| Fast and Furious: Modernizing Clinical Application
Fast and Furious:
Modernizing Clinical
Application
| Fast and Furious: Modernizing Clinical ApplicationFast and Furious: Modernizing Clinical Application
Mari_Pantoja-Smith@MEDNAX.com
Mari Pantoja_Smith, MSN-RN, CCSS, LSSBB
Product Owner| MEDNAX
David_Leung@MEDNAX.com
David Leung
Tech Lead| MEDNAX
Cari_Lewis@MEDNAX.com
Cari Lewis, MBA
Portfolio Lead| MEDNAX
WHO IS MEDNAX?
Our History: MEDNAX Solutions
LEADING THE WAY FOR OVER 40 YEARS
Pediatrix
Medical
Group
founded
Newborn
hearing screen
program
launched
Maternal-fetal medicine
and formalized Center
for Research, Education,
Quality and Safety
launched
Continuous quality
improvement
program introduced
Patient Safety
Organization
formed
Quantum Clinical Navigation
System introduced as a
quality initiative tool for
implementation at our
anesthesiology practices
MedData revenue cycle
management and Surgical
Directions specialized
health care consulting
service organizations
acquired
Pediatric cardiology
and pediatric
intensive care
introduced
EHR module and
clinical data collection
capabilities introduced
to bolster research,
education, quality and
safety initiatives
Online CME and CNE
for maternal-fetal
newborn community
launched
American
Anesthesiology
founded
MEDNAX parent
company founded;
100,000 Babies large
scale neonatal quality
improvement campaign
launched
Online CME and CNE
for anesthesiology
community launched
vRad radiology,
teleradiology and
telemedicine
organization acquired
1979 1991 1994 1996 1998 2000 2001 2007 2008 2009 2012 2013 2014 2015 2016
100,000 Babies Published in
Pediatrics, showing improved
outcomes and cost savings;
Center for Research, Education
and Safety receives 3rd
accreditation from ACCME;
2017
MEDNAX acquires
it’s first Radiology
Private Practice
Today, Every Day at MEDNAX
The Nation’s Leading Provider of Neonatal, Maternal-Fetal, Anesthesia,
Pediatric and Radiology Subspecialty Services
2,360
Hearing
Screens
> 5,160
Anesthesia
Cases
2,200
Newborns in
the Nursery
550
Pediatric
Cardiology
Patients
>400
Attended
Deliveries
5,350
NICU
Babies
> 4,350
Hospital
Partners
1,900
MFM
Visits
640
PICU and
Pediatric
Floor
Patients
20,000
Radiology
Studies
WHAT IS OUR GOAL?
Fast and Furious: Modernizing Clinical Application
The goal is to provide a specialty agnostic platform
that delivers a more efficient and dynamic means to
capture clinical documentation and metrics that
support billing processes, clinical quality initiatives
and contractual obligations.
BRIEF HISTORY OF BABYSTEPS APPLICATION
>200
Sites w/
Interfaces
MVP
5
MONTHS
>500
Unique
Interfaces
>1M
NICU
Babies
>350
SITES
LIVE @
3
SITES
| Fast and Furious: Modernizing Clinical Application
Fast and Furious: Modernizing Clinical Application
Fast and Furious: Modernizing Clinical Application
HOW?
…..Speed
to
Value…..
| Fast and Furious: Modernizing Clinical ApplicationFast and Furious: Modernizing Clinical Application
Taking a leap to low code, no code platform
| Fast and Furious: Modernizing Clinical Application
New to
OutSystems,
Agile, API,
Microservices,
Cloud…
Who is freaking
out?!?
Fast and Furious: Modernizing Clinical Application
MVP?!?
Done…
What’s
next?
WHY?
Todd_West@MEDNAX.com
Todd West, MD
Corporate Medical Director| MEDNAX
MIRACLE BABY
Take great care of the patient,
every day and in every way.™
Thank You!
Mari_Pantoja-Smith@MEDNAX.com
David_Leung@MEDNAX.com
Cari_Lewis@MEDNAX.com
Todd_West@MEDNAX.com
Fast and Furious: Modernizing Clinical Application

