Amalga helps hospital keep swine flu in check

When fears over the swine flu first broke out in many parts of the world in April, El Camino Hospital in Mountain View, California, was about to pull the trigger on an implementation of Microsoft's Amalga software.

Plans changed slightly, however, when hospital officials realized they might possibly have a flu pandemic on their hands, said Dr. Michael Gallagher, director of business intelligence and outcomes for El Camino.

The hospital did implement Amalga as planned, but with an addition to it designed to track patients that came to the hospital with flu-like symptoms -- as well as anyone else who may have been in contact with them in the emergency department, he said.

"We had to know who was exposed, how to track these patients," he said. "Because the Amalga system was extremely flexible, we put together a new application for tracking patients as they showed up in our emergency department."

Amalga is Microsoft's e-health aggregation software that helps health-care institutions like hospitals and other health-care service providers by capturing and storing patient and other information from disparate systems and presenting it in one place.

It took only three hours from concept to deployment to create the tracking software using Amalga, said Steve Shihadeh, vice president of the Microsoft Health Solutions Group.

While El Camino took the lead in conceptualizing, creating and implementing the tool, Microsoft showed them how it could be done through a feature of Amalga called User-Self Service, he said, which allows people to create a new application very quickly by re-using data aggregated by Amalga, he said.

Gallagher said it took some rethinking to get the new application in place. El Camino had designed its Amalga implementation to track inpatient units of the hospital, but the emergency department (ED) is an outpatient facility.

"We had to come up with a way to get information about ED patients and to keep track of them as a large group," he said. It was not hard to do in Amalga, however, because it allows users to query information based on links between the data, using commands such as "find me everybody who has had three heart attacks," Gallagher said.

Though there are other e-health platforms in the industry -- Eclipsys (formerly MediNotes) among them -- Amalga's ability to pull so much information from the many disparate systems found in a typical medical database is "amazing," as other systems tend to treat "each individual as sort of a separate encounter" rather than seeing the relationship between the data, he added.

"With Amalga, we can be more flexible with how we look at patients over time," Gallagher said.

Amalga information is served up in a dashboard that is in a way similar to an Excel spreadsheet, so it was easy to create new grids to keep track of all the patients who came to the ED, as well as related details such as what they were there for, whether they were there for flu-like symptoms, if they were sick enough to need a swine-flu test, if they were admitted or sent home, etc., Gallagher said.

El Camino tracked somewhere between 500 and 1,000 patients this way for about two weeks during the height of the swine-flu scare beginning on Monday, April 27, Gallagher said. The hospital saw many flu patients during this time, but fortunately, none of them ended up having the swine strain, he said.

Still, the tool was helpful in keeping health officials in Santa Clara County, California, which manages medical facilities in the area where El Camino is located, apprised of the situation at the hospital so it could allocate resources to other facilities to treat patients as needed, Gallagher said.

Since his hospital did not need medication to treat swine flu, that freed up those resources to go to other hospitals, he said. Similarly, "if another hospital was overwhelmed, our hospital could help," he said. "We were able to keep patients safe without taking money away from other facilities," Gallagher said.

El Camino wasn't the only hospital to use the tool El Camino created. Microsoft released it free to other Amalga customers so they could track swine-flu patients or potential swine-flu patients as well, Microsoft's Shihadeh said.

Though there are still swine-flu cases in the U.S. now, El Camino at this point has ceased using the swine-flu tracking application. However, Gallagher said the hospital is keeping the information and the tool on hand for any recurrence of a swine-flu epidemic, which some health-care officials said may happen later this year.

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