Hunterdon Medical Center’s CIO wanted the healthcare
facility’s new remote backup/recovery
hot site installed and brought online as quickly and easily as possible,
without interrupting existing processes or sacrificing patient quality care.

Going with QuadraMed as the overall
vendor made that goal feasible. “If I was to make a recommendation
to anyone, I’d say select an HIS (health information systems) vendor and let
them drive,” Glenn Mamary, CIO of the 176-bed acute care facility in
Flemington, NJ, told TechRepublic.

That was in the third quarter of 2003, when the hot site
went live. There’s also been a major upgrade of QuadraMed’s Web-native Affinity
HIS system, which is built on InterSystems‘ post-relational CACHÉ 5
database. This year, Hunterdon plans to implement a series of new systems.
Those plans include wireless system access to the IDN’s physician order-entry
system and work with tablet PCs.

Disaster recovery: Evaluating new solutions

QuadraMed was no stranger to Hunterdon, which has been a
QuadraMed Affinity customer since 1998. What Mamary was asking of QuadraMed
this time was a complete, electronic medical record system that would provide
clinicians access to patient information “anywhere, anyplace, anytime.”

Hunterdon already had a reputation for improving patient
healthcare through technology. Hospitals
& Health Networks
calls Hunterdon one of the nation’s “Most Wired”
medical centers.

However, the technology needs of a hospital system are very
different from those of a non-medical business. Hunterdon is a non-profit
healthcare organization in Flemington, NJ, committed to providing a full range
of quality services that respond to the needs of the community. Hunterdon
Healthcare System is partnered with the Hunterdon Physician Practice
Association, forming Hunterdon Healthcare Partners LLC, an integrated delivery
network (IDN) with 21 locations and about 2,000 employees; 11 physician
practices; a health and wellness center; a visiting health and support center;
and 1,400 desktops that handle approximately 347,000 patient encounters
annually. None of those patients can reasonably be asked to wait while
Hunterdon upgrades any of its technology.

Prior to the new hot site, Hunterdon used a vendor that
assisted with offsite storage and other disaster recovery systems. Hunterdon
did daily backups and those backups were tested. “If we were to have a
casualty, we’d have to order a batch shipment,” Mamary

For a long time, Hunterdon was satisfied with this system.
The vendor was always very accommodating and often was little more than a phone
call away. However, there were always the nagging realizations that Hunterdon
would not necessarily be the vendor’s priority and what could happen if
Hunterdon suffered a real disaster. Hunterdon, Mamary explained, would always
have to compete with the vendor’s other customers, which could cost precious
time. “I wouldn’t know where we’d be on the totem pole,” he said.

Then Hunterdon installed its critical information systems, a
development Mamary said was a “big turning point.” That change came
as Hunterdon continued to grow and that growth brought its own issues. “As
we grew, the expenses grew as well,” he said. The old backup and recovery
system was no longer the best option.

Hunterdon officials soon were mulling the value of a hot
site and this led a few years ago to a business impact analysis study, in which
Hunterdon officials looked into what would happen if their systems went down or
became unavailable.

Benefits of a remote facility

Hunterdon had a number of options. They could contract out
but that would be expensive. They could build onto what they already had in
place but the existing procedures and systems already were inadequate and
adding on would make them cumbersome. So Hunterdon began testing and finalizing
plans to develop the hot site, using in-house manpower and resources. They soon
found that, done this way, the hot site not only became a disaster survival and
recovery location but also could be used for training and other purposes,
Mamary said.

Other benefits tipped the scale in favor of this new
disaster management and recovery solution. Hunterdon would not only enjoy full
and immediate access to the computer room, but also full use of the facility’s
equipment for such tasks as printing, offloading, and training. “We’d
actually get to utilize all our assets,” Mamary
said. “They wouldn’t just be sitting there.”

These observations were backed up by Hunterdon Technology
Manager Alberto Cruz-Natal, who pointed out that the health care system
examined a number of “what-if” scenarios and is very pleased with the
results. “We can react better when the technology changes,” he said.
This also provides better security.

The benefits extend even beyond the disaster recovery system
and facility. Mamary said he appreciates having full control over what
operating systems were installed on which computers and always knowing the OS
distribution, something they never enjoyed with the vendor.

The new system was implemented in about six months. “What
we did was hold the line on the hospital information system,” Mamary said. This can be crucial, he explained. Hospitals
that need to expand their information systems often have trouble implementing
better, more streamlined solutions because of the need for constant change.
Instead, they usually end up adding on, which often creates unwieldy and
insecure systems.

This was where the importance of QuadraMed became most apparent.
The benefit of using QuadraMed as a single contractor was that QuadraMed was
able to coordinate almost all of the project. For instance, they worked with
the IBM reseller and they were able to oversee the project enough to be sure
that the new HIS system worked as envisioned. This eliminated the problem of
multiple people setting multiple priorities, he explained. “They all
worked together with QuadraMed as the leader,” he said.

InterSystems, creator of CACHÉ, reported to QuadraMed. CACHÉ’s
speed and reliability were key to the high level of system performance Mamary
wanted to achieve. In disaster recovery mode, Hunterdon can obtain a database
at the remote hot site in less than two hours, a dramatic improvement over its
old system. Also key to the success of the implementation is the CACHÉ RAD
environment, which made it possible for QuadraMed developers to quickly
customize Affinity to meet Hunterdon’s specific needs.

QuadraMed Affinity Patient Registration helps expedite
patient flow and improve Master Population Index (MPI) accuracy. QuadraMed Imaging is used to scan
insurance cards so that Hunterdon staff can access information on those cards.
QuadraMed affinity Patient Charting makes documentation easier, more thorough,
and far more accessible

Hunterdon plans to implement QuadraMed Affinity Computerized
Physician Order Entry (CPOE) this year.