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Electronic Records


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Electronic Records

  1. 1. Electronic Health Records (EHR) in Long-Term Care Copyright © e-Healthcare Systems 2005
  2. 2. Introduction The United States is on the cusp of change in the delivery of healthcare services. On April 27, 2004, President George W. Bush called for the majority of Americans to have interoperable health records within ten years. The first step toward this ambitious goal was to develop a vision and plan. Under the direction of the department of Health and Human Services (DHHS), National Coordinator for Health Information Technology David J. Brailer, MD, PhD, developed a framework for strategic action. Copyright © e-Healthcare Systems 2005
  3. 3. What are Electronic Records? Any resident information stored in a computer is, in sense, an electronic record. However, the terms “Continuity of Care Record (CCR)”, “Electronic Medical Record (EMR),” and “Electronic Health record (EHR)” imply additional characteristics and capabilities beyond just storing data in a database. When the record is limited to a single provider or institution, it can be stored in any convenient format. When the data must be shared with other providers or institutions, standards are necessary for the sender to encode and communicate the record, and for the recipient to decode the record and verify its authenticity. This is an enormously complex undertaking. Copyright © e-Healthcare Systems 2005
  4. 4. What are the Goals for Electronic Records? Electronic versions of records can be well safeguarded, shared efficiently, and used to improve care and are more patient-friendly, reducing the redundancy that many patients perceive when asked the same question each time they see a provider. Before widespread adoption can be realized, however, several conditions must be met: • The records must be guaranteed to be authentic • Unchanged from the time of authentication • Unable to be repudiated by the authenticator • The records must be available Copyright © e-Healthcare Systems 2005
  5. 5. What are the Goals for Electronic Records? Con’t. Moreover, the security requirements of HIPAA are essential minimum standards to ensure that electronic records will be safeguarded, from the technical standpoint. In fact, with adequate system design and maintenance, electronic records will be more secure and available than paper. Also, a lost or destroyed paper record cannot be re-created, while backups permit electronic records to be retrieved. The HIPAA privacy requirements are essential to gain professional and public trust in the electronic record. Electronic records will be safer from casual access than paper records, and evolving technology will reduce the security burden on providers to authenticate their identity for access.
  6. 6. What are the Goals for Electronic Records? Con’t. Sharing records among providers is another benefit of the electronic record. Sharing records with other providers requires records to meet standards that enable the receiving system to make sense of the record (and ensure its integrity, authentication, and non- repudiated status). Standards for records are evolving through groups of providers, academics, and vendors working in structured processes to document, standardize, and promulgate the standards. Electronic record developments will also aid medical research. Many of the difficulties in medical research are a result of privacy issues, inconsistent record keeping, and problems in accessing records. Copyright © e-Healthcare Systems 2005
  7. 7. What are the Goals for Electronic Records? Con’t. Electronic record systems can be designed to facilitate research while suppressing identifying information, consistent with HIPAA access rules. With electronic records, more attention can be devoted to study design and data interpretation and less to the mechanics of data access. The most important goal for electronic record development is improvement of healthcare. Once health records can be accessed from anywhere by authorized providers, providers will be better able to offer superior care, since the patient’s history and current treatment status will be immediately available. Copyright © e-Healthcare Systems 2005
  8. 8. How do Nursing Facilities fit into the Electronic Record Initiatives? Nursing facilities will be significant beneficiaries of electronic record development if the unique characteristics and needs of the facilities are considered in the development of record systems. The nature of information needs in nursing facilities differs from those in acute settings: • Nursing facilities need extensive histories and descriptive information with a relatively small amount of treatment information and provider communication • Acute setting –oriented systems are focused more on diagnosis and treatment and fast, accurate communication of orders and results.
