Diabetes Case Management

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USPHS Indian Health Service

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Enterprise integration to improve Diabetes case management.

Executive Summary

The Special Diabetes Program Initiative at Indian Health Service funds treatment and prevention programs for American Indians and Alaska Natives, whose diabetes rate is 249 percent higher than average. In 2002, the US Senate supported legislation that secured funding for this program at an increased rate of $150 million per year through 2008. IHS Billings Area Office and ZuniSoft teamed to implement a Diabetes case management system that would serve more than 20,000 Native Americans located in Montana and Wyoming who are diagnosed with the disease.

Business Challenge

IHS faced several challenges that led to the need for a new Diabetes case management solution. The legacy case management solution was implemented on the MUMPS based RPMS platform which made self-service reporting and analysis nearly impossible. IHS also faced increased pressure from service units wanting better data integration for a more complete picture of patient care.Strategically, there was a push to move from console based applications towards n-tier solutions leveraging modern relational data stores and commodity server technologies.

How ZuniSoft Helped

ZuniSoft developed the Diabetes Registry to help IHS meet their own strategic as well as congressionally mandated goals. The system was implemented using MS SQL Server, COM+ and Visual Basic. Patient data was replicated from multiple MUMPS databases on AIX using a custom RPC application to move the data to MS SQL Server. The client application in turn used COM+ business objects to retrieve the data from SQL Server and return it to the user.

Value Delivered

The business case for the Diabetes Registry was to improve the quality of care for IHS patients diagnosed with Diabetes. The Diabetes Registry project was a success. The Diabetes Registry team achieved the following benefits:

  • Delivery of a modern clinical application that fully integrated with the legacy EHR, preserving investments in that system
  • The ability for geographically dispersed providers to obtain a complete patient record regardless of the patient’s point of care
  • Improved reporting and analysis which helped identify best practices for Diabetes disease management