Collecting information near the patient (worldwide)

1. Collecting information near the patient (worldwide) Lieutenant Commander Mark Trasler Royal Navy

3. Outline • Defence Medical Services • Capability Gaps • Solution • Business Change • Examples • Benefit Realisation • Conclusion

4. Fit for Task INFORMATION Defence Medical Services COMPREHENSIVE HEALTHCARE DEPLOYABLE MEDICAL OPERATIONAL CAPABILITY MANAGING AND MOTIVATING THE DMS HEALTH PROMOTION

5. DMS Roles - Home & Garrison • Non Deployed Healthcare • Primary Care Medical Centres • Primary Care Dental Centres • Rehabilitation Centres • Community Mental Health Depts • Occupational Health Centres

6. 3 Overseas Hospitals Cyprus Gibraltar Northern Ireland MOD Hospitals • Rehabilitation • Headley Court

7. 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

13. Capability Gaps • Norman gets the point …

14. 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

15. REGULATIONS and INSTRUCTIONS for the MEDICAL OFFICERS of HIS MAJESTY’S FLEET MDCCCXXV

16. “ 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 ... ”

17. Health Surveillance – 19th Century

18. Health Surveillance – 21st Century

19. D. M. I. C. P. Solution Defence Medical Information Capability Programme “Dee - Mick – Pee”

20. DMICP Integrated Healthcare Record Med Centre Med Centre Med Centre Dental Centre Dental Centre Other Healthcare Facility Concept

25. 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

26. Business Change • Working Groups • Clinical Policies & Protocols • Reporting • Training • Culture & Communications • Interfaces • Transition • Deployed • Inpatient & Secondary Care

27. Clinical Protocols / Templates

28. Clinical Protocols / Templates

29. Clinical Policy / Patient Confidentiality • Legitimate Relationships • Role Based Access • “Sealed Envelopes” • Auditing

30. Local HQ DMICP iHR Server Corporate Reporting & Analysis Query Database

32. Communications

33. Deployed Working Group

34. Onboard DMICP Server

35. 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

36. 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

37. 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

39. Roll-Out so far …

40. 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

41. DMICP –Delivering information near the patient (anytime, anyplace)

42. mark.trasler373@mod.uk