Family Care Report Optimization

Family Care Report Performamce Optimization

Introduction

Family Care Certified Services is a Medicare Certified, Joint Commission Accredited (JCAHO) home care agency servicing Nassau, Queens, and Brooklyn counties. Family Care extends the benefits of in-home recovery to patients who require medical services normally associated with hospitalization.

Family Care also has a Long Term Home Health Care Program (LTHHCP), which provides services to Medicaid clients in Nassau, Queens, and Bronx Counties. Their Long Term Program offers an alternative option for the chronically ill patient who would otherwise require placement in a skilled nursing home.

Family Care Certified Services also manages Datahr Home Healthcare Inc. which provides services to special needs MRDD/TBI patients. This home healthcare agency serves clients in Westchester, Putnam, and Dutchess counties.

Family Care’s goal is to assist patients in getting better, regaining independence and becoming as self-sufficient as possible.

Situation

Family Care’s growth and geographic footprint was straining their information systems and network. The administrative staff had created multiple paper-based processes, labor-intensive data imports, and manual data manipulation to accomplish important billing processes and deliver financial reports. Management was demanding more timely financial information. The administrative staff was waiting hours for reports to run. The Brooklyn office launched a clinical point-of-care initiative running on laptop computers. Nurses were having difficulty connecting to the main server to sync data.

Simione Consultants engaged Rob Rossi to deliver an onsite assessment of their current technology including servers, networks, applications and staff. Rob worked with Ricky Smith of Simione Consultants to diagnose and resolve the problems in obtaining reports from their primary healthcare information system.

We also reviewed the network configuration and Internet service providers to each location so Family Care could better plan for the expansion of their point-of-care clinical platform.

The team engaged a network engineer to analyze network traffic and server memory utilization. This analysis revealed multiple issues leading up to significant calamities with network access, database and application server performance and report generation.

Solution

Our evaluation indicated the hosting environment was not configured to properly support the application and database servers. When specific financial reports were run the application timed-out waiting for the database to complete and return the query results. Whe remote users logged-in from remote offices the bandwidth was inadequate and they were frequently bumped-off the network. Our solution began with tuning database configuration settings so the database server could access more memory. This helped reduce server crashes and modestly improved performance. Further discovery supported the need for a database version upgrade. Since the healthcare system provider had not certified the application on the new DB version, and we were working with the only client experiencing these problems, our team needed to QA the application on the new DB version. In the end, we upgraded the database version, purchased a new, more powerful server, tuned the database memory settings and increased the network bandwidth to the data center.

Benefits

The database version upgrade and more powerful server improved report delivery performance by 320% and the system stopped crashing. The billing team recouped days of time every month and department moral improved significantly. Remote offices also benefited from a more responsive system and improved network bandwidth.

The Brooklyn office was able to smoothly expand their point-of-care clinical implementation. The field nurses reported more successful remote server connections and significantly shorter data sync times.