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Integrating SAP Patient Management and a clinical information system with the business process platform

 

First, let me introduce my company and our solution: MEIERHOFER AG is a technology enterprise in the health care sector that does business throughout Europe. Our solution, MCC, is a scalable information system that networks medicine, patient care and administration. The goal with this solution is to provide physicians, the nursing staff and administration with an optimum flow of information and consistent data, and to support clinical processes from admission to discharge and invoicing. We currently support more than 150 facilities where MCC is used either as a comprehensive solution or a ward-specific solution. We also have a partnership in Germany with RZV GmbH Volmarstein that includes more than 80 common customers who use MCC successfully with the SAP Patient Management (IS-H) solution.

 

Integration is especially critical for us. The typical IT landscape in healthcare companies today includes several different systems, some of which perform highly complex tasks. As the leading system used to document patient care, MCC needs to support the integration of other systems. Thanks to an integration scenario certified by SAP, data between all medical and administrative departments can be synchronized at all times.

 

The MCC solution today

 

MEIERHOFER changed the technological basis of MCC to Microsoft .NET in 2003. This was the first step toward developing a service oriented solution.

 

Today, the following use cases have been implemented and certified with SAP Patient Management:

 

  • Synchronisation of master data
  • Admission
  • Change of Case Type from out-patient to in-patient
  • Transfer and Discharge
  • §301 data communication
  • Transfer of diagnosis and therapy coding and DRG
  • Medical controller release
  • Medical activties communication
  • SAP failure concept

 

Our implementation with SAP is a combination of two technologies: message-based communication using the Healthcare Communication Management (HCM) capabilities of SAP Patient Management and BAPI. As the figure below shows, in the transfer from SAP to MCC, HCM is used as a trigger and BAPI is used to complete those data, which are not provided by HCM. In going from MCC to SAP, BAPI and RFC are used to run all transactions synchronously.

 

 

Today’s shortcomings

 

We have found that HCM export does not provide all necessary information, means the BAPI calls provide more information than the corresponding HCM export provides. Therefore after receiving the HCM trigger we call SAP via the standard BAPI and fetch the complete data necessary to conduct the transaction in MCC.

BAPI operations do not provide the same transaction behavior as the SAP GUI does.  Because of that, we encapsulated the standard BAPIs with our own BAPI set and added functionality missing in the standard set.

Not all SAP transactions needed by MCC were available in the first release of IS-H BAPI. Thus, we had to live with a mix of technology, which decreases stability and quality.

Using MCC and SAP IS-H is more like a synchronization scenario than an integration scenario. Therefore it is more complex than just calling a service.

 

The coming service-based solution

 

We were interested in using the SAP business process plattform, and so became a member of ESC, working in CDG Resource Planning & Scheduling. We are focused on the following enterprise service definitions:

 

  • Consuming catalog data
  • Consuming ADT-services
  • Providing scheduling, coding, grouping and treatment data

 

Our future solution is based on a service oriented architecture (SOA) approach. That means our MCC desktop calls workflows that are driven by a workflow engine. The workflow calls services that are needed to fulfil the transaction enterprise-wide. (See diagram, below)

 

 

 

For orchestration, we use our integrated workflow engine, which is based on Windows Workflow Foundation.

 

 

 

Lessons learned

 

The business process platform and the services belonging to IS-H are well designed. SAP put a great deal of effort into involving partners and customers in the design process. So the product Management team and the development team in Germany are very keen to push this difficult project.

 

We’ve also found that the synchronization of master data, such as hospital organizational structure data, is not considered in the today service definition. And it is very important that services behave the same way as the SAP transactions.

 

Looking ahead

 

Today, our prototype is running, and we are about to present our first scenario – “out-patient admission with change to inpatient treatment” – based on the new technology. Over the coming year, we plan to add all other recent ADT scenarios, and by the end of 2008, we plan to have the first version of ADT transactions based on the business process platform. Then, in the beginning of 2009, we plan to do our first integration based on the platform.

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