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1 Practice Management Document Management Medical Records e-prescribe e-health Patient Portal One Integrated Solution Our practice has been working with Sequel Systems for many years and is extremely satisfied. The way the world of medicine is today, you have to have a company that is available at all times to handle your software needs. It is a comfort to know I can call with a problem and a solution is relayed almost immediately. Peggy Voelpel, Eastern Suffolk Cardiology Dear Sequel, I wanted to thank you for your excellent support and help these past few weeks, and for all your patience. I was worried about learning a new system, but your trainers and support personnel have made it a breeze for all of us here. We appreciate it more than you know. Thank you again! Dr. Kurt Hellinger, Chiropractic Medicine What I love most about SequelMed is the fact that I can get any report I want, any time I want, any way I want. In earlier systems we have used, customizable reports were virtually non-existent and if they were somehow provided, we were charged every step of the way. In essence, SequelMed allows us to be versatile and creative, and has considerably improved our skills. Dr. Ajax George, NY Radiologic Consult Services

2 We are here to meet your electronic medical record needs. Please take this opportunity to learn how we can help you utilize SequelMed to keep your practice running smoothly, efficiently and profitably. Clinician s Dashboard SequelMed is a secure, real-time, point-of-care, patient-centric application for clinicians, providing built-in decision support tools and alerts to aid clinicians in automatically capturing their decision-making rationale, ultimately providing comprehensive access to patient record instantaneously and efficiently. With our unique method of customizable templates and flowsheets, clinicians will be able to automate and streamline their workflow thereby allowing more patients to be examined. In essence, the clinician will be able to focus on what they do best: taking care of the patient rather than taking care of the paperwork. Moreover, SequelMed is fully and seamlessly integrated with its Electronic Practice Management (SequelMed EPM) and Electronic Document Management (SequelMed EDM) systems thereby supporting collection of billing and financial data as well as all image and document management for uses other than direct clinical care. Secure, real-time, point-of-care, patient-centric application Captures and manages episodic and longitudinal health records information Financials, inventory management, outpatient and inpatient management, admission, discharge and transfer management, quality management, outcomes analysis, resource planning, and public health disease surveillance and overall reporting Built-in decision support tools and alerts to aid management and clinicians in automatically capturing their decision-making rationale Comprehensive access to patient record instantaneously and efficiently Closing loops in communication and response that other wise result in delays or gaps in patient care Fully and seamlessly integrated to practice and document management systems Automated and streamlined workflow allowing comprehensive, expedient and meticulous monitoring of patient activity, from administrative, financial and clinical points of view Electronic Patient Chart SequelMed Electronic Patient Chart captures and manages both episodic and longitudinal electronic health record information and can function as the primary information source during the provision of patient care. This will facilitate clinical workflow tasking to manage tasks related to components of the health record with appropriate timeliness and thereby support delivery of effective healthcare providing complete clinical records information. In addition, it will facilitate access to the patient information needed with integrated views, specialty specific forms, and flagging of information outside of normal limits, provide access tools and displays that can be tailored to role or specialty and customized to end user preferences, provide access to knowledge sources at any point within the clinical workflow, provide access to relevant information from the prior care for subsequent episodes or encounters, and organize and prioritize patient-related communications such as messages and diagnostic results and supports management of communications until resolution. Patient Portal Communication and education are critical to patient care. In today s technological advancements, a patient portal provides the perfect balance between two of the most directly engaging entities in healthcare - the provider and the patient. In addition to improving and speeding up communication, it allows the physicians and other providers more time to focus on caring about patient s health. Appointment Requests Reminders and Alerts Patient Registation & Health Forms Referral Management Patient Messaging Personal Health Records evisit Consultations Prescription Renewals & Refills Lab Results & Alerts Online Bill Payment

