Clinical Documentation
Clinical Documentation That Makes "Time" for Patient Care
Having the information you need – at your fingertips – when completing clinical documentation during home visits can mean the difference between providing just adequate vs. excellent patient care. What's more, almost all clinicians agree that too much time is spent filling out papers, while trying to meet increasing regulatory demands. This "burden" of regulations can distract clinicians from focusing on what's most important - patient care.
Home-Based Hospice
With CareAnyware, clinicians can be clinicians! Our system is designed, first and foremost, with the clinician in mind. Our workflow guides a clinician through the visit note, showing only the information that needs to be seen, when it needs to be seen. No backtracking. No forced progress through non-relevant information. Additional tools, such as the Edmonton Symptom Assessment Scale (ESAS) and patient flow sheets deliver critical hospice functionality.
- Hospice-specific visit notes for all disciplines, including flow sheets, ESAS, and risk scales
- Care plans that are easy-to-develop and customize
- Real-time, updated patient information for all disciplines - regardless of location
- Anytime access to all visit notes and communications – across disciplines
- Standard Orders feature that allows for quick order entry
- Communication notes that support Interdisciplinary Team (IDT) preparation
- Focused change documentation which compiles all individual patient details that have new information since the last IDT
- Hospice-specific reports that monitor processes and efficiency - CoPs reports for core services, infection control, CPR, tracking comprehensive assessments, QAPI measurements, and much more
- Web-based Physician Portal for point-of-care, order approvals, and remote access to patient information
- Latest and most up-to-date regulatory requirements are included in the hospice software, meeting all federal and state requirements
In-Patient Hospice
Medicare's requirements for documenting at the bedside for in-patient hospice patients are very specific - each and every direct encounter with the patient needs to be logged and tracked. CareAnyware fully supports the need of hospice organizations to meet this Condition of Participation (COPs) by providing the user with individual, specialized visit notes. And, an interactive Medication Administration Record (MAR) is a critical function of in-patient care and an exciting new feature of CareAnyware. What's more, we leveraged the expertise of our hospice clients when developing this functionality to design clinician-friendly functionality that meets your needs.
- Hospice-specific visit notes for all disciplines, including flow sheets, ESAS, and risk scales
- Care plans that are easy-to-develop and customize
- Real-time, updated patient information for all disciplines - regardless of location
- Standardized orders feature that allows for quick order entry
- Easy-to-use, hospice-centric MAR is tailored to support both standard and PCS administered medications
- Quick communication notes that support Interdisciplinary Team (IDT) meeting and preparation
- Powerful patient changes feature compiles new information for orders, care plans and other key documentation since the last IDT meeting
- Hospice specific alerts and reports that monitor processes and efficiency - CoP reports for core services, infection control, CPR, tracking comprehensive assessments, QAPI measurements, and much more
- Web-based Physician Portal for POC and order approvals and remote access to patient information
- Latest and most up-to-date regulatory requirements are included in the hospice software, meeting all federal and state requirements
Encompassing All Aspects of Providing Hospice Care is Our #1 Priority
Complying with regulatory requirements and COPs is a critical concern for hospice organizations. CareAnyware understands the impact of QAPI and differentiates itself from other vendors by ensuring that new CoPs are incorporated into the system via seamless updates and easy-to-use features. If needed, CareAnyware is prepared to offer training prior to the release of new functionality to ensure that your organization does not "miss a step" when new requirements take effect. With the most recent hospice changes in December 2008, our customers experienced updates which appeared to be system "enhancements" versus major regulatory compliance upgrades that require system down-time to install on client/server based applications. The new regulations resulted in enhancements which included:
- New IDT processes – including access to relevant changed information for each patient since the last IDT meeting
- Additional risk assessments and flow sheets - for example nutritional risk assessments for SNs and ESAS flow sheets
- Updated visit note documentation - infection control, CPR, controlled drug questions, additional discipline visit notes, and note about type(s) of visits
- Current adaptation of terminology for hospice disciplines
- New reports to reflect core services, infection control, and tracking comprehensive assessments