  9. 9. How do Nursing Facilities fit into the Electronic Record Initiatives? Con’t. Nursing facilities trying to implement acute hospital- oriented systems have encountered limitations because of the larger records and longer lengths of stays at the nursing facility. While most standards work to date has focused on the acute-care and ambulatory environments, the interests of long-term care facilities are represented on associated task forces. Actually, the new data-management technologies being applied by CMS, IT vendors, and standards organizations have the potential flexibility to accommodate the needs of all providers. Long-term care’s MDS 2.0 record was an example of standardization using the technology available at the time it was specified: fixed field
  10. 10. How do Nursing Facilities fit into the Electronic Record Initiatives? Con’t. position records. For the upcoming MDS 3.0, CMS has committed to using XML technology to make system changes easier for providers to accomplish and maintain, and vendors will do well to make the same commitment. Also, future versions of the MDS will have to meet the promulgated HIPAA data standards, a task made easier by using XML technology. Once electronic records are accepted in nursing facilities, claims will be easier to compile and backup documentation will be more readily accessible. Wholesale copying of clinical records will be replaced with an electronic transmission.
  11. 11. How do Nursing Facilities fit into the Electronic Record Initiatives? Con’t. The CCR is an intermediate step toward electronic records that can have an immediate impact on nursing facilities. A group of clinicians, health information specialists, and information technology personnel under the auspices of the American Society for Testing and Materials (ASTM International) has developed a draft standard of the CCR that will be reviewed and voted on. The CCR could be implemented in stages – first on paper and then electronically in local communities. This could facilitate communication between hospitals and nursing facilities during transfers and to other providers involved in the referral. Copyright © e-Healthcare Systems 2005
  12. 12. What Standards will Nursing Facilities have to meet? Nursing facilities will have to meet all of the HIPAA requirements for electronic records. Some of these are already in place (transactions and code sets, privacy, and security), while others are still under development (electronic signature, record structure). Since all nursing facilities have at least some clinical data in electronic format, the evolution to electronic records may be less difficult for them than for all-paper healthcare organizations. Copyright © e-Healthcare Systems 2005
  13. 13. A Special case: The Electronic MDS The MDS systems in most nursing facilities contain all MDSs in an electronic format. However, as the situation stands now, the paper copy is the only version of an MDS that is legal for payment or forensic purposes, since no standard exists to: 2. Verify the integrity of the electronic version; 3. Ensure that the person attributed to having signed the MDS actually signed it; and 4. Ensure that the person signing the record cannot deny that the record is the exact record he/she signed. Copyright © e-Healthcare Systems 2005
  14. 14. A Special case: The Electronic MDS Con’t. It is worth noting that HIPAA requires the Department of Health and Human Services (DHHS) to develop an electronic signature policy, and CMS verified that they are close to publishing a proposed standard for this. Copyright © e-Healthcare Systems 2005
  15. 15. What Issues need to be addressed? Technology has evolved to the point that hardware is not the limiting factor for electronic health records. While additional development will continue to improve speed and capacity, the current environment of new processors and equipment for memory, storage, and communication is an adequate starting point. Further development of voice recognition, portable devices, and authentication methods will serve to enhance the acceptance of electronic records. Software programs are the major limiting technical factor. Current systems are vendor-unique, which many vendors trying to offer comprehensive solutions in their own ways. For each product, the user interfaces, data Copyright © e-Healthcare Systems 2005
  16. 16. What Issues need to be addressed? Con’t. structures, and processing flow are closely guarded proprietary property. Professional acceptance of electronic systems has been problematic for all but the most adventuresome or technological sophisticated clinicians. Several large systems for computerized physician order entry have failed recently because physicians reject them as too cumbersome to use. New approaches to system interfaces must be explored. Methods to facilitate the drafting of content, signing the content (authenticating), and correcting errors will have to developed and certified. Public acceptance also must be considered. Patients
  17. 17. What Issues need to be addressed? Con’t. are unhappy if they perceive their clinician spending more time at the keyboard than listening to them! Assurances of the privacy of their information will continue to be necessary, as well. Before facilities can entrust their clinical information to electronic systems, methodology must be developed to certify the trustworthiness of such systems. Questions of liability will have to be addressed – e.g., who is responsible if a resident is harmed by a system failure? Furthermore, the system standards being developed must be implemented by vendors and then certified by an outside agency. Currently, only the HIPAA Transaction and Code Sets standard has a certification mechanism.
