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 coordination of care. Patient Care Guides simply focus on achieving the milestones in the care delivery process in the order that they occur.

An important feature of the way Patient Care Guides are implemented in Emerging Health Solutions is the way Care Guides 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.

Variance Tracking

In the event that the progress of a patient during an episode varies from the expected pattern, each variance is captured and tracked in Emerging Health Solutions. 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 needs to be updated. 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.

Pre-Admission

In the hospital environment, the Pre Admission component in Emerging Health Solutions allows for much of the patient information needed to initiate an episode of care to be captured prior to the episode of care or admission. This module also permits pre-admission tasks to be performed that may shorten or streamline a subsequent inpatient episode. The work done during the pre-admission period can reduce pre-operative bed days. Clinicians can be alerted to abnormal test results and address issues prior to the patient’s admission for surgery. Once potential problems are detected, early intervention reduces the risk of late cancellations.

The Pre-Admission component within Emerging Health Solutions encompasses all the processes commonly occurring during in-patient pre-admission periods, including the necessary:

Risk Assessment

The Risk Assessment component is a pro-active risk profiler that helps staff to identify patient care risks and provide alerts in the medical record in order to avoid possible complications associated with an episode of care. The key objective is to address risks that may increase the episode of care unnecessarily.

The risk assessment profiler uses the Waterlow scale for assessing risk but could just as easily utilise any of the risk assessment tools, such as Norton or Braden. The choice scale is a clinical choice that presents no implementation problems.

Occupational health and safety risks are highlighted; consequently incidents can be avoided by managing high-risk patients differently.

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

The clinical Risk Assessment component provides assessment tools for:

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 their care guide, ensuring safety procedures are initiated where necessary.

Patient Dependency

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 patient’s 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 used in relation to Staff Allocation.

Staff Allocation

Staff Allocations allows for staff to be allocated to individual patients or groups of patients. The system also allows for the automatic linking to staff paging and telephone systems.

Medical History

The Medical History component 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 at the time of admission, including pre-existing medications, care needs and social circumstances.


Clinical Questionnaires

Emerging Health Solutions provides the facility for clinicians to create clinical questionnaires that capture any information that is relevant to the episode of care and 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 medical record and can be reported on in conjunction with any of the information captured in the electronic medical record.

Questionnaires are useful for the:

Validation Rules

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

Observations

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 are reached.

Progress Notes

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 and 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 Notes 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.


Clinical Messaging

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 patient specific messages are delivered and acknowledged by the relevant team members and reduces 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.

Order Entry

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.

CSU Job Management

The Clinical Services Unit (CSU) Job Management facility is used to display, allocate and manage patient transport orders and routine CSU tasks. The colour coded display clearly indicates the following:

Results Reporting

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.

Maternity

The Maternity component captures a comprehensive record of mother and baby details. The care provided to both mother and baby is captured making it possible to track indicators of health and to update patient care from pregnancy through to labour and delivery.

Discharge Summaries

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 are 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.


Management Reporting

The Management Reporting function provides a range of standard reports customised for each organisation. The dropdown box enables the user to select the relevant standard or custom reports with a user defined date range.

The comprehensive nature of the information captured in the electronic medical record make it a rich source of information for analysis and ensures appropriate continuity of care irrespective of where care is provided.