Electronic Health Record web platform for medical facility

Development and on-facility implementation of the electronic health record system for making an opportunity to reduce task management time by 10%, re-examine workflows and redesign processes to maximize the benefits of digital clinical workspaces.

About

Customer's clinic has combined expertise in geriatric care with a mission of compassion to become a top provider of long-term care. They have several operative facilities with licensing for just over 1,200 beds; five of them have implemented an EHR system with the help of the team. The implementation of the system ensured reducing medical error by improving the accuracy and clarity of medical records, providing clear processes for certifying organizations, and enhancing the reliability of the clinic's services.

Challenge

Being sure that accurate data, reporting and clinical decision support tools are no longer an option, but a requirement, the customer decided to contact the team for the creation of the specialised tool. In such a way the system had to cover all the aspects of their services and deliver reliable quality and security levels.

Solution

Primarily, the EHR system was designed to automate processes, improve efficiency through clinical decision support in real-time and reduce overtime expenses related to manual month-end chart review and changeover.

Pecularities of implementation

Design and development of the modular all-in-one platform

The general approach to the development process ensured reliable delivery of the product workflow as well. Clinical departments got their own workflow prompts, to address the areas of admissions/re-admissions, falls, monitoring of BPs, pain assessments from therapy, diet changes, and psychotropic medication reductions. Each workflow contained a list of tasks to be completed and a time frame that is uniquely created for that specific area. Associated with each workflow are key information and required forms for staff to use during this process. This includes therapy notes or forms for staff to review, with space to note items such as diet changes. Having this important information within the workflow allowed dietitians, speech therapists and nurses to view the same critical notes on a specific resident. Nursing evaluation forms are also included and can be easily completed. Another big block of the system was residents’ personal profiles, their data, and monitoring of their statuses. Deliberately designed flow for the platform helped staff members monitor changes in resident health/behaviour with touch charting in a real-time environment and outlining patterns to predict further outcomes. This module was connected to the alert block allowing immediate notifications of managers of concerning changes with the resident.

Analytics for improvement of the efficiency

The clinic required a deep analytical system integrated into the platform to improve care delivery, operational efficiencies and financial performance across facilities. That included numerous dashboards and data tables, and a documentation database with real-time notifications and alerts. The designed live charts were build interactive to respond to any threads at once as they occur rather than while reviewing a closed chart As for the general analytical function, the EHR operator can create customizable alerts to monitor protocols for certain diagnoses and see any problems before they go too heavy. Deliberately built UX ensured consistent data capture with resident care profile, internal data dashboards and metrics, digital charting and reviewing flow. EHR data flow directly to a dashboard of key indicators driving appropriate care decisions, highlighting overdue items and indicating areas requiring special attention. In addition, the dashboard provided a tool for nurses to analyze the resident chart, identifying areas of improvement such as incomplete documentation or unsigned progress notes.

Phased development and deployment

The clinic took a phased approach to the implementation of the developed platform as it was too complicated for staff to get all at once and too costly for a clinic to change all infrastructure at once in several facilities. A special implementation team supported these activities and assisted with deployment and adjustments. Specific modules of the platform were deployed gradually, such as managing system configuration, designing and implementing training efforts or monitoring the patient census to ensure newly created records matched current resident records. This dedicated team also focused on the start-up tasks for implementation, including scheduling and facilitating training sessions and reviewing workflows to ensure another part of the team worked efficiently with their own tasks. At the same time, the team answered questions while other functional modules were built and helped clinic staff navigate the system during training and adjustment.

Results

EHR system made all clinic processes faster and clearer. It allowed staff to review every assessment inside the care module against key quality measures and identify coding errors or missing information in real-time—instead of waiting for data to be compiled from the previous six to nine months. This enabled staff to take immediate action to correct any deficiencies and engage in real-time quality reporting. Significant improvement in efficiencies of personal care program staff was realized through this initiative and hence improved the quality of care for the residents. With alerts and a clear workflow, the facilities are able to save hours of time, reduce paper use and provide better documentation tracking. All information is kept in one central location and is easily accessible to team members.