3 Flow Sheet Vital Signs Outcome, Status & Quality Reporting Ability to automatically capture decision-making rationale in documenting the decision-making processes, Ability to easily customize clinical templates in multiple views and generate flow sheets to view progress of patients over time in both text and graphical manner, while incorporating knowledge bases and outcomes tools to support direct monitoring and feedback of outcomes to clinicians. SequelMed, therefore, as a predictive modeling application, captures patient s health related data to identify intensity of service for predictive resource allocation, real-time surveillance and alerting of potential adverse events. Such type of concurrent management-level care is facilitated by on-line displays enabling easy access to summary views and flow sheets of pertinent information for cohorts of patients (e.g., all patients on a specific care unit, all patients assigned to a particular case manager, all patients associated with a specific physician or group, all patients with specific symptoms and demographics, etc.) to support detection and resolution of potential quality, staffing, and risk management issues. Furthermore, quality m e a s u re s a re e n h a n c e d b y t h e p ro v i s i o n o f longitudinal and appropriately masked information to support clinical trials & research, public health reporting and population health initiatives. For example, decreased incidence of undetected signs and symptoms of impending deterioration of patient s condition and increased incidence of timely intervention. All in all, SequelMed will assist the organization in meeting as well as maintaining excellent regulatory, safety and quality standards that will benefit both the care-receiver as well as the care-giver. Measurement, Monitoring and Analysis Aspect of Care Indicators Performance & Accountability Measures Predictive Resource Allocation Real-Time Surveillance Alerting of Potential Adverse Events Decreased Incidence of Undetected Signs Increased Incidence of Timely Intervention Safety & Regulatory Standards User-Friendly Entry of Clinical Information Easy-to-use entry of information by the clinician at the point-of-care, aided by sentence-building while the information is being recorded, further facilitated by ability to automatically generate problem description text from physician s dictation. History Built-in Decision Support Tools & Alerts Ability to record and maintain patient s clinical history for each encounter in the episode of care and for archived problems for subsequent review, showing progressive and historical status for each visit. HPI Automated Clinical Documentation Ability to link the rationale for clinical decision making with all clinical practice as well as E&M guidelines to show how and why deviations may have occurred.

4 Review of Systems Clinical Review of Body Systems Ability to document and customize review of body systems based on both clinical as well as administrative workflow of the clinician. Physical Exam Intuitive Learning of Clinician Work Flow Facilitate documentation of individual clinician s thinking as well as that achieved through the interaction of other healthcare providers as well as protocols. Health Education Integrated Patient Education Material Utilize key patient-specific parameters to automatically access appropriate analyses providing highly-targeted information for patient education as well as clinical problem-solving. In addition, access to diverse problem - solving aids (e.g. knowledge bases, analytical tools) including support for automatic tracking, documentation, and evidence showing the logic and rationale used. Access to a wide-ranging online knowledge database of reliable educational material is the technological cornerstone of today s healthcare management and information arena, commonly known as Information Therapy. As such, it will provide authenticated and expertly reviewed information on a vast range of health related topics including health conditions, medical tests and procedures, medications, and everyday health and wellness issues. This will improve cognizance of health related issues not only for the patients but also for the physicians and ultimately for the clinical administrators, whether at the time of point-of-care or at any other time prior or post point-of-care. Furthermore, extensive research and analyses may be conducted, leading to more informed and effective health decisions and improved quality of care. Identification of specific populations of patients who can benefit from health management initiatives Provision of integrated disease management support for education, outreach, and care to patients Informed and effective health directives, promoting successful outcomes and helping patients to comprehend and remember instructions Reduction of health risk factors by identifying key elements ahead of time Effective analytical management of health related concerns and questions leading to improved quality of care Easy dissemination of educational material to patients Information Therapy at its best

