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					                                            Microsoft Server Product Portfolio
                                            Customer Solution Case Study

                                            Epilepsy Study Chooses Microsoft for EDC,
                                            Global Collaboration, and Data Management

Overview                                    “This is such an advance for the field of clinical research
Country or Region: United States
Industry: Public sector—Life sciences       informatics that we’re looking at making components
                                            of the architecture available to others in the research
Customer Profile
The University of California at San         community.”
Francisco is dedicated to advanced
                                                    Gerry Nesbitt, Director of Bioinformatics, the Epilepsy Phenome/Genome Project,
biomedical research, graduate-level
                                                                                               University of California at San Francisco
education in the life sciences and health
professions, and excellence in patient      Unlocking the genetic secrets to epilepsy might provide the key
care. It has 10,000 employees.              to better treatment and prevention. To pursue that possibility,
Business Situation                          hundreds of researchers at more than 26 academic medical
The university needed an unusually large    centers throughout the United States and Australia are working
and sophisticated technology platform to
support hundreds of researchers at more     on the global Epilepsy Phenome/Genome Project (EPGP)—a
than 26 centers around the world, while     large-scale effort to collect detailed clinical and genomic
minimizing the burden on the informatics
staff.                                      information on thousands of patients. They face major
                                            challenges in collecting, processing, storing, accessing, and
Project directors chose to base their       analyzing huge amounts of data, and in collaborating with
public website, intranet portal,            colleagues. To solve those challenges, the researchers chose
applications, and databases on Microsoft
technologies from end to end.               Microsoft technologies for patient tracking, electronic data
                                            capture, global collaboration, and data management. The
 Speeds development by 50 percent          resulting solution provides reliable and efficient data collection,
 Provides exceptional ease of use
                                            low-cost support and training, faster application enhancement,
 Delivers near 100 percent uptime
                                            faster knowledge discovery, and improved productivity.
“We chose Microsoft                           Situation                                        work with and analyze that computerized
                                              According to the World Health Organi-            data.
technology and servers                        zation (WHO), epilepsy afflicts more than
                                              50 million people worldwide. Epilepsy can        In addition, the large numbers of geo-
running Windows over                          strike the young as well as the old. Symp-       graphically dispersed researchers meant
LAMP because we needed                        toms can range from brief staring spells to      that the project’s five-person informatics
                                              full-blown seizures. There are treatments        staff, based at the University of California at
100 percent reliability and                   but no known cure. Although some pa-             San Francisco, couldn’t possibly provide in-
                                              tients respond well to the first anti-epilepsy   depth technical support; the project there-
scalability, and we had                       drug they take, others experience intract-       fore needed applications that were as easy
very little time to get the                   able forms of epilepsy that do not respond       for the researchers to learn and use on their
                                              well to medications. They may require            own as they were easy for the informatics
solution into production.”                    massively invasive surgery, such as the          staff to deploy, administer, and support.
                                              removal of part of the brain, to achieve a
 Gerry Nesbitt, Director of Bioinformatics,
  the Epilepsy Phenome/Genome Project,        level of relief.                                 That the group of researchers was large
  University of California at San Francisco                                                    and dispersed also indicated the need for
                                              In 2007, the National Institutes of Health       collaboration and workflow tools, so that
                                              provided a grant of U.S.$15 million to           researchers halfway around the world could
                                              establish the Epilepsy Phenome/Genome            work together as though they were down
                                              Project (EPGP) consortium to study one of        the hall from one another. Reliability was
