TrakCare Solution Guide

2.4 TrakCare Departmental and Add-On Modules

In addition to TrakCare’s Electronic Patient Record, Master Patient Index, Foundation CIS, and Foundation PAS, a number of TrakCare departmental and add-on modules are available. Some of these may be implemented as stand-alone modules, and all are available as optional add-ons to the TrakCare core. All share the same, unified TrakCare information architecture.

TrakCare Departmental and Add-On Modules

2.4.1 Community Health Management

The TrakCare Community module ensures clients treated in the community receive the same professional quality of care they would receive if admitted to a hospital by providing healthcare professionals with access to all information normally available to them from within their own offices. A client’s medical history, alerts, referral information, and assessments may be viewed, appointments can be booked, and new care plans can be created from the client’s home instead of the hospital. Refer to section 1.2 for details about Community functionality.

2.4.2 Polyclinic

The TrakCare Polyclinic module facilitates efficient scheduling of healthcare professionals and ancillary clinic locations. The coordination and management of daily planning and activity can be based on a centralized or decentralized booking environment.

Polyclinic functionality is fully unified with all TrakCare modules. This unification means information related to pre-assessment, clinic attendances, emergency attendances, past admissions, and services provided as part of these events can be viewed in the patient’s EPR. For any clinic attendance, the patient’s demographic details are linked with his clinical and billing processes, which allows for the real-time clinical and billing management of patient cases. Refer to section 1.3 for details about Polyclinic functionality.

2.4.3 Emergency Management

The TrakCare Emergency Management module handles the triaging and treatment of patients and is designed to perform the registration, movement, and capture of care interventions during emergency attendances. Like all other TrakCare modules, Emergency Management is built with the EPR at its center. When installed with other TrakCare modules, Emergency Management is fully unified so that information related to pre-assessments, clinic attendances, past emergency attendances, and past admissions is available for viewing in the EPR. Refer to section 1.4 for details about Emergency functionality.

2.4.4 Operating Theater Management

Wouldn’t your job be easier if you knew the whereabouts of theater patients as they traveled from pre-op to post-op? Or what about having the ability to automatically assign the surgeon’s preferences for a specified operation, including assisting staff, order items, and even preferred music, simply by entering the surgeon’s name against a surgical booking?

TrakCare Operating Theater Management facilitates the coordination and efficient management of the theater rooms with skillful use of colors and icons to alert where necessary. Workflow is streamlined and data entry minimized through functions such as surgical preferences, allowing orders and interventions to be automatically placed.

The TrakCare Operating Theater Management module provides a comprehensive tool that enables the coordination and efficient management of theaters, resources, and clinical staff. Daily planning and activities based on a centralized or decentralized booking environment are supported, and information is dynamically updated as events occur. This module can be used in a single day-surgery unit, private and public hospitals, and large multi-site enterprises.

Operating Theater Management functions include:

• Registration allows the user to create a new patient record or search for an existing patient previously registered in TrakCare.
• Theater Inquiry allows the user to make general, online theater inquiries by procedure, surgeon, anesthetist, resource, location, and patient.
• Theater Booking enables a user to request or book a theater slot for a patient, specifying the required operating theater and/or surgeon. Assuming appropriate authority, bookings can be made outside a schedule in the event of an emergency case. Theater requests/bookings can be generated from TrakCare Emergency, Waiting List, and Inpatient modules.
• Equipment Booking and Maintenance allows equipment required for an operation to be recorded, monitored, and managed, and it enables the facility to place specific pieces of equipment under a maintenance schedule.
• Booking Management facilitates the scheduling of a patient’s theater booking.

The user is able to:

• Request or book theater appointments
  
• View request or booking details
  
• Record/update booking status (e.g., arrived or completed)
  
• Transfer bookings (single or bulk)
  
