Surface Automation (Region) mode, should be 100% reliable if built correctly with the location of all your elements based upon dynamic positioning calculated using image searches. Some Partners have extensively used Surface Automation to create robust interfaces with Citrix environments.
For your query, I would guess Accessibility mode is most likely to work - ensuring you are attached to the correct process, your next option would be Surface Automation.
I am also guessing that a Lotus Database has some API options that might be available to you if you research them, including ODBC drivers that might be useful.
