1. Electronic Patients Records system
based on Oracle Application Express
A real life case study

2. Agenda
 Who am I
 Background
 Challenge
 Technical Selection
 The Solution
 APEX wishlist
 Recap

3. Who am I
 Jan Karremans
 Working in IT since 1991
 Working with Oracle since v. 7 on Alpha VMS
 From administration to development
 From customer to sales / management
 Oracle SE evangelist around the Globe

4. I’m on-line
 Jan Karremans
j.karremans@jk-consult.nl
johnnyq72
jankarremansnl

5. Reversed Q&A
 Position of Oracle APEX?
 Standard Edition database?
 Healthcare background?
Obviously there are more APEX
implementation architectures possible!

6. Background

7. VIR e-Care Solutions
 Healthcare Software development
 Complete medical / administrative support
 Based in and focused on The Netherlands
 45 staff and growing
 30+ years in business

8. Background
 Dutch Healthcare sector
 Host based / Client - Server application
 Small development team
 Broad operational field

9. It is called…
 The main product, Ecaris is:
A computer system which supports the
complete treatment-process of each patient
Primarily arranged for multi-disciplinary
working organizations
Arranged for each Healthcare organization
Built from separately available modules

10. Background
8,000
users total
2 core
developers
164 k. clinical
tests / year
App. 400
concurrent +100 k. appts. /
month
€ 395 mio.
annualy

11. Challenges

12. Challenge - 1
 Create a web based solution
 Without big infrastructural (€) changes
 Easy to maintain
 Maximum use of system resources

13. Challenge - 2
 Create Oracle Forms like* functionality
* Full keyboard support
Completely functional plan board
Fast!

14. Challenge - 3
 Retain delivery methodology

15. Selection

16. Selection - infra
 Non-Oracle
Not an option, to difficult
 Oracle Enterprise
Even with special terms too expensive
 Oracle Standard (One)
Strong core, peripherals made to fit

17. Selection - technique 1
 Webforms
Too limited environment
Still needs lots of additional programming
 ADF
Does not ‘fit’ PL/SQL environment
Way to ‘intense’

18. Selection - technique 2
 APEX
Fit for 60 per cent of environment
Note: this is summer 2010
 Pre-APEX
90% PL/SQL
100% fit to technical requirements

19. BUT…
 This is an APEX session
 This is an APEX solution!

20. Demo plan board
 All mouse-clicks are also function keys
1. Show plan board
2. Mouse-over’s (no function keys, obviously)
3. Appointment contents (with warning)
4. Appointment change history
5. Changing plan board layout
6. Move appointment

21. Demo plan board

22. Solution

23. Core architecture
“Zero Footprint”

24. Core System
Monolithic, secure application core
 Oracle database Standard Edition One
 Oracle HTTP Server Powered by Apache
 Backbase BXML Ajax Toolkit
– Replacement under investigation

25. Core System
Specific settings
 Rule Based Optimizer
“If you have developed OLTP applications using Oracle version 6, and
if you have tuned the SQL statements carefully based on the rules of
the optimizer, then you might want to continue using the RBO when
you upgrade these applications to a new Oracle release.”
 utl_file_dir

26. Core System
Default system
 HP rx2600 w. HPUX 11i R3
 2 CPU w. 2 cores
 12 GB RAM

27. Reporting
 Oracle Reports Server
 Awkward licensing
 Knee fall to architecture, why?
Alternate solution
 PL/PDF or iAdvise Doxxy

28. Disaster proofing
 Standby database critical in Healthcare
 Oracle Data Guard not available
Alternate solution
 Dbvisit Standby

29. Federated authentication
 Web application needs single sign on
 Support from application core
Alternate solution
 Dell now Quest One Quick Connect

30. Couplings
 Healthcare informatics is comprised of
numerous individual systems
 Standard messages HL7 (http://nl.wikipedia.org/wiki/HL7)
 Open source broker
Alternate solution
 Mirth connect

31. Offloading and BI
 Operational BI
 Management BI
 Optimization settings
 Second database required
Alternate solution
 Dbvisit Replicate

32. Microsoft Office integration
 Actually just xml
 Legacy ODBC connections
not possible with SaaS delivery
Alternate solution
 iAdvise Docufy

33. Monitoring
 Weakest link
 Under surveillance
Alternate solution
 Nagios

34. Monitoring
 Application Performance Monitoring
 Analyse and compare performance
 Get numbers to feeling
 Gartner APM Conceptual Framework

35. Result
 Lowest TCO possible
 Super fast
 Rock stable

36. Looks like a lot of work…
 Many systems
 Much configuration
 But isn’t this always so?
 “Setup and forget”

37. APEX Wishlist
 Active Directory integration
 Connection driven background image
 Zero Footprint Reporting
 FOEX
 Connect to the community

38. Key points (recap)
 Oracle Application Express is a valid choice
for core systems
Yes!
 Oracle Database Standard Edition is a valid
choice for core systems
Yes!
 There are valid alternatives to the Oracle
Red Stack
Yes!

39. Q & A

40. The End…
 Jan Karremans
j.karremans@jk-consult.nl
johnnyq72
jankarremansnl