the physician/provider portal & cpoe portal suite€¦ · • the physician/provider portal...

THE PHYSICIAN/PROVIDER PORTAL & CPOE PORTAL SUITE

PROVIDES PHYSICIANS & PROVIDERS WITH AN EFFICIENT, FAST, COMPREHENSIVE, INTUITIVE, POINT OF CARE APPLICATION TO ENHANCE CLINICAL DECISION MAKING

1304 West Walnut Hill Lane Suite #240 Irving, TX 75038 | Phone: 469.586.3317 | Fax: 214.292.8841 | Email: [email protected] | www.shamsgroup.comV2.7

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LOrganizational Challenges – Physician/Provider Portal

One of the biggest challenges of any Hospital Information System is to present a complete account of patient health experiences in an accurate, organized, concise electronic health record.

Three types of Organizational Challenges exists in the hospital environments. They are:

Physician/Provider Workflow

• Data Sets and documents from many applications must be combined and housed in one place.

• Information is often fragmented forcing the user to go to more than one computer application

plus check the paper chart to obtain vital data regarding the patient’s current health status.

• This takes valuable time away from where it is needed most; providing quality patient care.

Disparate Messages

• Some patient information is electronic, in various applications and some information is on

paper.

• The Physician/Provider must spend a significant amount of time obtaining information;

treatment is delayed, and life saving measures could have been identified and performed

sooner.

Fragmented Chart

•If results are not displayed in an organized, concise, complete, and accurate manner then the

patient is at risk. Information may be missed resulting in misdiagnosis and mistreatment.

•The Physician/Provider may not see critical values if they are not flagged as abnormal in a way

that draws attention and is easily viewable.

Patient Safety Risk

My Patients View Alerts Results Review

Decision Making

Enter Orders

Outcome

31304 West Walnut Hill Lane Suite #240 Irving, TX 75038 | Phone: 469.586.3317 | Fax: 214.292.8841 | Email: [email protected] | www.shamsgroup.com

THE SHAMS GROUP

Nurse Reports & Nurse Trending

Rad and Pac Images

Lab Reports & Lab Trending

Scanned Documents & Other Images

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Physician/Provider Portal & CPOE Portal Suite

The Physician/Provider Portal & CPOE Product Suite is delivered complete with the fully-functional components below:

Physician/Provider Portal & CPOE Portal Suite

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Physician Central Homepage

Legal ECM /Chart Deficiency/Chart

Management

Results Review/Clinical

Decision Support

Computerized Provider Order Entry

(CPOE)


Reference Links

Alert Manager

Advanced search

Secure Messaging

Rounds Reports

Patient List

Multum Knowledge Base

Features & Functions

Point of Care (POC) Alerts

Medication Reconciliation

Order Management System (OMS)

Administration Tool

Order Integration Engine

Reports & Analytics

Allergy List

Clinical Decision Support

Problem List

Annotation

Delinquency List

E-Sign

Addendums

Deficiency List

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LAbout Physician/Provider Portal

• The goal of the Physician/Provider Portal is to provide physicians with an efficient, fast, comprehensive, intuitive, point of careapplication that will enhance clinical decision-making, provide for patient safety and improve the quality of patient care.

• The Physician/Provider Portal integrates any form of data, whether paper or electronic, and displays it in any web-based browser foreasy maneuverability. The result is a unified patient electronic health record that is easy to use and maximizes the view of patientinformation.

• To accommodate the unique needs of each hospital, personalization of the Physician/Provider Portal is available: from homepage/dashboard layout, internet links, secure messaging, tab/page order, web part application display, to the date/time filter for eachtab, and much more.

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Features

• Point and click access to Admissions, Laboratory, Radiology, Transcription, Pharmacy, Order Entry, and Clinical Documentation information, plus scanned documents, PACS and other images/ recordings or any other interfaced application

• The Current Status tab – Last 24 hours of Laboratory, Radiology, Reports, Medications, Allergies, Vital Signs, and Intake and Output data displayed on one page.