• Cancel bookings

• Schedule displays a calendar view for selected care providers and their associated theaters, showing their workloads on a given day.
• Schedule Management enables management of operating theater rooms, including the management of theater allocations and the defining of irregular sessions. Schedules and diaries can quickly be changed if required.
• Schedule Calendar displays a calendar view for a selected theater, showing utilization for a given month. The calendar may be configured to display summary information or details.
• Schedule Transfer and Copy allows existing theater schedules to be used as a template for new schedules. Schedules can be copied to reduce setup time, and the schedule template, together with all future appointments attached to it, can be easily transferred.
• Operating Theater Swap allows the user to swap a surgeon’s session, complete with booked patients, to another theater in a user-friendly and efficient manner. This is an effective method of managing session overruns.
• Care Provider Activity enables the user to search for available session times. Time slots can then be assigned or offered to a surgeon and/or anesthetist requesting additional operating times.
• Variance records details of any amendment to actual schedule start and end times, including reasons for change.
• Worklist displays bookings associated with a specific operating theater, surgeon, and/or anesthetist. It provides the user with estimated procedure start and end times, and allows the re-sequencing of procedures as needed. Visual prompts regarding patient and procedure progress are provided in the form of icons. Many of the functions that enable day-to-day management of the theater and the bookings are available from Worklist (e.g., updating or changing a booking status, or updating patient information or episode details).
• Surgical Preferences are used to allocate items for use during surgery. Preferences include special equipment, staff allocation, and order items. Preferences can be set up for individual surgeons and anesthetists, and for recovery. For each perioperative phase, the preferences provide a list of the usual items required for the procedure. Items specified in a surgical preference may include billable consumables such as equipment that has a rental component (e.g., implants or expensive items that need to be ordered in advance).
• Orders are used to enter interventions and other electronic orders for a patient. Orders included in a surgical preference are automatically entered in preparation for review and editing if required. Orders are viewable from the patient’s EPR.
• Prosthetics Management informs the user about the status of requested prosthetics. It captures details about the type of device requested and the supplier, and status is indicated using a series of easily identifiable icons.
• Movements is a tool used to record a patient’s movements to and away from the operating theater.
• Billing allows any procedures performed and/or services rendered as part of the surgical event to be captured for billing purposes (refer to section 2.4.9 for details about TrakCare Patient Billing).
• Bulk Transfer allows the user to select a number of theater bookings for a given theater and cycle through them, transferring the bookings to another theater or surgeon.
• Theater Icons provide a visual alert or prompt that helps users identify pertinent information about a patient or the progress of a patient through the stages of surgery.

Example: Procedure Preference

• Operating Theater Preferences Workbench enables a user to quickly modify the items in a surgical preference and apply the change to all preferences for a single surgeon or to all preferences, irrespective of surgeon or anesthetist.
• Anesthetic and Operation Details allow the healthcare professional to enter details about anesthetics given and procedures performed. The outcome of anesthetics and the operation can be recorded. Both of these screens are viewable via the EPR.

Example: Operating Theater Preferences Workbench

Example: Anesthetic Preference

Example: Anesthetic Preferences – Items Used

2.4.5 Maternity

Prior to the delivery of a new baby, a woman will on average have had around nine antenatal appointments. Subsequent to giving birth, she will have multiple community interactions that may include discharge support, baby clinic, and vaccination services. With so many occasions of care, it’s important that the care provider with whom she is engaged has access to an information system that dynamically captures administration and clinical data during the antenatal, intrapartum, and postnatal periods of a pregnancy. The TrakCare Maternity module does just this.

TrakCare Maternity is built on the EPR. It provides a complete obstetric history for clients, including planning and progress of care for both the mother and the baby.

TrakCare Maternity provides administrative personnel with the tools to capture data and coordinate and manage mother and baby encounters across the continuum of care in an intelligently efficient and automated way. Maternity is unified with other TrakCare modules, ensuring that clinical data from pre-assessments, clinic attendances, emergency attendances, past admissions (obstetric and other), and services is available online and in real time.

Maternity functions include:

• Pregnancy Events provide a consolidated and concise view of past and current obstetric detail and key risk management information.
• History of Previous Pregnancies facilitates the capture of past obstetric history. Data captured can include artificial reproductive procedures and previous or current antenatal complications.
• Pregnancy Details and History of Care for Pregnancy Management creates a detailed record including plans for the type of antenatal care to be provided, the client/patient’s delivery or birth plan, and the tracking of key pregnancy progress indicators such as antenatal complications and estimated date of delivery based on ultrasound and other findings. A history of care is created and updated whenever key items in the pregnancy record are changed, for example if the delivery plan, consultant, or midwife team is changed. This allows the care team to see at a glance how the plan has changed over the course of the pregnancy.
• Registration allows for the creation of a new patient record and the ability to search for an existing patient previously registered into TrakCare.
• Admissions allow both the mother and the baby to be admitted into the hospital. Selective obstetric details can be displayed in the Patient Banner for any maternity client, making patient status immediately recognizable anywhere in the facility. Flexible definition of parity to meet national standards or conventions is provided.

