Integrated database lets doctors track patients

Integrated database lets doctors track patients


Typically, Air Force doctors rifle through reams of paper records and database files to view a patient's medical history. It's a task that can take several office visits before doctors get to the root of a problem.

The system can be built for about $100,000.
' Brig. Gen. Klaus O. Schafer
Today, at a handful of military hospitals from Texas to Italy, a doctor can track a patient's complete file by using the Integrated Clinical Database. ICDB relies on an Oracle8i database running in an open architecture. It uses extraction applications to retrieve patient and provider data from legacy military systems. For doctors and clinicians, the front-end application is the Microsoft Internet Explorer browser.

With ICDB, doctors can peruse a patient's cardiology and X-ray tests, as well as surgery and emergency room visits via one user interface, rather than having to search multiple systems independently.

Once the data is extracted, doctors can correlate the information from the independent databases by using a set of identifiers.

Doctors can create their own extraction applications to build patient profiles or make queries across a population of patients by lumping their records together in one category. For example, because Oracle8i is a relational database, a doctor could take all of his high-risk diabetic patients and compile their records in a separate group.

ICDB allows doctors to search across legacy databases for patient information.
Developed in 1995 by a team of doctors at the Air Force's largest medical facility, Wilford Hall Medical Center in San Antonio, ICDB can store information from other systems at any Defense Department hospital facility that uses the Composite Health Care System I.

CHCS, developed by Science Applications International Corp. of San Diego, is a clinical information system that interfaces with ICDB, said Dr. Edward Martin, health care sector vice president for SAIC.

CHCS I tracks laboratory, radiology and enrollment information for patients who visit the more than 100 Defense hospitals and 600 department clinics worldwide.

'Doctors can manage cases better. They can manage populations at risk,' said Brig. Gen. Klaus O. Schafer, assistant surgeon general for medical readiness, science and technology. Schafer has been touting the success of the ICDB.

Time for a checkup

'Doctors can actively see for the first time who [each] patient is,' Schafer said.
In addition, the system can be built at a large medical facility for about $100,000, Schafer said. To run ICDB, a hospital needs servers and PCs with Intel Corp. chips and running Microsoft Windows NT.

'It provides a lot more quality and content to the visit,' said Martin, whose company maintains ICDB for the Air Force.

ICDB works by integrating data warehousing techniques with Internet applications, Martin said.
Besides its use at Wilford Hall Medical Center, the service is running ICDB at Aviano Air Base in Italy and at Walter Reed Medical Center in Washington.


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