Client

Apple Physical Therapy (ApplePT) is a physical therapist owned private practice specializing in diverse outpatient rehabilitation services since 1984. With 25 locations around the Puget Sound area, Apple is Washington State's largest private practice and physician demand for its services has exploded in recent years. 

The Challenge

One of our main goals as a company was to centralize all our Patient Information to a Microsoft SQL 2005 database. We began by creating an InfoPath form that would submit Patient billing data. We were able to achieve this goal by simply using the Microsoft technology of a SharePoint 2007 Form Library. During testing, the new form seemed like it would be a perfect fit to our scenario.

Soon after deploying this solution we saw huge problems. The first thing we noticed was how slow the forms performed over a VPN connection. Clinics are connected to the internet by 348 kbps to 1.2 mbps connections and submit most of the billing information. This meant that employee productivity slowed down dramatically. Our company creates ~120 Patient Information forms/day and each form is submitted at least 3-4 times a day. That works out to about 400 submits/day from the hours of 7am to 7pm. Our testing found that the form would take from 1 to 2 minutes to open because of the amount of secondary data that would be required to fill in drop-down lists. Submitting and closing would take up to 30 seconds because of the slow nature of InfoPath data connections.

Another problem with submitting InfoPath directly to a SQL database is when your form submits to multiple related tables. Our form submits to three tables which have row relationships. A big problem would occur when an end user tried to delete a row in the second table while there was related information in the third table. InfoPath would give a key constraint error because the form wasn't smart enough to realize that if an end user was deleting the Patient Information that the underlying Treatment Information should also be deleted. The only way around this was a two step delete which would just cause added frustration because of the slow nature in submitting.

I was getting a lot of complaints from end users, and rightly so. From my readings I knew that InfoPath could submit to a Web Service, but how could I integrate that with my solution? I did weeks of research and finally came across Qdabra. Other Web Service solutions required you to know how to write code and build things from the ground up, or they would charge you to write a custom Web Service for your application. Qdabra's Database Accelerator for InfoPath seemed to be designed specifically for our situation. It claimed to increase the performance and functionality of integrating InfoPath with SQL

The Solution

We are now set-up with Qdabra Database Accelerator as the Web Service that submits data from InfoPath to SQL. All the primary and secondary data sources are using DBXL web services. The forms now take ~10-15 seconds to open and just a few seconds to submit and close. End users love the new forms and the bandwidth used over the remote VPN connections has dropped dramatically.

DBXL solved the problem of deleting/submitting relational database records because it controls all aspects of table relations. DBXL knows how deleting a parent table row will affect the child rows. Now end users can delete patient information and DBXL will handle the child tables as it should.

Qdabra DBXL solved the key limitations we had with InfoPath to make our solution meet the scale and performance demands of our multi-site scenario.

Client Feedback

Users are so pleased with the performance boost using Qdabra DBXL that they thought their internet connection speed to the central office had been increased. And building new forms into DBXL has been easy and seamless as Apple Physical Therapy's needs have grown. In the words of network administrator Jeff Tangen, "Qdabra’s DBXL seemed to be designed specifically for our situation. And the team at Qdabra worked very hard to help me find the issues with my old form. They are a great group of people to work with.

Click to see his original testimonial posted to InfoPathDev.

Screenshots

Web Portal 1. A Microsoft SharePoint intranet web dashboard provides the central location to access the system. The user clicks the Charge Sheet link to open the Charge Sheets system.

Web Portal 2. Each therapist completes one charge sheet per day. All the active charge sheets are available organized by clinic and date for quick access.

Form 1. Each InfoPath Charge Sheet form lists the therapist's patients for a given day. The therapist selects a patient and fills in the procedures administered in the lower detail section. By directly entering data into the system, retyping errors are eliminated from typical paper-based processes.

Form 2. The Front Office can open a read-only copy of the same form to review the therapist's charge sheet for accuracy. They then check the FOC Reviewed box to log their review. The elimination of paper has streamlined data flow throughout the office.

Form 3. When it comes time for billing, the Central Billing Office (CBO) opens the CBO View of the same form. Here they see the charges for each patient and copy the data to the billing system. Once the billing is posted they check the Posted checkbox to track what has been submitted.

Report 1. The Clinic Daily Report allows managers to analyze clinic profitability performance in real-time.

Report 2.The Treatment Type report allows managers to analyze which therapies are most common and profitable.

Report 3. The web portal displays a "Dundas" report which allows the team and managers to view clinic performance at a glance.