                                              the least understood aspects of epilepsy: its    another requirement because project
                                              genetic basis. EPGP has become a center-         leaders knew that they couldn’t afford to
                                              piece for what is an international, multi-       lose or compromise any of the research
                                              institutional, multiyear, collaborative          data.
                                              research effort at more than 26 academic
                                              medical centers throughout the United            The project’s informatics staff had a com-
                                              States and Australia, making it one of the       plex, multifaceted set of requirements to
                                              largest such studies of epilepsy ever            meet—and not much time in which to meet
                                              conducted. The broad scope of the                them. The staff had just eight months
                                              project—which encompassed thousands of           before the project was slated to enroll its
                                              data points for each of thousands of             first research subjects, and informatics
                                              research subjects—was necessary to give          systems had to be live by then to accept
                                              researchers a study population large             incoming data.
                                              enough that they could identify and link
                                              genetic information to phenotypic data.          Solution
                                                                                               The first step in developing the informatics
                                              It wasn’t only the research population that      infrastructure was to identify the services
                                              needed to be large. The researchers quickly      and functions that the solution would have
                                              realized that they needed an informatics         to support. Working closely with the
                                              infrastructure and application architecture      researchers, the informatics staff developed
                                              that were as large and sophisticated as the      a list of requirements that included
                                              questions they were studying. One reason         everything from collecting and managing
                                              was the large volumes of data that re-           detailed phenotypic data, electroencepha-
                                              searchers would need to store and access.        lographs (EEGs) and magnetic resonance
                                              Another was that the researchers—who,            images (MRIs), to tracking the status of
                                              after all, were experts in biology, not com-     participants and their blood specimens
                                              puter science—needed the ability to easily       throughout the term of the study.
“Enterprise-class data                       Off-the-Shelf or Custom Development?             Server 2008 operating system, Microsoft
                                             The next step was to decide how to               ASP.NET, the Microsoft Visual Studio 2005
management was                               implement this functionality—that is,            development system, and, later, Visual
                                             whether to purchase and modify an off-           Studio Team System 2008 Team Suite.
essential, and SQL Server                    the-shelf solution or to develop a custom
provided that.”                              solution. The responsibility for that decision   Six Applications and a Portal
                                             fell to Gerry Nesbitt, the project’s Director    The informatics team worked for eight
Gerry Nesbitt, Director of Bioinformatics,   of Bioinformatics. He and his team consid-       months, and its solution went live in Jan-
 the Epilepsy Phenome/Genome Project,        ered commercially available software for         uary 2008. That solution consisted of six
 University of California at San Francisco
                                             clinical trial management, such as Oracle        applications accessed through a secure
                                             Clinical and PhaseForward InForm, and            intranet portal. All components of the solu-
                                             found them wanting—some were too                 tion were web based, which addressed the
                                             expensive, others were unable to accom-          requirement that the solution be easily
                                             modate the electronic collection of large        accessible both to global users and to
                                             phenotypic data sets, and most were not          informatics maintenance and support
                                             scalable enough.                                 personnel.

