“It’s a better form of communication rather than just filing things into cabinets. The communication aspect of Dr Cloud EMR is huge! ”
– Mr. Robert Kravitz, Sr. Counsellor – BestCare Treatment Services
Washington State auditors say “DrCloud EHR is the most easily navigable and audit-ready EHR they had experienced at a provider agency thus far!”
Megan Gifford, Chemical Dependency Supervisor, Muckleshoot Tribe Behavioral Health Program
“This is the EMR that can grow with the evolving needs of our retirement home and community.”
– AFRH CIO
Dr Cloud EMR helps BestCare achieve Meaningful Use and CARF certification
Dr Cloud EMR helps addiction and mental health non-profit to effectively transition from paper to digital
With the assistance of EnSoftek and the subsequent implementation of DrCloudEMR, BestCare Treatment Services, Inc., a central Oregon substance abuse and mental health treatment non-profit with seven clinics spread over four cities, three counties and nearly 200 miles, shifted from being totally paper–oriented in client service case notes, billing, and analytics to an entirely digital system. This allowed BestCare to create an efficient, streamlined workflow for clinicians, increase the depth and breadth of inter-clinic staff communication, reduce the number of clients who fall through the cracks, attain stronger external audit outcomes, and produce a very clear picture of the agency’s productivity and financial situation at any given time.
“Dr Cloud EMR allows greater scrutiny when problems are getting into the system, with paper files, you could get months behind before you find out!” – Mr. Treleaven
BestCare Treatment Services found itself in an environment in which there was an increasing—and shifting—burden of regulations and requirements for client care and billing. Additionally, except for a locally-created spreadsheet software that was becoming more and more outdated as technology advanced, the agency was almost completely paper driven for files and billing. The outdated spreadsheet software resulted in low business/financial quality and associated analytics that was time-intensive. Having paper-only files and case notes meant clinicians treating clients often found themselves isolated in delivering care and with an incomplete picture of what other care the client was receiving. Another factor in systemic inefficiency was that each of the seven BestCare clinics had created its own way of delivering services, with several instances of the various clinics creating their own forms. Not much was standardized throughout the BestCare system.
Simultaneous to this EnSoftek, Inc., an IT Solutions and Services company solving technology problems for a variety of organizations all over the US including IBM, Nike, Northrop Grumman, Unisys, Fred Meyer, General Services Administration, Multnomah County, OR, and the Port of Portland, OR, among others, was moving into the Electronic Medical Records (EMR) arena. Originally focusing on primary healthcare, EnSoftek eventually settled on creating an EMR specific to the behavioral healthcare community. The company needed a partner in that field to assist it in refining its EMR to compete in the behavioral EMR marketplace.
Once these two entities found one another, a close partnership was developed with BestCare agreeing to become the early adopter for the newly developed DrCloudEMR, giving real time, real life input to EnSoftek with the goal to provide a reasonable, enterprise-class EMR solution. For its part, EnSoftek distilled BestCare staff requirements and suggestions into a seamless workflow, refining the software initially for the inpatient and then outpatient, substance abuse clinics, the mental health clinic, and the all-Spanish language clinic came on board.
EnSoftek began its efforts by meeting directly with BestCare personnel for interview sessions in which counseling, clerical, and administrative staff all outlined how their paperwork flowed through initial contact, first appointments, assessments, case notes, group sessions, and one-on-one sessions. The software developers conducted subsequent meetings of various end user groups for a more in-depth understanding of the processes including the business and customer perspective. From this extensive input, EnSoftek staff then created a flow chart that it presented to BestCare for additional input and modification. An online demonstration site was developed on which BestCare staff could practice using DrCloudEMR and give even additional input. There were other issues to overcome as well. 42 CFR, Part 2, was something EnSoftek staff had to research and learn so the correct security oversight could be embedded. The initial template for Dr Cloud EMR had a strong framework for security and EnSoftek staff had to merely refine it to meet 42 CFR, Part 2, compliance.