Obstetric details displayable in the banner include:

• Agreed Estimated Date of Delivery (EDD)
• Current gestation
• Parity
• Gravida
• Waiting Lists and Outpatient Appointments Automatically Linked to Pregnancy Events allows outpatient visits and episodes to be viewed and managed in the context of the pregnancy.
• Newborn registration and Admission Workflows include the ability to:
The Mother/Baby Link is a bi-directional link between mother and baby.
• Pre-register a baby who has yet to be born and link this fetus to the mother’s pregnancy event. An estimated date of birth (in the future) can be entered
• Automatically trigger Newborn Registration and Admission workflows upon update of the baby clinical details screen
• Automatically populate data on the baby registration screen by defaulting information from either the mother or the delivery screen
• Labor/Delivery facilitates the recording of delivery details, baby clinical details and placental details for single or multiple births. A complete history of the four stages of labor can be recorded, and, for each neonate, birth details are captured, including Apgar scores, baby weight, baby length, resuscitation required, and abnormalities.
  
  Additional information such as personnel present at birth, perineum details and the use of sutures can be recorded. The use of anesthetics, analgesics and Oxytocics can also be documented and these may optionally trigger the automatic placement of electronic orders for the agents entered. The date and time of induction of labor and augmentation are recorded separately as are the date and time of a decision to deliver via cesarean section.
  
  Upon completion of delivery details, the length of each stage of labor is automatically calculated and displayed. A number of validations are also available, such as baby weight and gestation.
  
  The delivery details link to the mother’s EPR.

Example: Pregnancy Events List

• Mother/Baby Link provides a bi-directional link between mother and baby. It provides a list of babies associated with the mother and ensures that maternal details also appear on the baby’s record.
• Discharge allows details of the discharge to be recorded, including destination and referral for further care. A flexible, obstetric-specific discharge process is provided so that mother and baby can be discharged independently or sequentially.
• Obstetric Inquiry provides users with an online Obstetric Data Inquiry tool. The user is able to select query criteria such as neonatal morbidity, delivery method, delivery outcome, and postpartum complications. Alerts are available to assist with the management of obstetric risks, improve patient care, and streamline administrative processes.

• Maternity Icons provide a visual alert or prompt to identify pertinent information related to the patient, orders, and progress of the mother through the stages of labor. A variety of interactive and static icons are available.

Examples include:

• Current pregnancy complications
• Previous pregnancy complications
• Client/Patient has delivered
• Client/patient is breastfeeding

2.4.6 Radiology and Departmental Workbench

TrakCare Radiology and Departmental Workbench streamlines all the work processes of medical imaging departments. Easy and efficient order placement, order authorization, and appointment scheduling are provided, and all the details of procedures are accessible during result reporting and transcription. The module can also be used to support other departments, including physical therapy and cardiology.

The flexible workflows associated with capturing pre- and post-examination data and unified dictation, transcription, and result verification combine to deliver comprehensive functionality that reflects the way imaging services are delivered. Authorized healthcare professionals have access to the patient EPR, where they can review current treatment and patient history, including previous order and results details. The ability to document care and enter results directly into the patient’s EPR is possible. Results can be sent electronically, printed, emailed, or faxed to the referrer.

Radiology and Departmental Workbench functions include:

• Appointment Management allows authorized staff to schedule an appointment, place the patient on a waiting list, or perform a procedure immediately once an order has been approved. The system provides the ability to display available time slots at a resource or departmental level, making scheduling both simple and efficient.
• Departmental Workload Manager provides a prioritized worklist of patients and orders, displaying the essential clinical and administrative information for efficient workload management. This is available in standard, diary, and split-screen views.
• Order Authorization allows authorized staff to review, authorize, or reject requests. Changes to request or procedure information can be updated or changed by authorized staff when required.
• Radiology Pre- and Post-Examination Details allow authorized staff to record information about the procedures completed, including consumables used, processing notes, assisting staff, and technical parameters of the examination.
• Result Reporting (Dictation, Transcribing, and Verification) allows the results of investigations to be recorded, documented, and verified by authorized staff. Supported result entry methods include direct text entry, canned text entry, digital dictation with subsequent transcription, and simplified reporting using questionnaires (user-defined forms). Workflows are optimized for single or batch processing. A dedicated result workbench is provided to facilitate efficient management of the workload.
• EPR View provides access to the Electronic Patient Record. Completed questionnaires (user-defined forms) are available for review and can be defined against the patient’s episode of care or an individual order item.
• Image Viewing is available directly from the workbench or through the EPR via a context-sensitive link to the Picture Archiving and Communications System (PACS).
• Scanning of Documents and Images and attaching them to the patient record is possible throughout the episode of care as is the recording of patient clinical observations. The observations can be defined to suit the clinical requirements of the site or user, and can be accessed from the EPR, worklists, or other functional workflows.

