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When you plug in, are you on?

One of the biggest challenges facing healthcare providers is the need to create integreated systems using applications from completely different software companies.

THERE have been exciting developments in Internet technologies over the past few years, including in healthcare. If we're not on time, patients walk out. Healthcare is now all about better services with a better system.

In any typical organisation, its processes are complex and often wrongly understood. The problem is that processes are organic and are built upon over time. They are modified, nipped, and optimised until they support the business in the most efficient wa y. The smallest change in the process can have a widely felt impact and the potential to create chaos. Careful attention should be paid to the processes that the technologies are geared to support, or else all technology can be detrimental.

The common processes that most healthcare institutions encounter today and solutions that preserve the integrity of the processes while leveraging advanced Internet technologies are as follows:

One of the biggest challenges facing healthcare providers is the need to create integrated systems using applications from completely different software companies. How can they make sure the applications will work together - that their accounting program will invoice their patients for procedures recorded in their electronic medical record?

Different solutions are adopted by healthcare institutions. One such solution is ActiveX for Healthcare. It is a component which uses Microsoft ActiveX technologies, based on the Microsoft component object model (COM), to enable ``plug and play'' interop erability between healthcare applications in a way analogous to hardware plug-and-play products.

ActiveX - key building block

ActiveX for Healthcare is a combined effort among Microsoft, healthcare organisations, and independent software vendors to bring Microsoft's enterprise object technology to the healthcare industry. Fortunately, merging legacy systems with new technology is not unique to healthcare. ActiveX is the key building block for interaction between applications and services - whether on the same machine, on a local network, or over the Internet. ActiveX components can be written in any language and deployed acros s multiple operating systems.

ActiveX components using Microsoft's Distributed Component Object Model (DCOM) are the key for accessing Active platform applications and services such as messaging, transaction processing, database, directory and Internet services. ActiveX for Healthcar e is designed to provide easier and less expensive interoperability between healthcare applications and systems.

The ActiveX for Healthcare Messaging Components are the first step towards ``plug'' it in with the assurance that it will ``play'' within the existing system. Based on encapsulating HL7 messages into objects, these components make it easy to connect syst ems from different vendors. Applications simply request the appropriate object like an admission note or a medication order, adding the appropriate data elements and transparently sending the object to applications which are configured to receive it.

A flexible transport architecture gives users a migration path between today's legacy systems and interface engines, and tomorrow's networked, component based applications.

Many transcription companies in the US use Microsoft's Visual Basic, Visual C++, WordPerfect and Word technologies. It allows transcriptionists to transcribe into Word templates which are prefilled with demographics, order, and other information, and to save these through a transcription service using third-party technologies.

*Standard-based technologies (Third-party technologies):

Breakthrough object technology will provide doctors with the latest information on all types of medical conditions, enabling them to tap into both local clinical decision support systems and remote clinical databases to determine the best treatments. The implementation will be based on standards-based technologies, like:

*OpenDoc (registered trademark of Apple Computer Company): It is a robust desktop architecture for creating component software solutions that can be shared and customised across heterogeneous environments.

*System Object Model, SOM (registered trademark of International Business Machines Corporation): It enables developers to build applications using software components that can be deployed on different operating systems.

*Java Beans (trademark of Sun Microsystems): It has the industry specification that enables developers to write portable networked software components solutions in Java once and run them anywhere.

CogniTech Corporation, Salt Lake, Utah, released their first product based upon the application of OpenDoc and CORBA to enable users to access Lotus Notes databases. CogniTech released this component as a generic part applicable to any application domain . This Notes data component will present and allow the user to manipulate Lotus Notes data within an OpenDoc document. The user will have the option to copy, view or manipulate data from a Lotus Notes database through editing within a cell, context-sensi tive popup menus, and drag-and-drop functionality. These graphical capabilities will be further enhanced by the addition of speech navigation, with later support for Speech Recognition Application Programing Interface (SRAPI) standard planned.

This product will benefit organisations with existing Lotus databases and heterogeneous enterprises. Lotus has established itself as a leader of groupware for the enterprise, particularly for healthcare enterprises.

It is convinced that object technology, open standards, and integrated networking capabilities that Java Beans, OpenDoc, and Lotus Notes and Domino support will lead to rapid increase in health information system development, evaluation and maintenance; which are necessary to support the complex, evolving healthcare environment.

CogniTech's use of OpenDoc and Java to integrate the desktop into the powerful world of network-centered computing environments and their exploitation of their speech and AI expertise clearly demonstrates the compelling nature of the next generation of s olutions.

Contributed by Orleans Healthcare. orleans_healthcare@usa.net

(Please e-mail us at bleditor@thehindu.co.in if you have queries on computer usage or if you find an interesting way of using a computer.)