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