CNS Response, a laboratory information services company, uses Saleforce.com's Force.com platform in a unique way: to compare patient QEEG data (brain mapping and neurometric analysis) and return the results to physicians quickly.

Showing the utility of Salesforce.com beyond CRM, the company runs its process almost entirely through Force.com. According to Mark Desrosiers, SVP of Commercial Operations at CNS Response, the company as able to reduce its turnaround time by about 75%.


An EEG visualization by artist Enzo Varriale via Flickr.

Physicians trying to treat behavior illnesses with medication face a major challenge - everyone's brain is different. One patient may react radically differently to a medication than others with the same condition taking the same drug. Doctors end up doing a lot of trial and error and rarely get the right medication on the first try.

CNS Response compares patients' QEEG scans with the EEG scans of others to find similaraties. Doctors can use this information to make better prescriptions based on 17,000 trials available in CNS Response's patented Referenced-EEG (rEEG) database. According to Desrosiers, clinical studies suggest that
physicians using rEEG get the medication right the first time 65% of the time.

Desrosiers is quick to stress, however, that CNS Response does not diagnose, treat patients, or process personal health data.

Desrosiers describes CNS Response's former process as "fragmented," with each step of the process carried out manually. The company considered building its own software platform from scratch, but decided instead to use Salesforce.com, which it was already using for sales, to keep as much of the process in one system as possible.

Plot of 1 second of human brain (EEG) activity by Varriale, part of the Sounds of Complexity project, via Flickr

Here's how it works:

  1. A doctor fills out an order form and uploads the patient's QEEG file into Salesforce.com through a custom built "Provider Portal."
  2. Salesforce.com sends the file off to be artifacted. This is the only part of the process that is still done manually.
  3. The artifacted file is analyzed using an FDA-approved normative database to identify statistical deviations from normative brain values and is then sent back into Salesforce.com
  4. 4. Salesforce.com orchestrates a comparison of the abnormalities through CNS Response's patented correlation technology and outcomes database.
  5. Salesforce.com then saves the results into its database and generates custom views using Visualforce as well as generates a PDF of the data.
  6. Physicians can then access the custom Visualforce pages and the PDF through the Provider Portal. The portal can be accessed through a traditional Web browser or on a version optimized specially for the iPad.

Desrosiers says the company ran into no show-stopping problems in implementation, but did have engineers more involved than they wanted. He emphasizes that this was not an out of the box solution - the company had software engineers that architected these solutions using Force.com, Visual Force and Apex.

"Sometimes we had to write more original code than we wanted, but we evolved as Salesforce.com evolved," he says.

Lead photo by Aigars Mahinovs