• Jeanne Harmon of the WA Diabetes Prevention & Control Program presented draft cardiovascular measures for the next WA State Collaborative scheduled to begin at the end of June. The "Setup Wizard" was used to demonstrate creation of the cardiovascular track in CDEMS. Much of the discussion centered around terminology distinctions and CDEMS coding for cardiovascular, CVD, coronary & peripheral vasuclar, artherosclerosis, vasuclar disease, heart disease...
  
  
• Callie Gard and Betty Mafnas discussed the asthma and HIV CDEMS setup developed at Community Health Care in Tacoma. The "Copy/Paste Append" method was used to demonstrate copying an existing asthma setup from an Excel spreadsheet into CDEMS. The group discussed at length the pros and cons of creating special forms by health condition. Two schools of thought (philosophies) influence the CDEMS setup and the choice to use special forms: a DISEASE-SPECIFIC approach or FULL PATIENT CARE.
  
  A hepatitis tickler was requested for HIV. The CDEMS tickler currently works on a single variable, but Dusty noted interest and will consider revising CDEMS to accomodate this need.
  
  In setting up new conditions, Dusty suggests defining an education track for each type of condition (e.g., diabetes educ, heart educ, asthma educ, etc.). Also, create a "PHQ" (Patient Health Querstionnaire) service for depression screening and record the PHQ score as the result.

• Database Backup. Think about it -- how much data would you be comfortable losing? Back up the cdem_dta.mdb file often. Verify that your cdem_dta.mdb file is part of the server backup if your CDEMS is installed on a network. Never assume that the CDEMS files are included in the network backup!
  
  Follow the steps below for backing up your CDEMS files:
  
  1. Label & date backup medium (floppy, CD or Zip) before inserting into the appropriate drive
  2. Navigate to the cdem_dta.mdb file in the CDEMS folder on your computer
  3. Right click on the file cdem_dta.mdb
  4. Click Send to and select your backup medium - floppy, zip drive, CD
  5. Make back up copies of CDEMS Data Entry (cdem_8-8-03.mdb) and Report (rpt_5-04-03.mdb) programs if you've made customizations worth protecting.
     
     User Tip: Rename your backup file on the floppy, CD or Zip drive to include the date the copy was made (for example: copy_cdem_dta_030404.mdb). This helps identify the most recent backup file in the unfortunate event your data must be recovered. It also prevents writing over previous backup files you may have made.
  
  If your database becomes too large to fit on a floppy, it will have to first be zipped or condensed before copying to the floppy. Compacting and repairing the database, described below, will also help to reduce the size of the database.
  
  
• Compact & Repair the cdem_dta.mdb file to improve performance and conserve disk space. The more activity that occurs in the database, the more frequently this operation should be performed. Also periodically compact & repair CDEMS Data Entry and Reports program files if changes/customizations are made. It's recommended to backup the cdem_dta.mdb file before compacting & repairing, particularly if you think the database may be damaged.
  
  Instructions for compacting & repairing the CDEMS database:
  
  1. Open cdem_dta.mdb file directly
     
  2. Click Tools in menu bar > Click Database Utilities
     
  3. If using Access 2k version, click Compact & Repair Database.
     If using Access 97 version, compact and repair database are separate operations -- compact first, then repair.
     
  4. Close cdem_dta.mdb file
     
  
  User Tip: "Compact on Close" - It's possible to set your database to automatically compact on closing (if the size will be reduced by at least 256KB). Here's how:
  
  1. Open the cdem_dta.mdb file > Click Tools > Options
     
  2. Click the General tab of the Options box
     
  3. Click the Compact on Close check box
  
  
• PCP list/data cleanup - Click Clean up PCP list for instructions in a related CDEMS User Forum discussion.
  
  
• Ethnicity list/data cleanup - Click Clean up Ethnicity data for instructions in a related Forum discussion. Though this discussion refers to cleanup in DEMS, the instructions are the same for CDEMS -- just make the changes in the cdem_dta.mdb file.
  
  
• Telephone format cleanup - Click Clean up Telephone formatting for detailed instructions in a Forum discussion on this topic.
  
  

Q & A

Below are responses to key questions addressed at the meeting with links to additional information:

• Q #1 - When setting up a new health condition, is it possible to customize the data collection page for the new condition? For example, we have set up asthma tracking where the referral and decline options are not needed though they still appear on our blank data collection form.
  Click Customize Data Collection Page.
  
  
• Q #2 - We have an EMR coming soon. Will the system talk to CDEMS?
  Click CDEMS Compatibility with EMR.
  
  
• Q #3 - Is it possible to display labs and services in a different order on the progress note? And, I would like to have the numbering order explained more thoroughly for the set up of the page. I understand that groups of numbered things appear together like 90, 100, and 110. Are there assigned blocks of the page in the coding for these particular numbers? Why not use numbers like 1, 2, 3 or 10, 20, 30?
  Click Re-order Labs & Services.
  
  
• Q #4 - Please discuss the linking/re-linking process when the data file is copied or relocated. I want to be sure the master data file is safeguarded when files get reorganized or when I'm working with a copy of the data file in test mode.
  Click Relink Data File.
  
  
• Q #5 - How can collaborative and non-collaborative patients be managed in CDEMS without setting up a separate clinic or inventing a new condition for them?
  Click Collaborative/Non-Collaborative Setup.
  
  
• Q #6 - Can you incorporate Framingham CHD risk assessment into CDEMS calculations like BMI (as part of the visit note)?
  Click Framingham CHD Risk Assessment.
  
  
• Q #7 - What are the differences in report changes from DEMS to CDEMS?
  Click Differences between DEMS/CDEMS Reports.
  
  
• Q #8 - Can the diabetes summary report be modified to add depression screening?
  Click Add Depression Screening in Summary.
  
  
• Q #9 - Is there a way to delete a health condition once it's entered it in setup wizard?
  Click Delete a health condition.
  
  

Next User Support Meeting... to be announced