Lieutenant Commander Mark Trasler Royal Navy

Collecting information near the patient (worldwide)

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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

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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

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40

60

80

100

Realisation %

*

*

*

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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