Microsoft SQL ServerCustomer Solution Case Study

Medical Software Firm Optimized IT Platform, Improves Services for Healthcare Providers

OverviewCountry or Region: GermanyIndustry: Healthcare

Customer ProfileBased in Greifenberg, Germany, GMZ is the creator of PVVS, a web application that helps healthcare providers manage patient data and bill for medical services.

Business SituationGMZ needed to enhance PVVS to handle increased business growth and higher web traffic.

SolutionTo increase the performance and reliability of PVVS, GMZ engaged Microsoft Services Premier Support for Developers to upgrade the company’s web platform.

Benefits Faster system performance, higher

availability Better trained, more knowledgeable IT

staff More responsive service, better patient

care

“Testing Services of Premier Support for Developers helped us improve the performance of our PVVS medical services web application by 120 percent.”

Dr. Elmar Schmid, Chief Executive Officer, GMZ

The flagship product of GMZ—Patient Management and Care Software or PVVS—links doctors, hospitals, and nursing services across southeastern Germany. The PVVS web application helps these providers manage the data of 30,000 patients and bill health insurance companies. To support the company’s growth, GMZ needed to improve the performance of PVVS and scale it to support twice as many simultaneous users while maintaining rapid response time. To achieve this goal, GMZ and its IT partner I-Motion engaged Microsoft Services Premier Support for Developers to optimize the company’s web platform by redesigning it in a test environment that simulates real-life conditions. This included a code review, additional software development, and training for GMZ and I-Motion developers. The result was a 120 percent increase in the web platform’s performance and more reliable service for GMZ customers.

SituationFounded in 1998, GMZ has dedicated itself to helping healthcare providers in Germany offer better service to their patients. Using the company’s flagship product—Patient Management and Care Software, or PVVS as it’s abbreviated in German—providers reduce time spent on day-to-day administrative tasks. These include creating medical reports, maintaining patient documentation, managing electronic patient data, and billing for medical services. The result is more time available for medical care.

GMZ links physicians, nursing service providers, and hospitals located in and around Munich, Garmisch-Partenkirchen, Mühldorf an Inn, Neuötting, Waldkraiburg, and Weilheim. Through the centrally hosted PVVS web application, healthcare providers can manage and exchange the medical data of nearly 30,000 patients and bill health insurance companies. GMZ also plans to integrate pharmacies into its network and to allow patients to access their records online. “Traditionally, every medical service provider has had to keep its patient data in its local IT system and send it to a clearing center for billing,” explains Dr. Elmar Schmid, Chief Executive Officer of GMZ and a General Practitioner in Munich. “Information is moved between physicians and hospitals, for example, using printouts or faxes. PVVS greatly streamlines this process.”

PVVS was developed by GMZ along with its IT partner I-Motion. Microsoft Partner Network member I-Motion develops, installs, and operates communication solutions for the German healthcare industry. Over the years, the companies

have improved PVVS, which is now based on Microsoft Silverlight, the Windows Server 2008 R2 operating system with Microsoft Internet Information Services 7.5, Microsoft SQL Server 2008 R2, and the Microsoft .NET Framework 4. The application’s graphic user interface is built on Windows Presentation Foundation, a key component of the .NET Framework. “It was very important to us that any changes made to patient data should be visible in real-time through an intuitive graphical interface for every logged-in client,” emphasizes Schmid. This prevents double entries when two or three users are working on one document at the same time.

At the end of 2011, GMZ and I-Motion tested PVVS live with 200 users. During this process, the companies identified problems with the application’s form management system and slow performance that would hinder scalability. With the growing popularity of PVVS, GMS also wanted to improve functionality to simplify processing medical reports, billing, and budgeting. But most of all, it had to resolve the performance hurdles, which was key to supporting expected business expansion. “At that time, we had little experience with scalability issues,” says Robert Wölzlein, Chief Executive Officer of I-Motion. The companies needed expert help to significantly upgrade PVVS to handle the increased customer volume.

SolutionOn the recommendation of I-Motion, GMZ engaged Microsoft Services Premier Support for Developers to test the scalability, performance, and stability of PVVS and to evaluate the application’s

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“After just two hours, the Testing Services specialist from Premier Support for Developers discovered the cause of two memory leaks that were slowing down our application.... The application has been stable ever since.”

Robert Wölzlein, Chief Executive Officer, I-Motion

overall architecture. Premier Support for Developers helps an organization’s development team by giving it access to experienced Microsoft resources and a full suite of Microsoft services designed to both accelerate project results and reduce risks across the entire software development life cycle. Specifically, GMZ was eager to take advantage of the program’s individual workshops on technologies and products, prototyping, testing under various scenarios, and architecture and code reviews, as well as 24-hour technical support.

In early January 2012, experts from Microsoft Testing Services, provided by Microsoft Services Premier Support for Developers, thoroughly tested PVVS in a laboratory located at the Microsoft office in Unterschleißheim near Munich. The facility can configure enterprise solutions in a variety of test environments on 700 current server systems with up to 25,000 virtual users working simultaneously. The test environments can also be accessed remotely. For GMZ, Microsoft staff recreated the PVVS production environment and tested response time from the perspective of typical end users. The test’s starting point consisted of 100 users (a normal load) working simultaneously and accessing the GMZ wide area network (WAN) through connections such as digital subscriber line (DSL) 1500. (The lower bandwidth and characteristically increased latency period of the WAN connection significantly affect the response time of the application.)