• Color coded alert flags on the patient lists and results

• Alert Manager – view all your patient’s critical results on one page

• Two-way integrated secure messaging between physicians and medical records staff

• Ability to read, approve, and e-sign patient documents in one system

• Alerts for delinquent, ready to approve, and ready to e-sign documents

• Ability to access reference information on-line from the same application

• Designed by physicians for all healthcare providers, with ease-of-use and built-in personalization capabilities

• Personalization available to accommodate the unique needs of each hospital

• System utilization and audit reports available

• Print capability from any tab/page/web part

• Scalable, portable, easy to deploy, and much more

Key Strengths

• Private and confidential viewing of comprehensive patientinformation from hospital and/or off-site locations, such ashome, physician’s office

• Easy to use, intuitive, web-based, browser front end

• Customization and personalization available

• Integration with Meditech and any other Hospital InformationSystem

• Dictionary synchronization with Meditech (including MIS)

• Alert notification

• Real time patient information

• Unifies the electronic health record


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Physician/Provider Portal Usability

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Medical software is often hard to use, causing productivity to drop. The SHAMS Group puts usability at the center of ourhealthcare software development process. Our usability experts ensure that people who use your system don’t need to besoftware experts.


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EPhysician Central Homepage

• My Patient Lists – the physician has several list criteria to choose from – customizable

• Alert Manager – view all critical, abnormal, or new results for My Patients from one central location

• Rounds Report – view/print a list of My Patients, My Groups Patients, or as a covering physician

• Deficiencies – E-sign, addend documents

• References Links – research drug or disease treatment information

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Home Page/Dashboard/Physician Central


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• Date time frame selection or use the default

• Select results and view on single or multiple graphs

• View spreadsheet format and graph on the same page


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Results Review - Patient Information Content

• Last 24 Hours of Patient Information – patient’s present health status at a glance – on one page

• The number of web parts and content contained on this page is configurable to the unique needs of each facility

• Note the tabs available for review of results, reports, and clinical documentation

• The Marquee notifies the physician of Alerts and Delinquent documents


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The biggest challenges for any organization is physician adoption of CPOE technology. Secondly, how effective is the CPOE

workflow across key stakeholders like Nursing and Pharmacy? Lastly, is it built on Intelligent Clinical Decision Support?

Following are some key questions to ask for CPOE success in a hospital environment:

CPOE Workflow

• Is CPOE browser-based & easy to use like ‘Google’ technology?

•Does it behave the way a physician thinks?

•Can it be personalized for various types of physician specialty?

Physician Adoption

• Is the CPOE product built on a collaborative architecture which includes

nurses and pharmacy?

•Does CPOE product come with real-time dashboards for nurses and pharmacy

for order and workload management to enhance patient care and safety?

CPOE Workflow

• Is the CPOE built on a true clinical data repository with intelligent alerts?

•Does the CPOE uses best available knowledge base platform in the

marketplace?

•Can order sets based on diagnosis be sent to order templates with minimum

keystrokes?

Intelligent Clinical Decision Support

Patients List

View Alerts Results Review

Clinical Decision

CPOE Orders

Outcome


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About Computerized Provider Order Entry (CPOE)

• Reduction in medication errors at the point of entry reducing patient risk

• Increased patient safety with robust alert checking system

• Increased provider efficiency in a single view(orders are entered while viewing results/reports)

• Improvement in patient care (tells a patient story)

• Unification of patient chart via Portal technology with full interoperability

Features

• CPOE is conveniently launched at the patient level from the

Home page or from any page within the portal – no

additional login is necessary

• Current Orders and Current Medications are in view while

entering new orders

• Personal order sets created by the physician plus standard

order sets and protocols may be utilized

• Medication orders are transmitted to Pharmacy with all

alerts that physicians saw for processing

• My Orders Queue contains the last N days of orders this

physician has entered so that reorder, renew is easily

accomplished

• Orders are placed in a ‘shopping cart’ until submitted, just

like ‘Amazon.com’

Key Strengths

• Browser drive, intuitive, and easy to use

• Robust functionality

• Improves patient safety

• Extensive clinical decision support

• Ability to link health issues to orders

• Alerts at result, medication, allergy, and disease level

• Orders interfaced to the ancillary systems

• Personalized at the user level or by role


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CPOE Usability


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CPOE Features & Functions


TSG’s CPOE Base System Software is built on Microsoft .NET Framework with web part modules that sits on a real-time MS SQL based clinical data repository (CDR) that consolidates data from a variety of clinical sources to present a unified view of patient orders.