                                             That left custom development. The most           Those components included the following:
                                             common technology platform in academia            A public website to provide information
                                             is the so-called LAMP stack—the Linux              about the project and to solicit volunteer
                                             operating system, Apache web server,               participation as research subjects
                                             MySQL database, and PHP programming               A private intranet portal for researchers,
                                             language—with Apple Macintosh comput-              which provided access to the appli-
                                             ers on the front end. But Nesbitt and his          cations, to the study’s documents, and to
                                             colleagues made a different choice.                collaboration tools
                                                                                               Participant activity tracker applications
                                             Choosing the Right Platform                        that made it possible for each clinical site
                                             “We chose Microsoft technology and                 to track its participants’ visits, manage
                                             servers running Windows over LAMP                  events and issues, and complete pheno-
                                             because we needed 100 percent reliability          typic data collection
                                             and scalability, and we had very little time      A specimen-tracking system to manage
                                             to get the solution into production,” says         the life cycle of blood specimens from
                                             Nesbitt. “Enterprise-class data management         the moment a blood sample was drawn
                                             was essential, and SQL Server provided             to its arrival at the specimen repository
                                             that. SQL Server also gave us fully sup-          A case-report form designer and data-
                                             ported, out-of-the-box, and third-party            collection tools
                                             options for reporting and analysis. MySQL         Applications for EEG data collection and
                                             didn’t. Similarly, SharePoint Server 2007          reviews by neurophysiology experts
                                             gave us the features, again built-in, that we     Applications for MRI data collection and
                                             needed for both a public website and an            reviews by imaging experts
                                             internal collaboration site.”                     Secure file transfer for EEG and MRI files
                                                                                               A central database repository providing
                                             In addition to Microsoft SQL Server 2008           data storage, validation and integration,
                                             data management software and Microsoft             and robust security
                                             Office SharePoint Server 2007, the project’s      A data warehouse through which
                                             informatics solution was based on Micro-           researchers query the data using
                                             soft technologies including the Windows            Microsoft or third-party tools including
“By using Microsoft                            Microsoft Office Excel spreadsheet            Studio Team System 2008 Team Suite.
                                               software, Office Access database soft-        Nesbitt estimates that because the team
technologies, we've been                       ware, SQL Server Reporting Services,          used the Visual Studio tools, development
                                               Office PerformancePoint Server 2007 (a        time was about 50 percent less than it
able to give our re-                           part of Office SharePoint Server 2007),       would have been using the alternatives
searchers and coordina-                        and Visokio Omniscope™                        Nesbitt might have chosen.