2.4.7 Prescribing

Acceptance by clinicians of electronic prescribing is crucial to realizing benefits such as the elimination of unnecessary prescriptions or dangerous drug interactions. TrakCare Prescribing has been designed with this in mind. The Prescribing module enhances core TrakCare clinical functionality, drawing on a synthesis of patient data and decision-support capabilities to facilitate efficient and safe prescribing practices. Prescribing seamlessly unifies with TrakCare dispensing and medication administration workflows, increasing the efficiency of the prescribing process for care providers while minimizing adverse drug events.

The addition of Prescribing to TrakCare’s core clinical functionality provides healthcare professionals with the safety of a clinical review system, including medication checks and patient alerts when generating and delivering on medication management plans. Previously entered diagnoses, alerts, and medication history are available and can be referenced in the prescribing workflows.

Prescribing functions include:

• EPR Order Profile displays medication orders in a variety of formats to assist with quick interpretation. For example, current medications can be separated from discontinued or completed medications.
• EPR Medication Profile allows healthcare professionals to view a patient’s current medications upon admission.

Example: EPR – Medication Summary

• Generic or Brand Prescribing provides flexible prescribing options. The clinical information needed for dispensing is easily entered, and default information can be set up against each medication item at the system level.
• Prescription Favorites are frequently requested items displayed for quick selection during the order entry process. Lists of favorites may be defined at the organization, location, group, or individual user level.
• Prescription Priority can be assigned to an order allowing medications to be identified as Urgent, PRN, STAT, Once Only, Discharge or Patients Own medication. The prescriptions will then be processed according to the priority in TrakCare.
• Prescription and Pharmacy Status allow care providers to track the progress of medication orders. Clinicians with appropriate authority are able to place prescriptions on hold or discontinue them as required. They can view the progress of the prescription through the Pharmacy Department (e.g., Pending, Accepted, Packed, or Dispensed), and also monitor the administration of the medication to the patient
• Questions can be defined for display at various points in the order entry workflow, ensuring relevant clinical information is collected. The answers to these questions can default from previous entries or can display relevant pathology results to facilitate decision-making. Expiry limits can be set for previously answered questions to ensure that up-to-date information is always provided.
• Order Sets enable prescribers to quickly order groups of items that are normally prescribed together, rather than having to select each item individually.
• Multi-Prescriptions allow clinicians to order, in a single session, prescriptions that have varying frequency and duration.
• Alerts and Checks are included in the prescribing process. When TrakCare is integrated with a third-party pharmaceutical drug knowledge database, the strength of these checks and alerts is enhanced.

Alerts and Checks include:

• Allergy Alerts display when the current medication being prescribed has the potential to create an allergic reaction. The patient’s allergy history can be viewed, showing the severity and the nature of the reaction recorded. Where a previous severe reaction was recorded, a mandatory override can be configured as part of the prescribing process.

Medication allergies can be configured to provide the following alerts:

• Ordering of the same brand
• Ordering an item that includes the allergy active ingredient
• Ordering an item from the same generic group
• Ordering an item from the same allergy group (e.g., penicillin)
• Ordering an item from an allergy group likely to give a cross-sensitivity reaction (e.g., cephasporins)

• Duplicate Checking Alerts are available at a number of levels including:
• Therapeutic Duplication Alerts
• Ingredient Duplication
• Order Item Duplication Alerts
• Interaction Alerts display when currently prescribed medications interact. Interaction checking can continue for a set period after a medication has been ceased based on set-up at the generic drug level. Severity of the interaction can be flagged by priority and color of display.
• Dose Quantity Validation Alerts allow the user to see when the amount of medication being prescribed exceeds the Maximum Base Quantity per day or Maximum Base Quantity per ordering session.
• Drug Information Check allows users to view details about the medication being prescribed. The data can be displayed as an order entry message or via links to third-party online or offline drug monographs.
• Therapeutic Substitution Check allows medications to be flagged as equivalent substitutes. TrakCare advises clinicians about suitable alternatives to the medication being prescribed and assists with formulary management.

