Chronic Disease/NCD Collaborative

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Chronic Disease/NCD Collaborative CDEMS
Patrick S Luces Augusta Rengiil Pacific Chronic
Disease Council
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Why we need this model?

• Regional Assessments
• Lack collaboration between medical care providers
  and public health staff
• Lack of system of clinical services to assure
  continuity of care
• Lack up-to-date policies and procedures
• Lack of standards of care
• Lack of consistent data
• FASC Recommendations listed (April 2009)
• Data
• Certified NCD lifestyle educators
• NCD Collaborative

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What is a collaborative?

• The Collaborative approach involves improvements
  in six elements of NCD team care
• Self-management
• Decision support
• Clinical information system (CDEMS)
• Delivery system design
• Organization of health care
• Community

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What is CDEMS?

• CDEMS Chronic Disease Electronic Management
  System
• is a flexible database to help document and
  track health care outcomes.
• is designed to assist medical providers and
  healthcare management and tracking and improving
  the care of patients with one or more chronic
  health conditions.
• allows both patient level tracking/reporting and
  population level tracking/reporting.

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Meeting your needs..

• CDEMS can easily be adapted to the unique needs
  of the USAPI (i.e. betel nut and sakau use) can
  be added as behavioral risks.
• Easily modify or change any clinic/hospital
  reports, formatting of Progress Notes, or any
  field in the program.

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Thank You!