Functionality

Patient Modules

Pre-Admission

In the hospital environment, the pre-admission component in EHS allows for much of the patient information to be collected prior to admission to hospital or organisation. The module also permits pre-admission tasks to be performed which may shorten of streamline a subsequent inpatient episode. The work done during the pre-admission period can reduce pre-operative bed days and alerts clinicians to any abnormal rest results prior to admission. Once potential problems are identified, early intervention reduces the risk of late cancellations.

The Pre-Admission component of EHS encompasses all of the processes commonly occurring during an inpatient stay including:

  • Patient information capture
  • Patient education
  • Pre-Admission investigations such as Pathology, ECG or Radiology
  • Observations

Admissions, Discharge & Transfers

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The Admissions, Discharge and Transfers screens allow the user to manually admit, discharge and transfer a patient as required. All patient movements are date, time and author stamped to provide a record of each movement.

The Transfer screen will allow transfer between Wards as well as between beds on a specific ward with a comments field related to the reason for the movement.

Patient Lists

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Accessing Patient Information by ward/ unit is easily enabled through selecting the Patient List which provides a snapshot of each patient and their details including Medical Record/ Unit Number; Surname, Given Name, Sex, Bed Number, Allergies & Alerts, Handover Comments, Status of Discharge medications, Outstanding Clinical Messages, Bed Comments, Medical Officer, Diagnosis, Admission Details, DOB, Age, Length of Stay, Medical Fund details.

Clinical Order Entry

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The Order Entry screens enable the automation of ordering for any given patient and remove the need to complete a printed form. Paperless ordering reduces the chance of order forms being lost or misplaced.

Order Entry screens are available for both patient and non-patient orders, to place new orders or to update the status of a current order. A snapshot of all orders is displayed. The status of an order is easily checked, avoiding inadvertent duplication. Orders can be placed to a range of departments within the hospital including pathology, radiology, medical imaging, blood bank, ECG and other departments.

Results Reporting

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The Results Reporting function retrieves results from provider systems through a direct electronic interface and adds the results information to the patient's medical record.

Authorised clinicians can access results from any connected location. Abnormal results are flagged and alerts are provided where results have not been read. Subsets of results can be selected avoiding the need to scroll through all the available results.

The Results Reporting function captures and displays, or 'plays back', all types of documented results be they in text, graphics, images, audio or video form.

Contacts

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The contacts directory provides an up to date listing of relevant clinical contacts reducing the need for staff to be searching around for contact information. The listings enable clinicians to outline when they can and cannot be contacted including out of hour's availability.

Medical History

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The Medical History component of EHS is a comprehensive record of the patient's current physical health taking into account their history and stated background.

The Medical History screens capture both medical history information provided by the patient and clinical assessment information provided at the time of admission, including pre-existing medications, care needs and social circumstances.

Progress Notes

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The Progress Notes component provides a set of screens for recording clinical notes about the progress of the patient's care. The use of Care Guides means that only variances have to be manually typed into progress notes, reducing the volume of documentation while increasing legibility while freeing up staff to complete other tasks.

Progress Notes information about each patient's care is integrated and easily accessible. Some of the information displayed in the Progress Notes screen is a reflection of data entered elsewhere thereby minimising duplication.

Progress Note entries include an "action" or "no action" label. The flagging of actions required ensures that active care of each patient is ongoing and reduces the risk that important tasks are missed. Legible, chronological, multi-disciplinary, auditable, (time stamped, date-stamped and clinician stamped) and cannot be retrospectively changed. This provides a safer alternative to paper based progress notes.

EHS progress notes support annotated line drawings – lung fields, body images and cardiac anatomy.

Medication Reconciliation

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EHS supports inbound and outbound medications and medications reconciliation. Medications are documented on Admission to Hospital and on Discharge.

EHS records the following: - Drug Name, Dose, Frequency, Ceased, Date Ceased and Comments

Allergies & Alerts

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Within the allergies screen, users can enter multiple allergies in three main groups of Drugs, Food, and Other (substances). Multiple alerts can also be added for each patient including information on the alert:-

  • Episodic or Not
  • Alert Type – Clinical, Administrative, System
  • Alert Group
  • Alert Sub-group
  • Start Date and time
  • Stop Date and time
  • Comments

Changes are date, time and author stamped for tracking.

