# Presentation: 116374

## AdvanceMed Hanford (AMH)

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- Epidemiologist
- Naoyo MORI
- May 23, 2006

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## Contents

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- About Us
- The databases we use
- How to collect/store data
- The System We Use
- Any issue
- Possible solutions

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## I. About Us

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- Prime Contractor to the Dept. of Energy, Richland Operations Office
- Hanford site;
- Established in the 40’s
- Plutonium production complex
- The largest cleanup site (586 miles2)
- More than 10,000 workers

- 3/16

**Notes:**
AMH is one of the prime contractors to the Department of Energy.
We provide comprehensive occupational health services to the DOE Hanford Site.

The Hanford Site was established in the 1940’s as a plutonium production complex for the World War II Manhattan Project.  
It is now the nation’s largest environmental clean-up project encompassing an area approximately one half the size of the state of Rhode Island.

Our occupational health program is designed to provide professional services in support of the health and safety of more than 10,000 workers on the Site.  The program is based on medical surveillance, prevention, identification and treatment and rehabilitation of work related disease and injuries, and education.

## II. The Database We Use

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- <Electronic data Program>
- Site Roster
- Return to Work
- CAIRS
- 	DOE Computerized Accident
- 	Incident Reporting System

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**Notes:**
We use an electronic data program.  We submit these three data to ORISE.  
We recently started to submit CAIRS Data to ORISE.

## III. How to Collect/ Store Data	1. Site Roster

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- III. How to Collect/ Store Data	1. Site Roster

- Hanford People Core Database

- Health Services System (HSS System)
-  1) Person Table
-  2) Person Companies Table

- Site Roster

- Latest Month Available Copy

- Oracle

- ACCESS

- Data Entry generated by AMH & other contractors, respectively

- Submit ORISE

- 5/16

**Notes:**
First thing I would like to mention is how we collect data, especially data sources and the types of data.
The first data system is the Site Roster.  
We have basically two sources. First one is generated by AdvancedMed, which are readily accessible and controllable by us.
The other one is more difficult to access because those are generated by other contractors. Each contractor register their data into People Core, respectively.  Unfortunately, AMH is not capable or responsible to check or control data generated by other contractors. Different types of man-made errors happen, for example;
Timing: Some people are already resigned but you can see their data in the Roster.
Misspelling
Missing data, esp. Job Category
Inconsistency from other contractors
Although we works closely with the contractors to establish real-time data, we sometimes have difficulties due to the different format or compatibility with our system.

## III. How to Collect / Store Data      2. Return to Work Data

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- III. How to Collect / Store Data      2. Return to Work Data

- <Conditions for a check-in>
- Five days of more consecutive workdays
- Hospitalization
- Anything that may affect your working performance
- HR policies require it
- etc.
- <Note>: AMH Capture any absence of at least one day of work due to injury or illness

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**Notes:**
The return to work database, submitted to ORISE on a monthly basis. It is designed to capture absence of  work due to injury or illness.  We use ICD-9 diagnostic code.  

## III. How to Collect / Store Data      2. Return to Work Data

- III. How to Collect / Store Data      2. Return to Work Data

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- People Core

- Health Services System (HSS)

- Occupational Health System (OHS)

- Return to Work

- Submit ORISE

- CAIRS

**Notes:**
Return to work data is generated from the combination of Health Services System and Occupational Health System.  Demographic data are provided by People Core.  Those are ORACLE database.
Then, We generate Return to Work data which is ACCESS database to submit ORISE.  We also encrypt the social security number.

HSS---Demographic information
OHS---Medical information
RMMS---Job information

## III. How to Collect/ Store Data	3. CAIRS

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- III. How to Collect/ Store Data	3. CAIRS

- Injury happens

- Go to Health Center

- Interviewed by Provider

- Complete ROV (Record of Visit) by Provider

- Investigation by Safety Person

- Complete CAIRS System by Safety Person

- Submit ORISE

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**Notes:**
The last one is CAIRS, Computerized Accident Incident Reporting System.  When any injury case happens, he or she go to the health center and will be interviewed by a medical provider.  A provider completes ROV.  ROV is initiated for any worker reporting to AdvancedMed Hanford for an injury or illness that may be work related.
This is an ACCESS data base.  Before submitting this ACCESS database, we encrypt the Social Security Number.
The considerable problems might be:
Misspelling
Missing data
Vague diagnosis
Recall biases by patients
Inconsistency from other contractors

## IV. The Systems We Use	1. Database

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- IV. The Systems We Use	1. Database

- Oracle
- People Core
- Health Services System (HSS)
- Occupational Health System (OHS)
- ACCESS
- Site Roster
- Return to Work
- CAIRS

- 9/16

- Submit ORISE

**Notes:**
We have three ORACLE databases, People Core, Health Services System and Occupational Health System.  HSS and OHS is respond each other and generate Return to Work data.
We submit all data by using ACCESS.

## IV. The Systems We Use	2. Codes

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- IV. The Systems We Use	2. Codes

- Common Occupational Classification System (COCS)
- ICD-9 code
- Job Categories

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**Notes:**
COCS is a partial data of EJTA.
Job Categories are designed by ORISE.
This other problem we can think for all kinds of data managing is occasionally, it would be difficult for data manager to define the job category.  For example, in our case, we usually EJTA, we have a automated computer system to convert the job code from EJTA to Job Category code.  However, I am not sure yet how other contractors deal with this conversion.

## V. Any Issue

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- Collection Issues
- Cross-Functional Activities
- Analytical Issues
- Multiple Database
- Biases

- 11/16

## A. Collection Issues

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- Cross-Functional Activities
- Five prime contractors
- Many subcontractors
- Registration done by each contractor
- AMH cannot control their primal data

- 12/16

**Notes:**
We have basically two sources, one of which is AMH clinical outcomes which are readily accessible and controllable by us.
The other one is more difficult to access because those are generated by other contractors.  Although we works closely with the contractors to establish real-time data, we sometimes have difficulties due to the different format or compatibility with AMH system.

I would like to solve these types of issue with higher priority with your helps.

## B. Analytical Issues

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- Multiple Database
- Oracle
- ACCESS
- Hard Copy
- Microfilm
- Microfiche

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## B. Analytical Issues (Continued)

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- . Bias
- Potential Inaccuracy
- Variability
- Complexities
- Misidentification
- Specific Differences
- Inappropriate Assignment and Maintenance

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## VI. Possible Solutions

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- Build up horizontal relationship b/w
- Other contractors
- HR
- Clinical staff
- IT People
- In order to
- Keep quality of data (People Core, etc.)

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## Contact Information

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- AdvanceMed Hanford
- 	1979 Synder St., Suite 150,
- 	MSIN G3-70, Richland, WA 99354
- Phone: (509) 376-6479
- E-mail: Naoyo_Mori@rl.gov
- 			 (Most Preferable)

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