Canadian users help develop e-health database

User feedback is fine as a means of refining the second release of a product. But by that time, the horse is out of the barn, so to speak.

To get that feedback earlier on in the process, Oracle Corp. has been using a six-member customer

advisory board (CAB) to help develop its Healthcare Transaction Database (HTB) since February.

HTB, according to Oracle, is a comprehensive data repository and service infrastructure designed to enable health care organizations to integrate disparate systems and create a central repository for patient information and clinical services.

Two of the HTB customer advisory board members are Canadian — New-Brunswick-based Atlantic Health Sciences Corp. and Alberta’s Capital Health Authority. There are three U.S. representatives as well as one from Wales. Eight other Canadian provinces are also exploring the use of HTB.

Oracle has used the customer advisory board model with a number of other software development projects as a way to create products better tailored to its target market than just beta-testing them, says Henk Dykhuizen, director, public sector for Oracle Canada.

“”I know if our customers and our developers work together we build better software,”” says Dykhuizen.

CAB members, he explains, commit to spending more time with the program than do beta users.

“”This is a little more than just getting some code,”” he says. “”If it’s a beta program we can just send code to a customer and we’ll get their feedback — their developers will send our developers some notes. With the CAB there are formal meetings set up; the board meets couple of times a year and sits down with the Oracle development team, usually in Redwood, Calif.

“”We’ll meet as a group and discuss not just how the product is looking and working but where should it be going and what other things are needed in the product to make it really worthwhile and special to that group.””

Specifically, he says, this board’s members have helped by letting Oracle know about the many legacy systems the HTB needs to interact with through the use of the HL7 database standard.

“”They’re saying here are some of the repositories we have to deal with; please make the product do this.””

Donna Sprating, CIO of the Capital Health Authority (CHA), which serves 1.6 million residents in central and northern Alberta and is one of the largest integrated academic health regions in Canada, says the CHA got involved with the CAB because it was looking for ways to implement one of the key recommendations in the December 2001 report of the Premier’s Advisory Council on Health, which was to invest in technology and establish an electronic health record.

Sprating agrees that participating on a customer advisory board provides her organization the opportunity to shape the final format of a technology that will be key to developing electronic patient records in the Western province — one that won’t have to be tweaked excessively to fit the Canadian model of public health care.

“”Health care is different in the U.K.; it’s different everywhere,”” says Sprating. “”One of the things we always get concerned about is when there isn’t that representation, you get a product that just fits one model, so to bring it to other markets you have to do tons and tons of customization and a lot of changes. We believe we bring a lot of insight and value to the U.S. in terms of how to do things differently around managing a person because we own that person, not as a payer but as a caregiver.

“”Our hope is that a lot of the needs of the Canadian environment will be built into the new solution so we’ll have something that can hit the ground running.””

The model of having customers help develop a product is a good one, not just for the buyer but for the developer as well, she says, but whether or not it will be adopted by other vendors is hard to say, she adds.

“”I think Oracle will benefit from it because we’ll feel more comfortable with it and our decision processes will be a lot easier in terms of understanding how to expand and fit it in than it would be if they had marketing people come knock at my door and say, ‘we have another wonderful product, do you want to use it?””

And while the main advantage for the CHA is the first-player access the organization has to a cutting edge technology, it also is benefiting from its exposure to different perspectives on approaching the implementation of an electronic health record system, she adds.

In this first phase of developing an electronic health record using Oracle HTB technology, the CHA is pulling together the databases to put together the record as a presentation of clinical information from all the health care organizations under the CHA’s umbrella, which includes all of the province’s health care facilities except physicians’ offices and cancer services. By the end of July the CHA plans to do its first proof of data release with core data set items, she says, which comprises lab data of about 40 million records. Nine of the province’s 13 facilities are involved in the HER project — the rest are projected to be brought into it by next year.

The entire development process will be done by the end of November, with rollout scheduled for February 2004.

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