Attached and Detatched

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I received another good question from a user. Her question was about attached records, detached records and how to reattach records. This feature is not a very obvious feature and it kinda lurks in the background. I thought this was a good opportunity to explain this topic to everyone.

Attached Records

What does it mean when records are attached? You may have run across this, if you have access and are in the “Rescuer” tab. (Not everybody has access to the “Rescuer” tab. It is a security precaution feature.) This happens when you create a new record with multiple patients.

Example – Bob Smith brings in 10 mallard ducklings, and you use choose 10 on the “Number of Patients”.

Those 10 records will all be attached to one another under Bob Smith’s name and admit information. If you change his name or information in any one of those records, they will all change. After the admission process the only time the attachment is really relevant is within the “People” tab.

Detach Records

When you detach a record, it basically just detaches that rescuer from the record and allows you to edit the admit information without changing the other attached records. The fact that you detached one really doesn’t make a difference to the patient’s record, just to the Rescuer’s list of patients they have brought in.

Example – Bob Smith actually only brought 9 mallards in, you counted wrong. You can go to any of those records and within the “Rescuer” tab you can Detach one (usually the last one created is wise) of those records so that you can either delete it (if it was the last record created) or you can rewrite over it with new information. If you rewrote over it with new information without detaching it, all 10 of the mallards admit information would change as well, so detaching a record in this case would be critical.

Reattaching Records

There are times when you detach a record by mistake or Bob Smith comes back in with 2 more mallards a few hours later and you want to make sure all the mallards are attached.

Example 1 – Actually, Bob Smith did bring in 10 mallard ducklings and you have already detached the last record, but you have not changed anything about it yet. The only way to reattach this record is in the “People” tab. What you have to do is “Combine People” and find the 2 Bob Smiths that have the same information but are not known as being the same person. If you combine them, then that mallard will be reattached to Bob Smith and therefore to the other 9 Ducklings.

 

Example 2 – Though Bob Smith is really nice his records are beginning to give you a head ache. Two hours after Bob Smith leaves, he is back with 2 more mallard ducklings. There have been a few admit’s since he left. What you can do now, is go to any one of those mallard’s record. Go to “Share” and “Duplicate Record”. It will give you the choice on how many to duplicate, you would choose 2. All the information will be the same. Next you create the 2 new records. Now all 12 records are attached to one another and linked by Bob Smith’s information.

 


On the Topic of Computers and Browsers…

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I received a message today from a new user. They were very concerned that they could not easily print the record of new intake patients. They explained how once the record was created there was this long tedious process of clicks and screen changes as well as having to find the PDF somewhere in the blackhole of computer files, all to just print that patients record.

At first I was a little confused, what possible could this poor group be doing? So I had to do a bit of my own research to try and figure out what exactly was happening.

For being a rather Techy wildlife rehabilitator I (Rachel) still do not know everything about computers (Devin, knows way more) but if I could not figure this out on my own without help, I am sure many others could not as well. So, I did a little experimenting and researching, to see how I could help this group out.

I thought this topic a really interesting question and a very real occurrence in a less technological crowd I felt that discussing this issue was important. There could be so many factors in place and WRMD really has very little control over anything the “Computer” might do.

Here was my response…
“I can see where you are coming from, however I think much of this can be fixed with changing your computers preferences. The first thing you should know is, we can not get around using a PDF. A print screen does not work. As you can see, what is printed is specially formatted to fit all of the patients information unto the least space possible. The only way to do that is via a PDF. Also, in order to print the record you have to create the record first, that is why we have the option to go the patients record immediately after creating it, so you can edit it or print from it. If the browser is set-up appropriately it takes only 4 clicks and no manual screen changes to print a PDF.

To me it really sounds like the way your computer’s preferences are set-up is a biggest part of your issue. My guess is that the way your browser deals with PDF’s is not efficient. I highly suggest using Chrome if you are not already. If you go to the Browser’s Preferences you can select where a PDF is downloaded to, you can create a file on your computer just for PDF from WRMD. However, at least on my browser I can choose to always have a PDF pop up when I download one. So, I select from WRMD Share – “Print Record” and the PDF shows up automatically and I press print and it is done, I do not have to find it anywhere, it is there on my screen in front of me.