  18. 18. What Issues need to be addressed? Con’t. Cost will also be a factor. Current budgets in nursing facilities devote less than 2% of operating costs to information technology, while the hospital sector spends about 5%, and other service industries much more. Lawmakers have proposed various approaches to increasing the use of technology and anticipating significant reduction of medical errors and other savings. However, the savings claimed will not necessarily go to the facility making the investment – insurance companies and fiscal agents experience the most financial benefit from some systems. Nursing facilities can expect to benefit from the use of electronic records through increased efficiency, reduced claim rejections, improved documentation, and more
  19. 19. What Issues need to be addressed? Con’t. informed and coordinated clinical processes. Information technology budgets must be part of the strategic plan for all facilities. Copyright © e-Healthcare Systems 2005
  20. 20. What can Nursing Facilities do now? Nursing facilities will inevitably become a part of the evolving national system of electronic records. President Bush has appointed a health information technology “czar” (David Brailer, MD, PhD) with the mission of developing a strategic plan to upgrade use of healthcare information technology and announced a deadline of ten years for an all-electronic healthcare system; DHHS confirmed this mission. Meanwhile, facility managers and information specialists can participate in local initiatives involving information systems, such as collaborations among hospitals, nursing facilities, and physician offices. When shopping for replacement systems, consider,
  21. 21. What can Nursing Facilities do now? Con’t. plans, and actual accomplishments of potential vendors. Ensure that the vendors you’ve considered have the attitude, commitment, knowledge, and resources to evolve in the changing world of electronic systems standards. Budgets for information systems, including hardware, programs, and personnel, should be reviewed and increased. Copyright © e-Healthcare Systems 2005
  22. 22. The Vision The framework layout of four goals to achieve the President’s vision are: • Introduce information tools into clinical practice • Electronically connect clinicians to other clinicians • Use information tools to personalize care delivery • Advance surveillance and reporting for population health improvement We will focus on the framework’s strategies from the point of view of post-acute and long-term care (PA/LTC) providers. All nursing facilities and home care providers already have made investments in information Copyright © e-Healthcare Systems 2005 technology (IT) to meet regulatory and payer demands.
  23. 23. The Vision – Con’t. Managing the current investments and planning for the additional required investments will be key to providers’ future success. Each provider must ensure that its vendors or IT staff can evolve to meet the emerging conceptual, technical, and operational requirements that interoperable health records will demand. The relevant standards are being developed and tested as we speak. New standards will be proposed, and new technologies will compete for inclusion in the developing system. Providers must budget time, money, and other resources to acquire, operate. And maintain the new systems necessary to continue providing care and billing for services. It is essential to understand the full scope of this massive undertaking to guide the strategic plan for Copyright © e-Healthcare Systems 2005
  24. 24. The Vision – Con’t. each healthcare provider organization. Premature action and/or action without a well-considered and researched plan may be costly. Copyright © e-Healthcare Systems 2005
  25. 25. The Strategy Goal #1: Inform Clinical Practices Informing clinical practice is fundamental to improving care and making health care delivery more efficient. This goal centers largely around efforts to bring EHRs (electronic health records) directly into clinical practice. This will reduce medical errors and duplicate work, and enable clinicians to focus their efforts more directly on improved patient care. Three strategies for realizing this goal are: Strategy 1: Incentive EHR adoption The transition to safe, more consumer-friendly and regionally integrated care delivery will require shared investments in information tools and changes to current
  26. 26. The Strategy – Con’t. clinical practice. PA/LTC providers will need to ensure their needs are considered in planning for the shared investments. Inclusion of PA/LTC in creating legislation and regulations is essential. Private foundation grants also may be sources of support for the transition. Strategy 2: Reduce risk of EHR investment Clinicians who purchase EHRs and who attempt to change their clinical practices and office operations face a variety of risks that make this decision unduly challenging. Low-cost support systems that reduce risk, failure, and partial use of EHRs are needed. Copyright © e-Healthcare Systems 2005
