IMS MAXIMS PAS & EPR SOLUTION Service Description MAXIMS PAS/EPR
Contents Introduction... 3 MAXIMS PAS... 5 Features... 5 MAXIMS EPR... 12 Integrated Care Pathways... 13 Order Communications and Results Reporting System... 15 User Defined Assessments... 16 Clinical and Patient Portals... 19 Care Provider Portal... 19 Patient Portal... 19 Technical Details... 21 Hosting... 21 Links to other systems... 21 NHS Information Standards... 22 Patient Safety... 23 Implementation and Support... 23
Introduction IMS MAXIMS is a leader in high-quality patient administration systems (PAS) and electronic patient record (EPR) systems. Our products enable healthcare providers to make significant efficiency gains and to improve patient care by ensuring that every member of staff responsible for a patient s care is able to access everything about that patient at any time, electronically. Our aim is to be the first choice for customers and to set the standard by which our competitors measure themselves. Over 100 hospitals and 20,000 system users already benefit from our solutions, and the numbers are growing all the time. Customers value the way that our products combine robustness with creative flair and ease of use. Our products are reliable, advanced, flexible and effective. They have been developed with extensive input from clinicians and other healthcare professionals so they work intuitively and can interoperate with other specialist departmental systems to offer a seamless integration of the patient record, cut costs, increase productivity and most importantly improve patient care. This document presents an overview of the MAXIMS PAS and MAXIMS EPR, which can be implemented separately or as an integrated PAS/EPR solution.
MAXIMS PAS MAXIMS PAS has been developed in the UK to meet the needs of healthcare in the NHS. It supports the full range of standard PAS functions, including: Patient Master Index Choose and Book Outpatients Referral To Treatment Waiting Lists Inpatients Admission, Discharge and Transfer Bed management Coding (automated when used with MAXIMS EPR) Casenote Tracking Commissioning Management Information and Reporting Features The Patient Master Index includes full demographic details, merge/unmerge, multiple addresses, registered GP, PDS verification, an interface to the tracing service, data quality assurance, NHS data dictionary compliance, etc. We aim for low error rates, minimal duplicates, mandatory use of the NHS number, and accurate CDS extracts together with all relevant statutory returns. Using the fully compliant MAXIMS PAS, Trusts can automate outpatient appointment booking via Choose and Book. The system provides complete
control over the Referral To Treatment (RTT) targets, monitoring patients along the pathway across outpatient and inpatient activity. MAXIMS PAS supports the setting of date triggers, clock stops, reassignment of pathways, and issues alerts and reminders so that targets are not breached. Flexible scheduling is supported to meet the needs of different patients, physical locations, resources and staff. Rescheduling, holiday processing, adhoc clinic sessions are all supported within the timeslots or sessions according to Trust priorities and policies. Minimal intervention is required to optimise appointment schedules and actions can be automatically triggered to minimise human intervention. Effective outpatient management is crucial to ensure the smooth running of clinics. Flexible slots and fine-grained appointments ensure optimal use of resources. Patient attendance is recorded together with room usage and discharge management from the time of arrival. We can demonstrate a reduction in DNAs, the optimal use of outpatient resources and a reduction in inpatient waiting times. Elective admissions, waiting lists and admission management are used to regulate the admission process and to ensure that patients are placed on the right pathway and against the correct contract. On arrival, the patient is recorded as having been admitted to a ward. Admissions, ward management, bed management, ward transfers, episode management, home leave, ward attenders, day cases, infection control monitoring, bed state, bed type, discharge planning are all key features within the inpatient functionality. When used in conjunction with MAXIMS EPR, the full patient journey is managed via the Integrated Care Pathway.
