Transcript Integrated Electronic Health Record for Correctional Health

Integrated Electronic Correctional Health Record:
One Integrated System for
Medical, Behavior Health and Dental
CTA CONFERENCE
MAY 17, 2016
A
TM
System
Confidential. All Rights Reserved 2016
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INTRODUCTION
Jointly Present
Phillip Winder
CIO Delaware Department
of Correction
Jose Colon
President
CNT Infotech
Muneer Ahamad
Project Manager
CNT Infotech
Vijay Nathan
Project Manager –
TechDoc’s iCHRT –
EHR Implementation
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AGENDA
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CIO – Delaware DOC
About the State of Delaware
Landscape and Population
About CNT Infotech
Objectives
EHR Functions – Integrated Healthcare Delivery System
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Medical
Behavior Health
Dental
Approach
Implemented/In-Process Functions
Standards and Guidelines
Differentiating Factors
Challenges Faced
Technical Specifications
Benefits of an Integrated EHR
Questions
Functions’ Description
Contact Us
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ABOUT DELAWARE DOC
About Phillip Winder, Director
Technology and Government Background
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Appointed Director of IT for the Delaware Department of Correction in October 2013.
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Implemented EHR (iCHRT), LSIR assessments, SB #226 (Good time Credits) and Inmate Accounting
System (iCASH).
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Appointed member of the DELJIS Board/Committee.
Additional Experience in:
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Delaware Department of Transportation
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Delaware Motor Vehicle Division (REAL ID, Modernization of DMV’s system platform, Web
Development, Online Services & AAMVA Partner)
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Department of Finance (FACTS, Training Module PeopleSoft integration)
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Maintenance & Operations
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DART First State
M&T Bank (VRU’s, Call Center Applications, PBX.’s, Melita Dialer,).
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ABOUT CNT INFOTECH
“We at CNT Infotech believe that the cornerstone of any long-term relationship
should begin with one focal point – our client’s satisfaction”.
Privately owned Information
Healthcare Services Company.
Technology
and
Serving
Corrections,
Correctional
Health,
Hospitals, Imaging Centers, Medical practices and
Private physicians in the US and Puerto Rico.
Healthcare Billing &
Management Association
Staff with more than 25 years of experience in:
Electronic Health Records
Healthcare Operations
Healthcare IT
Corrections, Correctional Systems
Gang Information System
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ABOUT CNT INFOTECH
About Vijay Nathan
About Jose Colon, President
Health Care, Technology and Government
Background
Healthcare, Technology and Government
Background
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Has been working with Large scale system
implementations for over 18 years.
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Implemented the TechDoc Electronic Medical Record
System for Physicians, Group Practices and Radiology
Centers.
Led the Implementation of the Delaware Offender
Management System.
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Led the Implementation of the TechDoc – iCHRT System
for the State of Delaware.
Education:
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Implemented the integration of TechDoc EMR to Voice
Dictation and PACS Systems.
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Education:

Has been working with Large scale system
implementations for over 18 years.
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Directed the Development of TechDoc Electronic Medical
Record System, CNTI Proprietary EMR, in 2001 .
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Bachelors Degree in Computer Science
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MBA in Business Administration
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Bachelors Degree in Commerce
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MBA in Finance.
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ABOUT THE STATE OF DELAWARE
Facts:
- Size: 2000 Square Miles
- Location: Eastern Seaboard
(About 2 hours South by car)
- Population: 900,000
- Elevation: Highest point
447.85 ft. above sea level
- Products: Agriculture,
Fishing, Manufacturing,
Mining
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LANDSCAPE AND POPULATION
Integrated Correctional System
Jail
Prisons
Probation and Parole
Population
Jail/ Prison: around 7000
P&P: around 12,000
Facilities
4 Jails/ Prisons
2 Violation of Probation Facilities
5 Halfway Houses/ Work Release Centers
7 Probation and Parole Offices
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OBJECTIVES
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Maintain a complete offender health record
Improved communication
Reduce human errors and duplications
Integration with our Offender Management system
Integration with Health Information Network (HIN)
Meet national standards
• HIPPA
• NCCHC
• ACA
• Meaningful Use
• State Regulatory Requirements
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EHR – INTEGRATED CORRECTIONAL HEALTHCARE DELIVERY SYSTEM
Inmate/Offender
Management
System
Medical
Behavior
Health
Dental
ePrescription
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WHAT ARE THE KEY FUNCTIONS THAT AN
INTEGRATED CORRECTIONAL EHR SHOULD
HAVE?
