Introduction
Clinical Care Management Systems are the health care systems used by physicians to automate the process of administering medical records of a patient and to eliminate medical errors.
Three clinical care managements systems are described below:
Eclipsys Sunrise Acute Care clinical solution
This health care system is built on the Sunrise Clinical Manager platform that integrates and connects departments and care teams within an enterprise. eLink an Enterprise Application Integration (EAI) solution enables seamless information flow with suppliers, business partners and customers. The nursing efficiency and effectiveness are enhanced by assigning appropriate acuity class derived with Van Slyck Management Solutions. The built-in up-to-date order sets for decision support provide high-quality care and save time and money. ObjectPlus/XA technology exposes Eclipsys business logic as objects that can be integrated with custom applications (Eclipsys).
Epic Systems EpicCare
MyChart provides controlled access to EHRs so that patients can find answers to most of their queries and participate in health care. Affiliate Link makes referral process efficient with provision for specialized physician online consultation. MyEpic is a dashboard that shows financial statistics, staff snapshots and census updates to aid management decision making. The patient acuity class is determined at the time of registration with efficiency of Prelude and Nurse Triage. OutReach enables external providers to interoperate with EpicLab Clinical Laboratory System (Epic).
Cerner PowerChart Office
This is a health care management solution for physicians in medium to large group clinics. The online secure access to medical records enables physicians to access patient information from any location. Patients can access the medical records for appointments, billing and referrals. Providers can find patient information to provide solutions for allergies, immunizations, surgeries and other medical conditions (PowerWorks).
Advantages
The features supported in these healthcare management systems are:
Features of Healthcare Management Systems (HIMSS)
- Eclipsys
- Epic
- Cerner
Electronic Health Records (EHR)
These records store information such as: patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports (HIMSS).
Acute Care has CPOE system that is most widely adopted by the health care system.
EpicCare Inpatient has CPOE for documentation of clinical & nursing workflow.
Industry-leading CPOE for documentation, orders and tasks according to physician workflow.
Health information and data
HIM system integrated with revenue generation and clinic workflows.
EpicCare has Health Information Management for scheduling workflow, tracking activities and inventory management.
PowerWorks PM has patient registration, accounting, billing, laboratory specimens & report tracking and appointment scheduling features.
Decision support
The clinical knowledge is delivered in partnership with Zynx Health and Wolters Kluwer Health.
Epic provides Clinical Practice Model (CPM) content for decision support in EpicCare.
Cerner Millennium has built-in expert medical knowledge for decision support.
Electronic communication and connectivity
Sunrise Clinical Manager can be accessed on WWW with web browser.
EpicWeb provide external interface for access to medical records.
IQHealth provides web interface for online access to PowerWorks.
Administrative processes & Results Management
Sunrise Case Management monitors patients and tracks clinic workflow.
Sunrise Patient Financials integrates payers and patients for higher ROI.
MyEpic is a dashboard that shows financial statistics, staff snapshots and census updates.
PlanLink provides interface for provider and payer organizations to submit receive and review referrals and invoices online.
Enterprise Cyberquery is a business intelligence management tool for clinics.
CodeScan is used for appropriate coding to avoid claim denials.
Integration and interoperability
The health care IT product must be able to integrate with other IT products within an organization such as inventory control that shall connect to the supply chain for drugs and instruments. The IT product must interoperate with health care IT products of other organizations in order to facilitate patient safety and reduced cost by avoiding redundant medication and tests (HIMSS).
eLink is an interface to integrate applications.
ObjectsPlus/XA technology exposes EHR for integration with other applications.
Multi-site laboratories are integrated with Cohort.
Epic supports Clinical Context Object Workgroup (CCOW) standard for coordination and interoperation of different applications by exchange of context.
PowerWorks is integrated with laboratory services for automated clinical, managerial and financial processes.
Inventory management is integrated into PowerWorks
Patient safety and quality
financial consideration and process improvement. Computerized Physician Order Entry (CPOE) and Bar Code Medication Administration (BCMA), the integration of two technologies shall address patient safety objectives. Automation shall simplify the medical administration process and eliminate communication errors (HIMSS).
Eclipsys has fully integrated Medication Management Solution that integrated physician order, pharmacy, nursing staff and point of care for medication.
The electronic MAR knew as EHR is longitudinal patient record and has barcode support to eliminate medical process errors at the point of care.
PowerWorks has ability to automatically assign code for billing after patient examination documents are entered into EMR and audit of documentation.
Privacy and security
Health care IT system must meet the confidentiality, integrity, availability and accountability. Security of patient data in EHR (HIMSS).
Automated file recovery to prevent duplication of records. Deficiency management workflows to reduce cost.
Identity EMPI prevents creation of duplicate records.
RapidEdit works with PowerWorks to eliminate errors in medical claims for fast reimbursement.
HIPAA compliance
Health Insurance Portability and Accountability Act (HIPAA) defines guidelines for health care organizations to implement health insurance and Protected Health Information (PHI) for patients in order to facilitate portability of health insurance plans and accountability to patients to ensure security of their health data (HIMSS).
Embedded evidence based content for HIPAA and Stark Law compliance.
HIPAA compliance is built-in Prelude for address verification, insurance information and accounting to avoid repeated tests and information recording in different care facilities.
Health Transactions is Electronic Data Interchange (EDI) interface to check patient insurance claims, eligibility and benefits for HIPAA compliance.
Certification
The health care IT product must be certified by Certification Commission for Health Information Technology (CCHIT) (Fitzmaurice, 2006).
Eclipsys Sunrise Acute Care is CCHIT certified.
EpicCare is CCHIT certified.
Cerner is CCHIT certified.
Disadvantages
- Feature
- Eclipsys
- Epic
- Cerner
Patient Safety and Quality
CPOE and BCMA integration was not found.
Interoperability
Object or context exposure of EMR data for third party interoperability was not found.
System Operation
Eclipsys provides integration support for Windows, UNIX and mainframe, the middleware supported is COM/DCOM, SOAP & EJB objects. WBT Manager, EasyAuthor and eLearning courseware are tools to educate customers.
Epic provides hands-on training and online tutorials on how to use Epic applications. Epic data can be ported on Oracle, MSSQL server or Teradata database for a customized report.
Cerner provides online and on-site training for PowerWorks. The cost of the system is $595 and 99% uptime is guaranteed with 24×7 support.
My Favorite – Eclipsys Sunrise Acute Care clinical solution for: provision of interoperability with ObjectPlus/XA and web documentation.
References
Acuity. (n.d.) APC Manual. Web.
CCHIT certifies six EHRs for hospitals. (n.d.). Healthcare IT News. Web.
Coding. (n.d.). AHIMA. Web.
Eclipsys. (n.d.) Web.
Epic. (n.d.). Web.
Fitzmaurice, Michael J. & Sensmeier, Joyce. (2006). Standards and Interoperability: The DNA of the EHR. HIMSS. Web.
HIMSS. Web.
PowerWorks. (n.d.) Cerna. Web.