Care Guides

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Patient Care Guides are multi-disciplinary patient care plans based on best evidence based practice for a specific patient population with a particular diagnosis or procedure. The Care Guides are in effect, a cascade of events or activities which the clinical team expect the patient to progress through during a given episode of care. The Care Guide is based on the procedures involved in the patients' care, their individual requirements and their history.

Patient Care Guides differ from practice guidelines, protocols and algorithms in that they are utilised by a multi-disciplinary team and have a focus on quality and the coordination of care. Patient Care Guides simply focus on achieving the milestones in the care delivery process in the order that they occur. . EHS care plans can be single discipline (for example, Nursing) or multi-disciplinary (medical, nursing, allied health) and be based on either standardised care for clinical conditions (for example, hips, knees, cataracts) or support the specific requirements of individual clinicians.

An important feature of the way that the Patient Care Guides are implemented in EHS is the way they can be dynamically and intelligently merged in cases of co-morbidity. The merging process eliminates duplication of activities and places the combined activities and interventions in the correct order.

Risk Assessment

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The risk assessment component is a pro-active risk profiler which helps staff to identify patient care risks and provide alerts in the medical record. This reduces possible complications associated with an episode of care.

The risk assessment profiler uses the Waterlow Scale for assessing pressure care/ skin integrity but can be altered to reflect your organisations choice of other scales such as Braden or Norton.

Occupational Health &Safety risks are highlighted; consequently incidents can be avoided by managing high-risk patients differently.

The risk assessment screen has mandatory fields which must be completed before moving on. This reduces the possibility that risks are missed.

The clinical risk assessment component provides assessment tools for the following:

  • Falls risk
  • Manual handling
  • Pressure &skin integrity
  • Infection risk
  • Behavioural risk
  • Nutritional risk

The score generated provides a more objective calculation of "risk to patient safety". Score rankings prompt risk prevention strategies relevant to that patient's condition. Once a risk profile has been updated, many of the risks associated with a particular patient are displayed in other screens and appropriate actions and interventions are automatically added to the care guide. This ensures safety procedures are initiated as necessary.

General Assessments

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EHS supports the complete range of assessment tools. For example, comprehensive nursing assessment, Braden, Falls Risk, ADL's, malnutrition, NOCC (Mental Health), Mental State Exam and Allied Health Assessments. Additional EHS assessments can be configured by health units to meet their specific clinical service requirements.

Clinical Messaging

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The Clinical Messaging module provides a secure communication facility between members of the care team that links the message to particular patient records. This form of messaging improves communications by ensuring that specific messages are delivered and acknowledged by the relevant team members reducing time wasted looking for people.

The capture of the messages provides a permanent record of communications, which can be recalled later for verification if the need arises.

Quick Ward Rounds

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Provides the clinicians with the ability to quickly write notes for a group each particular patient in the hospital for a particular clinician or Specialty (i.e. Dermatology Patients under a particular Consultant) in a ward round situation. The Clinician writing the notes does not have to go in and out of each particular patient notes but can document on one page which will write to each patient's notes. This ability promotes the use of progress notes due to the efficiency of this process.

Observations

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The Observations screens provide for the capture of patient observations and graphically show trends over time. The graphical presentation of recorded observations can be easily read and interpreted, making trends easier to identify and address. Parameters - such as high or low blood pressure - can be set specifying what action is to be taken once those parameters have been breached.

Wireless Observations using specific wireless enabled equipment are also part of the functionality within the system.

Diets

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Individual diets can be selected from the menu for each patient. Specific food allergies, reactions and comments are included. There is also a field for any specific diet information relating to a particular diet type.

Labour & Birth Record

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The labour and birth module is a series of screens which includes a full maternal history, record of labour, pain management & anaesthetics, birth of baby, third stage, full statutory reporting, and progress notes.

EHS Maternity is a proven time saving module as it captures all of the information throughout the labour and channels it into the appropriate reports reducing duplication of effort and allowing Midwives to spend less time on paperwork.

EHS captures a comprehensive record of mother and baby details and the care provided to both mother and baby. The data captured makes it possible to track indicators of health and to update patient care from pregnancy through to labour and delivery. EHS also incorporates a comprehensive partogram.

Maternity Assessments

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A proactive risk profiler that alerts and avoids possible complications associated with an episode of care. The tool tries to identify risk factors that may increase the episode of care unnecessarily and calculates a score for each individual patient.

