Overview

AMSplus is a provider of electronic medical billing and medical practice management software. For over 20 years AMS has been supplying hospitals and other large medical service providers with advanced solutions for continual improvement of the revenue cycle, as well as reducing business risks by integrating all aspects of the billing process into a single, seamless service. The technology is used by the 10 largest hospitals in the US.

Business need:

New Medical Appointment Scheduler (MAS) 

The current MAS was over 15 years old and based on outdated MUMPS technology.

Drawbacks included:

• user interface was text only and terminal-based, which was both inconvenient and dated;

• individual installation was needed for each terminal, requiring the committment of substantial resources for installation and support.

Special challenges:

• Because the MAS was a value-add service for the core, revenue-generating billing system, it required complete interoperability and transparent interaction with the legacy billing system.

• The hospitals' data and applications were stored on AMS' centralized server and were in constant use; it was impossible to suspend or hamper the service.

• The legacy code was somewhat buggy and unstable.

Technical approach:
Rewrite the MAS from MUMPS to next-generation web-based Caché CSP technology, creating a MAS that

• would seamlessly integrate with the legacy billing system and totally replace the old MAS;

• have an intuitive web-based interface; and

• substantially reduce maintenance requirements by using object oriented design.

Technology: Intersystems' Caché, CSP, Java Script.

Solution:
The interoperability and data communication challenges were solved with an object-oriented wrapper. This allowed us to encapsulate the legacy application, transforming its functional interface into an object interface.

• quick reference to a provider's schedule;
  

• easy registration for new and existing patients;

• powerful reports that help manage all necessary functions;
  

• graphic representation of schedules and appointments on the web-interface;
  

• a completely new object model capable of interacting with the legacy data (e.g., when a new patient is registered, s/he is reflected in the both systems); and

• exploitation of all Caché opportunities for building an effective user interface.
  

• The programs and data in the MAS reside on a central server so that when a user requests information the central server creates a content-specific web page for that user.

Benefits:
The Medical Appointment Scheduler can be used from any computer with Internet Explorer.

Additional features:

• Scheduling functions that are easy to learn and simple to use

• Centralized dictionaries (e.g. City and Referring Physician)

• Client-specific dictionaries (e.g. Provider, Type of Visit)

• Basic and override provider schedules (e.g. Templates)

• Online patient registration with the ability to enter only the basic information (for quick registration of new patients)

• Quick search for appointments based on provider, location or visit type

• Quick "check-in" to verify patient arrival for the appointment

• Extensive reporting capabilities

• Fully linked to patient registration with hooks to medical billing management software

Results:
In 2002 we delivered the project within the original budget, although it was two months late due to NTR staffing challenges.

In spite of the delay, AMS was delighted with the finished medical appointment scheduler and contracted for several additional modifications to the product.