The expected discharge date is used in conjunction with the integrated care pathway to optimise the use of resources, maximise patient throughput and reduce the average length of stay. Infection monitoring and control are used to ensure targets are met. The MAXIMS Bed Manager simplifies patient admission, discharge and transfer with a graphical plan-views of the ward. A patient search will return the patient s details and their current ward and physical location. The ward view shows a map of the ward indicating the precise location of patient beds. Alerts may be shown alongside each bed graphic, including infection control status, allergies, adverse drug reaction and child safety. Colour-coding shows bed status, availability and time to estimated discharge. Where the MAXIMS clinical modules are also implemented, certain mandatory assessments such as Dementia and VTE are monitored for completion and warnings generated if not performed in a timely manner. For Trusts that still use paper, casenote tracking is supported with the ability to track and identify multiple casenote folders. Casenotes can be requested, their physical location history recorded and automatic notification of impending appointments can generate a request to a medical records department to pull casenote folders. Casenote management supports for deceased patients, merged patient records, etc. The real-time management of casenote folders improves clinical efficiency and effectiveness, and reduces clinical errors by ensuring that the casenotes are always ready to be referred to during an encounter.
The MAXIMS clinical modules support live coding of diagnosis, procedures and outcome. But where the PAS is used without clinical modules, it supports coding and the automatic HRG grouping for CDS returns and reporting. A Discharge Summary is a concise record of all the care delivered to a patient during their stay, and gives authorised healthcare professionals and related disciplines the ability to input clinical data at each stage of the care delivery process, creating a complete care record which can be shared by all disciplines when required and printed upon discharge. The discharge summary can be reproduced in electronic or hard copy and sent to the referring GP in numerous formats. Users are notified of any omissions prior to the generation of the letter. Discharge summaries that were previously inadequate to support complete clinical coding, are replaced by fully coded MAXIMS documents. MAXIMS PAS has an integrated report builder that allows the Trust to create a variety of templates for letters, reports, personalised information leaflets, etc. The templates permit documents to be generated very quickly as most of the information is pre-filled. All personalised correspondence is stored as part of the patient record so that a record is kept of the information that has been given to patients. Any document can be created at any time, or an administrative event can generate a trigger to send a message in various formats to third-party systems. Existing electronic documents (PDF, RTF and DOC formats) may be imported into the patient record where they are converted to PDF and are securely held in MAXIMS EPR alongside locally created documents. Existing paper documents (e.g. referral letters) may be scanned into MAXIMS and the resulting PDF files are also held in the same manner.
We offer a whole range of ways to reduce the administrative effort devoted to correspondence, and to maximise the speed of communication, allowing healthcare providers to focus their resources on other tasks. This brings significant improvements in the quality of services and levels of patient satisfaction. MAXIMS PAS also uses the report builder to create new operational and analysis reports for clinical and management staff. Alternatively data can be extracted into a data warehouse where traditional Business Intelligence tools can provide in-depth analytical analysis. For real-time performance monitoring, a KPI dashboard is provided that can be configured to monitor almost any key data within the system, such as bed occupancy, wait times, breaches, etc. Commissioning is supported through the allocation of events and activities to contracts. Commissioning Data Sets are formatted ready for submission to SUS or verified using one of the third-party tools to verify and make the actual submission.
MAXIMS EPR MAXIMS EPR provides the foundation for a completely digitised, electronic record of the patient s clinical diagnosis and treatment and care. Specialist clinical modules do augment it but at the core the EPR comprises: Integrated Care Pathways Order Communications and Results Reporting User Defined Assessments Clinical and Patient Portals MAXIMS is a powerful, proven, sophisticated and scalable software solution that allows healthcare providers to create a complete electronic patient record (EPR) system that is tailored to their needs. Among its greatest advantages is that MAXIMS is a modular EPR and where PAS functionality is integral to the application, there is no need to rip and replace incumbent systems. MAXIMS EPR can easily wrap around an existing PAS to provide all the extra functionality needed without the time and expense involved in a wholesale replacement of the legacy system. Alternatively MAXIMS PAS/EPR can be delivered as a single solution. The MAXIMS EPR allows healthcare providers to replace paper-based systems with an electronic one that is fast, efficient, accurate, and improves patient safety and allows for the capture of clinical codes throughout the patient record. By using the full functionality of MAXIMS EPR, healthcare providers can create a single patient record that contains all the relevant information about every
aspect of their care and will code any diagnosis, procedure; allergy and comorbidity utilising any external taxonomy adopted by the organisation. This includes historic notes, all correspondence, past and future appointments and care details. Each stage of a patient journey can be planned and updated in real time ensuring that KPIs are not breached and that they follow the quickest, most efficient pathway. This goes right the way through to discharge, at which point summary details can be sent electronically to GPs. Our solution allows healthcare providers to monitor and improve the way they work by providing them with a full set of data on all their functions. This is vital to modernising their business to make the best use of financial and human resources in providing the highest standards of patient care. The versatility of MAXIMS EPR, the presentation layer, interoperability and Spine integration make MAXIMS the optimal solution for a flexible approach complete replacement where it is needed with deep integration for longerterm solutions, or light integration for short-term solutions. Integrated Care Pathways Sophisticated but easy to use, MAXIMS Integrated Care Pathways module enables workflows to be co-ordinated and efficient, accelerating patient services and reducing demands on staff. It promotes best practice and improved safety, while enhancing an organisation s overall performance. As with all our solutions, it is intuitive to use and can be customised to meet the clinician s particular needs.
