By Sarah Schmelling

 Mark Smith

When Mark Smith, vice president of Information Technology for Worcester, Mass-based Athena Diagnostics, informed his development team that the company had just purchased an Ensemble universal integration platform from InterSystems Corp, he remembers hearing a loud, collective sigh coming from the group. “It was as if, in that breath, they were saying, ‘Oh no; one more huge project,’” he says.

Little did they know what this product would be doing for the efficiency of their department—not to mention their morale—just a few months later.

Launched in November 2003, Ensemble is a computing platform designed by Cambridge, Mass-based InterSystems to combine the functionality of an integration server, an application server, a high-performance object database, and a unified development and management environment—all in one product. What this means for laboratories like Athena—which specializes in development and commercialization of diagnostic testing for neurological disorders—is that they now can combine information from all of the company’s data systems for use in applications that help their business run more smoothly. These applications, which Athena’s developers created in a matter of weeks, include a management alarm that automatically notifies staff if there are system problems, a method of automatically creating letters to deliver test results to Athena’s customers, and a coordination management system that matches customer information between different databases.

Assembling Ensemble
According to Trevor Matz, managing director of application integration for InterSystems, the company decided 3 years ago that, after relying on its CACHÉ postrelational database product for more than 20 years, it was time to offer a product that could tackle the emerging field of universal business integration.

As Matz sees it, customers today are looking for four primary functions from business integration technology. First, he says, they want to coordinate all transactional data between different applications to get consistency across all of their applications—so all of the systems transfer information transparently in exactly the same way. Second, they want to automate long-running processes that used to be manual, so all of their systems are functionally up to date and equal to one another.

The third driving factor, Matz says, is the ability to take all of your existing data systems and create a way of looking at all of the information in one, graphically simplified view.

The final function customers are looking for when using integration technology is also perhaps the most valuable: real-time business intelligence, Matz says. Here, a company can give a system a “key indicator,” which, when met or exceeded, will automatically notify the company, and then will take a preprogrammed action. For example, Matz says, you could program a system to notify you if there are more than 10 negative test results in one particular region, and the system could automatically generate a document to that effect and have it sent to the necessary party. “So when I build the key indicator, not only am I notified, but I kick off the process of taking an action,” Matz says. “That’s the adaptive feedback of real-time intelligence in business processing.”

Smith, who has worked for Athena for 11 years, began looking for an integration platform like this because, though the company was growing and providing more than 100 neurological tests, it still had several disparate IT systems, all operating in their own environments. “I needed a mechanism to connect many of these systems, and I needed to do it very quickly,” he says.

After looking at competing products—many of which were more expensive and had what he considers a much longer learning curve—Smith took action when he received a letter from InterSystems. Because Athena was a client of CACHÉ, the company was invited to try a pilot of Ensemble. “I immediately went to the Web site and signed up,” Smith says. “The next day I got a call from a sales representative and we started going through demonstrations, and once I saw what it could do, everything started coming together very quickly.”

Smith decided that because he had four internal developers, each of them could focus on creating one Ensemble application. “So not only would they each have a project under their belt, but they would feel comfortable with the applications,” he says.

Building the Building Blocks
In the following 3 months, Smith and his team created four applications, three of which are up and running; the fourth should be up by press time.

E-System Management Alarm: The first challenge Athena had was to create a program that could alert the IT staff when there was a system error. “I found it very frustrating to be informed by a user that we had a system problem before my IT group even knew about it,” Smith says. To change this situation, a developer was assigned to create an executive “dashboard” where all system activity could be monitored. Smith says it not only tells him in one view whether the systems are functioning properly, it also has gauges that monitor the space utilization and memory. “Most importantly, if it senses that the system is down, it immediately sends one of my administrators an email notification, as well as a text message to their cell phone,” he says. “What’s nice about that from a business perspective is that if I were to pay to have another company provide this service, it would probably be somewhere around $400 a month.”

“It’s proactive preemptive monitoring,” Matz adds. “Instead of waiting for a problem to happen, they can monitor the status of the systems at all times.”

