Client business profile: Enhanced Care Initiatives (ECI) is a pioneer healthcare service provider with focus on elderly disease care. ECI provides in-depth, personalized, comprehensive and innovative healthcare services for high-risk patients. The cost of Medicare and Medicaid keep increasing everyday. ECI with its customized services aims to provide the patients with the best available care at reduced costs without compromising on quality.

Business Challenge: ECI wanted the EasyCare application to capture patient data ranging from demographic to medical history to routine visits. In addition, they wanted it to manage and track communication between healthcare professionals, patients’ families, doctors, and insurance companies. ECI had faced immense problems with its vendor in the development of the EasyCare application and had contracted SAI to audit the work done by the vendor. SAI was able to pinpoint to ECI the problem areas and has suggested four ways in which the development of the EasyCare application should be continued so as to achieve ECI’s objectives.

SAI's Solution: SAI had completed the initial responsibility to audit the application for its completeness, functionality, architecture and scalability. SAI analysts gave detailed reports on the current system architecture, code, database, performance, and interfaces used and highlighted the inadequacies and the problem areas.

Instead of reinventing the wheels SAI decided to do performance tuning with limited redesigning and adopted phased solution for development of the EasyCare application.

Performance Tuning and Re-engineering The steps to be taken were as follows:
	Performance Tuning the database, but no restructuring
	Modifying the cold fusion code
	Completing the requirements of Phase-I
	Repairing all defects.
	Incorporating new requirements as enhancements to the exiting system.
	Security
	Backups
	Performance
	Enhancing the existing architecture

Phased Development
Some of the high-level modules included were as follows:

Module 1: Forms
This module provides user interface screens for entering, editing and viewing the patient’s data pertaining to his demographics and diagnosis. These screens contain forms for entering telephonic survey, initial assessment, routine visits and MD office visit information.

Module 2: Active Charts
Active Charts module contains screens, which are regularly updated by the nurse practitioners when they visit patients. Few of the screens in this module are pre-populated with the data from the Forms module

Module 3: Tools
This module consists of various tools such as fax, email, patient phone call logs, reminders and surveys.

Following are the screens that are a part of this module –
	E-Mail		Patient Survey
	Fax		Physician Survey
	Phone call Log report		Caregiver Survey
	Patient / General Reminder		Team Notes

Module 4: Reports
This module consists of various tools such as fax, email, patient phone call logs, reminders and surveys.

This module provides well-presented information, which is useful for analysis of patient’s data present in the database for the nurses and MD.
	Dr Report		Health Tracking
	Patient Report		Population Health
	Summary Report		Outcome Tracking and Summary Report

USER TYPES
	Administrator – The ‘Super Administrator’ has access to complete system, he can set user rights for Regional and Program Administrators, and create flexible system user groups and administer system functionality.
	NPR’s - The Nurse Practitioner can add, modify and access their patient’s information.
	Call Center Representative (CCR) – CCRs can add telephonic survey information.
Technology: EasyCare System” runs on Microsoft Windows Operating System and incorporates following technologies:
	HTML, Java Script and Flash for developing dynamic web pages.
	Microsoft™ SQL Server 7.0 ™ as Database.
	Cold Fusion to implement the client’s business logic.
	Microsoft ™ IIS ™ 6.0 as Web Server.
Client Benefits: EasyCare Systems now has the following features:
	Data access: Record of patient’s diagnosis information after each routine visit by nurse helps in tracking patient’s health, allowing access to current health status for subsequent visits.
	Useful suggestions: Displays suggestions / instructions related to the ailment, which are crucial for the complete diagnosis of the disease, this helps the nurse in accurate diagnosis.
	Internal communication: Enables effective interaction internally between the Doctors and Nurses by allowing them to share Patient’s data pertaining to phone call logs, important reminders, survey reports, team notes etc.
	Security: Flexible user groups can be created for assigning user access rights there by maintaining information security.
	Online usability: Call Center Representatives can easily add patient demographics, family background, social lifestyle, medical history and medical assessment information online during telephonic surveys.
	Communication Tools: EasyCare System also enhances the communication with external members by providing tools for sending important notes, letters and reports.