Figure 1: The view summary screen includes admission history, dictation and reports, scanned documents and other clinical information
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The first component to go live was the Patient Advanced Testing Clinic. The previous process involved two medical assistants whose job it was to assemble all of the paper associated with the patient to be evaluated. They would go to each of the various hospital computer systems (lab, radiology, cardiology, dictations, etc) and print off the data, compile it in a pile of paper and provide it to the faculty anesthesiologists for their review. The anesthesiologists would go through the pile of paper, extract important information and enter it into the paper form, interview the patient, and complete the rest of the Patient Advanced Testing paper documentation. With the implementation of MorCARE, it is now no longer necessary for medical assistants to print this information. The summary of all the clinical information is presented on a single screen. Figure 1 shows a summary of the clinical data associated with a typical patient. It includes the most recent labs and the abnormal lab values are highlighted. It also includes all of the dictations that are in our DMI dictation system. It also has a visit history so you can get a quick idea at how often that patient has been in the hospital. The software also included a very clever function known as the Intelliparser™ an application that automatically looks at discharge summaries and, based on some clever logic, extracts pertinent information such as past medical history, diagnosis, medications, allergies and previous surgeries. This information can then be reviewed by the anesthesiologists and checked off as confirmed and automatically brought forward to the History and Physical (Figure 3).
The Patient Advance Testing application also includes software that facilitates the management of the clinic and improves the work processes for clerks, medical assistants, residents and faculty. Figure 2 shows the scheduled patients to be seen in the clinic that day. The list of patients’ changes as the day goes on based on whether the patient has been seen or not. If the patient is in a room waiting to be seen by the anesthesiologist, the screen turns white, indicating that that patient is awaiting an evaluation by the anesthesiologist. In addition, the name will turn red if a resident has seen the patient and that patient’s information requires review and co-signing by the anesthesiologist. Once the anesthesiologist has reviewed that patient, it turns back to a normal color. On the right side of that screen (Fig. 2) are graphic representations of each room so the anesthesiologist can quickly determine the location of each patient. The same view appears to the clerk who admits the patient; they simply drag and drop the name to various rooms. This application has several important benefits to the clinic. For one, the anesthesiologists can simply look at the screen and see who’s been seen and who is waiting to be seen without having to have a clerk walking from the front to the back to tell the anesthesiologist that a patient is waiting to be seen. In addition, all of the data are captured and it is possible to now analyze the cycle times with regard to how long a patient has been waiting to be seen and so forth.
Figure 2: The clinic management view shows a graphic representation of the waiting and exam rooms as well as a list of all patients scheduled to be seen that day
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Figure 3 shows the actual history and physical part of the Patient Advanced Testing module. This application has several important clinical and business functions. Clinically it provides a basic history and physical of a patient, which is complete, legible, and queriable. It also prompts the clerk and the anesthesiologist to provide information that is required for the billing procedures. For example, the billing is different whether or not we have seen the patient in the last three years. Therefore the clerk asks the patient that question and enters that field; however, if for some reason that information did not get answered the anesthesiologist is prompted to complete that when they go to co-sign that document. In addition, this application includes an area for the HRA or billing staff to review the documentation and assign a billing code for it.