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MEDICAL
Schedule
Scanning
Lab/
Imaging
Progress
Notes
Allergies
Dashboard
Medical
Medical
Inquiry
Chronic Care
Sick
Calls
Infirmary
Intake
Nursing
Protocols
Discharge/
Release
Encounters
Immunizations
Electronic
Signature
Chart
ePrescription
Progress
Notes
E-MAR
Transfers
Consults
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BEHAVIOR HEALTH
Schedule
Individual
Treatment
Plan
Behavior
Health
Programs
Dashboard
Sick Calls
PreSegregation
CMHE
Comprehensive
Mental Health
Evaluation
Intake
Encounters
Chart
Assessments
Mental
Health
Screening
SUD
Substance Use
Disorder
Screening
ASI
Progress
Notes
Structured
Care
Unit
Reports
Bio-Psycho
Social
Assessment
Therapeutic
Community
Psychiatric
Close
Observation
Scanning
Brief
Intervention
Psychiatric
Evaluation
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DENTAL
Chart
Dental - Filing
Dental Extraction
Dental IOE
Dashboard
Dental
Dental Cleaning
Encounters
Denture
Multiple
Dental Surfaces
Sick Calls
Dental Recall
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E - PRESCRIPTION
Imaging
Vision
Medications
E Prescription /
Medical Orders
Durable Medical
Equipment
Other
Medication
Administration/
EMAR
Labs
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CHART HOME SCREEN
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APPROACH
Project Management
Requirements
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Customize
Testing
Training/GoLive
Sick Call, Physicals, Nursing Protocols and Scheduling
II
V
VI
Design
Admissions, Intake Screening, Medical Inquiries, Medical Administration, Transfers
III
Discharges, Chronic Disease Care, Immunization, Lab /Imaging Results, and
Pharmacy/Prescription Interface
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Behavior Health (Substance Abuse and Mental Health), Consults, Infirmary Stay, Medical
Emergency,, Dental, Court Ordered Medical/Mental Health Services Notification/Observation
Medical Service Compliance, Medical Services Governance, Surgery, Vision, DHIN Interface
Maintenance and Enhancements
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IMPLEMENTED/IN-PROCESS
FUNCTIONS
IMPLEMENTED
Sick Call
Nursing Protocols
Preventative Exams
Scheduling
Intake Screening
Transfers
Medical Inquiries
Medical Administration
Chronic Disease
Discharge
Laboratory
Diagnostic Imaging
Pharmacy Interface
IMPLEMENTED
• OB/GYN
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Consults
Infirmary/Surgical
Dental
Behavioral Health
Vision services
Medical Services
Compliance
/Governance
• Imaging Interface
• Voice Integration
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IN-PROCESS
• Integration with
Health Information
Networks
• Lab Interface
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STANDARDS & GUIDELINES
National Commission on Correctional Health Care
(NCCHC) Standards
American Correctional Association (ACA) Guidelines
HIPAA
Meaningful Use Requirements
State Regulatory Requirements
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DIFFERENTIATING FACTORS
State Correctional Health System
One system for Medical, Dental and Behavioral Health Departments
Integration with State Offender Management System
Meet State and Federal Guidelines – ACA, NCCHC, Meaningful Use, HIPAA
etc.
Integrated with Pharmacy Vendor and Health Information Network.
ePrescription, eMAR
Integrate with PACS and Voice Dictation Systems
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CHALLENGES FACED
Standardized Process
Policies
Forms
Identifying Super-users
Training
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TECHNICAL SPECIFICATIONS
 Architecture: Web Based, N-tier Architecture.
 Supported Browsers: IE , Chrome, Mozilla and Safari.