We have no control of how the browsers on users computers do stuff, so my first suggesting is to figure out how your browser can show you a PDF the second you download one. I think that would solve your problem.

For multiple patients like 8 opo’s if you go to the list view select the little box to the left of the Case #, you can choose to print all 8 of the opo records at once and you do not need to go to every single record to print it.

Every single organization uses WRMD in different ways. The hardest part is adjusting to it the first time. Sometimes you have to change the way you do certain things in order to make it work. Asking questions and finding out how to make it work best for you is really important and that is why we are here. Believe it or not we have not had one complaint about how records are printed on intake, at least no one has expressed concern. It is a tool, and it takes time and experience to use that tool to best fit your needs.

Please let me know if this helps you at all. We don’t want WRMD to be a burden to anyone and and try very hard to make it very streamlined and easy, but some things are completely out of our control.”


WRMD is NOT Hacked

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Today we were alerted to a hacking event on our blog. It could easily bee seen with the message “Hacked By SA3D HaCk3D” on the dashboard within WRMD.

WRMD itself was NOT hacked. Your Data Is Safe.

Fortunately it was an easily resolution and all is safe now.

PS: If you are using WordPress for your organizations website, you should upgrade to version 4.7.2.


The Miracle of OWRMD

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Oiled Wildlife Care Netowrk

The article below was written by Christine Fiorello, DVM, PhD, Dipl. ACZM of the Oiled Wildlife Care Network. Christine, along with her colleagues at the OWCN, have commissioned us to develop a version of WRMD (called OWRMD) that specifically meets the record keeping needs of wildlife affected by oil spills in California. Our project has been under development for over a year and we are already seeing some very exciting results! A HUGE thanks to Christine Fiorello, Mike Ziccardi and the entire OWCN staff for including us in the project!

https://owcnblog.wordpress.com


Unlike my six-year-old, whose list to Santa is comprised mostly of toy weapons, my wishes for the New Year are less tangible. Less war, less poverty, less hunger, less deforestation, fewer emerging diseases, fewer extinctions, lower carbon emissions, no oil spills . . . . you get the idea. Given the current state of the world, it would probably take a miracle for any of those wishes to come true. But one miracle I am counting on is the promise of OWRMD!

Many, many years ago, Mike realized that an electronic medical record keeping system would be a huge boost to animal care during a spill response. After a LOT of work, angst, pain, blood, sweat, tears, and electronic device purchases, we are close to having a truly game-changing system in OWRMD, thanks to Devin Dombrowski and the Wild Neighbors Database Project (a non-profit that is already doing great work providing a free online medical records option for wildlife rehabilitators – follow the link to learn more or to donate).

OWRMD is a medical records database system that is purpose-built for the care of animals during an oil spill response, and it has been worth waiting for.  OWRMD is not exactly the same as the WRMD that is currently used in dozens of rehabilitation centers, but it is closely related. Many operations will be the same, and if you are comfortable with WRMD, getting comfortable with OWRMD will be a snap. It’s intuitive and has a lovely interface design, so even those who are not used to electronic medical records will become accustomed to it in no time.

It’s not quite finished yet, but for those of you who already use WRMD, you can understand how great a tool OWRMD will be. In the coming months, look out for opportunities to learn more about OWRMD, such as participating in drills or specific training sessions. At first, OWRMD will be for birds only, but we will be integrating other species into it as we move forward.

This holiday season, be safe, be healthy, be happy  . . . . and be thankful for whatever miracles come your way!

Thanks Christine!

New Year Reminders

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I have received a few questions about what happens to the records when a new year starts. So, I thought it a good idea to send out some information and reminders of what goes on behind the scenes and the best way to use WRMD the first month or so of the new year.

Dec 31 2016 at around 10:00PM PST (I suggest not being on WRMD), we will start to prep the change over. What basically happens is that we start the counting over at 17-1. As you may have noticed WRMD defaults to the current year we are in when you first sign-in. There are a few inconveniences that we can not help when this happens, but we have suggestions on how to work with the system.