• Enter Orders – All order types supported with real-time integration with ancillary applications

• Enter Rx – All Medication orders with real-time integration with Pharmacy Module

• Alert Point of Care (POC) – Point of care alert checking for medication orders

• My Order Sets – Use standard or personalized order sets and protocols

• My Orders – Orders entered by this use in the last N days – review, reorder, renew

• Manage Order Sets – upload already created order sets, upload order sets from evidence based order set vendor, create

custom order sets or use our order set partner Order Optimizer

Enter Non-Rx Orders

Enter Rx Orders

PO Alerts

Order Sets Protocol

My Orders

Create Manage Order Sets

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SCPOE Base System – Standard Functionalities - Enter Orders


• Category, mnemonic, description, and wild card type ahead procedure search

• Current Orders are in view while new orders are entered

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XCPOE Base System – Standard Functionalities - Enter Rx


• Drug search by Drug, Therapeutic Category, or Disease

• Selection of most commonly ordered drug strength and route

• Drug to disease, result, allergy, lactation, and pregnancy alert checking

• Current Medications are in view while new orders are entered

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CPOE Order Management System (OMS)

OMS is a dynamic component of CPOE designed for Nurses for reviewing and completing orders that lackcertain data filed that are needed for placing final order in the ancillary system. Since most orders havedata requirements above and beyond what a physician is willing to enter, the OMS module provides aworkflow for orders that require nurses attention plus gives them a status dashboard on where things are.Team collaboration and communication is enhanced utilizing CPOE’s Order Management System (OMS).Physicians, clinicians, pharmacists, and clerical staff work in unison to complete the order in a highlyautomated and evidence-driven manner. The patient benefits from prompt diagnosis and treatment.Hospital length of stay and costly errors are reduced.

• Functions include the ability to:• View, edit, complete, verify, renew, reorder, review, acknowledge, cancel, hold, resume deactivate,

reactivate, and discontinue orders• Workload Management System - nurses and unit clerks have tab access and functions defined by role• Acknowledge Orders tab – site parameter whether Acknowledge is necessary• Renewable Orders Queue• Review Orders Queue• Transmitted Orders Queue• Hold Orders Queue• Search orders tab• My Orders Queue for physicians• All new orders placed that day may be viewed on one screen via the transmitted orders tab.• The nurse may check all new orders for his/her patients and ensure they have been carried out.• Orders that are coming up for renewal or review are conveniently located on one tab


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CPOE Point of Care (POC) Alerts

TSG can effectively and fully leverage any clinical evidence based

knowledge base the facility utilizes – Drug database content and alert

checking capabilities would include:

• Drug-to-drug interaction • Drug duplication • Drug-to-disease interaction • Dose range checking • Drug allergy and allergic cross-reactivity checking • Side effects by organ and frequency and backed up by detail case studies and

medical literature• Pharmacology information• Pharmacokinetics • Pregnancy and Lactation precautions


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NCPOE Medication Reconciliation

• As defined by TJC is ‘the process of comparing the patient’s current medications with those ordered for the patient whileunder the care of the hospital’. The reconciliation is done to avoid any discrepancies, such as, omissions, duplications,adjustments, deletions, and additions. It should be done throughout the continuum of care:

– at the time of entry to the hospital or admission,

– when the patients care is transferred within the hospital

– when a patient is referred or transferred from one hospital to another or

– when a patient leaves the hospital care


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CPOE Medication Reconciliation – Discharge Meds


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SCPOE Medication Reconciliation – Transfer Meds


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NCPOE Medication Reconciliation

Elements of Performance

• Complete list of the medications the patient is taking at home (including dose, route, and frequency) is created anddocumented)

o The patient and the family, as needed, are involved in creating this list

• The medications ordered for the patient while under the care of the hospital are compared to those on the list created atthe time of entry to the hospital or admission

• Any discrepancies (that is, omissions, duplicates, adjustments, deletions, additions) are reconciled and documented whilethe patient is under the care of the hospital

• When the patient’s care is transferred within the hospital (for example, from ICU to a floor) the current provider(s) informsthe receiving provider(s) about the up-to-date reconciled medication list and documents the communication


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CPOE Order Integration Engine

This integration engine delivers real-time integration communication to all appropriate ancillary applications as well as TSG’sGalacticaRx and Chart Deficiency applications if available.

• CPOE orders integration engine is capable of providing bi-directional interface with any HIS or other vendor systems. ForMeditech, interfaces come pre-built with no Meditech Involvement

First Integration – Session LevelTSG pre-builds the CPOE portal with all HIS applicable user names and passwords, dictionaries, and tables so that it issynchronized where the user can log into the portal using the same username and password. IS staff is not required tomanage the passwords and therefore no effort is required.

