Microsoft SQL Server 2008
Customer Solution Case Study
/ New EMR System Boosts Operational Performance for Enhanced Medical Service
Country or Region:Korea
Inje University’s Paik Hospital is a non-profit hospital group consisting of 5 hospitals with a total capacity of about 3,000 beds.
Inje University’s Paik Hospital needed to standardize its medical database to improve on the overall quality of its medical service - including reducing treatment time and prescription error.
Deployed Microsoft SQL Server 2005 and 2008 as database for EMR to create forms and utilized web service standard on .NET Framework for EMR business.
- 30% faster operating speeds
- Twice as fast backup speeds
- Enhanced system reliability
- Enhanced data warehousing
Kim Yong-wook, Director of Medical Information Department at Inje University’s Paik Hospital
Inje University’s Paik Hospital is a leading non-profit healthcare group in Korea. In 2009, it completed development of its pilot EMR system with one of its hospitals – Sanggye Paik Hospital, and subsequently deployed it to other hospitals under the group. Besides computerizing major forms, the new EMR system (integrated with SQL Server 2008) provided a single and standardized point of access to all data and business related to medical service. This provided enhanced data integration, analysis and reuse – necessary components to establish a basis for the Korean u-Healthcare service. With the new EMR system in place, hospitals in the Inje University’s Paik Hospital group have experienced a 30 percent increase in operational speeds, doubled backup speeds, enhanced system reliability and stability, and can now respond faster to data warehousing and supply needs.
While many hospitals were aggressively changing from mainframe to heterogeneous distributed environments including UNIX and Oracle, Inje University’s Paik Hospital promoted effective investments to standardize its entire environment with Microsoft technologies based on its own standard and philosophy.
Inje University’s Paik Hospital wanted to implement a new generation of EMR systems to standardize its medical information and improve the overall quality of its medical service – to reduce treatment time and prescription errors. However, to implement the new EMR for a group of hospitals this size was a massive undertaking.
Also, the choice of EMR systems being deployed at the time mostly featured the computerizing of paper documents – with limitations to the systems’ capabilities surfacing after three to four years of operation. As these systems were only focused on computerizing the forms and not the architecture or standardization of the data platform across the medical service, data links and integration with other systems were not seamless, resulting in limited usage of the data.
Kim Yong-wook, Director of the Medical Information Department at Inje University’s Paik Hospital, said, “We had been using SQL Server since the mid-1990s, and migrated all of our business to the Microsoft platform in 1999. At that time, there were some opinions to deploy Oracle, but we decided that it was more appropriate to deploy SQL Server. We knew that Microsoft technologies would evolve more rapidly in the future and have the capabilities to manage the amount of data that needed to be processed in the hospital.”
Sanggye Paik Hospital – a hospital of the Inje University’s Paik Hospital group – was the first to complete the development of the EMR system, and the system was subsequently deployed to other hospitals in the group.
In the case of the Sanggye Paik Hospital, its Medical Information System was focused primarily on database design and configuration when configuring the server infrastructure for EMR.
The hospital recognized that besides computerizing documents, the EMR system needed to provide business users relevant information in a timely manner with the assurance of security and reliability.
With data standardization and structure gaining importance, Inje University’s Paik Hospital chose to deploy SQL Server to consolidate all of the data; as well as implement business functions on the .NET framework. The hospital also invested resources to establish a unified data platform across its overall treatment and administrative businesses to fit the requirements of the next generation EMR system.
Each hospital deployed about an average of eight to ten instances of SQL Server 2005 or 2008 Enterprise. On the whole, more than 50 enterprise-class databases were required for distributing the new EMR systems to the entire Inje University’s Paik Hospital group.
As of January 2010, the Inje University’s Paik Hospital group completed partial deployment of its new EMR systems. The other hospitals did not simply transfer the framework deployed in the Sanggye Paik Hospital, but rather further developed their own systems in such a way that they were optimized for each individual hospital.
Kim said, “The EMR system deployed in Sanggye Paik Hospital was the matrix for all of the other Inje University’s Paik Hospitals. The stakeholders from each hospital’s Medical Information Department would take the specifications deployed in Sanggye Paik Hospital – including data attributes, development environments and server configurations – and utilize them accordingly after determining which areas were to be omitted or upgraded for their respective hospitals.” Kim added, “Our goal was not limited to just maintaining the latest version for databases, but also to share the experiences and best practices of the Ilsan and Haeundae Paik Hospitals; which deployed SQL Server 2008 – with the other hospitals.”
