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.
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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.
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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.
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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
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