CDEMS

Diabetes Electronic Management SystemChronic Disease Electronic Management

System

Dusty Knobel Computer Support Diabetes Prevention & Control Program Washington Dept of Health 360.236.3738

CDEMS

We are in a Revolution

Breakthrough SeriesChasm ReportOutcomes Measurement Project IOMAcute Care ModelCollaboratives

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Successful project include:

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Get someplace new - do something different

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Decide where you want to go

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Get the patient to help

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Track your progress

CDEMS

Chronic Care Model

GuidelinesVisit Redesign

Self Management Registry

Successful projects include:

Management Community

CDEMS

Rapid Change ToolsPDSA

Plan

DoStudy

Act

CDEMS

Change CyclePDSA

Plan

DoStudy

Act

CDEMS

Registry

Does Helps Provider during visit Assists Case management Allows Population Management Feedback on PDSA cycles

Is Not Electronic Record

CDEMS

Visit Note Helps Provider during visit Assists Case management Allows Population Management

CDEMS

Patient Lists Helps Provider during visit Assists Case management Allows Population Management

CDEMS

Summary Report Helps Provider during visit Assists Case management Allows Population Management

CDEMS

Impact on QualityHbA1C By Period Measured and Cohort

8

7.7

7.3 7.3

8

7.7

7.5

8.1

7.6

6.8

7

7.2

7.4

7.6

7.8

8

8.2

4/99-9/99 10/99-3/00 4/00-9/00 10/00-3/01

Measurement Period

Me

dia

n H

bA

1C

18mos

12mos

6mos

C/DEMS Features

Three MSAccess Files Data Entry Program Reports Linked Data File

Downloaded from www.cdems.com as self extracting zip files

CDEMS

Data Entry

Data TypesDemographicsVisit InformationHealth conditionsMedicationsServicesLabs

Actions Enter Edit Print

CDEMSReports

Summary Report Custom Hard coded

Patient Case Management ListUser Specific Queries

CDEMS

What is Cool

User can customizeProgram MorphsClinic basedUser driven

features Lab interface Multi-print Open Source Report Wizards

CDEMS

Inside CDEMS

tlkpSetUp (controls how visit note looks and what is stored)

tlkpCrosswalk (maps internal codes to displayed labels)

Building blocks

CDEMS

Crosswalk and SetupExamples:

CDEMS

Relationships

Maintain primary keys

Enforces data validity

Cascading referential integrity

CDEMS

Where are we?

National awardsCurrently 40,000 patients in C/DEMSCurrent Challenges:

Sandboxes in MSAccess 2003 EMRs Web based registries