The system is patient-centred, providing prompts for each action required by their care plan and supporting the clinician to carry them out. Forms or screens can be linked to any actions to enable quick navigation. It facilitates the patient journey, enabling quick treatment and ensuring that full and accurate information is recorded at every stage, utilizing either the comprehensive Nursing Documentation or Clinical Noting modules. Checklists can be filtered by ward, unit, team, or role so that services can be planned efficiently. Pre-populated order forms save time and reduce errors. MAXIMS Integrated Care Pathways not only suits standard surgical and medical pathways but also works well with assessment units, A&E referral, outof-hours and emergency care units. It readily integrates with outpatient pathways and helps manage the 18-week referral to treatment target. Order Communications and Results Reporting System MAXIMS Order Communications and Results Reporting (OCS) is a highly functional module within the MAXIMS EPR that allows healthcare professionals to order a wide range of diagnostic tests and treatment services instantly for a wide range of services (including pathology and radiology), for any registered patient. It includes orders and results from other diagnostic and treatment services, for example, Cardiology and Audiology, with future plans to support any patient-related order including therapies, transport and Dynamic Function Tests (DFTs). The range of investigations that are available to order is determined by the Trust through local configuration of the system but can include all necessary patient and clinical information to be sent with the order to improve safety.
The system also provides the functionality to view the results of these tests and investigations as part of the patient record. MAXIMS OCS uses the latest interfacing technologies to link to the Trust s current departmental systems, providing a fast, reliable and seamless integration between the systems. MAXIMS OCS allows diagnostic tests and treatment services to be ordered instantly, eliminating the delays, bottlenecks and errors of paper-based systems and functions just as well across multiple sites as within a single hospital. The system enables staff to track orders and view 100% accurate results as soon as they become available. This helps to reduce duplication and inappropriate tests. Delays in getting the results are eliminated, bottlenecks and transcription errors associated with paper-based systems are reduced, all contributing to improved care for the patient. User Defined Assessments The MAXIMS User Defined Assessments (UDA) module is a toolkit that supports the creation and configuration of structured assessments, both scoring and non scoring, depending on the data capture needs. The assessment provides comprehensive capabilities to capture, review and share patient clinical notes. The capability of IMS MAXIMS Clinical can be extended using features in this module that enable privileged hospital users to create their own screens, define their own data sets and build their own assessments independently of
IMS MAXIMS. The UDAs can also be used to generate additional forms or data input screens required by a healthcare organisation for any of the IMS MAXIMS range of systems. This provides enormous flexibility and allows the healthcare organisation to meet new and evolving requirements whilst simultaneously adapting the IMS MAXIMS solution to meet local needs and work practices. The screens allow patient assessments to be entered into the system as part of the care process. Each assessment is recorded as a clinical patient contact and inserted into the main patient record. Assessments may be partially completed and saved for completion at a later time or visit. Following assessment, the module can be configured to provide an appropriate treatment plan, outcome plan and referral documentation. Within the assessments, functionality can be used to build both scoring and non-scoring assessments; scoring assessments can be trended when the assessment has been completed on multiple occasions for a patient. The assessments can also include structured or graphical data, the latter allowing users to annotate images on the screen. Additional data items may be recorded on the image so the healthcare professional has a complete visual picture of the patient s presenting condition. Questions and information are configured on the system for use within Graphic Assessments and Structured Assessments. Questions may consist of free text, single or multiple answer types, in pick-list or drop-down style boxes and there are a number of different ways in which these questions can be set up within the screens.
