Challenge
Reduce the time taken to deliver test results to medical practitioners and streamline administrative tasks

Solution
Build a gateway that provides on-line delivery of test results along with a centralised ordering facility for samples and supplies, plus access to top news stories and links to key industry information

Benefits
• Pathology labs achieve significant cost savings through streamlining their   processes and by providing results to doctors through this medium
• Pathology labs gain competitive advantage through on-line results service
• Faster, secure and convenient delivery of test results for clinics
• Less time spent ordering samples and supplies
• Cost savings through replacement of manual delivery services
• Access to top news stories keeps time-strapped practitioners up to date with latest developments

Products Used
ColdFusion Server 4.5.1
ColdFusion Studio
Spectra 1.01
Spectra Webtop
Dreamweaver UltraDev

Platform
Windows NT and Debian Linux

Doctors are able to deliver tests results to their patients faster as well as streamline previously time-consuming administrative tasks following the development of a Macromedia-based Web site from on-line medical services aggregator eClinic.

By integrating Macromedia's back-end development tools including ColdFusion and Spectra with Macromedia Dreamweaver UltraDev as the front-end design tool, eClinic seamlessly created www.eclinic.com.au, which enables registered medical practitioners to securely and conveniently receive their patients' pathology and radiology tests over the Internet.

The eClinic site also provides a gateway to a range of on-line services for practitioners, including access to the latest medical and top-breaking news stories of the day, and on-line ordering of samples from pharmaceutical companies.

The dynamic content management capabilities of the Spectra-based system allows medical practitioners to call on the information they need for their clinical and non-clinical research and decision making whenever and wherever they need it, while the graphics and design capabilities of Dreamweaver UltraDev enabled eClinic to create a user-friendly interface for the site.

Service attracts several hundred registered users

The eClinic service, which was launched earlier this year in Victoria and South Australia, in partnership with diagnostic and analytical information services provider The Gribbles Group, has already attracted several hundred registered users and processes several thousand transactions per month.

Once a pathology or radiology test is completed, the results are entered into the Gribbles Group's computer system and transferred to eClinic in Health Level 7 (HL7) format, an international and Australian standard for interpreting medical data.

"We built the whole site in ColdFusion and Spectra, converting HL7 data into Spectra Objects and designed it in Dreamweaver UltraDev. We use Spectra to display content (including reports) effectively when the medical practitioner logs in to view it," eClinic Technology Manager Gavan Lim-Joon said.

"Doctors can print out the report or import the results into their patient management software. We have built a Java applet and servlet that is integrated with ColdFusion and Spectra directly, so reports can be downloaded onto a doctor's hard drive."

"The reports are managed via an inbox where practitioners can see in real time exactly what is ready and take action for their patients. They can see the results as they're made available. The inbox also provides value by being context sensitive - abnormal results are displayed in red (rather than the standard blue) for quick identification and urgent attention."

"The search engine enables doctors to look for historical reports. By using parts of the patient's name and/or date of birth, they are able to find virtually all of their reports immediately."

The flexibility of the system enables doctors to access results from multiple locations, such as home, a laptop and other clinics through the use of a digital certificate.

Viewing the results on-line delivers many advantages to medical practitioners and their patients. The results are available as soon as they are created. This helps reduce patient anxiety as they get their results faster. Importantly, it enables the doctor to take action and commence any required treatment in the earliest possible time-frame.

The speed of delivery of results is particularly beneficial to rural communities, according to Mr Lim-Joon.

"The service has been well-received in rural areas where clinics are often not on a courier path. Those areas benefit greatly in getting their report as soon as it's ready" he said.

The system also delivers cost saving benefits, as Mr Lim-Joon explained.

"The pathology labs save a lot of money by streamlining their processes and providing results to doctors through this medium," he said.

The process we're replacing is a physical one - the courier in the van driving around and dropping off reports to various clinics. We have replaced that manual process electronically, which delivers a lot of cost savings.