tors a level of informatics                  These applications are hosted in a West         “The Visual Studio tools allowed our team
                                             Coast data center and mirrored for backup       to get a real jump-start on development,”
sophistication rarely seen                   and disaster recovery in an East Coast data     Nesbitt says. “We took advantage of the
on projects funded by                        center. Each data center hosts a pair of        tools’ strong interoperability with our
                                             databases. One is a transactional database,     foundation applications, such as SQL
the National Institutes                      with which researchers interact through the     Server, and of their features for
                                             various applications for data collection,       collaboration among developers, such as
of Health.”                                  tracking, and transmittal. The other is a       check-in and check-out of code and strict
Gerry Nesbitt, Director of Bioinformatics,   reporting database that provides the basis      version control. That helped us to achieve
 the Epilepsy Phenome/Genome Project,        for analysis, data visualization, and reports   smooth collaboration between our
 University of California at San Francisco   in response to queries from the research-       domestic team and our outsourced
                                             ers’ business intelligence tools.               developers in Chennai, India.”

                                             Benefits                                        For example, the Microsoft tools supported
                                             The massive research project was up and         a 24-hour development and quality assur-
                                             running in just eight months and now gives      ance (QA) cycle in which local developers
                                             researchers easy and dependable access to       created code and performed QA before the
                                             applications and data. In addition, it mini-    end of day, and then passed their work on
                                             mizes the support burden on the lean            to the developers in Chennai to address
                                             informatics staff.                              bugs and other issues. The outsourced
                                                                                             developers finished their work just in time
                                             “By using Microsoft technologies, we’ve         for Nesbitt’s local developers to pick up
                                             been able to give our researchers and           again with the new code. That shortened
                                             coordinators a level of informatics sophis-     development considerably.
                                             tication rarely seen on projects funded by
                                             the National Institutes of Health,” says        The Microsoft technologies also helped to
                                             Nesbitt. “We’re seeing more reliable and        speed development by providing compo-
                                             efficient data collection, fewer resources      nents—such as business intelligence in SQL
                                             needed for support and training, faster         Server and collaboration tools in
                                             completion of application enhancements,         SharePoint Server—that eliminated the
                                             faster knowledge discovery, and higher          need to build or buy this functionality and
                                             productivity overall.”                          then integrate it with the rest of the system.
                                                                                             Master pages in Office SharePoint Server
                                             Speeds Development by 50 Percent                made it easy for the developers to add
                                             To build the large and sophisticated            logos, colors, and typefaces into the public
                                             informatics solution on an aggressive           website, and then to make the use of those
                                             project schedule, the EPGP developers           visual elements consistent throughout that
                                             turned to an Agile development strategy,        site. Nesbitt proudly notes that his team
                                             which they implemented through the use          got the public website and intranet portal
                                             of Visual Studio 2005 and, later, Visual        up and running in less than one week.
                                   Further, the same capabilities that            The intranet portal also gives researchers a
                                   supported the fast development of the          broad choice of analysis tools. Researchers
                                   solution are now used by the project           can work through familiar tools such as
                                   developers to speed application                Microsoft Office Excel; visual dashboards
                                   enhancements and extensions.                   based on Office PerformancePoint Server;
                                                                                  and research-specific, third-party tools such
                                   Provides Exceptional Ease of Use               as Omniscope. Because the informatics
                                   The EPGP informatics applications had to       solution uses web-based tools for tracking
                                   be as easy for researchers to use as they      participants and phenotypic data collection,
                                   were easy for the informatics team to          researchers and study coordinators gain
                                   develop. The Microsoft technologies also       real-time access to subject enrollment
                                   helped the informatics team to meet that       statistics, study metrics, and research data.
                                   requirement, according to Nesbitt.
                                                                                  Researchers also find that their work is
                                   Researchers benefit from the use of Office     expedited—and that the impact of having
                                   SharePoint Server for the intranet portal,     colleagues spread among various research
The informatics team used
                                   which provides a convenient, central place     centers is mitigated—by collaboration
Microsoft Office SharePoint
                                   to find all of the EPGP applications, all of   tools, especially those available in Office
Server 2007 to create a public
                                   the research data and tools, and all of the    SharePoint Server. For example, they use
website that doesn’t look like a   reports and other study documentation.         discussion boards for ongoing virtual
“typical SharePoint site.”                                                        conversations, while wikis provide a way to
“Because the applica-                        share best practices—such as how to boost        minimize ongoing support demands. The
                                             subject recruitment—among study                  Microsoft technologies meet that require-
tions are based on                           coordinators.                                    ment, too, and do so in a variety of ways.

