Most healthcare organizations, including public health departments, have a lot on their IT to-do lists. The Los Angeles County Department of Public Health (LADPH) is no exception.

The agency tries to purchase commercial off-the-shelf software whenever possible. The problem is that off-the-shelf apps often can't meet the agency's specialized needs. Custom development efforts, on the other hand, can be time-consuming and costly--and still often miss the mark in meeting users' needs, said Jim Green, CIO of LADPH in an interview with InformationWeek Healthcare.

So the department two years ago began taking an innovative approach to developing specialized tools. It began using Microsoft's Dynamics CRM platform for custom application development, a strategy also known as extended relationship management (xRM).

Green is using Microsoft 's CRM xRM framework to create customized applications instead of building custom .Net applications or purchasing expensive commercial systems, such as a pharmacy inventory management app that likely would have been overkill.

[ Take more control over your own health. Read 9 Health IT Tools Patients Should Understand. ]

"When we first dipped our toe in CRM two years ago, we developed an environmental application for our vehicle inspection program," said Green. The application enabled the LADPH's environmental department to track and manage cases related to the safety of food sold from vehicles in Los Angeles, such as fruit carts. That included food vendors with the required permits, as well as those mobile vendors operating unlawfully without permits.

The environmental department had a Microsoft Access database, but no reliable way to track and manage cases. Tapping the capabilities of Microsoft Dynamics CRM xRM, it took only a few weeks for Green's team to develop a special vehicle inspection tracking app, he said. "The previous application was an amateur database application. We created a more cohesive application for the department."

"The [CRM] platform accelerates development dramatically by taking care of a lot of the plumbing and providing many built-in capabilities," said Green. "We still have requirements analysis and specifications, writing a significant amount of Javascript code in the user interface, building the screens and reports, building system interfaces, and testing. But on the other hand, there is no database code to develop, all the basic user interface elements are there, basic reporting --including dashboards--is available with no coding, and auditing capabilities are built in too," he said.

Besides assessing environmental factors in the air, water, and food that might make people sick, among many other duties the LADPH investigates communicable disease cases and outbreaks and treating affected individuals.

Still, "there's a fairly narrow range of clinical services we provide," said Green, so purchasing a third-party pharmacy system to comply with California mandates about pill container labeling and patient drug information would have been going overboard. Most of the drugs prescribed by public health clinicians are related to just a handful of communicable diseases--including tuberculosis and sexually transmitted diseases-- that are screened for and treated at the department's 14 community health centers.

"We have a small formulary of drugs we prescribe, yet we still have to comply with state prescription labeling requirements, which have the goal of improved patient safety," he said.

Those requirements include dispensing medications that are labeled with information such as the drug name and instructions for taking the med, and also a picture or description of what the drug looks like. "We used CRM to create an application for generating prescription labels, and integrated it with our legacy patient registration and scheduling systems," said Green. Before that, labels were handwritten by public health workers.