Case Studies
The following case studies are actual projects completed by Precision Healthcare Solutions
for our Cerner clients. For privacy reasons, the name of the clients have been excluded.
Case Study #1 - Trendstar Rewrite
A client of ours recently struggled with an extract that was originally developed by Cerner and
later maintained by other consultants. The extract was designed to populate a software called
Trendstar with a large volume of patient and financial data. The original version of the script
had a number of problems. First, it was extremely slow. A typical run of the extract took over
28 hours to complete. The second problem is that the source code was too difficult for the clients
internal programmers to maintain.
We were contracted to rewrite the extract. After a short development period we returned with
a completed version of the extract. The new version weighed in at 1,400 lines of code (the
original was over 14,000) and executed in under 10 minutes.
In addition to the performance gain, our client was finally in a position where the source
code was maintainable by their internal programming staff.
Case Study #2 - DomainSense
A client of ours was preparing for a major Cerner upgrade that included the implementation of
CPOE. One of the challenges faced was comparing the build between production and the CPOE testing
environments.
Using a combination of CCL scripts, Microsoft SQL, and JSP (Java Server Pages), DomainSense
was born.
DomainSense was updated on a nightly basis with the current build of every domain. Client analysts
could then use DomainSense to immediately see if their build data was different between domains. The
result was a very clear picture of changes that needed to be moved to production before the CPOE
go-live.
Case Study #3 - A Faster Patient List
A client of ours was struggling with a major performance issue in Millennium Objects. The client
had a custom web based application that needed to retrieve a large patient list. Depending on the
size of the patient list, Millennium objects would either take too long to run (10+ minutes) or
simply crash.
Our solution was to create an external database on the web server that contained an up-to-date
patient list. Using CCL and Microsoft SQL, we were able to populate this custom database on a
near real-time basis (every minute). The client web team then used this custom database for all
of their patient lists. The end result was that the large patient lists could be retrieved in
a few seconds with very little impact to the Cerner system.
Case Study #4 - Kidney Transplant Failure Report
While this report was not a technically challenging report to write, it is mentioned in our
case studies because it represents some of the types of valuable research that can be
accomplished with a CCL report.
A client of ours needed a report that would help them in determining if any of their
kidney transplant patients were at risk for a kidney rejection. A number of conditions were
identified by physicians as signs of potential kidney failure (e.g. specific lab results).
While some of these factors were simple conditionals such as "if the patient has a lab result
of xxxx", others were trended over time. So, if a patient had certain levels of a test change
by a specific percent of x number of months, they should be identified.
This report was used against a list of over 300 active transplant patients. Trending this
type of data manually would have been a painstaking task. Our report reduced this task to a
simple click of a button.
Case Study #5 - Readable Pharmacy Labels
Barcode label readability is a fairly common problem with most Cerner clients. The problem is due
mainly to Cerner's limited support for all the features of client barcode printers. Intermec and
Zebra printers are all preinstalled with a number of very attractive and readable fonts that are not
available in Cerner's DIO functionality.
The pharmacy department at one of our clients had an issue where the existing Cerner labels
were very difficult to read. We were asked if we could create a better label.
To resolve this issue, we developed barcode labels using the language built directly into the
Intermec barcode printers (IPL). The result was that every font and feature was made available
for our use. The new labels were still written in CCL and are easy to maintain by other programmers.
Case Study #6 - CCL Training
In 2008, we finally began to offer CCL training to our clients. The response was fantastic. All
of our clients who have taken the course have stated that our course was the first course that
actually made sense. Tied in with our included manual, our training gave our clients the education
and resources needed to make their CCL programmers efficient at their jobs.
One of our clients had brought in three other organizations for training (the first being Cerner).
In each case, the programmers completed the course but were still not equiped with the skills needed
to produce advanced reports after the course.
Once we taught them the proper techniques for writing Cerner reports, our client was thrilled
to find that weeks after the course, they still understood everything we had taught them.