Microsoft technologies,                      Even non-research functions are made             First, the project solution is fully scalable,
we can train new coordi-                     easier for project researchers through the       able to support the hundreds of broadly
                                             use of Microsoft technologies. The public        dispersed, simultaneous users who contrib-
nators in one hour, fully                    website, for example, is maintained not by       ute to the project. Should the population of
                                             dedicated informatics staff but by two           researchers ever grow beyond the limits of
equipped with the skills                     researchers whose work on the site is one        the current architecture, the informatics
and confidence to use                        of their many duties. That work is made          team can add web and database comput-
                                             easier both by the publishing tools in Office    ers cost-effectively, using commodity hard-
the applications                             SharePoint Server and by the software’s          ware. In addition, because all the informat-
                                             workflow tools, from which Nesbitt and his       ics applications are web based, the Epi-
immediately.”                                colleagues created an automated workflow         lepsy Phenome/Genome Project spends
Gerry Nesbitt, Director of Bioinformatics,   that routes proposed content to authors,         less on deployment than it would to deploy
 the Epilepsy Phenome/Genome Project,        editors, and reviewers for approval prior to     traditional client-server applications, and it
 University of California at San Francisco   posting.                                         also saves on the maintenance costs of
                                                                                              keeping servers and workstations updated
                                             And researchers aren’t the only ones who         and trouble-free.
                                             can work effectively because of the
                                             Microsoft technology underlying the solu-        The system is also highly reliable. Built-in
                                             tion. The easy-to-use applications and tools     validation rules and checks in the applica-
                                             make it possible for study coordinators to       tions and databases help to ensure that the
                                             complete their tasks quickly, contributing       collected data is correct and verifiable, and
                                             to the widespread acceptance of those            that it follows the study’s protocols. Should
                                             applications, higher productivity among          problems occur with the databases, SQL
                                             coordinators, and reduced turnover in staff.     Server data mirroring between the East and
                                                                                              West Coast data centers helps ensure that
                                             “The applications had to be especially easy      data is available for backup or recovery.
                                             to use for two reasons,” says Nesbitt. “First,
                                             anything that distracts our researchers from     Not that Nesbitt is anticipating such prob-
                                             doing their real work is a problem. Second,      lems—to date, the system has experienced
                                             research projects generally have a high          negligible unscheduled downtime, provid-
                                             turnover of study coordinators—which             ing the equivalent of near 100 percent up-
                                             requires us to continually train new coor-       time. Even scheduled downtime for mainte-
                                             dinators. Because the applications are           nance is just 2 to 3 hours per month, 50
                                             based on Microsoft technologies, we can          percent of the downtime that Nesbitt says
                                             train new coordinators in one hour, fully        he would have seen with other platforms.
                                             equipped with the skills and confidence to
                                             use the applications immediately.”               All this means that researchers can use the
                                                                                              applications and data as they need to,
                                             Delivers Near 100 Percent Uptime,                without having to consider limits to system
                                             Minimizing Support Needs                         availability. Nor does the IT staff need to
                                             In choosing a technology set for their           devote significant resources to system
                                             applications, Nesbitt and his colleagues         support. Help-desk calls are running at the
                                             were also looking for platform that would        rate of one or two per day—a very small
For More Information                                  number for an endeavor the size of the              Microsoft Server Product Portfolio
For more information about Microsoft                  Epilepsy Phenome/Genome Project,                    For more information about the Microsoft
products and services, call the Microsoft             according to Nesbitt.                               server product portfolio, go to:
Sales Information Center at (800) 426-                                                          
9400. In Canada, call the Microsoft                   “Using Microsoft technologies, we’ve built a
Canada Information Centre at (877) 568-               major platform that delivers enterprise-
2495. Customers in the United States and              level scalability and reliability, along with
Canada who are deaf or hard-of-hearing                the functionality and ease of use that our
can reach Microsoft text telephone                    researchers need, all of which is supported
(TTY/TDD) services at (800) 892-5234.                 by an informatics administrative and
Outside the 50 United States and                      development staff of five,” says Nesbitt.
Canada, please contact your local                     “This is such an advance for the field of
Microsoft subsidiary. To access                       clinical research informatics that we’re
information using the World Wide Web,                 looking at making components of the
go to:                                                architecture available to others in the                                     research community.”

For more information about the
University of California at San Francisco,
call (415) 476-9000 or visit the website at:

                                                       Software and Services                             Microsoft Office
                                                        Microsoft Server Product Portfolio               − Microsoft Office Access 2007
                                                         − Microsoft SQL Server 2008 Enterprise           − Microsoft Office Excel 2007
                                                         − Windows Server 2008 Enterprise                 − Microsoft Office SharePoint Server
                                                        Microsoft Visual Studio                            2007
                                                         − Microsoft Visual Studio Team System
                                                           2008 Team Suite                            Hardware
                                                                                                         HP/Compaq servers
                                                                                                         Network Appliances storage area devices

This case study is for informational purposes only.

Document published June 2010

Description: Unlocking the genetic secrets to epilepsy might provide the key to better treatment and prevention. To pursue that possibility, hundreds of researchers at more than 26 academic medical centers throughout the United States and Australia are working on the global Epilepsy Phenome/Genome Project (EPGP)—a large-scale effort to collect detailed clinical and genomic information on thousands of patients. They face major challenges in collecting, processing, storing, accessing, and analyzing huge amounts of data, and in collaborating with colleagues. To solve those challenges, the researchers chose Microsoft technologies for patient tracking, electronic data capture, global collaboration, and data management. The resulting solution provides reliable and efficient data collection, low-cost support and training, faster application enhancement, faster knowledge discovery, and improved productivity.