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Collecting information near the patient (worldwide). Lieutenant Commander Mark Trasler Royal Navy. Outline. Defence Medical Services Capability Gaps Solution Business Change Examples Benefit Realisation Conclusion. Fit for Task. INFORMATION. Defence Medical Services.
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Collecting information near the patient (worldwide) Lieutenant Commander Mark Trasler Royal Navy
Outline • Defence Medical Services • Capability Gaps • Solution • Business Change • Examples • Benefit Realisation • Conclusion
Fit for Task INFORMATION Defence Medical Services COMPREHENSIVE HEALTHCARE DEPLOYABLE MEDICAL OPERATIONAL CAPABILITY MANAGING AND MOTIVATING THE DMS HEALTH PROMOTION
DMS Roles - Home & Garrison • Non Deployed Healthcare • Primary Care Medical Centres • Primary Care Dental Centres • Rehabilitation Centres • Community Mental Health Depts • Occupational Health Centres
3 Overseas Hospitals Cyprus Gibraltar Northern Ireland MOD Hospitals • Rehabilitation • Headley Court
DMS Roles - Operational • Deployable Med Op Capability • Primary Healthcare, Medical & Dental • Immediate Care • Immediate Life & Limb Saving Surgery • Secondary (Stabilisation) Care • Field Hospitals • Joint Casualty Treatment Ship • Casualty Evacuation • Public Health / Force Protection
Capability Gaps • Norman gets the point …
Capability Gaps Currently, DMS cannot: • Share information widely • Provide timely and efficient access to clinical records • Conduct effective Casualty Regulation • Conduct adequate epidemiology to support Force Protection • Expose the resource implications of military medicine • Provide information for research • Provide accurate and timely information to Parliament • Provide accurate and timely information on the extent and causes of medical downgrading and injury
REGULATIONS and INSTRUCTIONS for the MEDICAL OFFICERS of HIS MAJESTY’S FLEET MDCCCXXV
“ 32. When the Ship shall be on the Home Station, he is not to fail to transmit regularly to the Victualling Board, at the end of every Month, and when Abroad, at the end of every Three Months, a Nosological Return of the State of the Sick, in the annexed Form, signed by himself, subjoining thereto, ... , a full and comprehensive account of their Diseases ... ”
D. M. I. C. P. Solution Defence Medical Information Capability Programme “Dee - Mick – Pee”
DMICP Integrated Healthcare Record Med Centre Med Centre Med Centre Dental Centre Dental Centre Other Healthcare Facility Concept
Programme Governance SRO’s Steering Group Programme Board Benefits Monitoring Group Business ChangeCo-ord Group PolicyWG Training WG Interfaces WG Deployed WG ReportingWG Culture & Comms WG Transition WG Inpatient WG
Business Change • Working Groups • Clinical Policies & Protocols • Reporting • Training • Culture & Communications • Interfaces • Transition • Deployed • Inpatient & Secondary Care
Clinical Policy / Patient Confidentiality • Legitimate Relationships • Role Based Access • “Sealed Envelopes” • Auditing
Local HQ DMICP iHR Server Corporate Reporting & Analysis Query Database
Onboard DMICP Server
Laboratory Inpatient Working Group PHC / Dental PHC / Dental Command Post CP Resuscitation Resuscitation Resuscitation 12 Bed Ward 12 Bed Ward 12 Bed Ward 12 Bed Ward 4 Bed ITU 4 Bed ITU Pharmacy Pharmacy HMC Laboratory HMC Reception Reception Welfare Minor Treatment X Ray Minor Treatments X Ray 12 Bed Ward 12 Bed Ward 12 Bed Ward 12 Bed Ward 2 Table Operating Theatre 2 Table Operating Theatre Outpatients Outpatients Infect. Disease Control Area Infect. Disease Control Area Telemedicine █ Fully supported by DMICP █ Partially Supported by DMICP Interfaces Required █ Limited Support from DMICP – Work/Resources Required █ Supported by SICMAN Monitoring
High-level Benefits 1 Enable Improved Treatment of Personnel 2 Operational Situational Awareness Improvement 3 Forensic Capability Improvements 4 Improved Force Readiness 5 Improved Management of the DMS 6 Improved handling of Litigation 7 Meet Government Information for Health Targets 8 Meet Government Health Directives & Standards 9 Improved Efficiency in Compliance with DPA & FOI Legislation 10 Reduction in Record Duplication 11 More Effective Handling of PQs 12 Improved Integration with NHS 13 Improved Data for Studies 14 Improved DMS Morale
Benefit 1 - Enable Improved Treatment Realisation % Initial Imp Dev & Imp Interim Cap Dev & Imp Full Cap 100 80 OVERALL 60 * * 40 * FAC & MAT Component 20 IHR Component Sec Care Component Prot & Ref Component * 2005 2006 2007 2008 2009 2010 2011 ISD Full Cap ISD Early Cap ISD Interim Cap
Conclusion • Benefits to the patient: • clear and accurate tracking of medical history and interventions • thereby informing an appropriate treatment path • and preventing lack of access or loss of medical information throughout service • Benefits to clinicians: • full access to all medical records • full access to reference data • preloaded templates and audits • reduced administrative burden • any time, any place • Benefits to the DMS: • better visibility of the health status of the Armed Forces • healthcare planning with more confidence and accuracy • better use of resources
DMICP –Delivering information near the patient (anytime, anyplace)