Alerts, such as drug allergy and interactions, that occur during the prescribing process also display when the prescription is viewed in the TrakCare Pharmacy module and during administration of the drug.

• Dose Calculation and BMI are easily accessed during the prescription process. A link to the Body Surface Area (BSA) formula is available for changing the selection if required. Body Mass Index (BMI) can be updated from the dosing screen and will auto-populate the relevant EPR charts.
• Security Restrictions are a standard feature throughout TrakCare. For example:
• Security Group restrictions can be used to limit the ability to prescribe certain items or view sensitive orders.
• Scheduled Drugs’ functionality facilitates a reduction in the administrative overhead of complying with regulations that control the prescribing, dispensing and administration of drugs that are scheduled or controlled because of their abuse potential or risk.
• Phone Orders require counter-signing and validation by the care provider within a specified timeframe in order for the prescription to remain valid.
• Audit trail functionality is available on all parts of the prescribing process.

2.4.8 Pharmacy

TrakCare Pharmacy supports the dispensing activities of a pharmacy department within an organization. It manages safe prescription dispensing and inpatient dispensing directly from drug medication orders or ward stock. Additional tools are available to support clinical pharmacist activities such as medication review, patient counseling, and education. Formulary management and pharmacy stock control are included.

Pharmacy functions include:

• Electronic Prescriptions received directly into the dispensing system
• Full Prescription Dispensing
• Unit Dose Dispensing
• Configurable Dispensing Process
• Queuing of Medication Orders with verification, dispensing, and dose reconciliation
• Clear Display of prioritized patient lists with current clinical information
• Patient Alerts

Example: Patient Alerts

• Drug Manufacture records the manufacturing process and the prescription item formula. The quantity to manufacture is specified, and the quantity used is automatically deducted from stock when the process is started. The product is also added to the inventory at the conclusion of the manufacturing process.
• Pharmacy Dispensing Workbench includes the following features:
• Prescription Search
• Prioritized Worklist displays prescriptions ranked according to assigned order entry priority. Color coding is also available to assist with identification of urgent prescriptions.
• Pharmacy Queue facilitates workload management by sorting prescriptions according to status. Defined queues include Pending, Accepted, Packed, Collected, Rejected, Ready for Return, Completed, and Check.
• Single Entry, including therapy notes
• Review and Actioning
• Access to all relevant patient information and results
• Barcode Packing uses the barcode on the prescription and the drug package to quickly locate and pack prescription items; stock levels are automatically reduced and expiry dates checked.
• Drug Interaction and Allergy Messages are displayed on the workbench.
• Auto-Pick Packing selects stock from positively stocked batches starting with the batch having the earliest expiry date, providing quick packing while facilitating good stock management.
• Interaction Checking is an interactions search page that helps pharmacists quickly find interaction information.
• Formulary Workbench provides a simple and flexible means of managing and maintaining the facility formulary. Medications can be designated as formulary or non-formulary, and prescribing privileges can be restricted based on the user’s security group.

Example: Pharmacy Queues

Example: Formulary Workbench

• Access to Patient Medication Information is available through the EPR. It is also possible to use the TrakCare Clinical Summary function to securely create and share patient-specific medication summaries outside the organization.
• Pharmacy Stock Control provides the ability to manage all items dispensable from the pharmacy, including:
• Stock adjustment
• Stock disposal
• Stock replenishment
• Stock purchase order
• Stock return
• Stock issue return
• Stock receive discounts
• Stock take
• Security includes a range of security permissions to control what a pharmacy user can see or do. For example, the ability to dispense and manage scheduled or controlled substances, the ability to dispense non-formulary items, or the ability to substitute brands can be restricted. Permission to over-pack, ability to pack all repeats at once, and requirement to have packed items checked by a supervisor are also available.
• Bar Code Printing and Scanning is supported in TrakCare Pharmacy for a variety of function including stock returns and prescription packing functions.