E-Letter Management: The second application aimed to tackle the business problem of generating word processing documents from a database system. Smith says his staff wanted to obtain test result information from CACHÉ and automatically generate letters with it to go out to patients. The E-Letter Management application does just this. “We’re taking the information from our CACHÉ database and blending that right into a Microsoft Word program,” he says. This means less work for the IT department on a daily basis, and, more importantly, faster patient notification.

“As soon as the test status is updated, this generates an event,” Matz says. “Ensemble takes that information and generates a document describing the results of that test, and then goes into an email system and sends that document immediately to the patient updating him with that information. That’s a total change from a patient waiting and calling every day and wondering about the results.”

E-Data Coordination Manager: The third application deals with Athena’s large sales and marketing database. It coordinates all the customer information, such as names and addresses, and ensures that it is the same in every place, in every company system. The application can even compare this data with Web sites and other sources on the Internet.

“They used to have to check in multiple places and then go back and update the systems and remove inconsistencies,” Matz says. “Here, again, is the notion of real-time intelligence, real-time notification, real-time integration.”

E-Notification: The final application, which was due to be up and running by the end of 2004, integrates Microsoft Outlook with its database, so a secure email can automatically notify Athena’s clients about the status of an order. It’s something customers had asked for in surveys over the years, Smith says. “They kept saying, ‘just send me an email to let me know what’s going on with my test.’ ”

Smith is still amazed at everything the program can do. “I look at this E-Data Coordination Manager, and I can see a full flowchart on my screen of how it was programmed,” he says. “Consider the power of this application. A developer can sit with a user who requests a change, and it can be done.”

An Ongoing Solution
For Smith and his IT team, these applications are just the beginning. “I can predict that next year I’ll hear another big sigh, because I can see 20 projects for which we can use Ensemble,” he says. He adds that this just proves how ready the company was for integration.

He has no doubts about the team’s readiness, however. “Now I have an excited staff that truly enjoys their jobs more because they have a state-of-the-art tool they can use to program, to see what they’ve done, and to talk to other developers and show them what they’ve done,” he says. “It’s opened up a new line of communication in my department, which I think is phenomenal.”

According to Matz, Ensemble is the kind of product that can work in many types of businesses. “It doesn’t just have to be a laboratory, but any business that deals with patients, customers, or consumers, that wants to increase the efficiency of notifying their target market,” he says.

He explains that having a single view of multiple systems is helpful, whether you’re in health care, banking, or law enforcement. “What’s interesting is that everybody has this need. If you’re a state government agency trying to reconcile a child’s records, or a banking system trying to coordinate all of a customer’s information, or if you’re Athena Diagnostics trying to reconcile your contact information between laboratory systems. It all has relevance.”

Matz says it only makes sense for a CIO to look at all the company’s systems and, considering all of the money spent on it, want to find a way to put it all together, and to “really get the value from a single viewpoint.”

Smith says the quickly evolving industry Athena is in makes it a prime target for a solution like this. “We’re constantly changing, so one of my challenges is to do more with less,” he says. A platform like this allows him to automate processes while not adding employees to the payroll.

Smith believes this kind of platform could also benefit other laboratories. He says that because many health care businesses started with MUMPS database systems, they could easily move up into an integration platform like Ensemble. He also believes there will be more interest in such programs as government legislation such as HIPAA forces health care organizations to organize their patient information into electronic files.

For Smith, the primary reason an integration platform is useful for laboratories, however, is that it lets you keep old data within reaching distance. “Many times when you migrate to a new system, you don’t bring that data forward, and instead of converting it to a new system, you just leave it in the old system and you can only access it that way,” he says. “Ensemble is nice because it gives you the capability to not have to rewrite all of your legacy systems, and you can still maintain access to them and access the data within them.”

Smith explains that genetic testing labs are required to save information for 20 years, so he can now take all of the older data and integrate it into the new platform. This will be another big project for his developers, but a worthwhile one, he says. “I don’t know if I’ll be here for 20 years, but I want to make sure that the system is in place and that you can access that data for that time period.”

Sarah Schmelling is a contributing writer for Clinical Lab Products.