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Care Management Event Tracking (CMET)

Interest was initially expressed by the IHS Women's Health workgroup for a tool to provide a means of tracking and managing a patient's care to minimize the "fall through the cracks" syndrome whereby patients are passed over for routine and follow-up visits. Initially CMET will be deployed through the IHS population health iCare application and then later incorporated in the patient centric EHR solution.

 

CMET breaks down tracking and management of patients into four distinct steps:

1. Events

 
iCare CMET Events Tab.  Displays a listing of pre-defined events from your site. Users can decide whether to track, not track, or leave events in pending status
Events Tab

Events are pre-defined by taxonomies and are categorized into: Breast, Cervical, Colon, Liver, Skeletal, Prostate or STI events. A site's database is routinely mined for the occurrence of these events and when found, they are displayed with a status of "Pending". Individual users at the site will then decide whether or not they would like to track the event.

 

2. Findings

 
iCare CMET Tracked Events Tab.  Displays a listing of tracked events.  Users can view event related activity as well as enter Finding, Follow-up, and Patient Notification details via the CMET worksheet.
Tracked Events Tab

Findings are abbreviated results and have been pre-defined for each Event. These are presented for review and consideration by the providers. The entering of Findings requires user intervention.

 

3. Follow-up

 
iCare CMET Follow-up Events Tab.  Displays a listing of events based on user recommendations for follow-up action.
Follow-up Tab

Follow-ups provide a means of continued observation of patients and are based on the Event and provider input. How and when to follow-up a "Tracked" event is entered into the CMET worksheet and this in turn triggers a CMET Reminder.

 

4. Patient Notification

 
iCare CMET Worksheet. Utilized by clinical staff to process Events that have been tracked.  Enables data entry related to Findings Follow-up and Patient Notification
CMET Worksheet

Patient Notification enables the documentation of how the patient was notified of the results of the event and provider's recommendation for follow-up. CMET has integrated use of the existing TIU notes in EHR. This allows the utilization of existing RPMS templates to complete notifications.