Jessa Ziekenhuis • GEMS

— Quick and user-friendly electronic patient files

The Jessa Ziekenhuis is one of the larger non-academic hospitals in Flanders and originated by bringing 4 hospitals in Hasselt (BE) together. The hospital strives to provide the best possible patient care, therefore willing to invest in good IT infrastructure. Like many hospitals, Jessa Ziekenhuis faced the challenge of a more efficient exchange of information through an integrated and digital patient file system.

Jessa Ziekenhuis
1

Introduction

Jessa Ziekenhuis was looking for a partner to rewrite their Electronic Health Records software (C2M).

  • C2M was outdated, which increased the risk of unavailability and led to high maintenance costs.

  • Electronic Health Records software is one of the core hospital applications with a constant demand for more efficiency and user friendliness. Within C2M, this was either impossible or completely unaffordable.

  • Increasingly frequently, the whole C2M application became unavailable, which increased costs and the risk of medical errors.

  • The software was built on outdated technology and wasn’t flexible. Starting the C2M environment, for example, took quite long (half an hour or longer).

  • The Jessa Ziekenhuis had created a backlog of feature requests, but these weren’t implemented anymore.

  • The hospital didn’t have the time or expertise themselves to build such a large application in a short period of time.

2

Challenge

As a solution, we built GEMS: the Global Electronic Medical System.

ACA IT-Solutions has years of experience in building complex custom software projects. By combining our Agile methodology and the right technical knowledge, we were able to quickly deliver the first results. During the project, we faced a couple of challenges:

  • GEMS was a large project: the first production release consisted of 315 story points. Right now, we have delivered over 430 story points.

  • There was a tight deadline: the first production release had to take place in less than a year.

  • There needed to be a close collaboration with the Jessa Ziekenhuis.

Besides those, there were also some functional challenges, like

  • extensive functions for Electronic Health Records software, such as a medical dashboard, integration with several other applications and data security management.

  • parallel use of the old C2M and new GEMS application to reduce the risks of transition as much as possible, with visible data changes in both applications.

  • support for 2500 different users that are available for their patients 24/7.

  • a great UX and quick response times.

3

Solution

How did we handle this?

Working together

Together with the Jessa Ziekenhuis, we set up a joint development team that worked through all iterations of the new software. This joint team consisted of application administrators and various profiles from the healthcare sector. The team used the best practices from XP, Kanban and Scrum methodologies.

A wonderful and user-friendly application

From the start of the project, it was clear that the end users had to be able to use GEMS with minimal training. Quick interaction with the application was also crucial. That’s why we invested a lot of time in a great UX and UI, and this wasn’t without result! 80% of all interactions of users between two different screens happens in less than 2 seconds and end users deemed the interface quick and intuitive.

Built with great, innovative technology

For the technology stack, we developed a back-end in Java in an OSGI modular approach on a Felix application server. Some time ago, ACA built a Java Platform that combines a number of modern and constantly evolving tools and frameworks. This way, we can jump start projects and quickly start development. We were happy to use this ACA Platform for GEMS as well. We used IntelliJ for the development itself.

For the front-end we developed an Angular application and showed it to end users through WebPack in an Electron UI.

We tested GEMS thoroughly. We aimed for a high test coverage and different kinds of testing on all layers of the application. We used Protractor, Junit, Karma, JMeter and Selenium for this. Jenkins automatized our entire build, release and installation. Our provisioning happened on Linux using Ansible and Docker.

For the support of the project, we used the Atlassian Tooling. Monitoring happens with the New Relic suite.

Used technologies

  • ACA platform
  • Java 8
  • Entities
  • EclipseLink JPA
  • Spring
  • Liquibase
  • JaxRS
  • OSGI Modules
  • Bootstrap
  • Angular
  • Webpack
  • Karma
  • Gulp
  • Eslint
  • Protractor
  • Electron
  • JMeter
  • Unit Testing
  • Integration Testing
  • Jira
  • EasyBi
  • BitBucket
  • Confluence
  • Jenkins
  • Apache Felix
  • New Relic
  • Amazon
  • IntelliJ
  • Docker
  • Ansible
4

Rollout

Phased rollout

GEMS went to production in July 2017 and followed a strict schedule for its rollout. During 7 months, all departments of the Jessa Ziekenhuis were trained and configured. The entire migration of C2M to GEMS was ready by March 2018. Since that moment, we have only needed to dolimited maintenance on the system and added some feature requests to GEMS.

GEMS and all its functionality has been delivered completely on time and within budget. Jessa Ziekenhuis had a clear overview of the entire project before, during and after development. We are proud that there hasn’t been any unplanned unavailability during this entire period. GEMS now serves about 2500 users on a daily basis.