Diabetes Electronic Management System Chronic Disease Electronic Management System Dusty Knobel

1. Diabetes Electronic Management System Chronic Disease Electronic Management System • Dusty Knobel • Computer Support • Diabetes Prevention & Control Program • Washington Dept of Health • 360.236.3738

2. We are in a Revolution • Breakthrough Series • Chasm Report • Outcomes Measurement Project • IOM • Acute Care Model • Collaboratives

3. Chronic Care Model Successful project include: Visit Redesign Guidelines Self Management Registry

4. Chronic Care Model Visit Redesign Guidelines Self Management Registry Get someplace new - do something different

5. Chronic Care Model Visit Redesign Guidelines Self Management Registry Decide where you want to go

6. Chronic Care Model Visit Redesign Guidelines Self Management Registry Get the patient to help

7. Chronic Care Model Visit Redesign Guidelines Self Management Registry Track your progress

8. Chronic Care Model Successful projects include: Visit Redesign Guidelines Self Management Registry Community Management

9. Rapid Change Tools PDSA Plan Act Do Study

10. Change Cycle PDSA Act Plan Do Study

11. Registry • Does • Helps Provider during visit • Assists Case management • Allows Population Management • Feedback on PDSA cycles • Is Not • Electronic Record

12. Visit Note • Helps Provider during visit • Assists Case management • Allows Population Management

13. Patient Lists • Helps Provider during visit • Assists Case management • Allows Population Management

14. Summary Report • Helps Provider during visit • Assists Case management • Allows Population Management

15. Impact on Quality

16. C/DEMS Features • Three MSAccess Files • Data Entry Program • Reports • Linked Data File • Downloaded from www.cdems.com as self extracting zip files

17. Data Types Demographics Visit Information Health conditions Medications Services Labs Actions Enter Edit Print Data Entry

18. Reports • Summary Report • Custom • Hard coded • Patient Case Management List • User Specific Queries

19. What is Cool • User can customize • Program Morphs • Clinic based • User driven features • Lab interface • Multi-print • Open Source • Report Wizards

20. Inside CDEMS Building blocks • tlkpSetUp (controls how visit note looks and what is stored) • tlkpCrosswalk (maps internal codes to displayed labels)

21. Crosswalk and Setup Examples:

22. Relationships • Maintain primary keys • Enforces data validity Cascading referential integrity

23. Where are we? • National awards • Currently 40,000 patients in C/DEMS • Current Challenges: • Sandboxes in MSAccess 2003 • EMRs • Web based registries