DROP TABLE RESULTS; DROP TABLE EVALUATIONS; DROP TABLE EVAL_RULES; DROP TABLE MEDICAL_RECORDS; DROP TABLE APPLICATIONS; DROP TABLE ACADEMIES; DROP TABLE APPLICANTS; CREATE TABLE APPLICANTS( SSN CHAR(9) PRIMARY KEY, FirstName VARCHAR2(10), LastName VARCHAR2(20), DOB DATE); CREATE TABLE ACADEMIES( AcadID VARCHAR2(10) PRIMARY KEY, AcadName VARCHAR2(100)); CREATE TABLE APPLICATIONS( AppID NUMBER PRIMARY KEY, SSN CHAR(9) REFERENCES APPLICANTS(SSN), AcadID VARCHAR2(10) REFERENCES ACADEMIES(AcadID), Year INT CHECK (Year BETWEEN 2010 AND 2020)); CREATE TABLE MEDICAL_RECORDS( SSN CHAR(9) REFERENCES APPLICANTS(SSN), DateUpdated DATE, Pulse INT, Systolic INT, Diastolic INT); CREATE TABLE EVAL_RULES( RuleID NUMBER PRIMARY KEY, RuleName VARCHAR2(50)); CREATE TABLE EVALUATIONS( EvalID NUMBER PRIMARY KEY, EvalDate DATE, AppID NUMBER REFERENCES APPLICATIONS(AppID)); CREATE TABLE RESULTS( EvalID NUMBER REFERENCES EVALUATIONS(EValID), RuleID NUMBER REFERENCES EVAL_RULES(RuleID), Result INT CHECK (Result IN (0, 1))); INSERT INTO APPLICANTS VALUES ('111223333', 'John', 'Layman', '22-APR-1998'); INSERT INTO APPLICANTS VALUES ('222334444', 'Tim', 'Bowe', '22-APR-1993'); INSERT INTO APPLICANTS VALUES ('333445555', 'Nick', 'Reynolds', '22-APR-1983'); INSERT INTO ACADEMIES VALUES ('USAFA', 'United States Air Force Academy'); INSERT INTO ACADEMIES VALUES ('USMA', 'United States Military Academy'); INSERT INTO ACADEMIES VALUES ('USUHS', 'Uniformed Services University of the Health Sciences'); INSERT INTO APPLICATIONS VALUES (1, '111223333', 'USAFA', 2014); INSERT INTO APPLICATIONS VALUES (2, '111223333', 'USMA', 2015); INSERT INTO APPLICATIONS VALUES (3, '222334444', 'USMA', 2015); INSERT INTO APPLICATIONS VALUES (4, '222334444', 'USUHS', 2015); INSERT INTO APPLICATIONS VALUES (5, '333445555', 'USAFA', 2015); INSERT INTO APPLICATIONS VALUES (6, '333445555', 'USMA', 2015); INSERT INTO APPLICATIONS VALUES (7, '333445555', 'USUHS', 2015); INSERT INTO MEDICAL_RECORDS VALUES ('111223333', '10-MAR-2015', 70, 150, 80); INSERT INTO MEDICAL_RECORDS VALUES ('222334444', '20-MAY-2014', 60, 120, 80); INSERT INTO MEDICAL_RECORDS VALUES ('333445555', '25-APR-2015', 100, 145, 95); INSERT INTO EVAL_RULES VALUES(1,'Age'); INSERT INTO EVAL_RULES VALUES(2,'Pulse'); INSERT INTO EVAL_RULES VALUES(3,'Blood Pressure'); Systems Framework Review of what we have covered Systems Resources Human Resources (Clinical and non-clinical Physicians, nurses, therapists, technicians, specialists, food service, engineering, housekeeping, volunteers, pastoral care, social work, administrators, clerks, telephone operators Non-human Services IT- computers, ICU equipment, audio video, pharmaceutical, surgical equipment, diagnostic equipment Financing- Employers, Government, Individuals System Structure Structure (where) Hospitals Outpatient Long term care Within each of these are hundreds of processes known ...

1. DROP TABLE RESULTS;
DROP TABLE EVALUATIONS;
DROP TABLE EVAL_RULES;
DROP TABLE MEDICAL_RECORDS;
DROP TABLE APPLICATIONS;
DROP TABLE ACADEMIES;
DROP TABLE APPLICANTS;
CREATE TABLE APPLICANTS(
SSN CHAR(9) PRIMARY KEY,
FirstName VARCHAR2(10),
LastName VARCHAR2(20),
DOB DATE);
CREATE TABLE ACADEMIES(
AcadID VARCHAR2(10) PRIMARY KEY,
AcadName VARCHAR2(100));

2. CREATE TABLE APPLICATIONS(
AppID NUMBER PRIMARY KEY,
SSN CHAR(9) REFERENCES APPLICANTS(SSN),
AcadID VARCHAR2(10) REFERENCES
ACADEMIES(AcadID),
Year INT CHECK (Year BETWEEN 2010 AND 2020));
CREATE TABLE MEDICAL_RECORDS(
SSN CHAR(9) REFERENCES APPLICANTS(SSN),
DateUpdated DATE,
Pulse INT,
Systolic INT,
Diastolic INT);
CREATE TABLE EVAL_RULES(
RuleID NUMBER PRIMARY KEY,
RuleName VARCHAR2(50));