2.4.9 Patient Billing

Billing can be extremely complex. Rules vary markedly throughout facilities, states, and countries. Billing requirements differ from patient to patient depending on the insurance policy coverage, including lack of insurance coverage, or healthcare organizations’ differing billing requirements for non-nationals. Trak- Care Patient Billing is an eminently flexible module. Used around the world, it is designed to handle the most challenging billing arrangements. It automates the billing process, produces on-demand billing, and reduces the time required to discharge a patient.

The TrakCare Patient Billing module enables staff to coordinate and manage bills for different patient types, including inpatients (per diem, fee for service, or Casemix), same-day patients, outpatients, emergency patients, and various services such as theater, allied health, community, radiology, and dental.

Rules may be defined so bills can be generated according to a single payer per episode, multiple payers per episode, payment agreements, contracts, and currencies.

It allows billing to be controlled from a central point or in decentralized environments. For enterprise configurations, this means elimination of duplicate data capture and a complete billing and clinical history of patients, regardless of which sites they have visited.

For those healthcare organizations that need to provide informed financial consent on behalf of the patient, TrakCare provides an estimate-of-cost tool. Estimates of cost can be derived and calculated prior to services being rendered or upon arrival, and can be stored for retrieval, review, comparison, and update.

Core functions of Patient Billing include:

• Patient/Payer Bills (Total and Interim) displays all bill-related information and performs patient-related transactions (e.g., co-payment, excesses, receipts, deposits, invoices, outstanding aged balance, adjustments, discounts, tax, and billing comments) based on the payment agreement associated with the bill.
• Payment Agreement defines all levels of the contract by combining the payer, plan, tariff, contract (items to be included or excluded) and charging method for each payer. Based on the payment agreement and contract, patient/payer charges are generated.
• Charges are generated (automatically and/or manually) via administrative and clinical activity that results in an order being raised for a patient. The charge associated with an order is based on the payer’s payment agreements.

Types of charges include:

• Standard: Based on consumption or utilization
• Incremental: Based on time. For example, theater or intensive care services may levy an initial base fee plus an incremental charge depending on duration of use.
• Ad hoc: Allows a user with a valid security group to override/modify a contract for a patient for a specific episode of care
• Episodic: Charges billed for the episode
• Variable Room Rates: TrakCare allows different room charges (if applicable) to be raised based on the type of room the patient is occupying. Additionally, accommodation step down charges can be applied for a defined number of days (e.g., a higher fee for the first x number of days followed by a lower fee the longer the patient remains in the hospital).

• Raising Invoices includes the following capabilities:
• Creation of single and batch invoices
• Draft or pro forma invoices allowing review, modification, and finalization of the bill prior to printing
• Display patient and/or payer portion on invoice. Multiple payers can be associated with an episode, allowing the patient’s bill to be appropriated between nominated payers (e.g., an insurance provider and a patient)
• Aging of outstanding balances starting from invoice date
• Collection and allocation of invoice payments managed at an invoice level or at a service/order level
• Interim bill, usually associated with long stay inpatient care, enables invoices to be raised prior to discharge, allowing reimbursement on an incremental basis.
• Cancellation of invoices
• Billing comments can be added to a specific invoice
• Placing invoices on hold
• Recording the invoice printing history
• Adjustments allow for multiple variations to be made against a payer and patient bill. Adjustments can also be used to transfer outstanding balances between payer and patient bills.

Adjustments include:

• Ability to adjust the invoice
• Recording adjustment reasons
• Recording of adjustment history
• Allocation at the invoice level or at the service/order level
• Recording Receipts includes the following capabilities:
• Generation and printing of receipts
• Individual receipt or batch receipting (i.e., multiple invoices for a payer)
• Partial payments (if required, to an item level)
• Recording of receipt details and method of payment
• Cancellation of receipts by users with appropriate security access
Estimates of cost can be derived and calculated prior to services being rendered or upon arrival, and can be stored for retrieval, review, comparison, and update.
• Recording Deposits captures information related to deposits to be received from a patient and/or payer and deposits to be allocated against selected invoices. It also allows refunds of deposits if necessary.
• Recording Information includes the following capabilities:
• Recording billing reference notes and comments
• Adding notes and comments against an invoice for inclusion on the invoice
• EDI Transmissions includes the following capabilities:
• Creating, managing, and auditing invoices sent electronically to selected payers
• Sending invoices to particular payers (as defined in reference/code tables) via an EDI extract, rather than printed as a paper invoice
• Debtor Management provides the ability to search for outstanding invoices by payer, age, and outstanding amount.
• Letters functionality provides the ability to produce correspondence such as “aged debtor” letters to send to patients. The form the letters is defined by the organization, but InterSystems can provide an initial set of templates. A history of correspondence is available, documenting creation date and time, and any reprints made. Documents that have been sent may be viewed.
• Icons in TrakCare Patient Billing are easy to read and include:

2.4.10 Active Decision Support

TrakCare Active Decision Support can be employed to increase patient safety and improve workflow efficiencies for healthcare providers. The Decision Support Workbench allows users to build site-specific rules that provide targeted information, such as identification of critical patient risk factors, to assist clinicians in decision-making. This functionality is in addition to the decision-support messages provided in TrakCare, such as interaction and duplicate checking.

This module provides the unique functionality of creating user-defined rules that drive decision support actions. Actions can be as diverse as sending a pop-up message to users warning them that the order they are about to place is inappropriate for the patient, sending an email to the laboratory, or even changing the status of an order to ‘On hold’ or a waiting list status to ‘Cancelled.’ The rules for determining when a decision support ‘action’ should be triggered can be set across the conventional therapy and patient condition (e.g., issuing an alert if Warfarin is ordered for a patient who is just three days out of post-op).

Designed with uncluttered screens, TrakCare Active Decision Support ensures that the desired information is readily and clearly available, avoiding the pitfall of multiple, confusing alerts.

Active Decision Support functionality includes:

• Rules at the simplest level take two or more data elements and build a ready reckoner that can be referenced directly each time a decision-support condition needs to be evaluated. This dramatically reduces response times.
• Events are the triggers set in TrakCare when adding, updating, or deleting data in any table within the database. When an event occurs, Active Decision Support will check if certain data items are present. In this way, healthcare providers can draw on the power of rules to quickly assess if an event should trigger a decision-support action.

A simple event could be:

• If a patient is marked as “has violent behavior,” an action is triggered.

A complex event, containing multiple conditions, could be:

• If a patient is prescribed Atenolol,
  AND the prescription date is in the last two days,
  AND the patient has an active diagnosis of “heartblock,”
  an action is triggered.
• Actions are what should happen if the conditions for an event have been met. For this reason, the action screen offers a broad range of options.

Action types include:

• Alerts: A pop-up message that can be configured to display:
• An error message that precludes the user from proceeding
• A warning message that offers the user a choice to proceed or abort (“OK” and “Cancel” options)
• An information message offering read-only advice that will not affect the intended workflow (”OK” acknowledgement button only)

For example, when ordering a drug, a message listing available alternative drugs is presented for consideration.

• Messages can be directed to users, groups, or allocated care providers. The content of the message can be fixed or dynamic, allowing variables to be inserted.

Messages can take the form of:

• Emails
• TrakCare messages
• Pager alerts
• Short Messaging Services (SMS) via email/SMS gateway

For example, when an abnormal laboratory result is entered into TrakCare, an email is sent to the referring clinician advising that the result is available.

• Set Field Action allows direct manipulation of database fields.
• Action Offset allows TrakCare “actions” (e.g., a message) to be offset by a user-defined time interval to provide a means of escalating or drawing attention to outstanding tasks and to assist with risk management. Unless a decision-support process of escalation is halted, messages may be sent to different users over a given time period.
• Queries allow rules to be viewed and cross-referenced, enabling users to quickly data-mine and examine trends. Using the rules, queries such as the following can be created:
• Cross-reference a patient’s clinical diagnosis with laboratory test ordered
• Cross-reference a patient’s clinical diagnosis with patient's postcode

The total for each group is displayed, with users having the ability to further interrogate the results to display — for example, a list from which the patient's Electronic Patient Record can be accessed.

2.4.11 Connectivity

The Ensemble rapid integration platform embedded in TrakCare ensures interoperability of TrakCare’s modules with your other applications through the TrakCare Connectivity module. Ensemble has built-in support for many integration technologies and messaging systems. TrakCare Connectivity enables rapid connectivity between third-party HIS, CIS, PAS and/or other information systems and TrakCare. The Connectivity module allows TrakCare to interface with other systems, whether they are legacy systems or external systems such as national identity databases. Connectivity options include comprehensive HL7 messaging capability. TrakCare also includes the native capability to link to external systems passing context in a definable URL. Refer to section 4.0 for additional details about connectivity.