Using their technical experience and profiling and analysis tools, Testing Services staff identified which application

procedures required the most processing time, and they gradually increased the simulated load until a weak point (bottleneck) was reached, causing stagnated system performance. “The tests revealed inhomogeneous and inconsistent CPU usage,” says Wölzlein. “This was a clear sign of a lack of stability of the system.” With the weak points identified, the Microsoft team worked with GMZ and I-Motion developers to reduce the number of redundant queries or suggested more efficient .NET programming methods. These remedies were retested to document their effectiveness, including an overnight run to check whether the processor usage remained stable over time.

A debugging specialist also helped out with testing. “After just two hours, the Testing Services specialist from Premier Support for Developers discovered the cause of two memory leaks that were slowing down our application,” recalls Wölzlein. “He solved the problem, and the application has been stable ever since.”

He adds, “Throughout application testing, we were able to refer back to the knowledge of Microsoft experts at any time. They helped us solve many problems.”

With the application redesign and testing complete, GMZ deployed its upgraded PVVS web application live in February 2012.

BenefitsAfter engaging Microsoft Services Premier Support for Developers, GMZ was able to upgrade its most important software product, PVVS, and deploy it in a very short time. PVVS now boasts faster system

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performance and improved functionality. And thanks to the training offered through the Microsoft program, GMZ developers can better maintain the application themselves. As a result, GMZ provides improved service to its customers.

Faster System Performance, Higher AvailabilityBy recoding and correcting errors in key PVVS procedures, the application now runs much faster. “Testing Services of Premier Support for Developers helped us improve the performance of our PVVS medical services web application by 120 percent, and its stability and availability are now better than ever,” says Schmid. Specifically, at the beginning of the tests, PVVS was able to serve 100 simultaneous users with only adequate response time. At the end of the upgrade project, the application could serve 220 users, representing a 120 percent increase in overall computational capacity, while reducing response time by 56 percent.

Better Trained, More Knowledgeable IT StaffGMZ and I-Motion IT staff gained valuable training during the project. “We benefited from the knowledge transfer from Premier Support for Developers,” says Schmid. “We now have the tools and expertise necessary for better testing of our own applications. In this way, we can now continue to optimize PVVS, in cooperation with I-Motion.” In addition to its Testing Services, Microsoft Services Premier Support for Developers also supported I-Motion and GMZ with code reviews, tips for high-availability of the hosting solution, and more stable server operation, and it

provided advice about improving code quality and automatic testing.

More Responsive Customer Service, Better Patient CareWith the upgraded version of PVVS, GMZ has met the needs of its expanded business. The application now successfully operates with twice the number of users that is used to. Consequently, more medical practices and hospitals can take advantage of the benefits of PVVS. By easily and quickly accessing digital patient data, consultation reports, and treatment summaries, and by settling medical invoices directly with insurance companies, providers can handle more patients and improve service. “More doctors are now saving a significant amount of time because, with PVVS, they no longer need to manually process so many medical reports,” explains Schmid. “In addition, patient treatment is improved because duplicate examinations are effectively prevented.”

Reflecting on the improvements to PVVS made possible by Testing Services of Premier Support for Developers, Schmid concludes, “More medical practitioners are now in a better position to work according to patients’ needs and to provide their services in a targeted fashion. As a result, healthcare providers operate more efficiently and patients get better care.”

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“We benefited from the knowledge transfer from Premier Support for Developers. We now have the tools and expertise necessary for better testing of our own applications.”Dr. Elmar Schmid, Chief Executive Officer,

GMZ

Microsoft ServicesMicrosoft Services is a global team of professionals who are dedicated to helping customers maximize the value of their investment in Microsoft software. Microsoft Services touches customers more than 715 million times a year, helping them plan, deploy, support, and optimize our technologies. They also work closely with Microsoft Partners by sharing their technological expertise and product knowledge on a regular basis.

For more information about Microsoft Services, go to:www.microsoft.com/services

For more information about Microsoft Testing Services in Germany, contact: mstsger@microsoft.com

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For More InformationFor more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) 426-9400. In Canada, call the Microsoft Canada Information Centre at (877) 568-2495. Customers in the United States and Canada who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) 892-5234. Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to:www.microsoft.com

For more information about I-Motion products and services, call (49) 0911-936336-0 (Germany) or visit the website at:www.i-motion.de

For more information about GMZ products and services, call (49) 08192-99663-0 (Germany) or visit the website at: www.gmz-gmbh.de

This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY.

Document published December 2012

Software and Services Microsoft Services− Microsoft Services Premier Support− Microsoft Testing Services

Microsoft Server Product Portfolio− Windows Server 2008 R2− Microsoft SQL Server 2008 R2

Technologies− Microsoft .NET Framework 4− Windows Presentation Foundation− Microsoft Internet Information

Services 7.5− Microsoft Silverlight

Partner I-Motion