yourfanat wrote: I am using another tool for Oracle developers - dbForge Studio for Oracle. This IDE has lots of usefull features, among them: oracle designer, code competion and formatter, query builder, debugger, profiler, erxport/import, reports and many others. The latest version supports Oracle 12C. More information here.
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The restrictions placed on the use of wireless devices within hospitals didn't stop this company from deploying a handheld system that would address the leading contributors to escalating health care costs and accidental patient deaths: lack of secure access to clinical data and inability to document and reduce adverse drug reactions and medical errors.

Even as legislators and health care leaders attempt to finalize privacy and security parameters associated with HIPAA (Health Insurance Portability and Accountability Act) regulations, hospitals across the nation are moving forward with technology projects to address a myriad of demands: from the government to increase accountability; from consumers to lower costs; and from within their own industry to facilitate information-sharing. Each of these demands is expected to be met, while still protecting patient confidentiality.

Emerging wireless technology has often been touted as a cure-all for productivity woes, medical errors, and escalating costs, but savvy healthcare enterprises realize that there is no single cure for multiple ills. However, by providing mobile access to clinical data among hospital staff, administrators can address key organizational objectives and assist their staffs in meeting many of the required demands.

For many health systems the data on adverse drug reactions, medical errors, and clinical interventions is still collected and stored manually, and is not readily accessible by pharmacists, physicians, or hospital administrators. Thus, many health systems require a solution that joins current generation technology with emerging wireless and mobile applications to securely deliver key data into the hands of medical professionals.

In response to this challenge, HealthProLink, Inc., an application service provider (ASP), based in Bellevue, Washington, chose synchronization and device management components from Aether Fusion, Aether Systems' wireless technology foundation, to deploy an out-of-the-box solution that would provide hospital pharmacists with clinical data at their fingertips. Designed by pharmacists for pharmacists, the HealthProLink handheld computer system delivers bundled applications and the supporting infrastructure, which allows hospital pharmacists to collect data on adverse drug reactions, medication errors, and clinical interventions while enhancing management's reporting capabilities.

"Our solution provides mobile access to clinical records so hospital pharmacists can update and view data including therapeutic interchange guidelines and cost comparisons on prescription drugs," says Terry Gibbons, CEO, HealthProLink. "What made our offering comprehensive was Aether's wireless technology, which provides near real-time access to data."

The Foundation
Hospitals are no strangers to serving the masses. With more than 6,000 major hospitals serving millions of patients across the United States, hospital staff are inundated with a broad range of patient and clinical information on a daily basis. Nearly 60,000 hospital pharmacists manage not only the types, costs and benefits of various prescription drugs, but must also be knowledgeable about a patient's personal history when filling prescriptions.

The HealthProLink handheld system allows medical professionals to manage a vast array of clinical information while away from their desks. Using a PDA, pharmacists and other medical professionals can document and access information on clinical interventions, medication errors, adverse drug reactions, and prescription cost comparisons. Having this information at their fingertips reduces cost and risk, increases productivity, and enhances reporting.

Built using a Dell-based server facility, software and router-based security systems, Crystal Reports reporting engine, and IIS and WebLogic application servers to manage the business logic of the Web applications, the HealthProLink system required no additional deployment beyond setting up the network facilities.

In May 2001, HealthProLink integrated their solution with Aether's synchronization and device management software. The solution was designed to:

  • Increase pharmacists' ability to record drug interventions at the time and point of intervention
  • Increase pharmacists' ability to access the most current clinical data such as antibiotic effectiveness charts and generic therapeutic alternatives to more expensive medications
  • Increase pharmacists' ability to collect data on medication errors, which are often not recorded or reported
  • Increase pharmacists' ability to transfer knowledge about adverse drug reactions to physicians
  • Become a turnkey system for hospital pharmacy groups with mobile and wireless capability, eliminating the need for customers to go through extensive deployment measures and custom development
  • Synchronize handheld databases with central databases over any TCP/IP connection

The Solution
By integrating their system with Aether technology, HealthProLink was able to provide their customers with a flexible solution. Built on industry standards, Aether's flexible, scalable, and secure data synchronization server has an open and intuitive environment, which allows programmers to reuse their existing business objects. Also, Aether Fusion provides the flexibility to perform synchronizations over either wired or wireless connections, eliminating the risk of potential interference with complex electronic machinery within hospitals.

"Often, the challenge to implementing new technology is selecting one solution that will effectively answer multiple and sometimes divergent needs," says Gibbons of HealthProLink. "In this case, we had to provide the pharmacists with access to information while on the go, while also meeting the needs of the individuals responsible for the safety, security, and maintenance of the new technology itself. We integrated Aether's technology with our own to answer all of those needs."