If you want to view 2016 patients you have to be in the year 2016. There are 3 ways to do that. (Disclaimer: because it is not 2017 yet my examples are for 2016 and 2015, but the methods stay the same)

  1. You can just change the year entirely to view your 2016 patients. (2015 in my example)

  2. You can search for the patient’s case #, however you need to add the year in front of it. You will notice how there is a banner at the top of the screen that tells you that you are in a different year. (2015 in my example)

  3. You can also use quick search to give you list of all pending patients and just work from that list, however if you change your search that list will go away. (Yes our dummy account has some very long term patients)

Adding New Patients

Something that seems to happen during the change over is: if you are in a previous year, looking at records and you go to Add New Patient, you may create a new patient in the previous year, which you probably do not want. If it is caught quickly it can be deleted by a Super Administrator of the account. However, if other records are created after it, you can no longer delete them, you will have to Void them.

However, since many reports are not due until Jan 31, many people will continue to add the remainder of their 2016 records in. So again, just make sure which year you are in before you Add a New Patient.

Rechecks and Medications

If you use the recheck or medication features, and you have a pending 2016 patient, it will continue to show up on your daily reports without a problem, however I will caution again, once you are in a previous year if you go to Add a New Patient, it will be in the previous year.

Hope this helps some and Happy Holidays!!!


WRMD∙Surveillance: Enhanced Wildlife Disease Surveillance Application

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A novel wildlife disease surveillance tool for improving our understanding of wildlife health threats in California

We wanted to reach out to say a special thank you to our network of partnering centers for their willingness to collaborate with us on the Enhanced Wildlife Disease Surveillance project! Now that the WRMD∙Surveillance application has been active for a few months, we wanted to start reaching out to centers with regular communications. Through these communications, we aim to keep you informed of the information we are learning about wildlife health patterns in California; update you on interesting findings resulting from additional diagnostic testing conducted by California Department of Fish and Wildlife (CDFW) in response to the alerts and in collaboration with participating centers; and also hear from you regarding any unusual patterns you have observed in your admissions or information you would like to relay about the health of your patients as well as questions you have about the project.

Positive Impacts of the Application

Traditionally, wildlife disease surveillance systems have been specific to a particular disease. As such, these systems can miss trends that may signify a previously unknown disease or threat to wildlife health. This application allows for evaluation of diseases for which the cause is known (e.g., lead poisoning) and syndromes or diseases for which the cause is unknown (e.g., neurologic disease) in order to detect adverse health events that may warrant further investigation. It also facilitates early detection of wildlife disease events, enabling more timely investigations. We have included more details on the features of the application in an appendix at the end of this communication in case you are interested in learning more about how it works.

Since launching the application four months ago, WRMD∙Surveillance has alerted investigators at CDFW and the Wildlife Health Center to a number of specific disease outbreaks in which the cause was known and reported by the centers, including lead poisoning in turkey vultures and trichomoniasis in doves and pigeons. This information is extremely valuable for monitoring disease trends over time. It has also alerted investigators to increased numbers of individuals presenting with the same clinical signs/syndromes suggesting a disease outbreak in which the cause of the illness was not known. For a number of these alerts, CDFW followed up with centers for further investigation. In these cases, centers often shipped fresh or frozen carcasses to CDFW for post-mortem examination and laboratory diagnostics.

Highlights of New Findings

In August, the WRMD∙Surveillance application alerted us to an adverse health event in Cooper’s hawks. Juveniles were presenting in high numbers to wildlife rehabilitation centers in poor body condition with weakness (many were unable to stand) and mental dullness. Several of the birds also presented with traumatic injuries. Post-mortem examinations performed by CDFW revealed the cause of death to be West Nile Virus (WNV). West Nile has been reported to infect more than one hundred species of birds, with jays and crows seeming to be especially susceptible to infection. Since 2002, West Nile virus has been an important cause of mortality among raptors across the United States. The clinical manifestation of infection typically presents in three phases. Phase 1 is characterized by depression, decreased food intake, and weight loss. In addition to clinical signs in phase 1, birds in phase 2 present with head tremors, green urates, mental dullness/central blindness, and weakness. Phase 3 is characterized by more severe tremors and seizures. More information about the clinical signs in raptors and caring for infected birds can be found here: https://www.raptor.umn.edu/our-research/west-nile/caring-infected-birds. According to the California Department of Public Health, there were greater numbers of reported WNV mortalities in Cooper’s hawks this year relative to previous years. The epidemiology of the virus is complex and the reason for increased numbers of affected Cooper’s hawks this year is unknown. High temperatures and drought are known to affect WNV transmission. Drought reduces water availability for birds and mosquitoes, which subsequently crowd around scant water sources, leading to higher rates of spread of the virus among populations.

