CATEGORY: Database Performance & Systems Management

REVIEWER: Kenneth Billings, CIO for the Molecular Pathology Laboratory Network.

BACKGROUND: Molecular Pathology Laboratory Network is a pioneer in the field of molecular testing and in the forefront of applying molecular techniques to diagnostic testing. Headquartered in Maryville, Tennessee, Molecular Pathology specializes in genomic laboratory medicine including DNA testing for infectious diseases, molecular oncology, mutational analysis and human identity testing. The laboratory manages data for more than 100,000 tests annually.

PLATFORMS: Currently, CACHÉ is running in a Microsoft Windows 2000 environment. Laboratory data resides on an Apple Xserve that serves as the central file server.

PROBLEM SOLVED: Molecular Pathology's specialization in extremely sophisticated; and complex diagnostic testing has resulted in tremendous growth in demand from physicians, healthcare networks and hospital labs across the U.S. As a result, we had a critical need for a lab information system (LIS) that would automate our laboratory processes and support fast growth. An examination of LIS software packages convinced us that none currently available could meet our specific requirements for flexible reporting, the ability to manage non-standard data types, high performance and scalability. That led to the decision to build the LIS in house, using InterSystems' CACHÉ as the foundation database technology.

PRODUCT FUNCTIONALITY: CACHÉ is the underlying database technology for the LIS that literally runs our laboratory. Designed from the ground up as a Web application, this system interfaces with instrumentation, tracks lab specimens, produces automated reports, enables remote client test ordering and report viewing, and handles related administrative functions, including billing. The ability of CACHÉ to scale to handle very large data sets for genomic and diagnostics data contributes significantly to our ability to compete effectively in our area of specialization. Additionally, because CACHÉ enables us to deliver complex results via the Web very rapidly, the result is a high degree of satisfaction in our client base. CACHÉ also provides transactional bit-map indexing, which makes it possible to perform real-time queries on live data in conjunction with high-performance transaction processing. The queries can access the live transactional database, and the search speed – even with complex queries – is quite remarkable.

STRENGTHS: The post-relational database architecture, which includes a multidimensional data and application server and supports development with both fast, scalable SQL and advanced object technology, offers considerable advantages over legacy relational technology. Because there is direct access to the database engine, whether developing in SQL or with CACHÉ objects, performance is considerably better than when mapping is required, as is typical of relational databases. Additionally, CACHÉ provides a RAD environment that is easy to use and includes powerful tools.

WEAKNESSES: CACHÉ does not currently support the Macintosh platform, which is the preferred development and deployment platform in our organization. InterSystems is, however, planning to address this with a release for the Mac OS X platform later this year.

SELECTION CRITERIA: CACHÉ provides the performance and scalability needed for mission-critical Web applications. The capability to store multidimensional data makes it possible to manage complex transactions without sacrificing performance. The RAD environment with a graphical CACHÉ Studio interface at the front end and the rich feature set provided by CACHÉ object technology were also key in product selection. We also placed a high value on the innovative development approach that enables CACHÉ to support real-time data analytics – something that is still not possible with other major databases.

DELIVERABLES: For the LIS system, CACHÉ delivers fast, easy access to literally tens of thousands of diagnostic test results to internal end users and clients in locations across the U.S. Additional deliverables include the ability to access all of our tests, bill our clients and dynamically report results in a secure, fast and reliable manner. In addition, we use CACHÉ to assist in quality control measures and laboratory performance metrics.

VENDOR SUPPORT: InterSystems has worked with us in close partnership throughout the implementation process. They have been highly responsive when questions arise, and we see this as a very successful working relationship.

DOCUMENTATION: The enhanced documentation provided with CACHÉ Version 5 is easily searched and provides a complete reference set for all of the capabilities we use in CACHÉ.

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