Donald Frederick Fortin
Assistant Consulting Professor in the Department of Medicine

Entering the academic year on 1992, a major effort was undertaken to convert th e existing Duke Cardiovascular Disease Databank from a hierarchical database format to a rrelational database format employing client-server technology. This project was directed by Dr. Fortin and employed 8 full time database programmers and 3 network specialists in order to get this accomplished. The converion of the existing data in the database is approximately 70% completed with the underlying database schema for all components of the database now completed. Work on completion of data entry screens and report generation as well as administrative summaries is underway and is scheduled to be completed by 7-94. Dr.Fortin also supervised the expansion of the existing personal computer local area network to include the Duke North Clinical Services for the Cardiology Associates as well as the interventional cardiology laboratory. The concept is to create a Duke Information System for Cardiology Network in which all members of th e division are able to access information on the clinical databas as well as the hospital information system from a common desk top set of applications. This requires the evaluation of a number of aspects of new technology including advanced operation systems, and a number of front end products to access the database server.
Further expansion of network services to the Center for Living for facilitating delivery of an outpatient clinic note generation module was completed in August 1994 and the new version of the Cardiovascular Diseases Databank is now fully operational providing expanded services compared to its predecessor.
In addition, Dr.Fortin was actively involved in the Duke Imaging Center in which further method research was being performed in quantitative coronary angiography. Plans are being made for the implementation of this technology for every interventional cardiac catheterization as well as all diagnostic cardiac catheterization being performed at Duke Medical Center. This information will be intergrated into the existing Duke Cardiovascular Disease Databank providing more insight into patients with ischemic coronary artery disease. Dr.Fortin is also a member of the Duke University Emerging Technologies Group. He was also Co-Chairman of the Imaging Network Subcommittee which met as a subcommittee to the Medical Center Computer Advisory Committee.
Dr. Fortin also worked closely with Dr.Pryor on the Co-operative Cardiovascular Project. The project sponsered by the healthcare financing administration to examine the benefits of revascularization and examine the variable associated with long term survival in patients and all Medicare patients suffering myocardial infarction, coronary angioplasty, or coroary bypass grafting. Dr.Fortin was instrumental in developing the database schema as
well as definitions for all variables. In addition, Dr. Fortin has also been responsible for developing definitions and in large part the database schema for the Academic Medical Center Consortium project involving 10 academic medical centers whom admission is to examine the effects of revascularization procedures in patients with ischemic coronary disease. Dr.Fortin was also involved in agency for healthcare policy research on unstable angina guideline project in which he has agreed to act as a computer consultant for development of testing instruments for the algorithm which will arise from the unstable angina project. The above three mentioned projects are scheduled to be completed in no sooner than 3 years. These projects will require ongoing participation throughout the calendar year of 1993.
Dr. Fortin has also been appointed to the Clinical Advisor to MCIS and will supervise the telemedicine director, Dr. Tom Silbert. Dr. Fortin is also a Co-Investigator in the agency for Healthcare Poliicy and Research Myocardial Infarction Guideline Development Project with a specific focus on the development of outpatient arena for followup.
Dr.Fortin and Dr. O'Connor as Co-Directors of the Cardiology Associates Outpatient Clinic are also sponsoring the development of a new program called the Duke University Organization for Secondary Prevention and Dedication. The focus of this will be to develop new research arenas for the evaluation of emerging technologies for the treatment of hyperlipidemia, congestive heart failure and post myocardial infarction care. This effort will attempt to apply in a real work clinical setting emerging technologies from related clinical trials and evaluate their effect on long term cardiovascular outcomes in patients with disease 1.0 established ischemic heart disease.

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