The client optimizes quality, productivity, and market share for Integrated Delivery Networks. They deliver seamless, evidence-based care for personalizing engagement between referring physicians and patients. Just as other transaction-centric industries have experienced immense pressure to refine their customer segmentation and targeting campaigns to drive personalization, the healthcare industry is now being held accountable for a high-level of informational convenience.
To assuage new patient demands, the client began evolving their software suite. Today, their offerings boil down to three primary solutions: Imaging Workflow, Referral Management, and Decision Support. These value-driven workflow solutions increase physician productivity, improve utilization for the healthcare continuum, and supports an adaptable standard for patient care.
Although their solutions functioned well on their own, end-users were losing productivity to silos. When we met the client, they were in search of an Allscripts EHR-certified development partner who could integrate Sunrise Clinical Manager (SCM), an Allscripts EHR solution, with their preexisting offerings. SCM integrations would foster greater interoperability, issuing prescription suggestions to medical providers in alignment with each patient’s health record.
Our objective was to integrate Allscripts EHR SCM version 16.3. In integrating SCM, we would be introducing the client’s software to entirely new layer of functionality. SCM creates a more fluid exchange of information, automatically retrieving records when a medical order is placed, and relaying the data to the client’s system. From there, the client’s system determines if the order is warranted or not based on patient history, essentially forging a network of checks and balances.
The client's application is already integrated with two different EHR platforms, EPIC, and Cerner. Allscripts Sunrise Clinical Manager would be the third EHR integration. The client operates an API, the lesion between the EHR platforms and the end user's native system. User requests are filtered through the client's API every time a record is made in the SCM. In turn, the API sends a response back based on the data it receives, confirming if the order is accurate.
If the order does not align with corresponding data, the user is prompted to either add an explanation for the original order or choose from a list of suggestions contextualized to the data the system retrieves. There are two APIs in the clients net of offerings, including a Rich API that wraps the response data in HTML, and the second being SOAP API which is not wrapped in HTML.
Doctors generate orders related to diagnostic imaging, and the order calls on a specific Medical Logic Module (MLM), which interprets the data based on the corresponding Dynamic Link Library. The Dynamic Link Library method contacts the client's web-service and relays the response back to the MLM. Next, the MLM renders the output to the SCM pop-up page. Once the provider responds to the prompt, the data is sent to the MLM again.
In other words, the MLM, SCM, and Dynamic Link Library maintain a continuous dialogue to match provider inputs with logical outputs. For the first prompt, the doctor inputs the list of symptoms, the second pop-up prompts the provider to review the symptoms, and the third pop-up validates or invalidates the order.
The MLM has five sections that are predefined, and the sections are referred to as slots in the Arden specifications. Arden coding guidelines must be followed and preserved for the MLM. The MLM is responsible for retrieving the response from the doctor and passing the response to DLL, and the DLL method sends the provider's response to the client's API.
Since the client’s codebase was already mature and established, all new development mimicked the existing architecture in order to preserve integrity. To do so, we leveraged the following technologies:
In addition to the client’s parameters, we also maintained our Chetu standard for development. This included naming conventions and standards and keeping the developer-client channels of communication open throughout the project. By keeping these channels open, we were able to meaningful comments, producing a more successful final source code. The final source code has been deployed, and the Allscripts integration was an overall success. Now, the client maintains three EHR platform integrations and has widened their client base to include Allscripts users, ushering in a new era for healthcare technology.
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