  27. 27. The Strategy – Con’t PA/LTC actually has models for low-cost support systems: the Centers for Medicare & Medicaid Services’ (CMS) excellent RAVEN and OASIS systems, supplied at no cost to providers. These or similar products could provide PA/LTC the minimal support needed at a low cost. Steps could be taken to prevent states from mandating requirements that make the use of federally developed systems impossible in some states, as is the current situation with RAVEN. The government and private organizations can reduce risks by moving aggressively in developing and testing standards for data representation and communication to minimize confusion and changes in direction of systems. Copyright © e-Healthcare Systems 2005
  28. 28. The Strategy – Con’t Strategy 2: Promote EHR diffusion in rural and underserved areas Practices and hospitals in rural and other underserved areas lag in EHR adoption. Technology transfer and other support efforts are needed to ensure widespread adoption. Goal #2: Interconnect Clinicians Interconnecting clinicians will allow information to be portable and to move with consumers from one point of care to another. This will require an interoperable infrastructure to help clinicians get access to critical health care information when their clinical and/or treatment decisions are being made. Copyright © e-Healthcare Systems 2005
  29. 29. The Strategy – Con’t For PA/LTC facilities to benefit, their clinical systems will have to become interoperable with physician-order systems and hospital systems. The reduction in medical errors will accrue when current orders are available for residents transferred in and new physician orders are available from physicians’ order-entry systems. Mutually recognized standards for data representation and communication are the keys to success. The three strategies for realizing this goal are: Strategy 1: Foster regional collaborations Local oversight of health information exchange that reflects the needs and goals of a population should be developed. Local health information networks can begin to be
  30. 30. The Strategy – Con’t developed now with cooperation among healthcare organizations in geographic areas, even though the comprehensive standards needed for national adoption still are being developed. The national system will have to be based on evolutions of current standards. The local benefits both to consumers/residents/patients and to providers could be very positive: reduced errors, more timely care, and reduced costs of documentation and claims processing. Local implementation of the Continuity of Care Record (CCR) would make a difference immediately in transferring patients to and from PA/LTC facilities. Strategy 2: Develop a national health information network Copyright © e-Healthcare Systems 2005
  31. 31. The Strategy – Con’t A set of common intercommunication tools such as mobile authentication, Web services architecture, and security technologies are needed to support data movement that is inexpensive and secure. A national health information network that can provide low-cost and secure data movements is needed, along with a public-private oversight or management function to ensure adherence to public policy objectives. Strategy 3: Coordinate federal health information systems There is a need for federal health information systems to be interoperable and to exchange data so that federal care delivery, reimbursement, and oversight are more efficient and cost-effective. Federal health information systems will be Copyright © e-Healthcare Systems 2005
  32. 32. The Strategy – Con’t interoperable and consistent with the national health information network. Considerable work has been done by the Department of Defense (CHCS I and II) and the Department of Veterans Affairs (DHCP and VistA) with comprehensive systems deployed to more than 500 sites. The agencies are active participants in the standards organizations and freely share their experience with developing clinical support systems. As recognized in the framework, their experience will benefit the national goal and, specifically PA/LTC. Goal #3: Personalize Care Copyright © e-Healthcare Systems 2005
  33. 33. The Strategy – Con’t Consumer-centric information helps individuals manage their own wellness and assists with their personal health care decisions. The ability to personalize care is a critical component of using health care information in a meaningful manner. The three strategies for realizing this goal are: Strategy 1: Encourage use of Personal Health Records (PHRs) Consumers are increasingly seeking information about their care as a means of getting better control over their health care experience, and PHRs that provide customized facts and guidance to them are needed. PA/LTC settings would be great proving grounds for PHRs since residents/clients tend to be recurrent and eventually long term. Communications among the
  34. 34. The Strategy – Con’t various providers involved in a consumer’s care tend to be local in nature, which allows for building on Goal #2’s regional collaboration strategy. Issues of proxy for cognitively impaired clients would have to be worked through, but these clients’ care could benefit greatly from the PHR. Strategy 2: Enhance informed consumer choice Consumers should have the ability to select clinicians and institutions based on what they value and the information to guide their choice, including but not limited to, the quality of care providers deliver. Strategy 3: Promote use of Telehealth (Telemedicine) systems Copyright © e-Healthcare Systems 2005
