Yale Case Study

Dr. Prem Thomas at the Yale Center for Medical Informatics was a member of a research group working to improve the medical care of hospitalized patients who have elevated blood glucose levels. The group developed and published a measure of how well glucose was controlled. However, their measure, called glucometrics, involved manipulating and analyzing large datasets of glucose results. Over several months the Yale group developed a method to do this using several programs for analysis and report generation.

To encourage other hospitals to use glucometrics, Dr. Thomas built a Yale website allowing hospitals to upload glucose data and receive back a PDF file of glucometrics on that data. He built the site with the powerful data manipulation and analytical tools of Wolfram Research's webMathematica.

A important part of research is communication and collaboration with others. For quality of care measures, collaboration in measure construction and communication of their rationale is key to acceptance by other institutions or physicians. Harnessing the collective experiences of hospitals and physicians provides tremendous value, something that until now, has been largely untapped. For this task Dr. Thomas turned to OpenACS.

Edward Tufte, the dean of analytical information design, uses OpenACS as the software platform for a highly successful moderated web forum which Dr. Thomas admired. As he read more about OpenACS's mature and fully featured community system with an extensive collection of collaboration modules, he was convinced. OpenACS offered a powerful solution which could grow with his needs.

In addition to collaboration features, Dr. Thomas wanted to provide a way for hospitals to store data for later review and aggregation. However, it was important to provide privacy: hospitals should see their own data, but not the data of others. OpenACS has a finely grained, customizable permissions model which makes this easily possible.

Other factors contributed to Dr. Thomas's choice of OpenACS. He wanted the freedom and control that Open Source provides. Given a limited budget for development, he needed a solution that was affordable to initiate and maintain. As a programmer, he knew that he would be able to modify and maintain the code himself if needed.

Although Dr. Thomas briefly considered doing the entire project himself, his time constraints quickly convinced him that he needed some professional help. He chose Solution Grove because of the depth of experience with OpenACS and their ability to locate and contract to people with expertise needed for a project. In this case Solution Grove provided a project manager with an M.D., Vinod Kurup.  

"Vinod was just outstanding. As a doctor, he understood glucometrics making it easy to 'talk shop.' He also paid careful attention to the design specifications of web site. He was quick to respond to issues I raised. And his considerable programming expertise was backed up with the collective experience of the entire Solution Grove team. I was very pleased with the end product." – Dr. Prem Thomas, MD

OpenACS did not require any rewriting of the original glucometrics site, which ran as a Tomcat application. OpenACS does all of the user interfacing work and transfers the data files in the background to the Tomcat server running on the same machine. To manage the glucose data, Solution Grove made use of a new OpenACS package called 'dynamic-types' which allows creation of new object types and all related web forms from a web interface.  For example, the dynamic-type called 'ward' holds metadata about the ward where the glucose values were obtained. Because the hierarchical structure and object metadata can all be changed through a web interface, the system is flexible and can grow as usage increases.

The Glucometrics site also includes discussion groups and a dynamic content management system. OpenACS's flexible design makes it easy for the system administrator to add new discussion groups and other collaborative tools as the community grows.  Dr. Thomas is also using OpenACS's fine grained permission system to allow various experts to create and maintain content pages on their areas of expertise, without granting full site-admin privileges, which might breach the security of the medical data.

"In my internal medicine practice in New York City, I see diabetic patients every day and know the importance of proper blood sugar control. It was a privilege to have the opportunity to work on a project that addresses such an important problem." - Vinod Kurup, MD, Solution Grove

The Glucometrics site launches in the Fall of 2006 and is expected to make blood sugar tracking analytics available to doctors and hospitals around the world.

Learn More:
Glucometrics
Glucometrics poster, from American Medical Informatics Association 2006 meeting
Yale Center for Medical Informatics
OpenACS Open Source Community Platform
Solution Grove

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