2.4.12 Laboratory (LAB)

While traveling abroad, a person falls ill and goes to an outpatient clinic for a blood test. Blood is taken, sent to the lab, and tested. Using TrakCare Lab, as soon as the test is finished, results are made available with an alert sent to notify the doctor, highlighting any abnormal findings. If necessary, the results can also be made securely available for further consultation to the patient’s hometown doctor or even to a specialist on the other side of the world.

TrakCare Lab meets all of the operational needs of the modern pathology laboratory. It is designed specifically to streamline the diverse activities of laboratories in the areas of:

• Accounts receivable
• Blood bank
• Clinical biochemistry
• Hematology
• Histology/cytology
• Immunology/serology
• Microbiology
• Phlebotomy
• Specimen and request registration
• Work sent out

TrakCare Lab provides a comprehensive solution for the data management needs of any laboratory via:

• Customizable data entry screens
• Automatic faxing of results, including patient history and medical condition, to referring doctors
• Report scheduling
• Confidential printing of reports
• Remote system access
• Integration with Microsoft Word
• Export of information to other systems
• Patient management
• Defined patient and data flow
• Specimen pre-registration and online device load lists, facilitating rapid turnaround times
• Unlimited capacity for clinical history details and comments
• Image scanning

Over 100 of the most common and latest analyzer interfaces are available, offering uni- and bi-directional capabilities with barcode reader functionality and direct TCP/IP interface connections via dedicated instrument terminal servers, utilizing the ASTM or supplier/analyzer-specific protocols.

TrakCare Lab supports the needs of laboratory professionals to process and analyze results. It also provides caregivers access to those results in understandable formats. Clinicians can use mobile devices to access and review results.

Examples of TrakCare Lab modules that address specific departmental requirements include:

• Auditing and Rules Base: TrakCare Lab records a full audit for changes in data, whether they are configuration settings or result/demographic changes. TrakCare Lab also records any reports that have been sent out of the system, whether they are electronic or paper. The rule base allows access to all the data elements in the system either directly or via a customized condition. As an example, Rules allow suppression of results, reflexing of tests, warnings, and additional copies to be produced.
• Daybook provides departmental control for registration of specimens, allowing automatic retrieval for inclusion in reports. Users can allocate specimens, procedures, and stains, and print specimen-specific labels for slides, blocks, and cassette writers, either in batch mode or on an ad-hoc basis. Users can create custom screens that are consistent with their department’s workflow.
• Collector Entry allows users to register patients for future specimen collections, including single or repeat collections.
• Worksheets incorporate multiple tests with defined turnaround times. A dedicated worksheet module allows users to enter results on a screen that mirrors the layout of the printed worksheet, significantly improving the time of result entry for manual assays when interfacing is not available.
• Reports allow report templates to be defined by the user and customized to suit the laboratory’s report types and formats. TrakCare Lab includes a significant number of reports that satisfy the requirements of even the most complex laboratory. In addition, TrakCare’s underlying technology is fully ODBC-compliant, allowing users to use third-party reporting tools to create custom reports on an ad-hoc basis.
• Electronic Claims create electronic claim files suitable for exporting to external accounting systems.
• Quality Control incorporates a fully unified quality control module for manual assays and interfaced instruments, including Levy-Jennings and Youden Plot graphing capabilities, as well as inter- and intra-laboratory analyzer quality control comparisons.
• Interfaces provide for both uni- and bi-directional analyzer interfaces, including barcode reading functionality. For other interfacing requirements, TrakCare Lab uses PIT, HL7, and/or UN/EDIFACT formats. TrakCare Lab has also been configured to interface with external systems using client-specific proprietary formats.
• Specimen Storage includes a dedicated specimen storage module in TrakCare Lab. Configuration of storage locations, including buildings, refrigerators, and individual storage containers, can be configured entirely by users, ensuring accurate identification and retrieval of stored samples for further testing.
• Reminder/Recall Letter module provides the ability to set up verification queues to monitor patient who have been sent reminder letters for follow up examinations (e.g., cytology PAP follow-up screening).

 

TrakCare Solution Guide

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