Cares is an acronym for clinical, administrative, research, educations systems.
The system combines BI analytics and process management capabilities to track the treatment of patients and is currently being trialed in New York’s Mount Sinai Hospital where Strain has worked as a psychiatrist for over 25 years.
The Micro-Cares system is built on an large electronic medial records tracking database called CISCL (Clinical Information System, Consultation-Liaison), which was built in 1979 to support the hospital’s psychiatry practice. The Strains devised a set of key metrics to make business sense of all this data and allow for further analysis and mining. They devised a set of uniform codes – each relating to specific dimensional information like patient demographics, complaints, consultation status, treatment and prognosis, and so on.
So far, 300 dimensional variables have been identified – taking around 15 painstaking years to compile. The database was originally created on an IBM 370 machine, which the junior Strain getting the un-envious task of punching in the data.
Jay, the junior half of the team works as a surgeon in San Francisco, but also has a masters in computer science, focusing on medical informatics.
After several program iterations, the Strains have now productized the project research. Four years ago it started marketing customized patient record management systems, literature search systems and practice management systems under the Micro-Cares brand.
The current Micro-Cares suite (version 7.7) runs on Microsoft Windows 95/98/2000/XP platforms and stores data in a standard SQL relational database schema — which makes it easy to integrate the system into existing hospital IT infrastructures.
There is even a network version for multiple users, including support for Palm OS and PocketPC-based handheld devices to assist doctors doing their rounds. The handheld software comes with a visual interface for inputting consultation information and gathering survey and questionnaire data and episode data.
Diagnostics and medication history are tracked via the Literature Search archival component which references a database of medical papers and commentaries via handheld devices. Upon completion of rounds doctors synch their handhelds with a desktop PC and can produce reports (Excel spreadsheets and Word documents) based on the information gathered and perform standard analysis functions like slice-and-dice, drill-down, cross-tabs, etc.
The newest module, which is still work in progress, is called MedTrack which gathers information on medical students to help guide and tailor training programs. Handhelds again play a key role, used by the student to record their patients contact and treatment administrations.
While the Strains are treating Micro-Cares as a commercial software opportunity the junior Strain, who splits his time between the operating table and the keyboard programming, insists they’re not in it for the money or profit.
The goal is to make something that works and benefits patients, he said.
Often the Strains simply give the software away for free or arrange funding from external medical agencies (like Eli Lilly) to pay for the IT hardware and system set-up in a hospital.
The Strains believe that Micro-Cares could revolutionize how doctors address patient care as well as physician training.
It’s a well known fact that the healthcare sector has traditionally lagged well behind other sectors in the BI space. While the use of BI and data analysis isn’t new in this sector (used in financial and administration), the technology has not played a big role in delivering better care for patients. What’s required is an ability to cull medical-related data from operational systems into a queryable database for further analysis and gleaning trends.
The biggest obstacle remains getting medical data for analysis. Many hospitals are only just now computerizing paper-based patient files and many continue to struggle with information locked away in legacy home-grown systems. Around 15% of all clinical data is digitized today which makes cross-correlation a neigh impossible task.
Funding is also a problem. Generally, IT upgrades sit well below medical equipment and staffing on pecking order of many hospital budgets. But compliance issues like HIPAA are now forcing hospitals and other medical institutions to take a much closer look at how they control, manage and communicate patient information.
The Strains acknowledge that privacy issues need to be carefully balanced with the benfits of cross-analysis of patient data to identify valuable patterms and trends that relate to care. This has motivated the father and son team to develop the Micro-Cares system.
Right now Micro-Cares is being used by the psychiatric departments of 60 hospitals worldwide, including the US, Spain, Portugal, Mexico, Brazil and Taiwan. The CISCL interface has been internationalized accordingly.
While Micro Cares is currently aimed at psychiatry departments, the Strains are working to broaden the focus to other medical disciplines. Versions for surgery, pediatrics, geriatrics and internal medicine are under construction.
