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Integrated Clinical Database

CPT Joseph P. Edger & 1Lt S. Erin Elarton 26 November, 2003. Integrated Clinical Database. Outline. What is the Integrated Clinical Database (ICDB)? The History of ICDB ICDB Mission Statement ICDB Architecture Where is ICDB deployed? Why was ICDB created?

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Integrated Clinical Database

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  1. CPT Joseph P. Edger & 1Lt S. Erin Elarton 26 November, 2003 Integrated Clinical Database

  2. Outline • What is the Integrated Clinical Database (ICDB)? • The History of ICDB • ICDB Mission Statement • ICDB Architecture • Where is ICDB deployed? • Why was ICDB created? • How does ICDB improve overall healthcare delivery process easier? • How is ICDB important to the organization? • Where is it going in the future, the system, and the processes? • What does a healthcare administrator need to know about ICDB to be successful?

  3. What is Integrated Clinical Database (ICDB)? • Provides Clinical Information via internal Web access • Simplifies Data Access • Designed to Meet the clinical Needs of MTF Medical Personnel • Total Clinical information at your fingertips in seconds • Downloads CHCS and other Legacy data http://icdb.tricaresw.af.mil/default.htm

  4. 1994: Started as an AF Initiative at Wilford Hall Medical Center as a tool for enabling user-friendly adhoc reports for CHCS Providers, Nurses, and Support Staff Created the Functional Requirements for the ICDB Application 1999: Beta deployment to Walter Reed 2002: Air Force Medical Service approved ICDB for AF wide deployment 2002: DITSCAP process completed and C2 Accreditation awarded 2003: Certificate of Networthiness (CON) by the Air Force Communications Agency 2003: AFMS-wide deployment planned The History of ICDB http://icdb.tricaresw.af.mil/default.htm

  5. Integrate data from diverse clinical information systems into a single, uniform, open-architecture platform that facilitates the rapid development, prototyping, deployment and sharing of leading-edge tools that support local commanders and their staffs in meeting both their unique, MTF-specific missions and MHS strategic goals. Official Mission Statement http://icdb.tricaresw.af.mil/default.htm

  6. ICDB provides a relational database and software on the MTF intranet allowing all MTF users to share information Security and Privacy are continuously addressed for HIPPA compliance Downloads data from CHCS and SADR (Standard Ambulatory Data Record) HL7 Messages provide real-time updates from CHCS Information entered via ICDB, e.g. 2766 information, is stored and available to all software that uses ICDB database Installers have loaded 3-5 years of historical CHCS + SADR data into ICDB. ICDB Architecture for the MTF http://icdb.tricaresw.af.mil/default.htm

  7. Tertiary MTFs usually support several MTFs with their CHCS server All MTFs serviced by the Tertiary CHCS will have access to the Oracle/ICDB associated with the Tertiary facility Architecture for Tertiary MTFs http://icdb.tricaresw.af.mil/default.htm

  8. http://icdb.tricaresw.af.mil/default.htm United States Coast Guard Yard, Balt., Md

  9. Why was ICDB created? • Support Primary Care Optimization • Medical Team Concept • Expands the roles of nurses and medical technicians • Staff work closer to their selected patient population • Assists providers with their efforts to improve clinical practice http://icdb.tricaresw.af.mil/default.htm

  10. Decreases the number of times you have to enter data Obtain a patient’s clinical history in seconds Direct access to CHCS when you want to write orders/get new appointment, etc. Allows easy identification of your panel members View, edit, and update your patients Electronic DD Form 2766 Simplifies the Management of patients with similar medical conditions Identify and Follow “high risk” patients in your panel Simplifies Peer Review/Chart Review Helps you meet AFSG Initiatives Clinical education tool for Residents How does ICDB make the healthcare delivery process easier? http://icdb.tricaresw.af.mil/default.htm

  11. Improve the Quality of Care of our enrolled population Increases patient involvement in their own care Improves clinical decision-making Coordinates care across clinics Enables proactive interventions by identifying unmet needs Expands the roles and responsibilities of support staff Provides feedback to Providers, Staff, and Hospital Commanders on the effectiveness of their interventions Assists the MTF in passing inspections and surveys How is it important to the organization? http://icdb.tricaresw.af.mil/default.htm

  12. Provider Portal • Point and click obtains last 3-5 years of host CHCS individual patient medical history – IN SECONDS • Panel membership one click away • Diabetics easily identified • Identifies patients “falling through the cracks” • Simplifies Peer Review/Chart Review • Promotes better coding • Promotes clinical education • Promotes research • Data retrieval is easier, faster http://icdb.tricaresw.af.mil/default.htm

  13. ICDB Provider Homepage Opens to Your Appointments

  14. Identifying Cohorts of Patients Visiting ER

  15. Identifying Cohorts Overdue for Preventive Services Display in Excel File

  16. Clinical Summary -- ONE SCREEN

  17. Individual Patient Summary Click

  18. Medical Links – Research at the Click of a Mouse Takes you back to the ICDB Home Page

  19. Lab Results Over Graphed Over Time Note: Latest Labs Show On Trend

  20. Nurse/Technician Portal • Improve personnel management & efficiencies • Project clinic resource requirements • Coordinate care across patient conditions, services, and settings – over time • Assist in understanding unmet need • Case Management • Support meeting JCAHO requirements http://icdb.tricaresw.af.mil/default.htm

  21. Drilling Down on High Risk Patients In Your “ICDB Team” Panel

  22. DD 2766

  23. DD 2766 – Page 2 Over Due Prevention Alert

  24. WRHCS Outcomes Management Database • Outcomes Scorecards • Cardiovascular • Congestive Heart Failure • Chronic Obstructive Pulmonary Disease • Diabetes • Hepatitis C • Women’s Health • Childhood Asthma http://icdb.tricaresw.af.mil/default.htm

  25. Where is ICDB going in the future? “I see HealtheForces, MedBase, and [Park City Solutions] merging into one corporate ICDB solution.” COL Mark A. Lyford, MS, USA Joint Medical Information Systems Program Executive Officer http://icdb.tricaresw.af.mil/default.htm

  26. What does a healthcare administrator need to know about ICDB? • Helps move the organization to a proactive, prevention-based system • Ensures patients do not “fall through the cracks” • Enhances “point of care” processes • Quality measurement and improvement • Assists MTF’s in passing inspections and surveys http://icdb.tricaresw.af.mil/default.htm

  27. ICDB Contact Information • ICDB Program OfficeOffice of the Air Force Surgeon General 5201 Leesburg Pike, Suite 1401, Skyline #3Falls Church, Virginia 22041 • ICDB Operations Office7800 West IH-10 Suite 620San Antonio, Texas 78230210 292-8450   • http://icdb.tricaresw.af.mil/default.htm

  28. Summary • ICDB enhances CHCS I by providing coordination of care across: • Patient conditions • Clinical services • MTF settings http://icdb.tricaresw.af.mil/default.htm

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