Buyers Guide: Emergency Department Information Systems

By Patty Enrado
12:00 AM
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With the number of uninsured people growing, emergency departments have seen their usage grow exponentially and have become the largest single source of new hospital admissions. With this new reality, provider organizations are looking to emergency department information systems (EDISs) to automate and streamline workflow and provide patients with more efficient and improved quality of care. While EDIS is an emerging market, high performance continues to be dominated by best-of-breed vendors in this category, according to Jason Hess, director of business development for KLAS. Our EDIS buyers guide is based on the December 2004 KLAS Emergency Department Systems Study. KLAS will be releasing its June 2005 study on June 15. Our EDIS buyers guide is based on the December 2004 KLAS Emergency Department Systems Study. KLAS will be releasing its June 2005 study June 15, 2005.

MEDHOST
Emergency Department Management System (EDMS)
KLAS Rank 1
Features: Easy-to-use touch screen technology; customized to hospital's ED floor plan; mission-critical information always visible (demographics, staff, allergies, past medical history, vitals and more); full disposition features with auto-learning of each provider's preferred documents; comprehensive regulatory compliance, including JCAHO, HIPAA and EMTALA; previous visit information immediately retrievable; highly intuitive nurse and physician documentation, ensuring compliance and requiring minimal training; comprehensive and customizable templates; automatic charge capture; support for all codes used by hospital; E&M coding per CMS guidelines, with indication for over/under documentation; CPT coding for procedures; maximum reimbursement with documented level code compared to diagnosis; one-touch chart choices for quick and easy input; automatic sentence builder for complete chart output; built-in risk management with required fields and reminders, ensuring complete charts; complaint-specific HPI; historical information is shared and editable, eliminating redundant data entry; user-defined required fields and decision support; point-of-service billing; fastest and complete CPOE bidirectional solution designed specifically for the ED; customizable order sets for rapid input; First Data Bank allergy and drug-drug interaction checking; real-time lab and radiology status updates and alerts; suite-wide product customization in real time with no vendor intervention and no delays; standard and ad-hoc reporting capabilities; and so much more.
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? MEDHOST's newest version of its emergency department management system includes the industry standard in patient tracking with robust reporting, order entry, nurse and physician documentation with automatic provable charge capture and fully customizable templates, a Web-based encounter viewer that facilitates remote coding, ENA-compliant staffing tools, JCAHO-mandated administration metrics for monitoring patient flow, a powerful and unique toolkit allowing real-time customizations, and more.
Integration: Does your system integrate/interface with other hospital systems? MEDHOST has extensive interfacing experience in ADT, lab, radiology, order results, order entry, EMR, clinical and billing, adapting to such standards as DEEDS, CDA and HL7. Interfaces include but are not limited to McKesson, HBOC, SMS, Cerner, Meditech, SunQuest, HealthQuest and IDX.
Track record: How many implementations have you done for emergency departments?MEDHOST first introduced its EDIS products to the marketplace in 1999 and is currently ranked Best in KLAS for emergency department systems. MEDHOST is the preferred vendor for Tenet, one of the two preferred vendors for VHA, and the EDIS system for Baylor Health System, Memorial Hermann Health System, Meridian Health System and many others. The reason why we are successful today, why our very early customers have stayed with us, and why so many have added modules and upgrades is simple: We focus 100% on our Customers. Customer satisfaction is our Number 1 priority.

Picis
Ibex PulseCheck
KLAS Rank 2
Features: Ibex PulseCheck is an extraordinarily powerful EDIS that is easy to learn and easy to use, and delivers benefits to patients, hospitals, physicians and nurses. With a full complement of hardware accessories and additional software modules, Ibex PulseCheck offers comprehensive, customizable relief to the communication confusion and lost revenue experienced by many EDs. Ibex PulseCheck's patient-tracking board provides real-time updates of all the information that clinicians need to effectively treat patients — including chief complaint, high-risk alerts, nursing timers, acuity and a host of other items. Other key features of the system include real-time reporting of patient and department status, in-depth administrative reporting, disposition data capture, charge management for hospitals and physicians, nursing and physician documentation, risk management for documentation, biometric authentication, patient signature capture, voice recognition support, interfaces to all hospital information systems, discharge instructions, prescription writer, CCOW compliance, document scanning/digital imaging, handheld device support, biosurvellience and access educational postings.
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Yes, Ibex PulseCheck is the most comprehensive and well-integrated emergency department information system in the industry. Designed by clinicians for clinicians, this Web-browser based software combines triage, patient tracking, physician and nursing documentation, risk management, charge management, integrated voice recognition, prescription writing and other robust features.
Integration: Does your system integrate/interface with other hospital systems? Yes, Ibex PulseCheck can interface to virtually every HIS available. Common interfaces include inbound ADT, inbound master file, inbound order entry, inbound order status, inbound patient monitoring device, inbound results reporting, inbound transcription, outbound ADT, outbound facility billing, outbound order/entry, outbound order status, outbound patient admission, outbound patient document export, outbound pharmacy, outbound physician billing, outbound HL7 to CDR and outbound Non-HL7 or Postscript to CDR.
Track record: How many implementations have you done for emergency departments?More than 130 Implementations.

