Executive Summary

  • Critical Decision: Choosing between bespoke software development and adopting ToxAware® Cloud System involves evaluating expertise, development time, cost, and impact on staff.
  • Expertise and Time: Bespoke development requires a multidisciplinary team and can take months to years, diverting staff from their primary duties.
  • Cost and Security: Bespoke systems are expensive and pose security risks, while ToxAware® Cloud System offers a secure, compliant, and cost-effective alternative.
  • Expertise & Team Rarity: Poison center software development requires a team with rare expertise in health informatics, software engineering, data security, UX design, and QA testing.
  • Time Investment: The development process is lengthy, involving stakeholder consensus, iterative builds, and extensive testing, which can take months to years.
  • Software Security: Security is crucial for protecting sensitive patient data. Neglecting this can lead to data breaches and legal penalties.
  • Cost Implications: Custom systems like ToxSentry® can exceed a million dollars, while off-the-shelf solutions like ToxAware® Cloud System may offer a more cost-effective alternative.

The critical decision between developing an in-house poison centre software solution and adopting a system like ToxAware® Cloud System involves several factors. We provide a holistic comparison, focusing on expertise, development team rarity, time investment, cost implications, and the impact on poisons centre staff’s life-saving work.

Effective software development is contingent upon a team that is not just committed but also possesses extensive technical acumen. Poison centres often take the initiative to draft their software requirements, articulating their expectations and entrusting them to a development agency. While their intentions are well-meaning, they sometimes omit crucial details and assume that the agency will inherently understand how things should function. Unfortunately, many agencies do not have specialized teams for specific projects and instead utilize a cadre of general developers. The challenge of retaining expert developers means that your project may often be executed by a novice developer, under the guidance of a more seasoned one. This can result in a collage of code that, albeit operational, is suboptimal in terms of efficiency, security, and ease of maintenance.

Software maintenance is a pivotal aspect that often becomes complicated when offshoring. A significant concern is the high turnover of staff within offshoring agencies. This turnover can result in the loss of the original developers who were intimately familiar with the project’s nuances. Consequently, subsequent maintenance is frequently handed over to new developers who may not have the same level of understanding or investment in the project. This can lead to inefficiencies and a lack of continuity in the software’s evolution, as each new developer must first become acquainted with the existing codebase.

Expertise Required

Developing a medical records management system for a poison centre requires a multidisciplinary team with specialized expertise. Health informatics professionals are indispensable, as they possess a comprehensive understanding of poison centre operations, enabling them to manage health information systems with precision and efficiency. Software engineers with experience in poison centre applications are needed to ensure the system’s architecture is robust and compliant with medical standards such as HIPAA. Data security experts are crucial for protecting sensitive patient information, while user experience (UX) designers ensure the system is intuitive for fast-paced medical environments. Finally, quality assurance (QA) testers with a background in medical software can guarantee that the system functions reliably under various scenarios, which is critical for the life-saving operations of a poison centre. This collective expertise ensures the development of a system that is not only technically sound but also tailored to the critical needs of poison management and patient care.

Time Investment

The development of a software system for a poisons centre is a complex endeavour that necessitates consensus among all stakeholders. This process, from conception to deployment, can span several months to years, depending on the project’s scope and complexity. The initial development phase lays the foundation, but the software will evolve through iterative builds, incorporating new features and addressing bugs over the years. Testing is a critical and time-intensive phase that often extends beyond initial estimates, ensuring the system’s reliability and compliance with health regulations.

Effective communication with the development team is paramount to align the software with the centre’s operational needs. Training developers in the specifics of poison centre operations is equally crucial, as it equips them with the necessary context to design functional and user-friendly interfaces. However, iterative development can introduce data integrity challenges, leading to ‘dirty data’ that must be meticulously cleaned and validated. This ongoing cycle of development, testing, and refinement is essential to create a robust case management system that meets the high standards required for poison control activities.

The involvement of poison centre staff in the development of case management software is crucial and multifaceted. Staff members, who are experts in clinical toxicology and poison information, must work closely with the software development team to ensure the system meets the specific needs of poison control operations. This collaboration typically requires a significant time investment from the staff, with estimates suggesting that up to 30-50% of their time may be dedicated to the design and development process, especially during the initial phases. This includes providing detailed requirements, participating in design discussions, reviewing prototypes, and testing the software. As the project progresses, the time commitment may vary, but continuous involvement is essential for addressing ongoing refinements and ensuring the software’s effectiveness in managing poison cases. The staff’s contribution is invaluable, as their insights directly influence the system’s functionality, usability, and ultimately, its success in supporting the centre’s mission.

While a bespoke poison centre case management system offers tailored solutions, the benefits must be weighed against the costs. Custom systems like ToxSentry®, which cost over a million dollars to develop not including poison centre staff, provided a high degree of specificity to a centre’s operations. However, the advantages of such systems are incremental improvements in efficiency and accuracy, which may not always proportionally align with the high initial investment. The decision to develop a custom system should consider the marginal gains in operational performance relative to the substantial financial and time resources required for its development and maintenance. In most cases, off-the-shelf solutions like ToxAware® Cloud System with customization options might offer a more cost-effective alternative that still meets the essential needs of the centre.