BestCare Executive Director Rick Treleaven said he was immediately taken with the responsive nature of EnSoftek staff, observing it listened well to BestCare’s needs and developed innovative ways to address them. For its part, BestCare personnel worked hard at not incorporating the problems in the existing paper process into the new electronic system. As a result, its staff had to be quite clear in the problem it was attempting to solve so that the EnSoftek architects could design the appropriate solutions. Mr. Treleaven later noted he and his staff didn’t discover how much operational pain the agency’s staff had been enduring until they started using the Dr Cloud EMR solution.
The agency had rooms filled with boxes of paper charts. It was very difficult for BestCare staff to find out what was in any particular chart because it might be in one of those boxes in one of those rooms. With Dr Cloud EMR, all those charts are available online through the agency’s computers.
“We don’t have all those filled rooms now. When there is a critical incident and a client is involved, I can pull up the client’s file immediately from my desk or from my home,” Mr. Treleaven explained. “We have standardization of forms now, along with the Golden Thread embedded into our workflow, both of which were difficult with just a paper system. And getting meaningful data was painful and expensive.“
EnSoftek made it purely cloud-based to leverage the elasticity of the cloud, while providing something that was robust, extensible, always available, and secure.
The implementation process took a little over a year from beginning to end because BestCare facilities were brought online one at a time, each with on-site training. This allowed BestCare staff to learn the software so they could better articulate to EnSoftek their day-to-day activity, to further refine Dr Cloud EMR. As each facility was brought online, its staff received training on the system and access to a demo site on which to practice prior to going live. This was instrumental in increasing system acceptance.
Interviews with many of the BestCare staff indicate that while the process of transitioning from paper to digital was a tribulation, they are vociferous in their praise, feeling that by using Dr Cloud EMR the agency is stronger, doing better work, and none would want to go back to a paper-based system. Almost to a person, staff cites the ability to better stay on top of paperwork and client activities, substantially increased inter-office communications that help workflows, audits, and most importantly, clients.
Mr. Treleaven has noted his agency is getting better clinical outcomes because of Dr Cloud EMR. “What we have been able to research in the EMR in detail, there are two factors that really jump out from the data: the quality of relationship between counselor and the client, and the quality of the relationship between counselors at different levels of care,” he said. “The EMR allows greater scrutiny when problems are getting into the system or gaps getting in the way of the counselor creating a strong relationship with the client, and it facilitates communications internally and we can do quality management around that. With paper files, you could get months behind before you find out.”
He stated that he is on DrCloudEMR much more than he would ever be able to look at paper files. For every important strategic contract, he’s able to drill down very quickly and efficiently from the data to individual files, and understand what’s going on within the agency very well, very efficiently. He likes that the productivity reports are simple and don’t require central office involvement. The clinic managers know how to access them and use them in running their facilities.
BestCare clinicians are clear in that DrCloudEMR is advantageous in a variety of instances. Having all the client information available on their desk computers enables the counselors to pull up a client’s file and every case note, every group note is there along with the Individual Service and Support Plan (ISSP).
“It’s a major improvement from having to dig a file out of a cabinet. It’s more convenient,” explained counselor Chuck Roberts. “There are safety checks to make sure information isn’t left out. It can be accessed anywhere, any time. I don’t have to dig through files somewhere else if I get a call from a different office. I can pull up the file and know everything there is to know about that client and be informative for the person calling. It’s all in one spot. It’s a better form of communication rather than just filing things into cabinets. I don’t have to fax something, they can pull up the same client while we’re talking on the phone to see it. The communication aspect of it is huge!”
Mr. Roberts’ supervisor, Colin Taylor, outlined other benefits. “It used to be that the only view of a client was to the person holding the paper file. Now, I can watch every day to see how this person is doing through treatment. I can follow now because it’s so transparent to anyone in the company. I can go into a person’s file now and there are 3-4 treatment notes in the file every day. I can follow things from anywhere on any client. It’s the golden thing about this software. It’s huge! Group notes are breeze with DrCloudEMR. They are the best they’ve ever been. There’s so much documentation now. The concept of going to a single place and getting all the information you need is a no brainer.”
