Like many other businesses in the Web age, medical laboratories are realizing their business is largely about the distribution of information. "If you look at what we do, we are in the information business," says Mark Muenze, CIO for Esoterix, an investor-backed laboratory company based in Austin, Texas. Esoterix specializes in so-called esoteric testing, which focuses on specific diseases, including forms of cancer.
Delivering information to its customers, physicians and hospitals had gotten a bit complicated for Esoterix, which had purchased seven testing laboratories that specialize in different disease and therapeutic areas. So Esoterix built an extranet with an Oracle Corp. 8i-based central repository that links these geographically dispersed and technologically different sites and consolidates multiple test results. "We bring the results through our data center, and you get one interpreted result that combines the information from the various tests," Esoterix's Muenze says.
The next phase is to mine data gathered from previous tests conducted by the labs. Such a data warehouse architecture would let Esoterix take a pediatric endocrinology test result, for instance, and compare it with other results by age and sex. "Our scientists then report back to the doctor, 'Here's what's going on for your 10-year-old patient,'" Muenze says, "and [tell] whether further tests are needed."
Esoterix's database now runs on Sun Microsystems' E3500 servers, and the labs are connected over a frame relay WAN; the company plans to implement an IP VPN (virtual private network) in the future. Integrator Stonebridge Technologies is configuring the database and network infrastructure for Esoterix. One of the biggest jobs has been integrating seven lab information systems and databases - everything from Corel Paradox to SQL to Microsoft Word templates - most of which are homegrown. Stonebridge wrote interfaces to the different databases, and it uses plain, old ASCII tables as a staging area. Then the company's HIE Cloverleaf application, which can gather information for different databases and send it via EDI or IP, can recognize the data and import it into the central repository. "It's an important extra step that allows each laboratory to control and validate the data it sends to the central repository," says Roy Woodrom, a Stonebridge senior project manager for the Esoterix project.
Another problem for Esoterix was the lack of commercial tools to let labs send batch reports over the Web. So Stonebridge wrote a tool that prints to a PDF file rather than to a browser. "When someone requests reports, he or she gets one PDF sent down the wire instead of 100 separate ones," Woodrom says. That saves on server traffic and bandwidth.
Of course, physicians still are notoriously low-tech, and no one expects manila file folders to disappear anytime soon. That's why Esoterix offers results not just via its extranet, but also by some old-fashioned ways - fax, Federal Express and remote printer, or via EDI to a hospital. Esoterix also likely will go with digital certificates for identifying its customers and other users.
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