Software Security

Software security is a critical component of any development project, and its neglect or improper implementation can have dire consequences. Without a robust security plan, software is vulnerable to a myriad of threats, including data breaches, unauthorized access, and malicious attacks. These vulnerabilities not only compromise sensitive information but also erode user trust and can lead to significant financial and reputational damage for the organization. In the context of a poison centre, where patient data is highly sensitive, the stakes are even higher. A lapse in security could result in the exposure of confidential medical records, legal penalties, and a jeopardized patient safety. Therefore, it’s imperative to integrate security measures from the outset, employing encryption, secure coding practices, and regular security audits to safeguard the software against potential threats. Failing to do so can leave the system open to exploitation, with long-term implications that are often costly and challenging to rectify.

Software design by non-professionals can be a double-edged sword. On one hand, it democratizes the development process, allowing those with domain expertise but without formal programming training to contribute to the creation of applications that meet specific needs. This can lead to innovative solutions that a general professional developer might not envision. On the other hand, amateur software design often lacks the rigor and foresight that comes with professional training. This can result in systems that are inefficient, difficult to maintain, and vulnerable to security risks. Without a foundational understanding of best practices in coding, architecture, and security, non-professional efforts, while well-intentioned, may inadvertently create more problems than they solve, especially in environments where reliability and precision, such as in poison centres, are paramount.

The Right Developers

Finding developers with expertise in poison centre operations is a significant challenge due to the niche and specialized nature of the field. Poison centres require systems that are not only technically sound but also compliant with specific healthcare regulations and capable of handling unique toxicological data. Developers with this dual expertise in software engineering and toxicology are exceedingly rare, as the knowledge base for poison control is highly specialized and not covered in standard software development curricula. This scarcity often necessitates extensive training for developers or a search for professionals who may command higher salaries due to their specialized skills. Consequently, poison centers may face longer development times and higher costs to ensure their software is developed by individuals with the right blend of technical prowess and domain-specific knowledge. This can be a significant hurdle in the path to creating effective, reliable, and compliant poison center case management systems.

Case Types

In poison center case management, the meticulous tracking and analysis of exposures and queries are fundamental. Exposures, which detail the contact with potentially toxic substances, are meticulously logged to provide a comprehensive database for clinical assessment and research. Queries, on the other hand, are the inquiries received from healthcare professionals and the public, seeking guidance on drug interactions, identification and safe use. Together, these elements form the backbone of a poison center’s operation, enabling the staff to identify trends, inform prevention strategies, and contribute to the broader field of toxicology. A robust case management software must, therefore, be equipped with advanced functionalities to accurately record, categorize, and analyze this critical data, ensuring that the poison center can respond effectively to the immediate needs of its callers and the long-term requirements of public health surveillance.

Data Fields and Schema

When constructing a poison center case management system, it’s imperative to integrate data standards such as those from the National Poison Data System (NPDS) and the World Health Organization’s recommended minimum data standards. These benchmarks serve as a blueprint for developers, ensuring that the system is capable of capturing a wide array of data points that are critical for tracking and analyzing poisoning incidents. Adherence to these standards during the build phase guarantees that the system will be compatible with international data exchange, enabling poison centers to contribute to and benefit from global toxicology research. Moreover, aligning with these standards from the outset simplifies future data reporting and analysis, ensuring that the system can effectively support the center’s mission to provide timely and accurate information for poison prevention and treatment.

Incorporating a professional database architecture is paramount to this endeavor. A well-designed database not only ensures high performance but also facilitates the efficient analysis of collected data. By employing a robust architecture, the system can handle large volumes of complex data with speed and accuracy. This is crucial for poison centers, where the ability to quickly retrieve and analyze case information can have life-saving implications. A professional architecture allows for scalability, ensuring the system can grow with the center’s needs without compromising performance. Additionally, it supports advanced analytical capabilities, making it easier for toxicologists and researchers to derive meaningful insights from the data. This, in turn, can lead to improved treatment protocols and preventive measures. Ultimately, the underlying database’s architecture is a critical factor that affects the overall effectiveness and longevity of the case management system.

Multiple Centres

Collaboration between poison centers in sharing case data and resources offers substantial benefits, enhancing their collective ability to manage poisoning incidents effectively. By sharing cases, centers can access a broader range of data, which aids in identifying trends, improving treatment protocols, and developing preventive strategies. Moreover, the ability for one center to handle another’s calls during staff meetings or training sessions ensures continuity of service. This cooperative approach not only allows for uninterrupted access to expert advice but also strengthens the network’s capacity to respond to emergencies. Such inter-center support is invaluable, as it ensures that expertise is available at all times, fostering a resilient and responsive poison control system that can adapt to various operational demands while maintaining high standards of public health service.


Developing in-house poison centre software requires rare expertise, significant time, and financial investment, and poses security risks. It also diverts critical staff from their primary life-saving work. In contrast, the ToxAware cloud system offers a secure, compliant, and ready-to-deploy alternative with minimal financial outlay and staff involvement, allowing poison centre staff to focus on their essential work of saving lives.

ToxAware Cloud System: Maximizing Toxicologists’ Efficiency

The ToxAware Cloud System is designed to maximize the efficiency of toxicologists, allowing them to focus on what they do best—saving lives. By choosing a proven, ready-to-use system like ToxAware, poison control centers can minimize the time toxicologists spend on software-related tasks. This ensures that their expertise is directed towards patient care, research, and advancing the field of toxicology.


The decision to build custom software or to purchase the ToxAware Cloud System should be made with the understanding that toxicologists’ time is precious and should be dedicated to their primary mission of saving lives. The ToxAware Cloud System offers a solution that respects this principle, providing a tool that supports toxicologists in their critical work without diverting their focus from patient care.