Second Integration – Transaction LevelTSG integrates every single data element (both structured and non-structured), including Custom Defined Screens (CDS) andfields from the HIS into the Portal for selected application. TSG’s unique integration engine extracts, transforms, and loadsreal-time data into portal’s clinical data repository (CDR) from HIS applications such as ADM, OE, PHA, LAB, RAD, NUR, etc.

Third Integration - Database LevelTSG synchronizes your HIS MPI with Portal MPI to offer a high degree of MPI redundancy and functionality. The integrationengine also comes with a web module for managing all interface communication with full alert capabilities for high interfaceperformance.


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CPOE Administration Tool

CPOE configuration is highly robust and flexible module. It consists of security administration, user preferences and

personalization and other tables and dictionaries for CPOE management. By utilizing this module the IS staff can configure the

application and workflow to meet its needs:

• Security Administration: By entity, role, location, group, etc

• Personalization: This is available at various level. You can personalize for each physicians or physicians specialty or groups.

Clinical decision support views, order sets and orders templates can all be personalized at any of the above level

• Pre-built dictionaries from HIS system for Username/PW, provider, locations, service, all procedures, etc. Option exists for

keeping these dictionaries synchronized between the HIS systems and CPOE application


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CPOE Reporting and Analytics

CPOE comes with advance reporting tool using Microsoft Reporting Services and Data mining and Analytical Services tool. It also

has an option for Microsoft SharePoint Portal.

• Many pre-built reports are provided with CPOE Portal

• Reports are easily generated in different output formats such as PDF, Excel, TIFF, etc

• OLAP cubes can be used for data mining and slicing and dicing information

• Single or multiple user audit trail reports are available at your fingertips

• All reports may be exported/printed and/or saved for future reference

• Reports may be automatically generated and scheduled to e-mail to multiple addresses

• All data is available in real time

• Report audit trail available – report ran, user, date, time, etc

• User access is definable - assign specific reports to a user


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ISTCPOE Medication Allergy List

• The Allergy List enables the user to electronically record, modify, and retrieve a patient’s active medication allergy list as well as medication allergy history for longitudinal care.

• The default is to Active Allergies; inactive allergies may be viewed with one click.

• Free text allergies may be added and are color coded.


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TSG EHR Suite provides the capability to maintain an up-to-date problem list of current and active diagnoses, symptoms, conditions, findings, etc., based on ICD-9-CM to enhance care delivery and outcomes.

CPOE Problem List


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• The system provides

– a parameter to allow the physician to select all documents to sign without viewing the charts in the system (TSG Audits this feature)

– a parameter which mandates the physician to view the chart before completion

– a feature to display a warning message alert to the physician regarding the number of charts that will become delinquent based on the criteria specified

– a way to display indicators to the physician when a chart is deficient and delinquent

The dashboard provides clinical documentation that has been archived from various systems to review a patient’s legal chart and identify how many deficiencies are pending for completion. The dashboard also allows the physician to review charts within their physician group based on the facility workflow requirements.

• The system provides

– the ability for a physician reject a deficiency and add a rejection reason

– a comprehensive Search Criteria

– sorting Features on fields

– easy navigation through screens

– secure messaging

– Discreet Transcription Editing

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Physician E-Sign Discreet Editing


Discrete Transcription Editing provides the ability to Physicians and other clinicians such as Physician Assistants and Nurse

Practitioners, to edit documents before they electronically signed in Physician/Provider Portal.

Users will have the ability to edit discrete documents and annotate image documents prior to e-signing them in the portal. They

will be able to perform edit and e-sign actions from any tab that contain these documents such as– Reports, Radiology, Lab

Pathology etc.

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Clinical Decision Making

Enough information has been gathered to make an informed decision:

Critical, abnormal and new Laboratory results

PACs images and radiology reports

Consultation reports

Clinical documentation (vital signs and intake and output)

Lab and clinical documentation have been seen in trend view for quick assessment

Now it is time to enter orders and expedite patient care


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Physician/Provider Portal & CPOE System Diagram


GE-EKG

Medical Record Cleanup (MRC)

Enterprise-Wide

Master Person Index (EMPI)

ASTROIntegration Engine

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How To Arrange a Product Demonstration

Questions ?

Demonstrations of the Physician/Provider Portal & CPOE Portal Suite can be scheduled in either of the following ways:

• [email protected]

• 469.586.3317 Phone

• www.shamsgroup.comWebsite Address

Please feel free to contact us by either method above and we will be most happy to answer any questions you may have.