General risks include – Falls, Manual Handling, Pressure Risk, Infection Risk, Pre-existing Rx, Behavioural, and Nutrition. Specific maternity assessments to meet the specific clinical service requirements are also configured by the individual maternity unit.

Maternity Reporting

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The range of Maternal Reporting is extensive including statutory reports. All of the data has been captured throughout the labour & birth and is automatically translated into the required reports. Examples include Birth Summaries, Number of Births, Maternity Statistics and Clinical Indicators reports.

Appointments

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EHS appointments are set up to allow the booking of outpatient clinic appointments. Scheduling enables the administrator to set up multiple clinics by date and time while allocating clinical staff against each clinic. Multiple clinicians can be allocated to each clinic session as required and can be linked to a particular doctor as in the case of medical students attending clinical rotations.

Clinics can be set up in blocks or individually with differing time slots and length of time slot.

Patient bookings can be made against appointments and the flow monitored including appointment confirmation, arrival, departure, cancellation, reason for no show. A link exists to medical records to request paper records as required in advance of each clinic.

Administrative staff can view available appointment slots for a particular clinic and make bookings.

Mass Casualty Incident

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In the event of a major catastrophe/ disaster, the MCI page allows for the triage and documentation of all patients received at the hospital. There is the ability to also keep actions that have been undertaken during the event recorded.

Referrals

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A range of departmental referrals can be set up according to hospital requirements. These can be tracked within a referrals and search screen as well as by individual patient.

Specialist Letters

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This specialist letter module allows the user to write letters to specialists via HL7 secure messaging.

Discharge Summaries

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The Discharge Summary facility generates a report at the time of discharge summarising what took place during an episode of care, which is sent to appropriate clinicians involved in the ongoing care of the patient.

The discharge summary screens use a comprehensive set of dropdown lists avoiding the need for manual entry of already recorded information. Staff completing the discharge summary is prompted not to leave out important information. Additional referral screens can be used to provide specific information to clinicians providing care once the patient is discharged.

Nursing Referrals

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EHS Nursing referrals provide documentation of the patient stay including important information regarding the admission and any further information to assist as a baseline for the local community nurse or doctor where there may be no discharge summary.

GP Connect

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When a patient is admitted or discharged from hospital, an HL7 message will be transmitted between the patient's GP and the hospital advising them of the patient status. This enables the GP to be aware of the patient progress, patient history, current medication, procedures and other important clinical information providing improved patient outcomes.

This information forms part of the PCEHR.

PCEHR Connect

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EHS is now connected to the PCEHR in Australia giving the ability to upload and download approved documents such as Discharge Summaries, Event Summaries, Referrals and Specialist Letters to the National Repository.


In fact, Emerging Systems are proud to be the first hospital vendor to upload a document to the PCEHR in November 2012 as part of the NEHTA Eastern Connect Wave 2 site project. This technology is able to be replicated in other international markets outside of Australia

Mobility

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EHS has an iPad application to support Clinicians to access information from anywhere. The application not only allows the viewing of information to enable faster decision making but also allows Clinicians to create electronic orders, write progress notes either by typing or using our voice recognition feature, complete patient assessments, input observations and a range of other functionality.

Variance Tracking

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In the event that the progress of a patient during an episode of care varies from the expected pattern, each variance is captured and tracked in EHS. Variance records can be reviewed on a case by case basis or for groups of patients. Analysis of variance records can provide indications of how care delivery can be improved or ways the Care Guide can be improved upon.

The detailed information captured about each variance, and the clinicians response to the variance, provides an ideal basis on which to establish a continuous quality improvement cycle.

Patient Dependency

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The Patient Dependency screen provides a table that shows, at a glance, the patient's status in relation to conditions such as mobility and independence. This is updated daily to generate a quick record of the patients' progress. As one set of dependency details are recorded, they can be measured against the last set to gauge the patient's progress. Patient dependency information is also utilised in relation to staff allocation and rostering.

Clinical Questionnaires

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EHS provides the facility for clinicians to create clinical questionnaires which capture any information relevant to the episode of care and is useful in the process of providing care. Once created, questionnaires are available for routine use or only in specific instances as nominated by the clinician. The information captured becomes a permanent part of the patient or client medical record and can be reported on in conjunction with any of the information captured in the electronic medical record (EMR).

