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Lieutenant Commander Mark Trasler Royal Navy
Collecting information near the patient (worldwide)
3
Outline
• Defence Medical Services
• Capability Gaps
• Solution
• Business Change
– Examples
• Benefit Realisation
• Conclusion
Defence Medical Services
HEALTHPROMOTION
COMPREHENSIVE HEALTHCARE
DEPLOYABLEMEDICAL
OPERATIONAL CAPABILITY
MANAGINGAND
MOTIVATINGTHE DMS
Fit for Task
Fit for Task
INFORMATIONINFORMATION
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
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MOD HospitalsMOD Hospitals• 3 Overseas Hospitals
– Cyprus– Gibraltar– Northern Ireland
• Rehabilitation– Headley Court
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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
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Capability Gaps
•Norman gets the point …
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Capability GapsCurrently, 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
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REGULATIONS and
INSTRUCTIONS for the
MEDICAL OFFICERS of
HIS MAJESTY’S FLEET
MDCCCXXV
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“ 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 ...
”
Health Surveillance – 19th Century
Health Surveillance – 21st Century
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D. M. I. C. P.
“Dee - Mick – Pee”
Defence Medical Information Capability
Programme
Solution
Concept
DMICP
Integrated Healthcare
Record
Med Centre Med Centre
Med Centre
Dental Centre
Dental Centre Other Healthcare Facility
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Programme GovernanceSRO’s
Steering Group
Benefits MonitoringGroup
PolicyWG
ReportingWG
TrainingWG
Culture & Comms
WG
InterfacesWG
ProgrammeBoard
TransitionWG
Business ChangeCo-ord Group
InpatientWG
DeployedWG
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Business Change• Working Groups
– Clinical Policies & Protocols
– Reporting
– Training
– Culture & Communications
– Interfaces
– Transition
– Deployed
– Inpatient & Secondary Care
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Clinical Protocols / Templates
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Clinical Protocols / Templates
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Clinical Policy / Patient Confidentiality
• Legitimate Relationships
• Role Based Access
• “Sealed Envelopes”
• Auditing
Corporate Reporting & Analysis
Query Database
Local HQ
DMICP iHR Server
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Communications
Deployed Working GroupDeployed Working Group
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OnboardDMICP Server
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█ Fully supported by DMICP
█ Partially Supported by DMICP
█ Limited Support from DMICP – Work/Resources Required
█ Supported by SICMAN
Interfaces Required
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High-level Benefits1 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
Initial Imp Dev & Imp Interim Cap Dev & Imp Full Cap
ISD Early Cap
ISD Interim Cap
ISD Full Cap
2005 20112007 2008 2009 20102006
Benefit 1 - Enable Improved Treatment
20
40
60
80
100
Realisation %
*
*
*
*
IHR Component
Prot & Ref Component
FAC & MAT Component
Sec Care Component
OVERALL
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• Med Cen Chicksands
• Med Cen Waterbeach
• MRS Colchester
• PSMB Colchester
• DCMH Colchester
• RRU Colchester
• HQ APHCS (E) Region
• Med Cen MCTC Colchester
• MRS Bassingbourn
• Med Cen Wimbish
• Med Cen Chilwell
• Med Cen Grantham
• Med Cen Swanton Morley
• Med Cen Woodbridge
• Med Cen North Luffenham
• Med Cen Wattisham
• MRS Pirbright
• Med Cen Chatham
• Med Cen Hounslow
• Med Cen Combermere Bks, Windsor
• Med Cen Canterbury
• Med Cen Hyde Park Bks
• Med Cen Maidstone
• Med Cen Keogh Bks
• Med Cen Kneller Hall
• Med Cen Deepcut
• MRS Shorncliffe
• Med Cen The Baird
• Med Cen Victoria Bks, Windsor
• Med Cen Woolwich
• DCMH Woolwich
• Med Cen Wellington Bks
• HQ APHCS (LSE) Region
• Med Cen Arborfield
• Med Cen Thorney Island
• Med Cen Beaconsfield
• Med Cen Abingdon
• Med Cen Hermitage
• MRS Aldershot
• RRU Aldershot
• DCMH Aldershot
• PSMB Aldershot
• APHCS HQ
• HQ APHCS (HC) Region
• Med Cen, Minley
• Med Cen Southwick Park
• Med Cen Marchwood
• Med Cen Middle Wallop
• Med Cen North Camp
• Med Cen Bordon
• MRS Sandhurst
• Med Cen Shrivenham
• MRS Winchester
• MRS Bicester
• Med Cen Worthy Down
• Med Cen Colerne
• Med Cen Blandford
• MRS Bovington
Roll-Out so far …
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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)
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mark.trasler373@mod.uk
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