Advanced Screening for Active Protocols

Ohio State University Medical Center
Columbus, Ohio USA

The Advanced Screening for Active Protocols (ASAP) application was created for the Ohio State University Medical Center (OSUMC). OSUMC is located in Columbus, Ohio, and is one of the largest and most diverse academic centers in the country. It is the only academic medical center in central Ohio.

ASAP is used within OSUMC by medical screeners and clinical trial coordinators who look for patients to enroll in clinical studies.

This new application searches patients' electronic medical records (EMRs) using specific screening criteria to see if they are eligible for the clinical studies. The first step is for a screener or coordinator to register the study in ASAP via a typical Add Record page.

Patient EMR.

Once the study is registered, the user enters its eligibility criteria; for example, male, age between 18 and 70, diagnosed with diabetes, etc. A study may have more than ten criteria. Each criterion is a query template pointing to one of the EMR tables. The user selects a combination of the templates and fills in parameters via a customized Edit Table page.

Setup study eligibility criteria.

The criteria are run against patient EMRs on a daily basis for the duration of the study. Qualified patients are summarized in a Telerik RadGrid control, which has rows representing patients and columns representing criteria. The grid cells link to various Show Record and Show Table pages that display relevant portions of patient EMRs. From here, the user identifies candidate participants.

Screen result: potentially eligible patients.

Application size and scope

The Advanced Screening for Active Protocols (ASAP) accesses seven EMR-related databases and one ASAP-specific database, using Oracle. The ASAP-specific database contains 18 tables and 11 views. In addition, ASAP accesses the other seven databases through 14 materialized views. The largest database table has approximately 125 million rows, which equates to 1 million rows in its corresponding materialized view. The application has 36 Web pages, including ASCX controls.

In its initial phase, ASAP serves five ongoing medical studies. In the future, it may serve hundreds or even thousands of studies.

List of on-going studies.

The project

It took one person two months to develop the first working prototype of this project. After that, there were multiple changes based on user feedback. Each development iteration took about one week.

My time was spent 95% on page development, 20% of which was in Iron Speed Designer which I used to build the framework of this application. I spent the rest of the time customizing my application in Microsoft Visual Studio.

Code extensions and customizations

The ASAP application is extensively customized. I wrote approximately 5,000 lines of code in the following areas, among others:

	Large list selectors
	Email
	Conditional display
	Custom queries at runtime
	Ajax functions
	ASCX controls

The code customization took 80 percent of the development time. In addition to in-house code customization, I incorporated several Telerik controls including: RadGrid, RadWindow, RadCalendar, RadTextBox and RadComboBox.

Setup study eligibility criteria.

Page layout customizations

I made extensive page customizations, including:

	Rearranging control layout
	Adding additional record, table, ASP or ASCX controls
	Printable page
	Integrating third-party controls

I used the standard Fuji design theme in Iron Speed Designer.

Iron Speed Designer impact

Iron Speed Designer easily accommodated frequent user requirement changes, ranging from web page layout to the underlying data model.

Next steps

We have plans to expand the ASAP application in the future. As the application is rolled out to additional users, we will add more query templates. There is also a possibility of adding additional sites.

About the developer

Jing Ding has a PhD in Computer Engineering, Bioinformatics and Computational Biology, and an M.S. in Toxicology from Iowa State University. He received his B.S. in Biophysics from Fundan University in Shanghai, China. He is a self-taught programmer who "played" with assembly, C and C++ in the 1990s. He took a break from programming from 1997 to 2000. When he picked it up again in 2001, he worked with Java. Jing began working with C#.NET in 2006.