Clinical and Patient Portals MAXIMS Portals provide access for carers and patients to a summary of the care record with all key information visible on one screen. Healthcare professionals can use the portal to aggregate information from different sources this providing a single view of the patient record; clicking on a data item takes the user through to the underlying information system. Patients can view their record and interact with administrative services. Extensive and adaptable care plans and condition specific views provide real time views of gaps in care and disease management. Care Provider Portal Care Coordination addresses the continuum of care across health and social care boundaries and provide a clear view of real-time actionable information to all those managing the care of patients. It supports: Longitudinal Care Plans Care coordination, guidelines and alerts Disease registries Patient outreach Patient empowerment Patient Portal Patients can view their medical records, appointments and care plans across all connected organizations. Providers can view biometric data and results uploaded by patients, as well as communicate with patients.
Technical Details Hosting Hosted in the cloud in an NHS Network (N3) compliant data centre, the PAS/EPR is a modern web-based application and does not require any remote access software to Windows desktops. It uses web server technologies so that it is highly scalable, easily supporting the user population of a large Trust. Resilience and failover across multiple data centres ensures that the system meets stringent uptime requirements and is available 24/7. The architecture provides for greater flexibility in deployment and end-user access using a conventional browser. Links to other systems MAXIMS PAS/EPR is an open system and supports any authorized data access for queries and reports using standard database connectivity. The PAS/EPR also provides comprehensive bi-directional HL7 v2.4 integration to enable a seamless workflow with a wide range of other Trust-based systems via dedicated messaging concentrator or integration engine. We can supply the necessary integration skills via our services product. The PAS supports inbound and outbound Registration, ADT, Orders, Results, Scheduling and Master File messages. The solution also connects to the NHS Spine for Choose and Book and associated core services.
It supports LDAP/Active Directory to simplify user authentication and password maintenance and enable single sign-on across a wide range of systems. Our edischarge module provides an electronic discharge document in any of several file formats and automatically sends a copy to the patient s GP via several methods, including secure email and other messaging solutions. Our solutions comply with NHS and de-facto open standards where they exist and are relevant to the implementation. Currently this means that most of our preferred interfaces are HL7 based. The NHS is developing standardised interfaces through its Interoperability Toolkit (ITK) future releases of MAXIMS PAS/EPR will provide ITK compliant interfaces as the standards are widely adopted. NHS Information Standards In addition to technical standards, IMS MAXIMS products maintain full compliance to all relevant DSCN/ISN notices, including: NHS Data Model and Data Dictionary NHS Number Standards ICD-10 Classification SNOMED-CT OPCS 4.6 A wide range of mandatory reports and data sets are available including Central Return Data Sets, Commissioning Data Sets, and the Supporting Data Sets, such as the Critical Care Minimum Data Set, the Neonatal Critical Care Minimum Data Set and the Paediatric Critical Care Minimum Data Set.
The ISN is described within a new or updated specification. Software deliveries are scheduled on a regular basis to customer sites. Depending on the type of change and the implementation schedule, an ad-hoc delivery may be made to allow customers sufficient time to test the change. We pride ourselves on having a 100% track record of on-time implementation of all relevant ISN/DSCNs that have been issued over the past 12 years. Using our flexible reporting capability, many reports can be produced easily by trained Trust staff. Where further analytical capability is required we can also provide a Business Intelligence and Data Warehousing product suite that uses the IBM Business Analytics software called Cognos. It enables the quality initiatives and collaboration necessary to transform healthcare organisations by providing interactive dashboards, automated reports, KPIs and scorecards. And with IBM SPSS software, providers can incorporate predictive analytics to detect trends, predict outcomes support planning and provide innovative clinical research Patient Safety Patient safety is at the forefront when developing or enhancing our PAS and EPR applications, and it is embedded into software development lifecycle. Our accredited Clinical Safety Officer reviews all new software prior to release. Implementation and Support Please see IMS MAXIMS Services offering.