 Database: Oracle or SQL Server
 Application Server: Web Logic
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BENEFITS OF AN INTEGRATED EHR
HIPPA
•HIPPA
Compliant
•Access
Control
Cost
Effective
•ASP Model
•No Additional
Expenditure
Integrated
System
Integrated
Health/ Patient
Record
Sharing of
Information
Scan
Upgrades
CNT
Ease Of
Use
•User Friendly
• Template
Driven
•Intuitive
•Includes
Upgrades
•Updated
CPT/Diagnosi
s Codes
Real Time
Access
•Instant
Access
•Allows for
Informed
Decision
•Understand
Offender
Integration
• Healthcare
System
Specialists
Dashboard
•Scan
Documents
•Images
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C
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T
Patient Chart
Summary
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QUESTIONS
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FUNCTIONS’ DESCRIPTIONS
Dashboard
My Work list Tab – Displays all appointments by status and date range
Pending Tab – Displays all appointments that have been initiated but not closed
Notifications Tab – Displays all the notifications generated for the logged-in user’s
profile
Administration Tab – Displays Admin reports
Pharmacy Tab – Displays all completed medical orders and allows users to select
orders to get refilled
Lab/Imaging Tab – Displays all completed lab/imaging orders, view results and
attend lab/imaging appointments
Discharge Tab – Displays both preliminary and release lists by date, and allows
users to generate medical and mental health appointments before offender’s discharge
Chronic Care Tab – Displays offenders enrolled in Chronic clinics by date and allows
users to enroll and discharge offenders from clinics
Consults Tab – Displays all consult requests generated and allows users to manage
outside consult appointments
Infirmary Tab – Displays list of offenders enrolled in infirmary by date
Behavioral Health Work-list Tab– Displays assessments completed for offenders
enrolled in to Mental Health or Substance Abuse
Confidential. All Rights Reserved 2016
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FUNCTIONS’ DESCRIPTIONS
Intake
Needs Intake – Displays all intakes completed using offender management
system
Documents – Displays all documents attached for current intake
Initiated Intakes – Displays all intakes that were initiated or completed
Can document information for the following sections: General questionnaire,
Mental Health, Medical Conditions, Female Questionnaire, TB, Allergies,
Discharge Planning, Comments, Disability, Disposition, Insurance, Schedule, and
Addendum
Automatically schedules appointments for specific service types based on any
affirmative responses
Preventive Exams
Auto-schedules for Preventive Initial once Intake is initiated. Upon completion of
the assessment, schedules for a Preventive Periodic based on the offender’s age
Can document information for the following sections: Offender History, Vital
Signs, Vision Screening, Hearing Screening, TB Screening, Pap Smear,
Mammogram, Fecal Occult Blood Test, Physical Assessment, Other Medical
Screening, Rectal/Testicular Exams, and Special Circumstances
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FUNCTIONS’ DESCRIPTIONS
Sick Calls
Allows users to triage the following types of sick calls – Medical, Behavioral
Health, Dental, Administrative, Pharmacy, and HIV/STD
Auto-schedules an appointment based on the Priority of the sick call and the
Provider to be seen
Encounters
Gives providers the capability to enter Diagnosis Codes and SOAP notes for the
nursing protocols
Total of 8 protocols and 50 sub-protocols to choose from
Allows providers to schedule for follow-ups or refer to a different department
Allows providers to enter medical orders
Gives providers the capability to complete infirmary and consult requests
Scheduling
Displays all open appointments for an offender
Allows users to schedule for an appointment
Provides the capability to generate the frequency for a recurring appointment
Provides the capability to reschedule or cancel from the existing open
appointments
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FUNCTIONS’ DESCRIPTIONS
Vision
Providers can complete an on-site Optometry consultation
Allows providers to enter medical order specific to vision
Auto-schedules for follow-up consultation, if required
Dental
Allows providers to complete a Dental Chart
Color-codes each tooth based on the condition(s) selected
Displays a checklist of items to be completed
Allows providers to enter dental medical orders as well as administer them
Provides a historical report of each tooth
Allows users to complete the Periodontal Screening
Displays a list of all proposed treatment plans that need to be completed
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FUNCTIONS’ DESCRIPTIONS
Medical Orders
Allows users to complete medical orders under the following categories:
Medications, Lab/Imaging, Behavioral Health, Dental, Durable Medical Equipment,
Vision, and Other
RN and LPN profiles are only allowed to enter a 3 day bridge order
Providers can document the Sliding Scales for Regular Insulin
All medications are accompanied with the PDR Brief
Interfaced with Medi-span to allow users to check drug-to-drug interactions
Allows providers to print e-prescriptions for all orders
Displays an alert for duplicate doses of medications
Disables the refill capability for all narcotics
Allows users to schedule for lab/imaging appointments with the technicians
Confidential. All Rights Reserved 2016
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FUNCTIONS’ DESCRIPTIONS
Pharmacy Administration
Allows users to filter the list of offenders that requires administration with the
following criteria: Administration Date, Facility, Housing Location, Building,
Wing/Unit, Floor, Tier/Pod, Room/Cell, Facility Time, and Delivery Method
Lists all the medications that requires administration on the selected date, time
and offender
Provides the capability to document the action taken for each medication
Allows users to print a med pass report every day based on the facility timings
Medication/Insulin Administration Record
Users can view an offender’s MAR/IAR for each month
Users can print out MAR/IAR for a week or a month
Displays the medication details, the facility administration timings, the actual time
the medication was administered, the initials of the administrator, and the action
taken during administration
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FUNCTIONS’ DESCRIPTIONS
Chronic Care
Allows providers to enroll offenders in one of the 24 chronic clinics
Allows providers to complete the Initial assessment, the Follow-up assessments and the
Nursing Chronic assessment
Providers can complete the Foot Examination if offender is enrolled under Diabetes
Providers can view all completed assessments even after the offender’s discharged
Consults
Allows user to schedule and track offsite appointments.