Earlier this fall, the application alerted us to an outbreak of neurologic disease in Eurasian collared doves in central California. Poisoning was suspected as the cause of the outbreak. CDFW followed up with centers receiving cases and the centers submitted carcasses for post-mortem examination and follow-up diagnostic testing. Results of the testing indicated that the doves were infected with Pigeon Paramyxovirus Type-1 (PPMV-1). PPMV-1 affects pigeons and doves causing depression, anorexia, excessive drinking, and diarrhea followed by neurological signs (incoordination, paralysis of wings and legs and twisting of the neck muscles) and rapid death, usually 1-3 days after the onset of clinical signs. It has been reported to cause die-offs of native and non-native species of free-flying doves in the U.S. Outside of the U.S., some strains of PPMV-1 have infected other taxa of birds, including chickens. Until recently, this virus hadn’t been detected in wild doves in California. CDFW has been investigating cases and documenting the distribution of detected infections. Detection of this PPMV-1 outbreak in Central California indicates this virus may be spreading northward by the non-native doves. The virus is spread by direct contact between birds, which is facilitated by bird feeders and bird baths. There are concerns that it could infect our native Band-tailed Pigeons and Mourning Doves. We are interested in continued monitoring of infection of native and non-native doves and pigeons and potential impacts on native species in California.

Currently, alerts in the application indicate an adverse health event in Western and Clark’s Grebes. Several grebes are presenting to centers in central and southern California with emaciation. CDFW is also receiving reports of ill and dying grebes at the Salton Sea and is working with centers and field biologists to conduct post-mortem examinations and laboratory analyses to investigate the cause(s). These alerts mirror findings by scientists documenting a downward trend in these populations along the Pacific Coast, which is hypothesized to be due in part to a change in the abundance and availability of their food base. We will provide results of this and other investigations in upcoming communications.

Gratitude for Partnership

Now, more than ever, there is a critical need for increased monitoring of threats to wildlife species, especially species that are difficult to monitor in the wild. In addition to the many positive contributions that centers bring to wildlife health and communities, the information that our partnering centers contribute to through this project is hugely beneficial for improving our understanding of threats to a diverse range of wildlife species across the state! We are so very thankful for the partnership!

Many thanks!

Terra Kelly, Wildlife Health Center, University of California
Devin Dombrowski and Anthony Riberi, Wild Neighbors Database Project
Nicole Carrion, Wildlife Investigations Laboratory, California Department of Fish and Wildlife
Krysta Rogers, Wildlife Investigations Laboratory, California Department of Fish and Wildlife

Please feel free to contact the Wildlife Investigations Laboratory at (916-358-2790) if you would like to report information and/or have questions about the investigations. Please also free to contact Terra Kelly at trkelly@ucdavis.edu or (530) 574-5093 or Devin Dombrowski at devin.dombrowski@wildneighborsdp.org if you have questions about the application and/or project.

Appendix:

Features of the WRMD∙Surveillance Application

The WRMD∙Surveillance application is the first of its kind, to facilitate real-time monitoring of diseases and mortality events in California wildlife. The application aggregates data from our center network on a weekly basis and alerts investigators to potential unusual wildlife health events (e.g., disease outbreaks) based on detection of a higher than usual number of admissions of a particular species. Personally identifiable data and information related to treatment/management of cases is not accessible in the application to ensure privacy.

The detailed view for each species exceeding the threshold includes a chart showing one or more years of data allowing for visualization of trends over time (Fig. 1). By using Google Maps’ API, the application includes a feature in which the location found for each case is displayed on the map (Fig. 2). The mapping feature is interactive in which the investigator can click on the location depicted on the map to display the underlying data for that individual animal. The application also includes a table displaying information for patients making up the alerts (address found, disposition, diagnosis, reason for admission, sex, weight, age group, initial exam) (Fig. 2).