The partnership between EnSoftek and BestCare Treatment Services has created an integrated, dependable, scalable solution that can be adapted to changing conditions, supports the agency’s staff, saves staff time and storage space, allows a 360-degree view of the client that can be shared across a wide geographic area. All this while still complying with HIPAA and CFR 42, Part 2, resulting in better audit outcomes, and operating smarter from both a clinical and business aspect.
EnSoftek builds PCMEDICS – The Peace Corps EHR for worldwide operations
ENSOFTEK HELPS PEACE CORPS CREATE A NEW, GLOBAL ELECTRONIC MEDICAL RECORD SYSTEM (EMR), INTERNALLY BRANDED AS PCMEDICS, TO CAPTURE HEALTHCARE DELIVERED TO VOLUNTEERS STATIONED IN 70+ INTERNATIONAL POSTS
TEAM ENSOFTEK HELPS PEACE CORPS CREATE A NEW, GLOBAL ELECTRONIC MEDICAL RECORD SYSTEM (EMR), INTERNALLY BRANDED AS PCMEDICS, TO CAPTURE HEALTHCARE DELIVERED TO VOLUNTEERS STATIONED IN 70 INTERNATIONAL POSTS
The Peace Corps is an independent executive agency of the federal government established to promote world peace and friendship through the service of American Volunteers. The agency currently manages more than 8,000 volunteers in approximately 70 international posts.
To meet its mission, the Peace Corps relied heavily on electronic processing and information management technologies. Peace Corps was looking for a vendor to implement a new, global Electronic Medical Record System (EMR), internally branded as PCMEDICS, to capture the health care delivered overseas by Peace Corps Medical Officers (PCMOs) and US-based Peace Corps clinical staff and to provide a database by which Peace Corps may assess quality of care and business processes through data and reporting.
Through a long competitive RFP process, the Peace Corps selected EnSoftek to develop, customize and implement PCMEDICS system using the OpenEMR and DrCloudEMR™ platform components, Dynamics CRM, SharePoint, BizTalk, and SQL server platforms and applications.
With the assistance of Team EnSoftek’s Solutions staff and the subsequent implementation of the EMR, Peace Corp is in the process of deploying PCMEDICS at their posts (70 Countries) around the World allowing them to enhance management of their volunteer’s health records, clinical documentation, care coordination and medical supplies.
The requirements of PCMEDICS system implemented by EnSoftek included:
- Providing a means in which Volunteer health information is securely stored and processed by Peace Corps staff members who have been designated to have pre-approved levels of access and a specific need to know such information.
- Providing an EMR tool that includes but is not limited to a framework for standardized, legible documentation and a chronological record of care by the Peace Corps providers.
- Support standardization and quality control of ambulatory health care practices of more than 140 Peace Corps Medical Officers in 70+ health units around the world.
- Providing health industry standard practice management tools for ambulatory care adapted to Peace Corps needs as defined during the gap analysis.
- Providing tools to improve the communication among PCMOs, Regional Medical Officers (RMOs), and HQ and individual volunteers
- Supporting other specialized business processes that involve medical records (e.g. sexual assault case management, mental health management, medevac case management).
- Supporting posts’ ability to track medical supply inventory.
- Provide the ability to efficiently and effectively track resource utilization of PCMOs, consultants, and other functions for business process analysis, cost benefit analysis, and Peace Corps’ supply of and demand for PCMOs.
- Provide analytic tools to process data to determine quality outcome indicators, epidemiological tracking, and reports that link quality care to business process efforts.
- Support and streamline the Peace Corps business process for delivering health care as defined in Peace Corps Manual Sections and Medical Technical Guidelines.
- The first ever enterprise “Electronic Medical Record” solution for the Peace Corps.
- Enhances the level of care for thousands of volunteers stationed around the world.
- Operational efficiencies achieved due to streamlined workflow processes.
- Electronic reporting of health data and trend analytics.
- Reduced paper use to reduce costs and errors and going green.
- Enables providers to more effectively diagnose patients, reduce medical errors, and provide safer care.
- Accurate, up-to-date, and volunteer health information at the point of care for more coordinated, efficient care.
