HexaGroup Software Engineering - Methodist Research Institute: Database System

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The Genitourinary Oncology Program at Methodist Research Institute
Database System

The Genitourinary Oncology Program at Methodist Research Institute (MRI) is recognized as one of the finest academic medical research facilities in the country for research on both prostate and kidney cancer. Led by Dr Robert Amato, the department is dedicated to the delivery of compassionate, state-of-the-art care to its patients as well as cutting-edge urology research. MRI large database of patients and their treatment holds a potential wealth of information for researchers working to solve some of urology's most complicated problems, including cancers of the prostate and renal system. HexaGroup was engaged to develop a system that would maximize researchers' ability to examine urology information collected by MRI including individual patient care, research protocols and test results. The system would also have to be infinitely expandable to accommodate future records and protocols. Essentially, HexaGroup needed to design a new brain for the urology department, accessible by the department's entire staff, research coordinators and serving as the main tool for data acquisition and retrieval.


	This project had several inherent challenges, the first of which being the immense size of the database. The information was not easily extractable, it included information from MRI's existing database, real-time laboratory results from Methodist Hospital's legacy system and radiology test results from a third-party visualization system, none of which offered readily available integration tools. HexaGroup also had to become more than familiar with the type of information collected in the database; we conducted hours of interviews with doctors, studied medical information and made inquiries into how the information was used by researchers. In short, we had to become urology experts ourselves to build an effective searchable database system for MRI.

The system gathers and tracks patient data, from initial baseline information through the patient's acceptance of an experimental drug treatment. Reactions to treatments are recorded and tracked throughout the patient's participation in the study; recorded data includes vital signs and other measurable reactions.

All of this relies on gathering information from multiple sources in multiple formats. All blood lab and pathology results are stored in Methodist hospital legacy systems. The data is sent to the system via HL7 messages that need to be filtered, read and imported into the SQL database. The import required various steps of error checking, as the HL7 messages often include typos and formatting issues. HexaGroup implemented real-time monitoring of all imports to build a knowledge base of all issues and resolve them immediately, either manually or by building fixes to each particular formatting error.

The other challenge resided in the reading of radiology reports, including text and images. HexaGroup interfaced with PACS, the newly developed radiology imaging system implemented at Methodist Hospital to provide MRI medical and research staff with radiology report data. This was realized by using a PACS web interface linked to each individual patient, providing direct access to the radiology reports.

The system also offers a user-friendly paper-to-computer interface to enable MRI data entry staff to import all existing paper reports into the relational database. This applies to blood, radiology, pathology, dictated notes and upfront studies. All paper reports are scanned and key data is entered into the database. Upfront patient data is now entered via an extensive patient questionnaire, available online and at MRI offices. The reports are designed to provide full flexibility in terms of querying capabilities. This enables MRI research staff to perform in-depth queries and isolate trends and key factors that will better assist them with their research protocols.

The system is built around Microsoft technology utilizing MS SQL Server 2000 database with stored procedure, .Net 1.1 framework, C# with Code behind technology. The system is hosted within Methodist Hospital's network and is fully compliant with HIPPA requirements.

The new MRI database is improving the department's already high level of patient care and the medical field's understanding of the causes and cures of urologic diseases. For the first time, all of the data pertaining to urology within the hospital is available in one central location. The increased querying capability of the central database has already enhanced the department's cutting-edge research. Furthermore, the department's professional statisticians no longer spend their time searching for hidden data. Their analysis is now quick and efficient, shedding light on new lines of research for the department. The next phase in this ongoing project is the implementation of a tissue database, and HexaGroup will keep developing the system as additional research protocols arise and additional functionality is required.

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