Leger des Heils has searched the market for a standard Enterprise Care Management System (ECMS), but could not find one that fitted their core business needs. Therefore, they decided to develop with Qubiz a custom-made ECMS. The three main drivers were to develop a system that:
can serve clients that have multiple complex care needs (from nursing to mental care, in any age group).
can handle the complex shift to decentralized financing in the Dutch healthcare sector.
allows Leger des Heils to standardize their care products and processes and become more effective, and constantly increase the quality of care.
Qubiz provided the consultancy, analytic thinking, design skills and development capacity to implement the entire ECMS in an agile way. It’s now being used on a daily basis by care-giving personnel, by administrative personnel and by managers in their decision making process. The solution is constantly evolving, with many innovative ideas being included in it, such as putting the patients more in control of their own care through a portal and several mobile apps.
Over a period of more than 3 years, this ECMS evolved from a customer (patient) administration solution to a well-adopted Care Management System that supports the various types of care services offered by Leger des Heils. The solution fulfills Leger des Heils’ needs regarding customer/patient care, financing, and standardization of products and processes.
From day one the end-users where involved in detailing the requirements for the system and where reviewing the results. End user participation turned out to be essential in the acceptance of the system by the organisation. At first the process of development was taking place in separate stages, later – when all main modules where in place – the development became more and more agile.
Essential in implementing the solution was to have the distributed team – from client in The Netherlands to the analyst/developers from Qubiz Romania – work well-focussed on a common goal.
There were several aspects of this collaborations that proved to be challenging. Firstly, our team had to work as one, although part of its members were located in The Netherlands, part of it in Romania. Besides the distance, there were cultural differences that we had to overcome. Secondly, this project marked our departure from the “Waterfall” project management system and the adoption of the more flexible “Scrum” project management approach. Thirdly, Microsoft Silverlight was a new technology back then, but we wanted to use it along with the .NET Framework, so we had to learn it on the way.
Our solution had to be a full Enterprise Care Management System that would support Leger des Heils in all their practices and processes. Thus, it contains the full range of modules typically needed in care management:
- client management (including his or her social network)
- product management
- contract administration (for contracts made with their suppliers)
- care planning
- activity and dossier management
- resource management for the care facility
- document management system
- notification management
- hour registration and approval
- invoice management
They also needed us to perform an ESB-based* integration of their support systems, which include:
- HRM (Human Resource Management) system
- Facility management system
- Document management system
- Financial system (general ledger)
*EBS stands for Enterprise Service Bus
The architecture of the system is divided into layers, each layer containing the components that support a specific functionality. These layers are:
- presentation layer: for managing user interaction
- business layer: for implementing the core functionality of the system
- data layer: for accessing the data hosted within the system and the data from other networked systems
- services layer: the application functionality will be presented through services
The communication between these layers is mediated mainly by direct method calls, for improved speed and reliability.
Workflow components are used to encapsulate tasks and to coordinate the steps required to complete them. To achieve this, we used Windows Workflow Foundation and Workflow Services. The main technology used is Microsoft .NET Framework, along with Entity Framework, Windows Workflow Foundation, Workflow Services and an Enterprise Service Bus.
The Enterprise Service Bus is implemented using NServiceBus. This service platform offers a full range of software features for facilitating the communication between applications. By using the Enterprise Service Bus, we make sure that a piece of data is filled just once, in just one application, and then it will be sent to all the linked applications.
For extracting useful information and insight from the database we implemented a series of business intelligence features.