Integrated Quality Database

Abstract

The organization: EMC provides ground and air ambulance services to Nova Scotians in emergencies. The services range from basic to advanced life support. Telehealth (811) is also part of this company which provides medical consultation to Nova Scotians for non-emergency conditions. The internship work: Since the organization uses several different solutions that are not standard and cannot exchange data with each other, different departments should query the databases and review and approve the data, according to their reporting needs. Creating a database to integrate the data from different sources (internal and external), so that, the records could be reviewed only once (not several times by different departments) was the main purpose of the project. I was responsible for requirement assessment, planning, categorization of data, database design and implementation, as well as documentation. I created a relational database in SQL Server with about 70 tables (including the reference tables) that could meet their reporting needs, primarily for cardiac arrest cases, but I designed the structure of the database in a way that other conditions can also be added if needed. How the internship work relates to health informatics The project was related to most of the courses in the master of health informatics program, including, project management, health information flow and use, flow and standards, systems and issues, as well as networks and web. The project management course helped me develop a plan for the project, using Microsoft Project. The health information flow and use, and the flow and standards courses made it possible for me to develop a storyboard, recognize the processes, assess the work flow, and understand the indicators. The systems and issues course helped me with the data flow and systems boundaries. Finally, the networks and web helped me identify the entities, categorize the data and the tables, build a logical relationship between the tables and design the database. Querying the existing sources of data helped me in determining the data types and the possible values for each attribute and creating the reference tables. The problems in EMC that merits a health informatics solution The main problem is that the software solutions that are used in the company are neither logically related nor standard (lack of interoperability). Reporting and conducting research requires a combination of automatic integration of data from some sources and manual data entry from other sources, as well as manual editing and approval of the integrated data which is labor-intensive. In addition, there are many fields in the application where user errors could be limited but they have been ignored by the vendors. Users have to type in the textboxes in the applications and the user errors have significantly affected the validity of the stored data. The same problem is seen with health card numbers, which are manually entered and card scanners are not used. Conclusion The future solutions should see EHS companies as one system and extend the boundaries of their systems or be able to exchange data automatically within the organization. An effective system enables the company to schedule shifts according to availability of the paramedics (the administration system) and the ambulances (the fleet maintenance system), and provide a logical relationship between the computer-assisted dispatch system (CAD) and the electronic patient care record (ePCR), while facilitating transfer of data from defibrillation devices and other subsystems. The current systems are not standard and cannot exchange data with external entities. Integrating the existing solutions as well as using standard semantic codes for data exchange is one of the options. The software companies should try to limit user errors by creating reference tables from historical data or scientific resources, and by using other methods such as card scanners. Some of the current software solutions are not user-friendly and the companies should try to customize their solutions according to the type of the service