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Innovative integration project could become model for all of Europe

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Vimercate Hospital near Milan leads a public trust of seven hospitals within the Lombardy region in northern Italy. In support of a new “Regional Service Card” (Carta Regionale Dei Servizi) program, Vimercate has used Ensemble to implement a regional electronic health record (EHR) among all its member hospitals. The results are so impressive that Lombardia Informatica, the company chosen to administer the Regional Service Card program, considers the ground-breaking Vimercate solution as a model that could be extended to all of Lombardy, and potentially all of Italy and the rest of Europe.

Like most electronic patient records, the Vimercate system can assemble and present patient data pulled from all its member hospitals and clinics. However, in accordance with the guidelines set for the regional project, the Vimercate EHR must be able to read information from the “smart cards” (cards containing a small computer chip) that have been issued to each citizen, and also access information from the “Domini Centrali” (Central Domain -a central data repository) for the Lombardy region. Thus, if someone from outside Vimercate’s service region shows up at one of their hospitals, doctors will still be able to access a complete medical history for that person.

No Need to “Rip-and-Replace”

Vimercate’s CIO, Giovanni Delgrossi, chose the Ensemble universal integration platform because it combines integration and development capabilities in one unified environment. “We could have solved our data complexity issues with a single ERP solution,” he says, “but we decided to leverage our prior investments and to offer integration of data and processes through Ensemble. Ensemble allowed us to develop a system that fits the regional requirements, as well as giving us tighter control, and therefore better management, of our data, information, and company.”

We decided to leverage our prior investments and to offer integration of data and processes through Ensemble

Giovanni Delgrossi, CIO
Vimercate

Ensemble is the backbone of Vimercate’s integrated system, which was built in a mere 3 months. Because of Ensemble, member hospitals are able to continue using the applications they already have in place. (Of the four major hospitals within the Vimercate trust, two have applications based on Oracle, one uses applications that were developed internally with Caché, and one uses Caché-based packaged applications from an InterSystems’ partner.) The difference is that now, all these varied applications “talk” to Ensemble for the purposes of identifying patients and retrieving their medical records. In addition, Ensemble interfaces with services provided by Lombardia Informatica that enable the reading of information from smart cards, and from the Domini Centrali. A simple Web portal allows health care professionals to choose which of the three sources (smart card, the entire Vimercate system, or the Lombardy central repository) they wish to access.

Planned Expansion

This kind of flexibility was mandated by the requirements of the Regional Service Card program and conforms to the model designed by Lombardia Informatica. Therefore, the work done at Vimercate can easily be replicated at other healthcare institutions around the Lombardy region. By early 2006, smart cards will have been distributed to approximately 9 million citizens, 2,500 pharmacies, and 145,000 healthcare organizations. In addition, because the Regional Service Card program complies with decisions made in 2003 by the European Commission, there is the potential for extending the program across all of Italy, and even to the pan-European level.

Immediate Benefits

We have put complete and clearly presented patient information within the reach of every doctor, which makes it easier to make good diagnoses and decisions.

Giovanni Delgrossi, CIO
Vimercate

Meanwhile, back at Vimercate Hospital, what are the benefits being realized by integrating their applications with Ensemble? Says Giovanni Delgrossi: “There are two positive results. For one, we have put complete and clearly presented patient information within the reach of every doctor, which makes it easier to make good diagnoses and decisions. Secondly, the public is impressed with the effectiveness of the Smart Card system, so the image of the hospital is improved due to customer satisfaction.”

“But our journey does not stop here,” he continues. “Over the next six months, we are planning to implement ‘Totems’, which will allow citizens to plan and schedule ambulatory visits for themselves, and provide their doctors with complete medical records, including information gathered from every hospital in which they were treated. The objective is to improve the quality of treatment, while also improving the overall efficiency of healthcare delivery.”