Sponsored by the Office of the Chief of Naval Operations, Medical Resources, Plans and Policy Division (OPNAV N931), the Navy Medicine Knowledge Management System (NMKMS) began as a research and development project to: address high-value capability gaps in current Joint Electronic Health Record capabilities; assess the value of data warehousing techniques for data storage and retrieval; and design an open architecture that could be leveraged by multiple sources with ease of integration.
The goal of NMKMS is to collect the highest quality of casualty care data in an operational setting with the minimum amount of disruption to the healthcare providers. Rather than simply exchanging data files, Navy Medicine requires interoperable applications that not only share data, but also leverage computing and storage resources.
What is NMKMS?
NMKMS is a data warehouse capability for the collection, standardization, storage and servicing of operational medical data of interest and value to Navy Medicine.
Data Collection
NMKMS accepts multiple data sources, including Armed Forces Health Longitudinal Technology Application – Theater (AHLTA-T) encounters; Shipboard Non-tactical Automated Data Processing (SNAP) Automated Medical System (SAMS) 8 and 9 environmental, logistical and medical encounters; and Theater Medical Information Program (TMIP) Composite Health Care System (CHCS) Cache (TC2) medical encounters. The encounters are transferred through either the TMIP Framework or SAMS Communicator in an encrypted manner to a centralized NMKMS data collection and storage instance (see Figure 1).
Data Standardization
At point of entry into NMKMS, the data is parsed and each individual data element is compared to the business rules governing that data element. These business rules allow NMKMS to reduce the "apples," "oranges" and "peaches" to "apples" so the reporting is performed using the standardized data. This apples-to-apples approach accounts for differences in data such as numeric code, capital letters and lowercase letters, and converts data to a standard format that can be used for query and reporting purposes.
Data Storage
Once the data has passed all validation tests and has been transformed according to the business rules, it is then stored in a data warehouse for optimal analysis and reporting.
"In the future, the NMKMS data warehouse is envisioned to serve as the collection point and data broker for all authoritative sources of Navy and Marine Corps operational medical data. NMKMS will then serve up properly normalized data marts that support critical applications and services to Navy Medicine decision makers, including the Navy Surgeon General and combatant command (COCOM) surgeons," said Claudia Kiefer, Space and Naval Warfare Systems Center (SPAWARSYSCEN) Atlantic project manager for NMKMS.
Data Servicing
NMKMS uses customized data marts that are specific to the reporting need. This prevents users from directly accessing the data warehouse, and helps to protect personally identifiable information. Additionally, these data marts allow for distributed networking of the enterprise components, abstract reporting from data storage, and allow the data model within NMKMS to evolve without breaking third party visualization tools.
Solving Business Problems and Creating Business Opportunities
SPAWARSYSCEN Atlantic employs agile software development and Lean Six Sigma methodologies within the overarching Department of Defense (DoD) Software Development Life Cycle (SDLC), using short iterations to break down larger goals. SPAWARSYSCEN Atlantic practices open and transparent communication with its partners and customers and believes in providing training and support in the adoption and implementation of best practices for agile software development and Lean Six Sigma methodologies.