Distributed Database Management for an Obstetrical Service: The BabyTracker Experience

An Obstetrical service is an ideal model of a structured clinical data set. Typically, patients undergo a similar course of routine prenatal care spanning six to nine months that leads to a common outcome (i.e. vaginal delivery). At various clinical milestones toward the end of the pregnancy and shortly thereafter, a series of standard documents must be generated in order to complete an obstetrical medical record. These would include a delivery note, discharge summary and birth certificate. One of the most challenging tasks for an obstetrical service is the timely completion and submission of birth certificates. Significant human resources have been required on our obstetrical service in order to complete birth certificates in accordance with state guidelines. In addition, completion of obstetrical inpatient records with a signed delivery note and discharge summary is necessary in order to generate an inpatient bill. Billing delays contribute to reduced revenue. In order to address these issues, we have developed an enterprise wide client/server relational database management system called BabyTracker that contains the majority of the functionality of an electronic obstetrical record.