  35. 35. The Strategy – Con’t The use of Telehealth remote Communication Technologies can provide access to health services for consumers and clinicians in rural and underserved areas. Telehealth systems that can support the delivery of health care services when the participants are in different locations are needed. PA/LTC would also be excellent proving grounds for these technologies. Reducing the burden on residents traveling to physician offices when remote access could adequately serve them will reduce costs and improve care. Emergency care will be better coordinated. And staff will be less likely to err in not contacting physicians on questionable issues. Goal #4: Improve Population Health
  36. 36. The Strategy – Con’t Population health improvement requires the collection of timely, accurate, and detailed clinical information to allow for the evaluation of health care delivery and the reporting of critical findings to public health officials, clinical trials and other research, and feedback to clinicians. Three strategies for realizing this goal are: Strategy 1: Unify public health surveillance architectures An interoperable public health surveillance system is needed that will allow exchange of information, consistent with current laws, between provider organizations, organizations they contract with, and state and federal agencies. Strategy 2: Streamline quality and health status monitoring Copyright © e-Healthcare Systems 2005
  37. 37. The Strategy – Con’t Many different states and local organizations collect subsets of data for specific purposes and use it in different ways. A streamlined quality-monitoring infrastructure that will allow for a complete look at quality and other issues in real time and at the point of care is needed. Strategy 3: Accelerate research and dissemination of evidence Information tools are needed that can accelerate scientific discoveries and their translation into clinically useful products, applications, and knowledge. Systems already are in use in academic settings that assist clinicians with prescribing. Additional tools will be developed that will bring best practices to PA/LTC, as well Copyright © e-Healthcare Systems 2005
  38. 38. The Strategy – Con’t as make information available for research to constantly improve practices of other clinicians, such as nurses and therapists. Development and dissemination of best practices will be improved. Copyright © e-Healthcare Systems 2005
  39. 39. Implications for PA/LTC PA/LTC providers are included as special cases within the framework and have already had significant attention paid to some of their unique needs. A study funded by the DHHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) carried out by the University of Colorado Health Sciences Center examined the current state of use of EHRs in leading-edge nursing facilities. This study found that all of the facilities studied used stand-alone MDS systems, with the EHR based on hospital information systems used by host acute hospital organizations. There is significant opportunity for evolution on the part of nursing facility vendors with new product development. The nature of many PA/LTC residents will require Copyright © e-Healthcare Systems 2005
  40. 40. Implications for PA/LTC Con’t. special accommodations to the framework’s consumer- centric goals. Residents with compromised cognitive abilities cannot fully participate in the personal choice aspects of the future system. And proxies will have to be found to ensure all residents’ welfare. The same residents stand to gain in improved care when information about their current and past health status is electronically communicated among appropriate providers. The regulatory instruments used in PA/LTC require special attention: The MDS used in nursing facilities and the OASIS used in home care do not comply with any of the existing proposed standards for data interchange. ASPE and CMS recognize this and are awarding a contract to study the issue. Copyright © e-Healthcare Systems 2005
  41. 41. Implications for PA/LTC Con’t. The national program’s major impacts on nursing facilities and home care agencies will be the ability to electronically receive medical orders and results of laboratory and imaging procedures. In addition, receiving or transferring a resident will be improved through electronic interchange of information, resulting in more timely care with less opportunity for incomplete information and missed therapeutic actions. Claims will be more accurate and timely, with no record copying to back up claims. Copyright © e-Healthcare Systems 2005
