T-Systems Austria has recently created "i.s.h.med occupancy management", an application that can be used to plan inpatient admissions in care units across different hospitals. It gives the user a Web-based graphical overview of current and planned admissions of the care units, and enables him or her to interact with that information in various facilities in order to change or create new appointments. From a strategic perspective, the i.s.h.med occupancy management application provides visibility into overall occupancy loads and helps optimize the efficiency of inpatient resources to avoid under-utilization or overloads. Ultimately, it is designed to help hospitals ensure that beds will be available when patients need them, and that the right clinicians will be available to provide treatment.
The fundamental challenge in creating this solution has been the need to design an application that works across institutions to combine the planning of resources in various hospitals, such as care units and beds, on one screen.
That is no simple matter in a world where different hospitals have a range of hospital information systems in place to store patient data and manage core administrative processes, such as inpatient admissions, discharges, transfers, and so forth. We knew that it wouldn't make any sense to design a scheduling application that works in a separate silo, where the planning information would not be connected with the people working in the hospital ward or at the admission desk. To work optimally, front-line nurses and doctors have to be aware of planned workloads so that they are ready for the number of patients that will visit the hospital in, say, the next week.
Therefore, we decided to design a scheduling application for occupancy managers that works independently of core hospital information systems, but communicates with them via Services to enable users to search and plan new inpatient appointments. Data stays in the "home" system that currently houses it, and the planning information is communicated to the existing work environments of nurses and doctors.
The first hospital information system that can interact with i.s.h.med occupancy management is SAP Patient Management (IS-H). The picture provides an overview:
Making use of business process platform components
In bringing these solutions together, we put a lot of effort into designing and describing the Services used by the new scheduling application. We also brought this information to the CDG for Resource Planning and Scheduling, which we joined for one year. The discussion within the CDG, in addition to our long-term partnership with the development team of SAP Patient Management, played a big role in the success of the project. Those relationships helped ensure that services were defined to meet the requirements of the inpatient scheduling application that needs them.
The i.s.h.med occupancy management is based on SAP NetWeaver 2004s. The UI was written in WebDynpro for ABAP, including a GANTT UI element that lets the occupancy manager interact with other systems via drag-and-drop to optimize the planned appointments. SAP NetWeaver 2004s is used as the application platform for i.s.h.med occupancy management, so SAP ERP was not necessary for our purposes.
Lessons Learned
After we made the decision to use SAP as our technology platform, the next question was: Should we implement the application on WebDynpro for ABAP or on Web Dynpro for Java? After a long period of investigation and training on Net Weaver Development Infrastructure (NWDI), we decided to go with Web Dynpro for ABAP. The additional infrastructure that would be required to implement and maintain applications in Java for SAP seemed to us to be too high an obstacle for our potential customers.
We also learned that when creating an application like this, you are on the spearhead of SAP's software development. There are actually lots of advantages to that, because you can easily get into direct contact with developers in Walldorf or the USA, and they can help you with any teething problems with their APIs. On the other hand, every patch of SAP BASIS software components includes changes and redesigns, and new integration tests are necessary with these corrections.
To design Services, you have to first describe the Use Cases for which you want to use the Services. The CDG initiative is very helpful in that regard, but you need to spend time talking to customers, development partners and other possible consumers of the Services. In the end, we were able to develop a clear picture of the Use Case "occupancy management."
What's next?
In the early part of 2008, the first customer implementation of i.s.h.med occupancy management will be completed. The first general release will be available in March 2008; it will be in German, with an English version to follow. We are now planning to gain experience in a range of planning scenarios, and incorporate the lessons learned into further development.
For further information
For more information on the i.s.h.med clinical system and its various modules, including i.s.h.med occupancy management, please visit http://www.ishmed.de/en/html/index.html.