Kim also commented on the fact that all of the Paik Hospitals utilized either SQL Server 2005 or SQL Server 2008, “When Sanggye Paik Hospital was first preparing for the EMR project, the latest version then available was SQL Server 2005. When the EMR system was subsequently deployed to other hospitals, SQL Server 2008 was released. Thus there were version differences between hospitals. But SQL Server 2005 and 2008 operate based on the same core engine, so there were no problems in allowing each hospital to freely choose their desired version.”
Kim further reiterated this point by saying, “Haeundae Paik Hospital, scheduled to release its EMR system in March 2010, configured its environment mostly with the latest technologies – including SQL Server 2008, Windows Server 2008 and Windows 7. However, there was no difference in either the basic concept or functionalities of the EMR system. In the future, we plan to gradually upgrade the SQL Server 2005 used in the other hospitals - including Sanggye Paik Hospital - to SQL Server 2008.”
Improved operating speeds by more than 30 percent
The EMR systems based on SQL Server 2005 and 2008 have begun operations in Sanggye Paik Hospital and Pusan Paik Hospital respectively – garnering positive feedback for enhanced data performance and convenience. Kim said, “Compared to when we were using SQL Server 2000, administrators have unanimously pointed out that Online Indexing is now much easier. In terms of efficiency, the data quality speed has improved by about 30 percent.”
Performance gains were also significant. Kim said, “The hospital business system experiences peak usage from 9:00am to 12:00pm and again from 2:00pm to 4:00pm; where memory or processor usage rates increases greatly. But with the deployment of the new EMR system with SQL Server 2005 or 2008, resource usage does not exceed 50 percent - even during peak periods.”
Twice as fast backup speeds
As the importance of storing and protecting medical information increases, hospitals are focusing more on backup and recovery; as well as making significant investments in storage. Improvements to the backup and recovery speeds of the SQL Server at Inje University’s Paik Hospital were very well received. Kim said, “Now, we are able to achieve two times faster backup and recovery speeds. In places such as Pusan and Ilsan that utilize SQL Server 2008, we were told that the speed is even much faster.” The high compression rate of SQL Server 2008 is also expected to increase the cost efficiency of storage investments even when taking into account the size of the entire Inje University’s Paik Hospital group.
Enhanced reliability and stability to guarantee continuous medical service
Inje University’s Paik Hospital has a 24 x 7 x 365 uptime policy for the EMR system, as any interruption to the medical service could lead to a life or death situation. The new EMR system provides the reliability and stability crucial to running a hospital. Kim said, “In the past, when work was conducted using paper charts, there would hardly be any interruptions to the overall operations of the hospital even if some business systems failed. However, the situation is different now. If the EMR system fails, then all work will come to a halt.”
Kim also added, “I fully expect the reliability and stability of the EMR system to increase as the capabilities of SQL Server are enhanced over time. If we do not have support for the management and maintenance of the database, then it is difficult to guarantee any reliability of the system. Fortunately, the Medical Information Departments of Inje University’s Paik Hospital have maintained standardized databases and development environments for a long time. As a result, they have accumulated significant expertise in this area. We also plan to improve system reliability and performance with continuous maintenance of the EMR system’s data platform environment.”
Enhanced data warehousing
With a wealth of data and information consolidated in the EMR system, business users now have ease in gathering and analyzing relevant information useful to improving the quality of medical service. As a result, the data demands of business users have quickly increased. This trend was anticipated, and the data platform of Inje University’s Paik Hospital’s EMR system has the capacity and flexibility to cater to such demands.
Kim said, “Now that all of the data are consolidated in the database via EMR, the need for data warehousing for medical treatments and clinical researches will increase over time. SQL Server can respond to data demands without additional investments. At the moment, we have received education and training for SQL Server based business integration, and we plan to deploy data warehousing soon.”
In conclusion, Kim said, “So far, we are satisfied in various aspects of the solution. We have not experienced any business problems due to database failure or any extra burden in terms of maintenance costs. Plus, it has been easy to operate.”
Microsoft SQL Server 2008
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