  42. 42. What “Interoperable” actually means The ability to securely exchange clinical, demographic, and financial data that are understood the same way by all users is predicated upon having a method of capturing, storing, and securely transmitting and receiving data. The different users can be using data systems from different vendors on different computer platforms with different user interfaces, but the data’s meaning and format are standardized upon transmission to allow use by other systems as if they were entered from within the system. For example. A nursing facility that may be using a Pentium-based microcomputer network running NetWare with Windows XP workstations, a proprietary Copyright © e-Healthcare Systems 2005
  43. 43. What “Interoperable” actually means Con’t. software package, and an Oracle database could receive medication orders from a physician using a Palm handheld computer running the Palm operating system and another proprietary software package. The order is entered and formatted on the physician’s system and transmitted to the nursing facility’s system, where it can be verified and acted on by the facility nurses without having to reenter the order. The nursing facility could forward the order to the supporting pharmacy, which may be running other software on another hardware, but it doesn’t matter – the pharmacy can receive and act on the order as if it were entered from within its system, fill the order, and deliver the supply to the nursing facility. Copyright © e-Healthcare Systems 2005
  44. 44. What “Interoperable” actually means Con’t. The chances of error are decreased, the speed of action increased, and the resident’s safety improved. Standardization of data meaning and communication makes interoperability possible. Copyright © e-Healthcare Systems 2005
  45. 45. Basic Criteria for Software • User-friendliness • A Windows-based operating system • Flexibility • A capability for generating reports • Vendor support services • Reasonable hardware requirements • Good technical support • Affordable purchase and maintenance fees • HIPAA compliance Copyright © e-Healthcare Systems 2005
  46. 46. Qualifications for outside project coordinator • An intimate knowledge of clinical processes • A thorough understanding of the MDS • A big-picture vision and the ability to add the details • An understanding of clinical impact on financials • Independence and initiative • Excellent communication and relationship skills for interaction with internal and external customers and colleagues • The ability to learn quickly • A broad understanding of reimbursement systems Copyright © e-Healthcare Systems 2005
  47. 47. Qualifications for outside project coordinator Con’t. • Excellent computer skills • prior use of a clinical EHR system • Knowledge of CNA documentation Copyright © e-Healthcare Systems 2005
  48. 48. Heartbeat Clinical Its Time Has Come! - Heartbeat - e-Healthcare Systems Copyright © e-Healthcare Systems 2005
  49. 49. Heartbeat Clinical Its Time Has Come! Heartbeat Clinical introduces you to the future of software, offering your facility a total management program that will never need rewriting or replacing. As technology changes Heartbeat Clinical software will only need to continue evolving alongside of these developments updating your facility via Internet uploading with the newest forms of communication and information systems as soon as they become available. Heartbeat Clinical is a 21st century software program for the clinical documentation in the Long Term Care Industry. Copyright © e-Healthcare Systems 2005
  50. 50. Heartbeat Clinical Its Time Has Come! Cont. Presently 65,000 nursing care facilities in the United States face the 21st century. Competing for new residents, a facility needs to be on the cutting edge of technology. Heartbeat Clinical offers you a new software program that will change the way you work, enabling you to be more productive and to cut support and training costs, saving you time and money. Our new software includes many features that will astound you and yet be simple enough for easy learning by your staff. Copyright © e-Healthcare Systems 2005
  51. 51. Heartbeat Clinical Its Time Has Come! Cont. A leading-edge “help” technology is incorporated to better aid your staff in understanding screen performance and functionality. Open Source Software Health care leaders now are considering open source software because it allows different IT systems to operate compatibly and gives health care providers more options and flexibility. It helps healthcare providers overcome the problem of incompatible IT Systems that can disrupt the smooth exchange of information. Copyright © e-Healthcare Systems 2005
  52. 52. Heartbeat Clinical Its Time Has Come! Cont. The potential advantages of open source software in health care are many. One of these is that it ensures correct and timely implementation of standards. The creation of technology standards that define how information is structured, defined, and exchanged is critical because successful health care information exchange depends on them. The mandate for Health Level 7 (HL7) in electronic medical records has enabled different computer systems to work in a compatible environment. Open source software is truly compatible with HL7 for electronic medical record systems. Open source software generally supports standards whenever and wherever they are relevant.