5 Health Maintenance Protocols Health Maintenance & Disease Management Protocols At the time of patient-physician encounter, it is of great service to have protocols for preventive care and wellness. For example, routine immunizations, age and gender appropriate screening exams (such as PAP smears, etc.). This will facilitate such protocols, as well as interactive reminders for preventive services and tests as well as behavioral actions that would be due for patient in-between patient-physician encounters. Examples include but are not limited to time-sensitive patient and provider notification of evaluation of patient preventive/wellness needs based on past due dates for patient appointments, labs, immunizations or exams; appropriate reminders about lifestyle behaviors such as nutrition, exercise, tobacco use. For example, a Pap test reminder might be sent to the patient a couple of months prior to the test being due, at 3 month intervals, and then brought to the attention of the administrator or clinician 9 months after it is past due. In addition, standardized surveillance performance measures that are based on known patterns of disease presentation can be identified by aggregating data from multiple input mechanisms. Elements include patient demographics, presenting symptoms. Preventive Care and Wellness Preventive Notifications & Responses Disease Management Protocols Critical Care Paths and Protocols Advanced Patient Directives Monitoring and Escalation of Health Risks Identification of Known Disease Patterns for the Prediction of Health Risks Better Surveillance of Predictable Disease Patterns Identification of deviation from standard protocols Assesment Automatic Capture of Decision Making Rationale Ability to automatically capture decision-making rationale in documenting the decision-making processes, including clinical details of the assessment as well as differential diagnoses. Clinical decision support can provide valuable input to help providers make more informed decisions at the point of care. With patient complaints and chronic / problem lists easily linked within the Assessment section, physicians can render a more comprehensive assessment based on a combination of clinical features entered throughout the progress note. In addition, our unique linkage of diagnoses, problem lists and complaints allows physicians to explore disease patterns conveniently and then formulate them in a textual format through our built-in sentence builder.

6 Lab Management Medication Management Comprehensive Lab Management Complete lab management and ability to automatically link problems with orders for lab, radiology, and other tests. This will allow improved electronic communication between lab orders and results along with episodic and longitudinal record of all the lab orders and results, ultimately leading to optimal utilization of time and resources. Hence, SequelMed Lab Management facilitates electronic sending and receiving of lab orders and results, allows easy entry of lab orders based on pre-defined criteria, provision of alerts for abnormal results, specialized views depicting historical record of all orders and results, ultimately leading to optimal utilization of time and resources. Complete episodic and longitudinal record of all the lab orders and results, leading to optimal utilization of time and resources Automated linkage of problem lists and assessments to lab orders allowing improved electronic communication between lab orders and results Provision of diagnostic templates for better clinical documentation and effective results reporting HL7 and DICOM support Easy entry of lab orders based on pre-defined criteria Provision of alerts for abnormal results Access to past clinical history leading to more efficient reporting of results Comprehensive Medication Management SequelMed Medication Management will facilitate both clinical ordering of medications in an organized and legible manner and administrative documentation of medications. This includes presenting the list of medication orders that are to be administered, administration instructions, times or other conditions of administration, dosage, route, form, strength, etc. Additionally, the drug formulary database would allow immediate prospective adverse alerts with respect to contraindications (drug-drug reactions, drug-allergy reactions, drug-food reactions, etc.). Drug classifications will enable the physician to easily search for drugs based on various classes of drugs. Appropriate time stamps for all medication related activity will be generated to substantiate the efficacy (or, lack thereof) of medications. Clinical ordering of medications in an organized and legible manner and administrative documentation of medications (administration instructions, times, dosage, form, strength, route, etc.) Drug formulary will allow immediate prospective adverse alerts with respect to contraindications (drug-drug reactions, drug-allergy reactions, drug-food reactions, etc.) Generation of appropriate time stamps for all medication related activity to substantiate efficacy (or, lack thereof) of medications Identification of potential allergic reactions and cross sensitivities between drugs and specific patient-known allergens Timely alerts to potential duplications of drug therapy, drug ingredients and prescription refills SequelMed incorporates industry s most widely used drug database, encompassing every drug approved by the FDA, plus information on commonly-used over-the-counter and alternative therapy agents, such as herbals, nutraceuticals and dietary supplements, and providing efficient ways of locating exactly the information you need for the task at hand for more informed decision-making, fewer medication errors and increased patient safety. In addition, a comprehensive source of drug-drug interaction information containing over 43,000 interactions on both prescription and over-thecounter drugs, including interacting drugs with generic names, severity levels indicating potential harm to patient, frequency and predictability of the interaction, and overall effects and description of the interaction as well as patient monitoring and management of the interaction.

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