In the early 2000s, Estenda Solutions began a project for the development of a diabetes disease management application funded by the Department of Defense and 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 interoperable with electronic medical record systems available with the Department of Defense, CDMP was successfully built and deployed at multiple institutions where it is 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. Please contact us (link to the contact page) if you’d like to access the following demos. Links to the demos on the CDMP section of the old website
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 90 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 study evaluation and reporting platform in half the time of previous versions while adding significant additional functionality.
Working closely with David Rodbard, MD and Robert Vigersky, MD, Estenda Solutions designed and developed a Clinical Decision Support System for Diabetes Medications targeting Primary Care Providers. The concept, content, and medication management algorithms were designed by Dr. Rodbard and Dr. Vigersky based on many years of treating patients and conducting extensive research in diabetes patient management. The CDS algorithm evaluates demographic data, current and past medications, labs, diagnoses, and the patient's blood glucose profile to make medication recommendations designed to better control their blood glucose. The program provides recommendations to increase or decrease dosages, add or discontinue medications, and provide explanations.
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 Study Manager. Incorporated into 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
Using eHIP, Estenda Solutions built a Bariatric Survey Patient Management system called PhoenixCare for a major Boston-area medical center's bariatric practice. 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.
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 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.
Estenda Solutions, using the eHIP architecture, partnered with the National Kidney Foundation of Hawaii for the creation of a state-wide Chronic Kidney Disease Repository. Integrating daily data feeds from multiple labs in Hawaii into the repository allows 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 additional programming resources.
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, developed 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 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.
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 architecture compatible for inclusion in AHLTA. eHIP easily met these requirements and was used to deliver the project on-time and budget.
Through partnerships with Numera, IdealLife, Entrahealth, MedApps, Medready, and Microsoft HealthVault, Estenda enhanced CDMP/eHIP to incorporate remote patient monitoring data (blood glucose, blood pressure, pulse, 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 partnering with the healthcare vendors allows patients to upload this information using the telephone, or wirelessly, without need for an internet connection or computer.
With its eHIP platform, Estenda has successfully integrated with the following EMRs and private laboratory systems, using industry standards: HL7 v2 or v3, HITSP C32 / CCD, IHE, and DICOMEMRS