- Enhanced ability to monitor and manage on a global basis medical supply inventory.
- Designed for less connected areas, accessible in low bandwidth or areas with no internet connections
National Veteran Home adopts Dr Cloud EMR
AFRH IMPLEMENTS DR CLOUD EMR TO TRACK AND MANAGE HEALTHCARE SERVICES OF OUR NATION'S VETERANS
For more than a century the Armed Forces Retirement Home (AFRH) has provided veteran airmen, marines, sailors and soldiers the finest lifestyles in their retirement. They provide support to approximately 1200 residents located at their Gulfport, Mississippi and Washington, DC campuses.
AFRH HELPS VETERANS ACHIEVE TOTAL WELLNESS IN EVERY ASPECT OF RETIREMENT, PLUS, A RANGE OF OPPORTUNITIES IN FITNESS, RECREATION, ARTS AND CRAFTS, OUTDOOR ACTIVITIES, LEARNING, NUTRITION, CAMARADERIE, AND ADVENTURE.
AFRH issued a Request for Proposal (RFP) in May 2012 in search of an Electronic Health Record System which possessed a broad spectrum of functionality to support its healthcare services (skilled nursing, social services, wellness center similar to an outpatient doctor’s office that provides onsite primary and specialty medical services, dental, optometry, nutrition, mental health, assisted living, long term care, memory support and independent living) and selected EnSoftek’s “meaningful use” certified DrCloudEMR™ Solution in February 2013.
This is a highly complex implementation effort supporting two campuses geographically dispersed (urban and rural), whose goal is automate and create a central repository of its resident’s health information and records for all aspects of their care. As part of the initial discovery and requirements gathering effort, it became clear the two campuses while adhering to overall policy guidance from Headquarters, also have implemented that guidance differently from an administrative perspective, resulting in alternative approaches to perform the same task. This increased the challenge to develop and deliver a new enterprise system, which required a uniform and standard approach to manage health care data by all.
Using a top down review, we uncovered a number of business processes and an array of forms unique to the campuses, which required further review, streamlining, identification of redundant data, and consolidation. Further increasing the complexity for this effort are the 325 plus individuals that were trained to utilize the new solution at the two locations.
The Implementation and customization effort started in March 2013. The completion of the initial version of Dr Cloud EMR was by mid-September 2013 including user-training. As users have become more familiar with the solution, they have requested modifications to the system to further enhance their operational efficiencies. Efforts are currently underway to capitalize on one of its strongest features, which is the ability to customize DrCloudEMR to meet the unique patient and business requirements of its users. These efforts include the following:
- Making workflow modifications to enable the staff of AFRH to further increase their productivity, scheduling/information flow and capture clinical information by eliminating the paperwork.
- Providing for secure, HIPAA compliant, role based login access for AFRH users.
- Pre-Admissions/Admissions module modifications to capture veterans information (DD 214), resident information, and track information in custom reports for pre-admissions from 20 different referral sources.
- Billing module modifications to track each resident’s private pay based on a benevolent percentage.
- Pharmacy integration with Computerized Physician Order Entry (POE) system.
- Ability to create personalized treatment plans for the residents.
- Integrated Self-service patient portal and Interfacing with several AFRH systems.
- Multi-facility support, and Multi-program support.
- Adding ePrescribing to more effectively manage the prescription process and enhance it safety.
- Provides AFRH and our Veterans with a world class healthcare EMR solution
- Provides accurate up to date and complete information about patients at the point of care
- Increased productivity as a result of the many processes that have become automated
- Reduction of expenses e.g. associated with paper charts, poor documentation, etc.
- Ability to retrieve and update patient clinical records is performed substantially faster and with fewer errors.
- Customized solution workflows to meet the needs of the residents and their care levels e.g. Independent Living, Independent Living Plus, Assisted Living, Memory Support and Long Term Care
- Provides full capabilities for pre-admissions, admissions, leave absences and scheduling care in one integrated record.
- Provides for the integration of wireless or hard wired touch screen kiosks and the ability to integrate with other devices i.e. iPad’s, tablets and mobile devices.