Number of individuals admitted weekly

Figure 1. Chart displaying number of individuals admitted weekly over one year (top) and over 15 year period (bottom).

Locations where patients are making up an alert

Figure 2. Map displaying the locations where the patients making up one of the alerts were found. The table at the bottom displays the supporting information for the patients making up the alert. This data improves our understanding of the reasons for admission and whether additional diagnostics would improve our understanding of the illness/event leading to the alert.


Winter is Coming…

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Winter is indeed just around the corner. With winter comes the New Year and the bulk of the annual reports are due. It is very important that you start looking at your State and Federal reports right now to find inconsistencies.

Winter To-Do List4-ways-to-rock-your-to-do-list

  • Search all pending records and make sure you close out all patients that are not in your care.
  • If your state has a state report, make sure you can access it and that it is working. It is found under “Quick Links”, “Reports” If you do not see a state report for your state, please send us a blank copy ASAP so we can get it into the system. We believe we have them all, but if we don’t we would appreciate your help.
  • Make sure mammals, birds and herps are where they belong in the report. Sometimes if a species is changed in the Cage Card it does not fully update, we can not find any reason why it does this, but we think it happens by not clicking update. It will change the species name but not the species info behind the scenes.
  • Identify unidentified species. It is very common to have several species that are not identified correctly. If someone just types is swallow instead of selecting Barn Swallow, then the database does not recognize that screen-shot-2016-11-28-at-1-42-37-pmanimal. The database is pretty smart, but not that smart. My hope is that this week we can create an easy way to fix the unidentified animals through settings. Until then, the easiest thing to do is search all 2016 records, Export Records, select the Common Name and all the Taxonomy and export. This will give you a list you can compare common names entered and the animals taxonomy. If it says unidentified in all the taxa, you know it is an unidentified animal. The Case # is the ID and you can go back into WRMD and fix the info.

Suggestions and Ideas

Throughout the year we get many new suggestions, ideas and possible fixes. We always look at these, filter through what can be done and can’t be done and put them on a priority list. I would like to invite our users to make any suggestions and ideas they would like to see in the New Year. We have many items on our lists, but we would like to see what is more urgent for our users. Please email me at rachel.avilla@wildneighborsdp.org. I will do my best to reply quickly on if it is something will can do and also the status of that suggestion.

We are particularly interested in ideas for analytic and reports you would like to see more of. Feel free to repeat yourself if you have already sent me ideas in the past.


Enhanced Wildlife Disease Surveillance in California

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Nearly six years ago, when we first set out to create WRMD, we set a few priority goals. We first wanted to provide wildlife rehabilitators with an amazing, simple, and free database to help them with their daily record keeping needs. We also wanted to create an interface to aggregate data across multiple organizations and to allow for the entire community to benefit from their shared data. We wanted a tool that could help wildlife rehabilitators identify emerging wildlife trends and communicate those trends out to a network of rehabilitators and other wildlife professionals. We are proud to introduce the beta release of WRMD Investigator and its pilot program Enhanced Wildlife Disease Surveillance in California!

Thank you once again to those centers who indicated their willingness to partner with us on the Enhanced Wildlife Disease Surveillance project! This week, we are launching the enhanced wildlife disease surveillance system using the new surveillance platform in WRMD.

This system is the first of its kind, to facilitate real-time monitoring of wildlife diseases and mortality events in California wildlife. Information arising from the enhanced surveillance will be made available to the network of collaborating wildlife rehabilitation centers in order to increase awareness of wildlife health events throughout the state.

The new platform to be used for the project aggregates data from our network of partner centers on a weekly basis and detects and alerts investigators to potential unusual wildlife health events (e.g., disease outbreaks). The data to be aggregated from participating centers includes admission date, reason for admission, location found, diagnosis, age, disposition, and clinical signs on initial exam.

WRMD Surveillance Investigator

Depending on the circumstances of the alert, the Wildlife Health Center and CDFW will be reaching out to partner centers to follow-up with collaborative investigations. Please note that this project doesn’t require extra effort for centers and personally identifiable information and information related to treatment/management of cases is not accessible to investigators or partners.

