthermore, pre-existing medical patient medical data from previous tests, procedures or existing diagnosis will alert physicians of otherwise unrealized medical conditions.
e. Who were the internal sponsors of the project? Which officials or groups were opposed to developing the application? Why? The Cardiology Vice-chairman
f. Were users of the system involved in the project during the planning and development phases? If so, how? Absolutely, the physicians who use the system provide most of the algorithms behind the articifial intelligence that generates interpretive text. They are very instrumental as well in helping us formulate our database design
g. What were the greatest challenges in completing this project? How were they overcome? There are basically two major challenges: Converting a physician idea into a viable algorithm and implementing parts of the project into the operation.
h. Were the goals changed as the project progressed? If so, what were the changes and why were they made? The goal of generating interpretive results while collecting researcheable data points has not changed. The scope of the project, however, has been greatly increased to include operational areas such as billing, because enough information was being already compiled to improve the data management.

III. Category

E-business Application Development

IV. Process

a. Describe how productivity tools or techniques were used in the project. Iterative development techniques using regular customer provided feedback
b. Were testing tools used during development? If so, when were they used? Was the testing cost-effective? PowerBuilder object libraries connecting to an Oracle test database were used to develop and test pilots of the program.
c. Was a formal or informal software development life-cycle methodology employed? If yes, please describe it. Informal
d. What formal or informal project management methodologies and/or tools were used to manage the project? If used, please describe how. Informal
e. Were software quality metrics used? If so, what were they, and did using them significantly help the project? No

V. Technology

a. What were the major technical challenges that had to be overcome to complete the project successfully? How did the team respond to those challenges? Integration of generated data with institution wide legacy systems
b. What software tools, including databases, operating systems and all development tools, were selected for the project? Why were they selected over competing tools? What process was used to select development tools and software platforms? PowerBuilder, PocketPowerBuilder and Oracle. Osher had initially evaluated visual basic from Microsft but chose Sybase PowerBuilderbecause of its ease of use,code re-use, the DataWindow Technology and because developers were familiar with the tool.
c. Describe the overall system architecture. Were elements of the technical infrastructure put in place to support the new system? Please describe. Client/Server architecture
d. What characteristics of the tools and technologies used were most important in achieving the business purposes of the system? PowerBuilder’s implementation of object oriented programming tools made it possible to turn around this important project in less than a year by a limited team. The Datawindow object, particularly helped in the programming effort by minimizing the amount of time spent on programming database connectivity issues. Also, PowerBuilder’s excellent implementation of inheritance minimizes the amount of time spent on applying changes from one iteration in the development cycle to the next.

VI. Project Team

a. What was the size of the development team? At first one person. Now four
b. Describe the software development experience of the team members. Original member had extensive knowledge of PASCAL, COBOL, MUMPS and then VB and PowerBuilder
c. What was the composition and skill level of the team? Did development teams require training to work with the technology? No. Knowledge of tools was acquired through experience.
e. How many person-months/days did the project take, and over what calendar time frame? Was a formal schedule created at the start of the project? Did the project stay on schedule? The initial phase took about 6 months (one person)
f. Did management and the user community consider the project a success? Yes
g. If you had to do the project over again, would you do anything differently? If yes, please explain why. Yes, I would give the middle management ownership of the product.