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Bridging General & Specialist Care - Information Systems Solution (BGSC-ISS)
Imaginet was to develop a product that would improve inter-action between Family Physicians (and/or other Referring Clinicians such as Nurse Practitioners) and Specialist Physicians to whom Family Physicians may refer patients for assessment and/or treatment.
BGSC would facilitate agreements between Specialists and Family Physicians with regard to such issues as what course of treatment Family Physicians should provide before considering a referral, what tests are required as a pre-requisite for a referral, and what preparation the Specialist may need prior to treatment.
DETAILS
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Situation
The goals for BGSC were to: | Solution A high quality, feature rich and visually appealing web-based application was delivered to WTTF in 10 weeks.The solution assists Family Physicians in diagnosing and assigning a Specialist to a patient?s care plan. By answering a number of sequential questions based on the initial diagnosis a Family Physician are now able to identify if a Specialist is required as well as any necessary tests that must be performed prior to booking the Specialist appointment. If it is determined that a Specialist is required, the Family Physician selects the Specialist and the Specialist will automatically receive the request to see the patient.The Specialist can accept or reject the referral. If accepted, an appointment is made. If the Specialist is unable to see the patient, the request is rejected and another Specialist can be referred. Patient information can only be entered via the Family Physician and viewed by the Specialist. If the Specialist accepts the referral, they may add additional information to the care plan. This allows the Family Physician to have immediate access to up to date information for the patient. The Health Administrator can perform the same actions as both the Family Physician and the Specialist. Additionally the Health Administrator can add and remove Family Physicians and Specialists as well as maintain system rights. |
Software Silverlight, coupled with the other Microsoft products, provided Imaginet developers with the efficiencies needed to complete this project on time, on budget and with a high degree of quality and efficiency. | Process The team followed an iterative delivery model over the 10 week projectThis process framework, known as Scrum, allowed for thorough testing of all features while the application was built. This reassured the customer early and often that the product was going to meet requirements and schedule. The BGSC project had two senior team members perform the preliminary technology research. This research defined the path ahead for the team, fine-tuned the development environment and removed areas of risk via ?spikes?. A ?spike? is a proof of concept that allows for a quick examination of problem and helps to validate technologies and processes. When the project started, the team found themselves in a stable environment with a strong foundation for making the most out of the selected solution technologies. Because of the initial research, the learning curve for new team members was greatly diminished. With Scrum projects, a high degree of client involvement is critical to ensure the requirements are met, features are developed in the correct order, and to review working software after the end of every iteration. |
Figure 1: Physician Care Plan is a dynamic window which allows the Family Physician to select the diagnosis. Once a diagnosis is selected, the care plan can be continued.
Figure 2: Patient Information window allows the Family Physician to select or add a patient along with any additional history that would benefit the Specialist.
Figure 3: Primary Care window varies depending on the diagnosis selected and the care plan required.
Figure 4: Diagnosis window identifies the tests required prior to seeing the Specialist.
Figure 5: Referral window allows the Family Physician to select the Specialist.
BGSC allows Family Physicians to follow a standard care path that concludes with the selection of a Specialist resulting in a shorter wait time for patients to see specialists and patients attend appointments with all the required tests thereby allowing patients to achieve the required care quicker.
Figure 6: Referral Confirmation allows the Specialist to view the patient information and the summary of information from the Family Physician, as well as accept the patient and set an appointment date, or decline the patient.
Once a patient has been scheduled, the outcome can be saved. When the patient arrives for the appointment additional information can be entered regarding further treatment or if no further treatment is required that too can be recorded. All information is forwarded to the Family Physician for their records and any follow-up that may be required.
Value An open working relationship resulted in a high level of trust between WTTF and Imaginet. Direct contact between the WTTF and Imaginet minimized impacts of project issues that often result in delays. The WTTF was able to provide almost instant feedback to either a development question or problem and the team was able to demonstrate ideas to the client and receive almost immediate feedback. The BGSC application facilitates communication between Family Physicians and Specialists, allowing patients to see Specialists in a more timely manner. Family Physicians can send their patients to Specialists with the most information and the necessary test results for their continued treatment. Specialists can review the case and determine if the diagnosis is correct, if the appropriate information has been supplied, and if they can meet the target appointment date to see the patient. | Innovations A process called Scrum was used for the BGSC project. This allowed product and team feedback to be gathered regularly required to deliver a solution of this size in 10 weeks. During the project the Imaginet team delivered what the WTTF needed on time, and within budget and schedule constraints. Imaginet provided a development environment in its head office, and is also hosting BGSC in a secure hosting facility. Due to the sensitivity of the information contained within this application Imaginet was required to comply with PHIA and FIPPA privacy standards. Additional security measures were taken within the application and environments to ensure compliancy. Microsoft's innovative solutions allowed Imaginet to deliver the application on time, on budget and with a far superior product than the client originally requested and expected. |