Case Study: Hospital's Prescription: A Dose of Database Software : Page 2

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It's easy to see how it could become a problem. Under traditional hospital practices, "If a doctor wants to give you a medicine, he writes (a prescription) on a carbon paper and faxes it to the pharmacy," Halamka says. If the handwriting is garbled, "the pharmacist might ask himself, is that 5 mg, or .5 mg? Is that in metagrams? You can imagine how dangerous it is to deliver medicine that way."

The old process has other flaws. Once the pharmacist keys the prescription into the computer system, it's filled by a human and delivered to a nurse for delivery to the patient. "At every handoff there's a chance for a mistake," Halamka says.

1 Million Patients' Records Accessible

Enter InterSystems, which provides high-performance post-relational database software systems for Web applications to more than 4 million seats worldwide. Its flagship product is Cache, a post-relational database for e-business that helps enterprises access and inter-relate vast volumes of operational data. (InterSystems is considered the leading database software vendor in the health care sector.)

Halamka says Cache does an excellent job at helping manage a huge data load -- in CareGroup's case, 21 terabytes of data, including records on about 1 million active patients. (Its Boston-area hospitals include Beth Israel Deaconess Medical Center, Mount Auburn Hospital, New England Baptist Hospital, Deaconess-Waltham Hospital, Deaconess-Glover Hospital and Deaconess-Nashoba Hospital.)

CareGroup runs Cache on clustered Hewlett-Packard Unix servers. It uses storage technology from EMC. Its hardware is located in a secure, 13,000-square-foot data center. To protect the system, it runs backup generators and employs redundant telecommunications infrastructure to prevent the system from going down, no matter what might happen. It also uses advanced security to authenticate its users, including RSA SecurID tokens to verify users.

Halamka says the database system cost $2.5 million to develop and install; annual support and maintenance costs about $250,000 annually. It took 18 months to customize the system, including the work of 23 programmers. A team of 35 clinicians (doctors, pharmacists, nurses, social workers) worked together to ensure features that were important to them were incorporated, including current pharmaceutical updates, and continue to add new content to the system.

The POE can be accessed from nearly anywhere -- from the hospital floor to doctors' homes -- using a Web browser. CareGroup maintains 8,000 PCs, or about one PC for every two hospital beds. The POE system is also wireless-ready and can be accessed via wireless laptops and handheld devices, as well as from off-site computers.

There are few other hospitals in the U.S. using such database system, so the eyes of other hospital CIOs are on them, Halamka said. In addition to health care applications, InterSystems' Cache is used in transportation, financial services, law, telemarketing, and retail, among other industries -- any business that needs high-performance, highly scalable processing applications to automate core operations.

Privately held InterSystems was founded in 1978, has 350 employees and its software is licensed to 4 million seats worldwide on 80,000 systems.

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