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

Integrated Clinical Database

CPT Joseph P. Edger & 1Lt S. Erin Elarton

26 November, 2003

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?

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

The History of ICDB

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


Official Mission Statement

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.


ICDB Architecture for the MTF

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.


Architecture for Tertiary MTFs

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


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

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

4N

4N

4A

PCM 1

4N

4N

4A

PCM 2

PCM Team NurseC ase M an ag er

H ea lth C are In teg ra to rTriag e /P t E d u ca to r


How does ICDB make the healthcare delivery process easier?

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 is it important to the organization?

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


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


ICDB Provider Homepage Opens to Your Appointments

Identifying Cohorts of Patients Visiting ER

Identifying Cohorts Overdue for Preventive Services

Display in Excel File

Clinical Summary -- ONE SCREEN

Click

Individual Patient Summary

Medical Links – Research at the Click of a Mouse

Takes you back to the ICDB Home Page

Lab Results Over Graphed Over Time

Note: LatestLabs Show On Trend

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


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

DD 2766

DD 2766 – Page 2

Over Due Prevention Alert

WRHCS Outcomes Management Database

Outcomes Scorecards– Cardiovascular – Congestive Heart Failure– Chronic Obstructive Pulmonary Disease– Diabetes – Hepatitis C– Women’s Health – Childhood Asthma


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


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


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


Summary

ICDB enhances CHCS I by providing coordination of care across:– Patient conditions– Clinical services– MTF settings


Documents

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