  53. 53. Heartbeat Clinical Its Time Has Come! Cont. Other benefits of open source software are the opportunity to innovate, provide higher quality, improved efficiency, and effective software for the healthcare industry. Conditions are fertile for open source solutions to take root in health care. Awareness of open source development models has become widespread among health care providers. It is our effort to create mature, rational, shared components that work with each other and to promote a common understanding of essential data structures in a context institutions will nurture. Copyright © e-Healthcare Systems 2005
  54. 54. Heartbeat Clinical Its Time Has Come! Cont. Internet-Intranet Approach The Health Care industry has been traditionally slow to embrace new technologies, but this is now changing: Contemporary Long Term Care, a trade magazine for the Long Term Care industry, dedicated an entire section in the October 1999 issue to the integration of new computer technologies to improve the flow of information. Internet technology makes software more user friendly. A browser offers a familiar user interface that is easy to learn and can cut training and technical support costs. Copyright © e-Healthcare Systems 2005
  55. 55. Heartbeat Clinical Its Time Has Come! Cont. Heartbeat Clinical is able to take advantage of instant software updates through the Internet, user intervention, thereby eliminating installation costs. Government regulations and requirements are changing constantly, so a timely software -update is crucial for a health care facility. All software will be ultimately based on Internet-Intranet technology. Copyright © e-Healthcare Systems 2005
  56. 56. Heartbeat Clinical Its Time Has Come! Cont. Nursing Homes across America are becoming better equipped with computer technology but the lack of sophisticated software systems have been a barrier to justifying the need and cost for this technology. Sophisticated Intranet software is yet to be offered by the majority of software vendors. THE SOFTWARE PRODUCT Heartbeat Clinical is an innovative Clinical Records software product for the Health Care Industry. Copyright © e-Healthcare Systems 2005
  57. 57. Heartbeat Clinical Its Time Has Come! Cont. Heartbeat Clinical is built on Open Source PHP, HTML (Hyper Text Mark-up Language), XML, Perl, Java and uses Macromedia's Flash for it's unique interface. The program is optimized for Microsoft's Internet Explorer or Mozilla FireFox, but can run theoretically in any browser. The software will be supplied as a stand-alone, SaaS and/or ASP. The program will require an Intranet (a local Internet that can only be used by authorized users and is not accessible by the public) consisting of a dedicated server. As a database we will be utilizing the MySQL compliant database. Copyright © e-Healthcare Systems 2005
  58. 58. Heartbeat Clinical Its Time Has Come! Cont. Because of the Heartbeat Clinical Internet architecture which is fully scalable there is no limit to the number of clients. Heartbeat Clinical is a software program that is unique in the way it utilizes the latest advances in internet technology. Its flexible architecture allows for easy integration of newly mandated government regulations and facility specified requirements. Copyright © e-Healthcare Systems 2005
  59. 59. Heartbeat Clinical Its Time Has Come! Cont. Many Features: • Open Source • Permission Based • HIPAA Compliant • User ID & Password Protected • Over 300+ Forms • Policy & Procedure Documents • Resident Picture on all screens & forms • Color Coding of MDS • Color Coding of RAPS • MDS Triggers • MDS Transmission Copyright © e-Healthcare Systems 2005
  60. 60. Heartbeat Clinical Its Time Has Come! Cont. Many Features: Continued • Faxing & email capabilities • Quality Assurance • HIPAA Risk-Gap Analysis • Quality Indicator Profiles • F-Tag Documentation • Nursing Math • Intravenous Drug Specifications • Drug Therapy • Drug Interactions • CNA Documentation Copyright © e-Healthcare Systems 2005
  61. 61. Heartbeat Clinical Its Time Has Come! Cont. Many Features: Continued • EMR (Electronic Medical Records) • Dietary Tables • Vial Expiration Dating • Physician Orders • Care Plans • ICD9/10 Coding • Inventory Control • Staff Scheduling • Staff In-Services Documentation • Educational Courses • Vitals Documentation Copyright © e-Healthcare Systems 2005
  62. 62. Heartbeat Clinical Its Time Has Come! Cont. Many Features: Continued • Resident Trust Fund • Financials • Database Entry/Edit (MySQL) • Procedure Videos • HL7 Compliant • Length of Stay • Weight Log • Resident Discharges, Archiving, Re-admit • Task Manager • Risk Management • Wound Care • Many other features!
  63. 63. Heartbeat Clinical Its Time Has Come! - Heartbeat - e-Healthcare Systems