Fast and Furious: Modernizing Clinical Application

  • 1.
    | Fast andFurious: Modernizing Clinical Application Fast and Furious: Modernizing Clinical Application
  • 2.
    | Fast andFurious: Modernizing Clinical ApplicationFast and Furious: Modernizing Clinical Application Mari_Pantoja-Smith@MEDNAX.com Mari Pantoja_Smith, MSN-RN, CCSS, LSSBB Product Owner| MEDNAX David_Leung@MEDNAX.com David Leung Tech Lead| MEDNAX Cari_Lewis@MEDNAX.com Cari Lewis, MBA Portfolio Lead| MEDNAX
  • 3.
  • 5.
    Our History: MEDNAXSolutions LEADING THE WAY FOR OVER 40 YEARS Pediatrix Medical Group founded Newborn hearing screen program launched Maternal-fetal medicine and formalized Center for Research, Education, Quality and Safety launched Continuous quality improvement program introduced Patient Safety Organization formed Quantum Clinical Navigation System introduced as a quality initiative tool for implementation at our anesthesiology practices MedData revenue cycle management and Surgical Directions specialized health care consulting service organizations acquired Pediatric cardiology and pediatric intensive care introduced EHR module and clinical data collection capabilities introduced to bolster research, education, quality and safety initiatives Online CME and CNE for maternal-fetal newborn community launched American Anesthesiology founded MEDNAX parent company founded; 100,000 Babies large scale neonatal quality improvement campaign launched Online CME and CNE for anesthesiology community launched vRad radiology, teleradiology and telemedicine organization acquired 1979 1991 1994 1996 1998 2000 2001 2007 2008 2009 2012 2013 2014 2015 2016 100,000 Babies Published in Pediatrics, showing improved outcomes and cost savings; Center for Research, Education and Safety receives 3rd accreditation from ACCME; 2017 MEDNAX acquires it’s first Radiology Private Practice
  • 6.
    Today, Every Dayat MEDNAX The Nation’s Leading Provider of Neonatal, Maternal-Fetal, Anesthesia, Pediatric and Radiology Subspecialty Services 2,360 Hearing Screens > 5,160 Anesthesia Cases 2,200 Newborns in the Nursery 550 Pediatric Cardiology Patients >400 Attended Deliveries 5,350 NICU Babies > 4,350 Hospital Partners 1,900 MFM Visits 640 PICU and Pediatric Floor Patients 20,000 Radiology Studies
  • 7.
  • 8.
    Fast and Furious:Modernizing Clinical Application The goal is to provide a specialty agnostic platform that delivers a more efficient and dynamic means to capture clinical documentation and metrics that support billing processes, clinical quality initiatives and contractual obligations.
  • 9.
    BRIEF HISTORY OFBABYSTEPS APPLICATION >200 Sites w/ Interfaces MVP 5 MONTHS >500 Unique Interfaces >1M NICU Babies >350 SITES LIVE @ 3 SITES
  • 10.
    | Fast andFurious: Modernizing Clinical Application Fast and Furious: Modernizing Clinical Application
  • 12.
    Fast and Furious:Modernizing Clinical Application
  • 14.
  • 15.
  • 16.
    | Fast andFurious: Modernizing Clinical ApplicationFast and Furious: Modernizing Clinical Application Taking a leap to low code, no code platform
  • 17.
    | Fast andFurious: Modernizing Clinical Application New to OutSystems, Agile, API, Microservices, Cloud… Who is freaking out?!?
  • 18.
    Fast and Furious:Modernizing Clinical Application MVP?!? Done… What’s next?
  • 20.
  • 21.
  • 22.
  • 23.
    Take great careof the patient, every day and in every way.™
  • 24.
  • 25.
    Fast and Furious:Modernizing Clinical Application

Editor's Notes

  • #10 Brief History of BabySteps. Introduce what is BBS. Include some stats on our footprint. Currently live @… here is what it's looks like today.….
  • #11 ATTEMPT #1 Under the perception VB6 is the issue and .NET is everything. Goal is to create the same look & feel of the application in C#.NET. Contractors ported the source code from VB6 to C# using online converter tool instead of rewrite. Database optimization was never considered even when told it is an concern. Putting a Ferrari body kit on a Yugo chassis, which leads to AICU (Application Intensive Care Unit) - pun intended. Rollout to pilot site in September but have to rollback immediately due to performance issue. Spend another 6+ months trying to root cause.
  • #12 The point before we blow it up.
  • #13 SECOND ATTEMPT (continuation of failed first attempt) Started April 2014 Dive deep into the application, database, server, network and etc. Memory Leak of 2.1 GB memory usage for single user session Function to create patient calls 80+ cascading stored procedures Viewing patient record for edit requires another 65+ stored procedures call No referential integrity Defects continue to be discovered in both front-end and back-end Finally cord was cut in January 2017.
  • #22 Journey through product delivery
  • #24  MEDNAX’s founding principle which is still true today is “Taking Great Care of the Patient”