The synchronization component of Aether Fusion allowed pharmacists to chronicle and access clinical data over any TCP/IP connection, wired or wireless. Data from the PDA was later synched back to the server, via a cradle, for updates and reconciliation - ensuring accurate records. Aether Fusion also provides certificates for authentication, SSL connections, and DES3 encryption.

In addition, the solution offered a built-in advantage to administrators, enabling them to manipulate databases on the handheld, push or remove files from the handheld, and perform batch or real time synchronizations when the device is synched to the server. The ability of administrators to actively manage and monitor devices ensures that a lost or stolen device can be rendered inactive, so that no vital information is accessed inappropriately.

"From a handheld application standpoint, we have complex programming routines that would not have been possible with other products, and Aether Fusion supported our complex front end development," says Charles Westergard, RPh MBA, and VP of product development for HealthProLink, Inc.

Real World Experience:
Testing and Launch
Over the course of six months in 2001, including three months of trials, pharmacists from several health systems including Johns Hopkins Children's Center tested the HealthProLink handheld system with great success. Designed to be user friendly, the system received high approval ratings during trials for ease of navigation and use.

"HealthProLink enabled our pharmacy department to substantially increase documentation of clinical interventions, medication errors, and adverse drug events," says Ginger J. Ertel, previously Pharm.D , Johns Hopkins Children's Center, Baltimore, Maryland, now director of pharmacy at Broadlawns Medical Center, Des Moines, Iowa.

The commercial system was developed over a four-month period, and tested for an additional 30 days. To ensure smooth implementation, site managers and key pharmacists were trained via live, interactive Web demonstrations. In addition, HealthProLink provided assistance to these individuals as they trained other staff, by using a Web interface to walk users through the process.

When the solution was launched in the Fall of 2001, HealthProLink was adopted by 20 health systems including Providence Health Systems. With 25 acute-care hospitals and more than 400 hospital pharmacists throughout the West Coast, Providence Health Systems adopted the HealthProLink solution because of its quick deployment capability.

"The process to implement the solution was straightforward, and we believe it will start paying dividends almost immediately. The ready access to powerful clinical tools and fast and easy documentation that HealthProLink provides will help our pharmacists improve productivity," says Rick Sahli, director of Providence's Regional Pharmacy Services in Portland. "The new system will also provide Providence clinical managers with standardized reporting of the pharmacists' performance on a system-wide basis."

Real Return on Investment
The American Society of Health-System Pharmacists (ASHP) estimates that one clinical intervention can result in a savings of $66. Within that realm, the HealthProLink system could potentially save a hospital over $16,500 per year, per full-time pharmacist. It is this real potential for return on investment that has made the HealthProLink solution an early success.

As more hospitals begin to invest in solutions that keep decision makers connected to vital data, the benefits are already clear. Pharmacists at Johns Hopkins using HealthProLink's solution increased intervention reporting by an average of 16 interventions per pharmacist, per day, a projected savings of over $1,000 per day, per pharmacist.

In addition to the cost savings, the HealthProLink system also provides health benefits. A hospital customer of HealthProLink relays the experience of a pharmacist approached by a doctor concerned about a patient in the emergency room experiencing profuse retinal bleeding. Using a PDA integrated with the HealthProLink system, the pharmacist was able to check the hospital's most current data and identify that the symptoms were similar to an adverse reaction from an anticoagulant. He immediately recommended an intervention that would reverse the side effect.

From both the financial and human perspective, near real-time access to clinical information and cost comparisons has many benefits. Doctors and pharmacists can write and fill prescriptions more accurately, translating directly to cost savings and a decrease in medication errors and adverse reactions. This generates cost savings, which are then transferred to patients through lower prescription costs. Hospitals ultimately reap the benefit of leveraging the secure flow of patient and medical data, as well as saving on pharmaceutical costs.

Many hospitals don't know to what extent adverse drug reactions, medical errors or lack of interventions are hurting their patients or their bottom line, but as Providence Hospitals in the Northwest is finding out, HealthProLink's solution can give them a turnkey, cost-effective solution with a compelling return on investment.

"Wireless data is very intriguing and many in the health care market are eager to see how it will impact the industry," says Gibbons. "We believe that working with Aether has given us an edge. Their solid expertise in an area that's still emerging helps us to assure our customers that our product is integrated with the technology of a company that's on top of industry changes and best practices."

About Brian Keane
Brian Keane is president of Aether's Enterprise Solutions Division, the business unit responsible for acquiring and servicing Fortune 1000 enterprise accounts covering a spectrum of industries including technology, utilities, manufacturing, health care, financial services, and consumer goods.

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