"Help desks and call centre costs can also be reduced because the doctors can find information themselves. They don't need to follow up the laboratories with phone calls to ask if their test results are ready."

eClinic also offers general practitioners and specialists a fast and convenient way of ordering pharmaceutical samples. Doctors simply select the samples they require and add them to their on-line shopping basket. Once the order is submitted, messages are sent to the respective pharmaceutical manufacturers, who immediately dispatch the samples to the doctor.

"Doctors regularly order pharmaceutical samples from numerous pharmaceutical companies. The on-line sample ordering system gives them a 'one stop shop'. It's a great replacement for the tedious and frequent ringing around with separate orders."

eClinic is about to add an e-commerce facility enabling doctors to purchase medical consumables such as surgical gloves and swabs on-line.

Spectra's content management features comes to the fore in eClinic's delivery of the latest medical and general news from Australia and around the world.

"We use Spectra to manage the dynamic news content that comes into the site every day from AAP. We have the top five or so leading news items of the day, and the top medical news stories," Mr Lim-Joon said.

"We defined Spectra news objects and containers for content layout and business rules for publishing. Once that work was done up-front, it is now automatically imported and put up onto the site every day in real time without any user intervention. It's really an autonomous system and we've found that it's one of the great features of Spectra. Other managed content include resources such as links to other sites, medical education references, Australian Medical Association conference information and a calendar of events.

"We also use ColdFusion and Spectra for our back end systems to handle registrations, manage accounts, and to track system usage data. We can use Spectra customisation/personalisation features for storing profiles of our customers, and we also use Spectra to store the pathology/radiology reports themselves for subsequent viewing."

Front and backend tools from the one vendor

eClinic developers and designers were able to work together using the seamless integration of Macromedia's front-end design and back end tools to create the site.

Web designer Kuljeet Pannu used Macromedia Dreamweaver UltraDev to create the look and feel of each page on the site including J-Peg and GIF graphics such as logos and banners.

"Dreamweaver made it easy for me to do roll-overs and it generated the Java script I needed. It made it easy for me to design the pages because I could immediately see in the browser exactly what I wanted. Working with the layout of the page, colours, and moving images on the page is all much easier to do in Dreamweaver," Ms Pannu said.

"Once I was satisfied with the look and feel I had created, I could transfer the files to the servers for the developers to do programming in ColdFusion. The way the Macromedia products integrated together made it easy to send the files back and forth and make changes as needed."

"Dreamweaver UltraDev works well in our ColdFusion development environment with it's ability to recognise ColdFusion tags. It made my design and graphical layout activities easier to integrate around the code. The developers then used Macromedia ColdFusion Studio to develop the code."

It was features such as dynamic content management capabilities and the integration between Macromedia products that led to the decision to build the site using ColdFusion and Spectra.

"We did research and looked around at what was in the market at the time and decided to go with ColdFusion and Spectra. It offered the most cost effective way of being able to do a proof of concept and prototype, which was important for us as a start up company," Mr Lim-Joon said.

"The ColdFusion and Spectra feature set was rich in comparison to other products. It enabled us to do what we wanted to do, and that is content management. Spectra was the best technology for user personalisation and manipulation of dynamic data."

Speed of development and ease of integration

Speed of development and ease of integration with other systems are other benefits delivered to eClinic by ColdFusion and Spectra.

"There was a lot of work up-front, with the integration of security, establishing the architecture and working with Spectra objects, but we were able to move through that development rapidly."

"We were also able to integrate ColdFusion and Spectra with our PKI (public key infrastructure) solution for the use of digital certificates which adds another layer of authentication - that's very important for this market where you are dealing with privacy of patient data and highly confidential medical results and records."

The scalable Macromedia-based solution will grow with eClinic as it adds new on-line services and extends its reach to the rest of Australia and possibly overseas, according to Mr Lim-Joon.

"Traditionally medical professionals have been slow in the take up of IT, but through technologies like these, we're making it easier for them." he said.