3. CREATE TABLE EVALUATIONS(
EvalID NUMBER PRIMARY KEY,
EvalDate DATE,
AppID NUMBER REFERENCES APPLICATIONS(AppID));
CREATE TABLE RESULTS(
EvalID NUMBER REFERENCES EVALUATIONS(EValID),
RuleID NUMBER REFERENCES EVAL_RULES(RuleID),
Result INT CHECK (Result IN (0, 1)));
INSERT INTO APPLICANTS VALUES ('111223333', 'John',
'Layman', '22-APR-1998');
INSERT INTO APPLICANTS VALUES ('222334444', 'Tim',
'Bowe', '22-APR-1993');
INSERT INTO APPLICANTS VALUES ('333445555', 'Nick',
'Reynolds', '22-APR-1983');
INSERT INTO ACADEMIES VALUES ('USAFA', 'United
States Air Force Academy');
INSERT INTO ACADEMIES VALUES ('USMA', 'United States

4. Military Academy');
INSERT INTO ACADEMIES VALUES ('USUHS', 'Uniformed
Services University of the Health Sciences');
INSERT INTO APPLICATIONS VALUES (1, '111223333',
'USAFA', 2014);
INSERT INTO APPLICATIONS VALUES (2, '111223333',
'USMA', 2015);
INSERT INTO APPLICATIONS VALUES (3, '222334444',
'USMA', 2015);
INSERT INTO APPLICATIONS VALUES (4, '222334444',
'USUHS', 2015);
INSERT INTO APPLICATIONS VALUES (5, '333445555',
'USAFA', 2015);
INSERT INTO APPLICATIONS VALUES (6, '333445555',
'USMA', 2015);
INSERT INTO APPLICATIONS VALUES (7, '333445555',
'USUHS', 2015);
INSERT INTO MEDICAL_RECORDS VALUES ('111223333',
'10-MAR-2015', 70, 150, 80);
INSERT INTO MEDICAL_RECORDS VALUES ('222334444',
'20-MAY-2014', 60, 120, 80);

5. INSERT INTO MEDICAL_RECORDS VALUES ('333445555',
'25-APR-2015', 100, 145, 95);
INSERT INTO EVAL_RULES VALUES(1,'Age');
INSERT INTO EVAL_RULES VALUES(2,'Pulse');
INSERT INTO EVAL_RULES VALUES(3,'Blood Pressure');
Systems Framework
Review of what we have covered
Systems Resources
Human Resources (Clinical and non-clinical
Physicians, nurses, therapists, technicians, specialists,
food service, engineering, housekeeping, volunteers, pastoral
care, social work, administrators, clerks, telephone operators
Non-human Services
IT- computers, ICU equipment, audio video,
pharmaceutical, surgical equipment, diagnostic equipment
Financing- Employers, Government, Individuals
System Structure
Structure (where)
Hospitals
Outpatient

6. Long term care
Within each of these are hundreds of processes known as
procedures.
System Process
Clinical example –
Admitting (demographics, clinical issues, financial status)
>Medical Unit - diagnostic workup, labs, physical exam
Treatment and discharge or
>Surgical (pre-op workup blood tests, labs), surgery,
post op, discharge
Emergency Room for non-scheduled ( triage, diagnostic
workup, treatment, and either discharge or admission
System Process
One other area of admission that is separated from general
admissions and ED is usually
Labor and Delivery
Systems Process
Other sets of process that evaluate the clinical care
Cost (Individual, the employer, the government, society)
Access (geographic, specialty service, cost) Quality –
Measurements of patient satisfaction, # of complications, # of
deaths,
System Outcomes
Cost – To develop a more efficient system so costs can be

7. contained
Access – Geographic and Specialty services
How long does it take you to get to see a doctor?
Is it available to everyone?
Quality – Patient Satisfaction and Safety
Overall goal
At the same time as we are trying to provide excellent medical
care at a reasonable cost
We are trying to move toward prevention of illness and disease
as a society.
It means educating people to how their lifestyles and beliefs
determine their health
Example
Breastfeeding
Reduces the rate of breast cancer for breastfeeding mothers and
their baby girls
Helps to protects the baby from infections while baby is
breastfeeding
Reduces gastrointestinal illnesses and disease for the child
throughout their lifetime (colitis and studies are being done now
on Crohn’s)
Reduces rate of ovarian cancer for mother by 3 % for every
month she breastfeeds
Reduces type 2 diabetes and obesity for children
Reduces ear infections for children
Reduces hyperactivity for children
Health care is changing everyday

8. Choose one area that we have covered in this class that
interested you.
Read an article about one topic in health care.
How does it affect the health care of individuals?
What steps could you take fix it?
Post it as a thread to blackboard.