Questionnaires are useful for the:

  • Routine capture of specific information in particular circumstances
  • Capture of information for clinical research

Validation Rules

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Emerging Health Solutions (EHS) provides clinicians with the powerful facility to create ad hoc Validation Rules using any information and parameters available in a patient record. The identification of instances where any given rule applies can then be used to trigger one or more actions or tasks

Staff Modules

Clinical Handover

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Clinical handover or transfer of information, accountability and responsibility for a patient or group of patients is consistent with the approaches endorsed by the Australian Commission on Safety & Quality in Health care and the Australian Medical Association. The key principles of clinical handover will aid effective, concise and complete communication in all clinical situations and facilitate care delivery. The standardisation of key principles of clinical handover will contribute to improved safety of patient care.

EHS enables these principles to be followed providing timely, effective, complete and concise information to users regarding individual patients and groups of patients. Clinical data is easily accessed in a range of formats including screen views and reports.

Staff Rostering

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EHS Rostering enables rostering throughout the hospital by ward. Standard mapping can be utilised to reduce the set up time for rostering staff that have the same shifts throughout the week.

Staff can make requests and view their own rosters in an easily accessible manner.

Management can set totals for each shift by date as a baseline for operation and the system will highlight whether the totals have been met or exceeded. Utilising the care guides module with the rostering module enables predictive workforce resource calculation to optimise productivity throughout the hospital based on a current patient population and the care needs required.

Allocation

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Allocation of staff in EHS can be set up according to individual patients or by grouping patients by section or level of care required.

Staff can be allocated to a group of patients on a particular ward or unit for a particular shift by the Nurse Manager or appropriate trained personnel. If the technology allows, then the staff can receive calls from patients to their pagers during the shift to improve communication and response to patient needs.

Workforce Resource Calculation

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Optimising the workforce according to the needs of the patient population for a particular shift has been made easier with EHS workforce resource calculation. Management can review the predicted hours of care required, based on the patient population of the individual ward or entire hospital, for any time ranges over a 24 hour period.

The skill level of the staff rostered is also taken into account, to further assist in the best allocation of staff based on the needs of the patient population.

Both predictive and actual hours required can be reported on and reviewed by management to enable better workforce planning.

Clinical Dashboard KPI's

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Evaluating compliance in completing assessments has never been easier with the clinical dashboard which measures the compliance of staff in completing documentation. Measuring compliance electronically allows management the ability to regularly evaluate any issues relating to compliance without having to manually collate paperwork which can take hours of a Nurse Unit Managers time. EHS supports management to further optimise patient outcomes through ensuring that important assessments are completed.

Staff Messaging

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The Staff Messaging module can be utilised for a range of internal communication needs, whether it is advising staff of educational sessions or general announcements.

Messages can be sent to individuals or specified groups. Messages can also be marked to be retained until read by recipients, indefinitely or for a pre-determined time. Replies to messages are also part of the EHS Staff Messaging system.

System Modules

Authentication

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EHS allows users, once logged on, to access other software applications seamlessly. Users are unaware that they are moving from application to application which enhances the user experience significantly.

Audit

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All activity within EHS is auditable – time, date and user stamped and user

Archiving

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EHS allows for easy management and access of files. The system can be set to archive files for a particular period from when patients have been discharged. The user is relatively unaware that the file has been 'archived' and can easily access all material related to a particular patient or patient episode.

Integration

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EHS Integration engine allows communication with other proprietary applications including Patient Administration, billing, theatre management, clinical coding, medications and to other systems as required. We are currently integrated with many of the available systems on the market. Ask us which systems you wish to integrate with.

System Administration

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Importantly, EHS is configurable according to the site needs. The side bar below demonstrates the basic functions of the system that are configurable. Usually, a staff member is allocated the role of System Administrator to manage the set up and ongoing management of the system. This may be an IT person or Clinical person according to the organisational requirements. EHS system integration is intuitive for users.

Personalisation

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EHS is personalised according to your site and clinical requirements. Emerging Systems will personalise the system from the look of the interface right through to the assessments, care guides, ward definitions, reporting etc. EHS is configured to suit your needs.

Reporting & Writing

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Comprehensive, customisable reports ensure that the information entered into EHS is used to meet the business needs of the organisation. In terms of reporting, EHS can provide an exhaustive range of reporting groups as dictated by organisational requirements from Risk, Patient, Orders, Staff, Rostering, Research and much more.

Report Writing

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Users can create their own reports using crystal reports within EHS utilising any of the clinical data captured.

 

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