Advancing Healthcare Research and Medical Informatics
Projects
Every project is unique. In few places is this more true than the world of healthcare research and medical informatics. One key to success is partnering with a technology team that takes your project vision to heart; is truly obsessive about quality; and is realistic about deploying new technologies. At Estenda we invest the time to truly understand the unique context of each project allowing us to consistently exceed expectations.
Flagship Projects
  • Comprehensive Diabetes Management Program (CDMP)
    In the early 2000s, Estenda Solutions began a project for the development of a diabetes disease management application funded by the Department of Defense envisioned by Dr. Sven Bursell, then at the Joslin Diabetes Center and now at the University of Hawaii. This application would facilitate patient care and management based on the Chronic Care Model and create a holistic view of the patient uniquely combining clinical and patient behavioral data.

    Designed from the start to be interoperabale with electronic medical record systems available with the Department of Defense, CDMP was successfully built and deployed at multiple institutions where it is successfully used for patient care and research. CDMP's flexible nature combined with its use of open source software evolved into the Estenda Healthcare Informatics Platform (eHIP).

    Extensive information about the diabetes solution is available on the CDMP wiki.

  • Diabetes Eye Care and Treatment (DECAT), formerly known as Joslin Vision Network (JVN)
    Estenda Solutions is the primary development partner for a large consortium dedicated to reducing the incidence of preventable blindness among people with diabetes. By utilizing a secure telemedicine model we are able to deploy technician operated retinal imaging equipment in a wide variety of locations and have the images remotely evaluated by highly trained retinal specialists. Estenda supports imaging modalities in over 70 locations from tiny Native American tribal clinics to some of the most well respected and advanced Diabetes specialty practices.

    Utilizing the eHIP platform, Estenda was able to build the latest generation DECAT study evaluation and reporting platform in half the time of previous versions while adding significant additional functionality.

  • Study Manager
    Extensive experience participating in clinical research projects and frequently asked to address issues concerning medical informatics, Estenda in cooperation with numerous clinical researchers and medical informatistics created the Study Manager module. Study Manager is a powerful feature incorporated in CDMP/eHIP. It can be deployed as an integrated solution or as a standalone application. Study Manager enables the efficient administration and management of clinical studies from recruitment, through data collection, analysis and finally publishing. Estenda employees are often an integral component of planning research programs and frequently included as author on study publications.
  • eHIP Jumpstart Projects
  • Bariatric Surgery Patient Management
    Using eHIP Estenda Solutions built a Bariatric Survey Patient Management system for a major Boston-area medical center's bariatric practice called PhoenixCare. PhoenixCare is a suite of patient and practice management applications designed specifically for managing patients pre and post surgery. The application improves both patient outcomes and clinical efficiency by uniquely combining optimized access to traditional health metrics and alerts with patient-reported behavior data.

  • Chronic Kidney Disease, Congestive Heart Failure & Liver Disease Management
    Building on eHIP and the successful Diabetes Management application in partnership with clinical experts, Estenda adapted the functionality of CDMP to address the unique aspects of managing patients with chronic kidney disease, congestive heart failure and liver disease. Adapting the CDMP for these chronic conditions helped each practice develop a customized solution to target their population's unique needs in mere months. This accelerated development saved millions of dollars and was successful in less time than it takes to implement most commercial systems because it was expressly tailored to their needs.

  • Chronic Kidney Disease Statewide Data Repository & Reporting
    Still in its early stages Estenda Solutions using the eHIP architecture has partnered with the National Kidney Foundation of Hawaii for the creation of a state-wide Chronic Kidney Disease Repository. Presently lab data from multiple labs in Hawaii are flowing daily into the repository allowing researchers to access the data cleansed of any patient identifying information. With the ability to create custom reports using eHIP's reporting capabilities, researchers can query the data to answer pertinent questions in a timely fashion without having to involve technology resources.

  • Hepatitis B & C Screening and Immunizations
    Estenda Solutions in cooperation with The Hawaii Medical Center East Liver Center and the University of Hawaii Telehealth Research Institute (Liver Alliance) with funding from the HMSA Foundation are in the process of developing a state wide clinical information system to support the individuals and institutions that screen for, treat, and manage patients with Hepatitis B and C. The first stage, currently in production, is managing the screening process for Hepatitis B and C. Higher than normal rates of infection drive the need for aggressive screening programs and often the same people are screened multiple times resulting in duplicate lab testing and financial strain on the screening programs. Through integration with the screening laboratories and incorporating historical data, screeners can quickly determine if a person has already been screened and how best to direct them for treatment if necessary. Successful immunizations and follow-up for individuals testing positive are tracked through the system to close the loop saving valuable resources in terms of time and dollars.

  • Electronic Nursing Documentation System (ENDS) for Latent Tuberculosis Infection
    The ENDS application allows nurses to easily document activities related to providing care for patients with Latent Tuberculosis Infection (LTBI) in an outpatient setting at Tripler Army Medical Center in Hawaii and Fort Bliss in Texas. Key technical requirements for successfully accomplishing this project were meeting a compressed development schedule and utilizing an architecture compatible for inclusion in AHLTA. eHIP easily met these requirements and was used to deliver the project on-time and budget.

  • Medical Home Model - Remote Patient Monitoring
    Through a partnership with iMetrikus, Estenda enhanced CDMP/eHIP to incorporate remote patient monitoring data (blood glucose, blood pressure, heart beat, and weight) with the clinical and behavioral information already available within the system to complete the holistic view of the patient between medical appointments. Previously patients could upload this data automatically through our available patient portal, but iMetrikus allows patients to upload this information using the telephone without need for an internet connection or computer.
  • Next Generation Person Health Record
  • Robert Wood Johnson Project HealthDesign
    The Robert Wood Johnson Project HealthDesign was envisioned to encourage and support technology pioneers to design the next generation of personal health record systems in ways that empower patients to better manage their health and health care.

    Estenda Solutions in cooperation with T.R.U.E. Research Foundation— working at Walter Reed Army Medical Center and the University of Hawaii envisioned a prototype personal health application to improve the lives of people managing diabetes and reduce their risks for further illness. The prototype PHR application is designed to capture information about daily living that is important for diabetes management and gives action-oriented advice for self-care. The team’s application is not a standalone device; rather, it is a set of rules, algorithms and data structures with user interfaces that consumers can access on the Web via a computer or Internet-enabled mobile device.

    The PHR application will analyze, summarize and display data, advising users on nutrition, daily physical activity, blood glucose, emotional state, and the interaction of all these factors. It will also enable consumers to conduct “what if ” analyses that can predict the health results of choices they might be considering, such as the effects of a particular meal on blood glucose levels.
  • Interoperability
    Estenda has integration experience with multiple EMRs and private laboratory system utilzing eHIP. We have successfully integrated with the following EMRs using HL7 using Mirth and/or properietary mechanisms using web services and direct database access.
  • Nextgen
  • Department of Defense/Military Healthcare CHCS/AHLTA
  • VA Vista
  • Indian Health Services RPMS
  • PECS