BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. With net revenue of $3.1 billion, BJC serves urban, suburban and rural communities and includes 13 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

Problem

The abundance of new technology that healthcare organizations can leverage as part of their IT infrastructures can be complex to evaluate, especially when problems appear after products have been implemented. For BJC, the monitoring system for the IBM WebSphere MQ environment was a home-grown application requiring components deployed on multiple servers. On top of that, the solution required a lot of maintenance and fine-tuning and was thus expensive to maintain, ultimately making replacement a necessity.

The business-critical applications at BJC capture data at both doctor’s office and hospital settings. This data includes patient visit details, dates the patient was admitted, transferred, or discharged, lab results, vital signs, radiology reports and medication. Having this data available 24/7 and keeping the systems running smoothly to handle the large volumes of timely data are crucial to daily work. For its part, WebSphere MQ functions as the communication middleware that moves these data from the source to their processes, using individual queues along the way.

For instance, a doctor might dictate a letter through a specific transcription system. The letter is then transmitted using HL7, a standard for interoperability of health information technology through the electronic interchange of clinical, financial and administrative information among healthcare-oriented computer systems. WebSphere MQ is responsible for “store and forward” services, that is, highly reliable delivery of the data put in the queue by an application. An application converts the data from HL7 to XML and moves it to a report queue where the essential formatting and required tag elements are validated. The application will then look up the patient in the system based on the patient’s unique identification number. The next queue brings the message into the database, an outbound queue or an error queue (if it fails).

The same process is applied to lab results and pharmacy orders, both of which are extremely time-sensitive and, of course, patient-critical. Other time-sensitive information that isn’t transmitted can immediately elevate risk factors for patients.

Recognizing the need for a more robust monitoring platform happened to coincide with the system’s migration to clustering. A stronger and more reliable monitoring solution would be especially useful for error queues and queues that had an unusually large number of messages on them. But where would BJC be able to find an application performance management solution strong enough for such a complex data system?

Solution

Mike Tammenga, Technical Specialist in Information Services at BJC, was a key person on a team charged with finding a monitoring solution that could handle the high volume of transactions taking place within the IT infrastructure. He and his team evaluated a number of solutions— including IBM’s Tivoli Monitoring for Transaction Performance—but there was ultimately one standout that caught their eye.

“One of the first things we noticed about Nastel AutoPilot is its simplicity to implement,” says Mike Tammenga. “That, coupled with a few other primary factors, was a huge selling point for us.”

While IBM’s solution was a major contender, the product was too expensive. AutoPilot’s comprehensive functionality, performance and high scalability proved to be a reliable and more affordable option. Between its predictive determination of problems, complex event processing, flexibility, simplicity of use, features and total cost of ownership, Nastel trumped the competition.

For queues that have built up, Nastel AutoPilot is efficient at monitoring and alerting IT staff as problems develop, thus improving customer satisfaction and decreasing the likelihood that a crucial error could be made. AutoPilot efficiently monitors the queues for their Electronic Data Management System (EDMS) and other healthcare applications that run on their servers.

Mike Tammenga adds, “In accordance with HIPPA regulations, Nastel AutoPilot helps us with our regulatory and compliance issues by safeguarding data as it is transmitted.

Benefits

“Compared to our old homegrown system, AutoPilot has proved much easier to manage and far more cost-effective. It doesn’t require a lot of tinkering, alerts us when queue managers go down or queues fill up, and keeps the MQ environment running properly or alerts us when it isn’t,” mentions Mike Tammenga.

The system before had been reliable, but programs could still fail. As a result of implementing AutoPilot, Mike Tammenga claims that the environment has been much more reliable.

Mike Tammenga says, “We’ve been really fortunate with Nastel AutoPilot. Nastel’s support desk is very responsive and knowledgeable. Upgrades and changes are done in a timely manner without interruption to the system. Having a program that performs accurately and without interruption is absolutely crucial to the healthcare IT environment.”

About Nastel AutoPilot

Nastel AutoPilot provides businesses with 360° situational awareness of both operational and transactional data, reduced transactional latency and improved business transaction performance ™ to ensure optimum service levels while eliminating the hidden costs, or “stealth waste,” in business processes. AutoPilot’s capabilities for transaction management, automated root cause isolation, performance analysis and determination of business impact enable its users to improve business process efficiencies and service levels while reducing cost and managing risk.

About Nastel

Nastel Technologies is a premier global provider of business transaction performance™ solutions for mission-critical applications. Nastel is a privately held company headquartered in New York, with offices in the U.S., the U.K., Germany and Mexico, and a network of partners throughout Europe, the Middle East, Latin America and Asia. For more information, visit Nastel’s website at www.nastel.com.