Published on 31-Mar-2011
Emerging Health Information Technology, a subsidiary of Montefiore Medical Center, is comprised of healthcare executives, technologists and seasoned clinicians who have designed, implemented and supported healthcare solutions for more than 25 years. To help its customers increase operational efficiencies and improve patient care, Emerging Health IT created Clinical Looking Glass, a clinical information tool used by physicians, clinicians, researchers and quality improvement staff at hospitals.
Address and integrate real customer needs and business drivers within the Emerging Health application, with a focus on managing requirements gathered from a broader selection of users, while meeting reporting requirements, hospital administration needs and HIPAA compliance.
Deploy IBM® Rational® DOORS® to enable a complete understanding of Emerging Health’s application features and capabilities, including user priorities, along with full life cycle traceability from requirements through testing.
Achieved a 69 percent reduction in the cost of quality within the six-month period Reduced effort spent on requirements from about 21 percent down to 9 percent Shortened life cycle delivery to 3 months, which previously took 6 to 8 months or more
Emerging Health boosts competitive edge through increased customer value
Since its founding as a separate software company seven years ago, Emerging Health IT has been building lasting client relationships, with each project engagement aimed at achieving sustainable business value. However, the company recently began to look for ways to enhance usability and address the needs of actual users, who are the business drivers for the product. To help increase value to these customers, the company needed to better integrate user needs and business drivers all the way through its application. To accomplish this goal, the company sought an improved requirements process, with requirements that are both clear and gathered from a broader selection of users.
By listening to their users and sharing user needs with its engineers and developers, Emerging Health’s technical staff now had a better sense of why they were adding features and/or functionality. However, the company still needed to speed up the process of building the right functionality into its application, based on specific user requirements and business drivers such as leveraging large patient data sets, while ensuring compliance with healthcare regulations such as the Health Insurance Portability and Accountability Act (HIPAA).
“Managing customer expectations for flexibility and scalability is our first priority,” explains Mia McCroskey, project and requirements manager at Emerging Health. “Putting a well-executed requirements process in place at our location would help us ensure customer satisfaction, while getting our Clinical Looking Glass product out the door faster.”
Until implementing IBM Rational DOORS, Emerging Health found it a challenge to increase the speed of software development due to limited interaction between engineers and the lack of coordinated workflow processes. Engineering and database team members tended to work in isolation on separate elements of each project with minimal sharing of knowledge essential for the speed in which the product could be brought to market. Additionally, this limited interaction of team members also slowed the introduction of new features demanded by the marketplace.
IBM Rational DOORS opens up responsive environment for customer requirements
Emerging Health improved team workflow by implementing IBM Rational DOORS and IBM Rational DOORS Web Access, which unifies the development team with external stakeholders and vendors in the supply chain. Additionally, the software lets customers enter online comments within the context of particular requirements, creating an integrated environment aimed at improving customer experience.
“We started looking at ways to achieve a competitive advantage by improving customer value, and incorporating user feedback is the way to do that,” McCroskey says. “Rational DOORS gave us the more responsive environment we needed to improve customer satisfaction.”
This new responsiveness has also helped Emerging Health IT speed up time to market for its Clinical Looking Glass application. “We now can anticipate many requirements—or quickly understand requested modifications—when customers want versions of our software tailored to their environments,” McCroskey says.
Product functionality targets informational needs and regulatory compliance
The improved requirements management process has enabled Emerging Health IT to more rapidly add capabilities like bioinformatics. “Bioinformatics is important throughout the industry, and our application now presents that functionality in a way that’s easy for customers to work with,” McCroskey says. “The next step is to add new functionality and scaling for ever-larger volumes of patient data, such as those found in military hospitals. Because we’ve been able to improve our product and our time to market simultaneously, we aim to have this continue as our product scales to meet new challenges.”
One such challenge is HIPAA compliance. As a result of the quality improvements made possible by Rational DOORS, Emerging Health’s Clinical Looking Glass application includes key safeguards to help ensure that only specific users can access patient information. To screen users, the software typically requires proof that they are involved in an institutional review board inquiry or management-dictated quality improvement project.
“Rational DOORS allowed us to manage the specification of our tool to give our customers the functionality they need, while ensuring regulatory compliance,” McCroskey says. “The physicians and researchers who use Clinical Looking Glass software for probing patient data are now subject to verification and traceability features that alleviate security and privacy concerns.”
“After customers enter patient information, Clinical Looking Glass logs and stores it, and the information is audited, which protects its security,” McCroskey continues. “This feature provides peace of mind for our customers who are concerned about federal compliance and government reporting requirements. The change management flexibility in Rational DOORS makes this possible.”
Costly requirements efforts drop by more than 50 percent
Using Rational DOORS to optimize communication, collaboration and verification among developers, testers and engineers, Emerging Health was able to reduce effort spent on requirements from about 21 percent of the overall development effort down to 9 percent. The IBM requirements management tool made it possible to build standard views and attributes into the Emerging Health application. As a result, the company can ensure that all Clinical Looking Glass modules now provide a uniform user experience.
“We now have unified test and production environments that yield continuous process and quality improvement,” McCroskey says. “With Rational DOORS, we have the flexibility to link code to test cases, enter comments and enable integrated workflow for the requirements model across the entire engineering team.”
This flexibility allows Rational DOORS to work seamlessly with Scrum, a project management methodology for agile software development that Emerging Health has recently adopted to increase staff efficiency. Rational DOORS complements the Scrum production tracking methodology while allowing team members to focus on developing individual requirements without being distracted by hundreds of other requirements that do not affect that particular work.
“Using Rational DOORS for collaborative life cycle management shortens the entire development process and adds new workflow efficiencies, allowing our team to function like a well-oiled machine,” McCroskey says. “Feedback from our clients can now be incorporated on the fly by our engineers, so we can deliver the functionality our customers need most.”
The company reduces development costs 69 percent and speeds time to market
Since deploying IBM Rational DOORS, Emerging Health has seen a 69 percent reduction in the cost of test preparation, testing and rework in the development process. At the same time, the development team is able to customize the Clinical Looking Glass application for unique client requirements 25 percent faster than in the past.
Time to market is always a critical benchmark, but especially so in the fast-paced healthcare industry. “Because our industry is so competitive, being able to deliver the product faster enhances our reputation and the confidence our customers have in us,” McCroskey concludes. “Faster time to market is vital to our success, and we’ve now achieved that with the more responsive environment Rational DOORS has allowed us to establish.”
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