If your center is interested in participating in the study, it is not too late to join our list of partners. If interested, please email Devin at devin.dombrowski@wildneighborsdp.org.

Threats to wild animals are increasing at an alarming rate. There is a critical need for increased monitoring of impacts of these threats on wildlife species, especially species that are difficult to monitor. In California, centers collectively rehabilitate ~ 500 different species of wild animals annually and are uniquely positioned to contribute significant information about threats to a diverse range of wildlife species in the state!

Thank you for your support and please let us know if your center is interested in participating in the study!
Devin Dombrowski, Wildlife Rehabilitation MD Developer
Wild Neighbors Database Project (WNDP)
Terra Kelly, Wildlife Veterinarian and Epidemiologist
Karen C. Drayer Wildlife Health Center
University of California- Davis, School of Veterinary Medicine
Nicole Carion, Statewide Wildlife Rehabilitation Coordinator
California Department of Fish and Wildlife

Quick Update on Some Updates

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I know we’ve been a bit quite lately but that certainly does not mean that we haven’t been doing anything. So just to keep you informed, here is a quick post about some resent updates.

Update Quick Search and Recent Patients

1. Quick Search by Current Location

You can now do a quick search by the patients current location. You can search separately on the area/room or enclosure fields or combined as its displayed on the patients record.

2. Two Recent Patients Lists

The recent patients panel on the sidebar now has two tabs. One for recently updated patients and the other for recently admitted patients.

4. Updated the Total Dispositions by Species Report

The Total Dispositions by Species report has been updated to now include the Died +24hr, Died in 24hr, Euthanized +24hr and Euthanized in 24hr dispositions. Previously these dispositions were combined in to Died and Euthanized. Because this is not an official annual report we felt it was important to separate them out.

Updated List to include multiple lists

5. Added List Categories to the List Patients Page

On the List Patients page, that typically lists all the patients paginated in groups of 20, you can now click on the LIST ALL PATIENTS header to see a drop-down list of other lists that you can view. As of right now there are only two lists available (All Records Admitted Today and All Records Updated Today) but I’m sure in the future there will be other categories. These lists will show all the matched records on one screen so that you don’t have to paginate through them.

Updated printing the rechek reports6. Simplified Printing the Recheck Report

We are often asked to allow for printing of all sorts of combinations of the recheck lists and frankly it was getting out of hand. So instead we just simplified printing the recheck list into 2 options. The first is that you now just print the currently listed rechecks. For example; if you want tomorrows clinic rechecks grouped by your patients locations then change the settings to those criteria, the displayed rechecks will update and then you can click the Print the displayed rechecks link.

Updated printing the rechek reportsSecond, we added the ability to print out each recheck group individually. For example you can now print only the Veterinarian rechecks if that’s what you want. To do so, just click the PDF icon next to the recheck group name that you want to print.

7. Datetime Custom Field

We added a datetime custom field type. This may be less exciting but it was needed. This field is just like a date field but it adds two additional fields so that you can also record the time if that’s important for you.

Things That we Are Currently Working On

There are a number of new things that were working on that were hoping to have done soon. Among them are Batch Updating, Importing and Multilingual features.


Donor Report

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Screen Shot 2016-06-02 at 4.07.53 PMYou can now finally export all Donor information. We understand how important donors are to our wildlife rehabilitation community. Without them our community would have a hard time operating.

With the Donor export feature, all information recorded with a Donor can be exported to a spreadsheet. From there, users can organize and search Donors however they like.

Screen Shot 2016-06-02 at 4.08.44 PM

Now, keep in mind that each time you export Donors you will export all Donors. We are not likely to create any special reports for Donors within WRMD’s software. This is why…

As important as the “People” aspect is in our line of work is, WRMD needs to stay a manageable software, not only for our users but for WRMD’s staff and volunteers.  We have had experience with “People” organizing software. These programs, all by themselves, are as large and even more complicated in some cases then WRMD. So, in the spirit of sustainability, WRMD recognizes that it can only do the basics of “People” organizing software.

Our focus and specialty is in the wildlife patients not on organization operations. So, that is where we think we need to put our time, resources and creativity. With that said there are a few common operational characteristics associated with our community, and those needs, we do want to address.