1. Introduction to RPMS Steve Bowman Information Systems Consultant

2. Resource and Patient Management System A set of decentralized, integrated computer applications designed to support the clinical and administrative functions of a health care program n Provides a comprehensive clinical, financial, & administrative environment n Designed for Health care programs that focus on Community Based Comprehensive Care Preventive Health Service n Comprised of Multi-User Database Caché programming Language VA - Fileman, Kernel, & Applications IHS Applications

3. Integrated Database Structure Applications designed to either stand alone or integrate with each other Integrated Data  Only need to enter once to be available to all applications

4. RPMS Applications.... As productivity tools for clinic employees.... To generate statistics for transmission to the national database.... To create facility databases available for local reports Function on 3 Levels

5. n Hardware n Comprised of servers, PC’s, printers, cables, & connectors n Network n Allows local access to data for a single facility via a LAN n Access for multiple facilities, Area Offices, and headquarters via a secure WAN n Worldwide access via the Internet n Database n Allows data capture just once at point of patient contact Shared with other users, and/or commercial applications Maximizes resource utilization for patient care n Data automatically aggregated to create a national database Used for program funding decisions Epidemiological studies n Applications (more than 50) –Clinical –Administrative –Infrastructure Components

6. Patient Care Component Pharmacy Dental Data System Clinical Laboratory System Blood Bank Immunization Tracking Women’s Health Emergency Room Clinic Scheduling Clinical and Field Health Applications Mental Health/Social Services Nursing Patient Acuity Nutrition and Dietetics Radiology Diabetes Management Chemical Dependency Community Health Worker Module Admission/Discharge/Transfer Asthma Register OB Register Integrates data into a comprehensive patient record Creates a comprehensive patient database for healthcare planning, research, and evaluation

7. Patient Care Component Integrates Multiple Clinical Systems to form a Comprehensive Patient Record Laboratory Appointment System Patient Registration Dental Emergency Room PCC Patient Database Inpatient Surgery Radiology CHR Field Nursing Pharmacy Mental Health/ Social Services Women’s Health PCC Data Entry

8. Collects, stores, & reports Demographics Appointments, discharges, & transfers Alternate resources Resource requirements & supplies Administrative Applications Patient Registration Referred Care System Third Party Billing Accounts Receivable DRG Grouper Supply Management Equipment Inventory Admin. Resources Mgmt. (ARMS) Supports the business of providing healthcare Manages third party resources Claims Bills Receivables

9. VA Fileman A Cache based database management system Integrates the application code and data into the Kernel environment Infrastructure Framework for RPMS Provides & maintains environment for developers & end users Provides data security VA Kernel Interface between the O/S, application code, and users Comprised of tools for –Development –Capacity management –System, User, Device, and Task management –Electronic messaging –Security

10. PCC MODULES n Data Entry n Health Summary (Snapshot of Clinical History) n Registers n Management Reports n Taxonomy n Query Manager

11. PCC Data Types n Visit n Provider n Diagnosis n Measurement n Laboratory n History n Health Problems & Treatment plans

12. Reminder letters for women needing pap smear Immunization status data for your patients List of diabetic patients who need eye or dental exams Lists of patients with special needs Lists of patients with Medicare, Medicaid, Private Insurance, or HMO Health Plans Lists of patients re-admitted within 30 days of a previous discharge The RPMS Produces

13. A list of patients needing an annual flu shot A count of active users at your facility The top ten health problems in your community 3rd party claims for billable visits Workload statistics by age, sex, community, payor A health profile for individual patients A profile of community health status The RPMS Produces

14. Electronic Medical Record Point of Service Entry of Data Provider Data Entry Use of Portable Devices Internet Access The RPMS Will Include:

15. Indian Health Service Mission “To raise the health status of the American Indian and Alaska Native people to the highest possible level.”

16. RPMS Design Goals...universal accessibility......supporting decisions......for managers and clinicians......universal accessibility......supporting decisions......for managers and clinicians... To provide universally accessible decision support information which positively impacts the management and delivery of health care.

17. n Powerful –Data rich with good mining tools n Wealth of applications (more than 50) n Integrated or standalone n Low costs to implement & maintain n Flexible hardware and software n Integrates with numerous commercial applications n Constantly enhanced with input from end users n Good end user support n Proven track record Features

18. Indian Health Service Mission “To raise the health status of the American Indian and Alaska Native people to the highest possible level.”

19. RPMS Design Goals...universal accessibility......supporting decisions......for managers and clinicians......universal accessibility......supporting decisions......for managers and clinicians... To provide universally accessible decision support information which positively impacts the management and delivery of health care.

20. n Powerful –Data rich with good mining tools n Wealth of applications (more than 50) n Integrated or standalone n Low costs to implement & maintain n Flexible hardware and software n Integrates with numerous commercial applications n Constantly enhanced with input from end users n Good end user support n Proven track record Features

21. Patient Care Component ( PCC) n Collects stores, and integrates a broad range of data from all patient visits & providers gathered during each patient’s encounter to form a comprehensive patient record for each patient. VisitsProviders InpatientPhysicians OutpatientClinic and public health nurses Field Mental health workers Pharmacists Community health representatives Nutritionists Radiology and laboratory technicians n PCC data supports Quality health care delivery Facility planning Management Research Funding health care initiatives n Health Summary –Aggregates all PCC data into a snapshot History of each patients health status –Promotes delivery of high quality health care by making data quickly available to providers –Output is fully customizable