Allows users to the capability to complete multiple consult requests per offender.
Providers can view all administered vaccines and document the reactions on a VAERS
form
Confidential. All Rights Reserved 2016
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FUNCTIONS’ DESCRIPTIONS
Behavior Health (Mental Health and Substance Use)
Allows users to screen offenders for both Suicide Behaviors and Mental Health
Screening.
Assessments include:
Mental Health Screening
Comprehensive Mental Health Evaluation
Substance Use Disorder Screening
Addiction Severity Index
Individual Treatment Plan
Bio-Psychosocial Assessment
Substance Use Disorder Screening follows the Texas Christian University Method
Mental Health Encounters include:
Mental Health Evaluations
Placement to PCO ( Psychiatric Close Observation)
Automatic Referral to Psychiatrist
Placement to Structured Care Unit/Transitional Unit
Refer to Medical, Therapist
Substance Abuse Encounters include:
Placement to Brief Interventions
Refer to Therapeutic Community
Refer to Medical
Refer to 90 Day Program
Automatic Referral to Psychiatrist
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FUNCTIONS’ DESCRIPTIONS
Infirmary
Allows providers to admit offenders to Infirmary
Offenders can be referred to PCO along with Infirmary
Providers can complete the following assessments: Physician, Nurse, 24 hour rounds,
Psychiatric Evaluation, Clinical Note, and Mental Health Observation
Providers can view all previously initiated assessments
Auto-schedules for a Physician and a Psychiatrist Encounter when transferred out of Infirmary
Transfers
Allows users to transfer offenders and his/her records from one facility to another
Allows users to view and accept appointments and medications from the outgoing facility to the
incoming facility
Lab/Imaging
Allows technicians to attend lab/imaging appointments
Users must document the number of the form completed during the appointment
Allows users to attach results received on paper
Allows users to view results received electronically
Highlights all critical lab results
Confidential. All Rights Reserved 2016
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FUNCTIONS’ DESCRIPTIONS
Immunizations
Allows users to administer vaccines and document any given prior to
incarceration
Providers can view all administered vaccines and document the reactions on a
VAERS form.
Medical Inquiry
Allows users to document inquiry pertaining to an offender
Provides capability to document inquiries from multiple sources including
newspaper, court, family, etc
Allows users to document responses to the medical inquiries
Discharge
Allows users to view list of offenders who have been released and offenders who
are in the preliminary list to be released
Allows users to document for both medical and behavioral health discharge
planning for planned releases.
Confidential. All Rights Reserved 2016
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FUNCTIONS’ DESCRIPTIONS
Chart Home Screen
Allows users to view the offenders Allergies, Medical Orders, Vitals, Sick Calls,
Problem Lists, Immunization, and Infirmary among many others
Allows users to print historical records with a specified date range
Allows users to view all attached documents and progress notes from here
Reports
Allows administrators to view and print details for customized report
Provides graphs and bars for visual representation of the numbers reported
Confidential. All Rights Reserved 2016
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CONTACTS
Phillip Winder
CIO
Delaware Department of Correction
[email protected]
(302)857-5282
WWW.CNTINFOTECH.COM
(800) 939-6690
Jose Colon, President
[email protected]
646-452-9350 Ext. 307
Vijay Nathan, Director
[email protected]
646-452-9350 Ext. 308
Muneer Ahamed, PM
[email protected]
646-452-9350 Ext. 309
Confidential. All Rights Reserved 2016
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