In 2005, Botsford General Hospital chose CDR-Web as their Clinical Data Repository / Clinician Portal, providing comprehensive, real-time results reporting in a visually appealing, integrated clinical record. Botsford clinicians being equipped with this configurable, secure, Web-based portal increased clinician and patient satisfaction by improving the quality and timeliness of care, and reduced the length of patient stays in the hospital.

in 2007, CDR-Docs, a commercial grade web-based document scanning feature, was added, allowing for paper-based reports, charts, and other supporting documentation to be directly added to the patient record, and visible as a PDF to the clinician user.

“The physicians and nurses provided excellent feedback regarding the application” said Dr. Paul LaCasse, Executive Vice President and Chief Operating Officer at Botsford General Hospital and executive sponsor of the clinical portal application project.

CDR-Web was used by Botsford Hospital as their primary medical record for 12 years.

In 2005, Bay Medical Hospital, joined Botsford Hospital in choosing CDR-Web as their Clinical Data Repository / Clinician Portal.

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CDR-Web was used by Bay Medical Hospital as their primary medical record for …

A commercial grade web-based document scanning was added, allowing for paper-based reports, charts, and other supporting documentation to be directly added to the patient record, and visible as a PDF to the clinician user.

Portlet Technology developed during a re-envisioning of our User Interface, we created the concept of a script “wormhole” that used a small Java component linked with Javascript to communicate back to the server and obtain a small portion of the web page to be rendered asynchronously. This has been since deemed “Web 2.0” by the Internet Community, but to this day, we still lovingly refer to those bits as “Portlets”.

In 2000, Providence Hospital in Southfield, Michigan, was the first hospital to adopt CDR-Web as their primary medical record point-of-truth for both their primary and offsite hospitals and supporting facilities. This brought patient record access immediately to the point-of-care.

Within the following two years, comprehensive, CDR-Rx, a hospital-based computerized physician order entry (CPOE) was integrated into CDR-Web, resulting in significant improvements for the inpatient pharmacy, enabling medication delivery to the floor five times faster than before CPOE implementation. 

The SQL Data Model is a third-normal-form based model, with nearly all tables using large integer Identity based keys, providing performance and referential integrity.  The Data Model began with our Clinical Data Repository (CDR-Web), focusing on the primary portions of a patient record: Demographics, Procedures, Diagnoses, Lab Results and so on.  In CDR-Web’s product evolution, this expanded to include Order Entry, Medications, Pharmacy Order Entry, and Scanned Documents. 

During our partnership with HFHS for EXR/CPNG, our data model was chosen for the basis of the new product, and was enhanced to support Teams, Work Queues, Clinical Documentation, Pathways/Protocols, and much more.  At one point, out of curiosity, one of the HFHS data model team printed the entire logical model. It took up his entire wall.

We continued to expand EXR to be certified as a complete Inpatient and Outpatient EHR, and the Data Model was further enhanced to support some of the feature points, and encryption methods required for certification.

When we created Arcana, we enhanced the Data Model for all of our external sourced data tables and expanded them to fully accept any sourced data. This allows us to accept data from any combination of source systems, and be properly aggregated, preserving the original while at the same time being able to easily map it to any known Point-of-Truth (i.e. CPT, ICD and similar codesets).  With it, Arcana is able to assess patients realtime and have reaction situations for any number of use cases, including aiding in insurance reporting of HEDIS matching patients and their related data points.

In 1998, we released CDR-Web, the first commercially available web-based Clinical Data Repository, as our flagship product.  A Clinical Data Repository is a “patient-based” database that is focused on clinical healthcare data, allowing users to view patient records electronically.  In the time where every hospital in the world had people dedicated to managing and delivering large paper charts, being brought up from the Records Room to the patient’s nursing station for the physician and clinical staff to review, CDR-Web made that same information immediately available via laptops and mobile workstations, directly in the patient’s room, using a powerful SQL Database and intuitive web-based interface.

Over the next 7 years, additional modules were added to CDR-Web, each just as revolutionary as the product itself.  These included web-based document scanning, prescription order entry with real-time medication interaction screening, and a personal view or “portal” to a patient’s own record (later becoming known in the industry as a PHR, or Patient Health Record).  On top of that, CDR-Web itself had multi-tier permissions and preferences, allowing the user experience to be customized at the facility, user’s role and down to the individual user.

For over a decade, CDR-Web was installed and operated as the primary medical record for several Michigan Hospitals, including Providence Hospital of Southfield, Botsford Hospital of Farmington, and Central Michigan Community Hospital as well as Bay Medical Hospital in Florida.

To date, some still refer to CDR-Web as “the most easy-to-use and intuitive” application they have ever used.

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We started Reliance Microsystems as general IT consulting company, focusing on Networking, including Internet connectivity, and custom web-site design. Comprised of all of two people, we set out tackling jobs that intimidated larger companies, including a complete state-wide upgrade of an entire banking network’s computers within 30-days. Another was assisting a company after a merger had upset the original IT staff, which sabotaged the network on their way out, and we were able to restructure and regain control of everything within 2-weeks.

General Motors

As we started to gain traction, a partner software developer brought us in on a project for General Motors known as the GM Truck Town. It was an internal web application, then referred to as an Intranet Application, which had several components, each named after something automotive related. We were tasked with “The Depot”, which involved designing and building a 100% web based secure and departmentalized document sharing solution. Many would refer to this concept now as a well known website whose name rhymes with “BropDox”, however, in 1994, this was monumental.

Mercy Health Services (aka The Sisters of Mercy)

After our success with the Depot project, we were brought into another consulting project with the Mercy Health Services (also known as “The Sisters of Mercy”, a healthcare group in Farmington Hills. They had a project to turn their paper-based medical records system into a computer database, known as a Clinical Data Repository, and more importantly, to use a purely web-based user interface, again written as an Intranet Application, to be named Clinical WorkStation. Once complete, and after verifying that they had no desire to use this concept commercially, we reformed as Reliance Software Systems (RelWare) and began writing our own commercial Web-Based Clinical Data Repository, known as CDR-Web.

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