WellSoft
Wellsoft v10
KLAS Rank 3
Features: Wellsoft v10 provides complete information management for the emergency department. Drawing on 17 years of experience in designing emergency medicine software solutions, Wellsoft provides the most comprehensive functionality and configurable product in the marketplace. Enterprise or single hospital solutions use any combination of wireless, laptop and desktop workstations. Implementation options include LAN/WAN, web-enabled and thin client. A defining feature of Wellsoft implementations is the extent of workflow consulting provided by Wellsoft. Wellsoft analyzes the current patient flow and determines how the system can best support the desired practices. Wellsoft v10 is then custom-configured to tightly weave into the emergency department workflow. The system transforms processes, improving effectiveness and enhancing patient care. Wellsoft v10 interfaces with hospital-wide information systems and ancillary systems such as laboratory and radiology using standard HL7 messaging. Orders may be placed in the emergency department, sent electronically to the ancillary departments, and results received on the Wellsoft system as a background operation. Wellsoft provides complete installation, implementation and training on the system. Extensive project management support is provided for each installation and Wellsoft is on site during go-live to provide hands-on assistance. On-going support is provided 24/7 via toll-free support line.
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Wellsoft provides the most extensive functionality of any EDIS, including patient tracking, nurse and physician documentation, order entry, results, discharge planning, reporting and automatic e-mail and faxing of patient records. Wellsoft provides additional tracking functionality for unresolved issues, registration, medical records management, admissions and clinical competency and certification. In addition, Wellsoft provides features such as paging, drug/drug interaction checking, charge capture and a CCOW-enabled version.
Integration: Does your system integrate/interface with other hospital systems? Wellsoft has extensive experience providing complete integration with other hospital systems using the HL7 standard. Wellsoft interfaces with systems including registration, laboratory, radiology, CDRs and also with monitoring devices.
Track record: How many implementations have you done for emergency departments?Wellsoft has approximately 150 emergency department implementations including discharge instruction sites.

LOGICARE
OnTrack, OnRecord
KLAS Rank 4
Features: Discharge instructions, automated log, comprehensive reporting, real-time electronic patient tracking, triage documentation, HL7 and custom interfaces, CCOW compliance, follow-up provider communications, order entry (now at development partner site; general release 4th quarter 2005), nursing documentation (development partner deployment 4th quarter 2005; general release 4th quarter 2005), physician documentation (development partner deployment 1st quarter 2006; general release 2nd quarter 2006).
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Yes. LOGICARE will have order entry, triage documentation and nursing documentation available for general release this year. Physician documentation will be available for general release in second quarter 2006.
Integration: Does your system integrate/interface with other hospital systems? Yes. LOGICARE integrates with all major HIS systems, and our applications are CCOW compliant for user and visit contexts. We offer inbound ADT, orders and results; outbound document, including charting summaries; master provider file synchronization; and outbound orders to HIS order entry and notification to ancillary departments. We can offer bidirectional meds and allergies, and will offer billing and coding as our applications support these functions—features we expect to release after the general release of physician documentation.
Track record: How many implementations have you done for emergency departments? LOGICARE has more than 500 Emergency Department customers with varying degrees of automation.

A4 Health Systems
HealthMatics ED
KLAS Rank 5
Features: HealthMatics ED is the most comprehensive emergency department information system (EDIS) for streamlining patient registration, triage, tracking, nursing and physician charting, disposition, charge capture and reporting. HealthMatics ED provides the ability to do the following: Enable concurrent staff and provider management of a single, seamless patient record in a Microsoft Windows-based environment. Users value the solution, developed by an exclusive team of ED physicians, nurses and technologists, for its design focus on the unique demands of the emergency department environment. Use drill-down navigation and voice, pen-based or touch-screen technology to perform all aspects of data management for the emergency department. Integrate to existing hospital systems via interfaces, and to A4's other electronic medical record solutions, including the HealthMatics EMR for sharing information with physician practices, and the HealthMatics CDR for longitudinal patient records across the healthcare enterprise. HealthMatics ED provides shareable, real-time, mobile access to comprehensive patient information from registration to disposition, including tracking board, triage, chart review, reports, biometric sign-on authentication and passive tracking.
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Yes. HealthMatics ED has sophisticated order entry, charge capture and results reporting capabilities. All inbound and outbound orders and results are documented in the electronic chart and sent to and from various departments using HL7 interfaces. A4 emphasizes the use of order sets, as they allow clinicians to place orders with fewer keystrokes. Order protocols and processes are established based on chief-complaint and clinician preferences. Each hospital has the ability to customize the required order data utilizing the application administrator tool. Verbal orders from a physician can be documented by a nurse, PA, and so on. HealthMatics ED enables complete nurse and physician documentation at many points throughout the ED visit, including HPI, ROS exam, procedures, orders, results and disposition, prescriptions, aftercare instructions and work-school notes. A comprehensive database captures nurse and physician documentation.
HealthMatics ED also has, triage, prescription writing and discharge instruction functionalities. The system has an Application Administrator tool for data customization. A4's newest release, version 5.0 set for General Availability in mid-2005 includes: Chart Builder customized chart output, Order Management/Order Sets to view and execute multiple orders as well as flexible order sets, Facility E&M Scoring, Diagnosis-Related Discharge Instructions and Vital Signs Interface Support.
Integration: Does your system integrate/interface with other hospital systems? Yes. Bi-directional interfaces are supported for ADT, order entry, lab, radiology systems, chart packaging for billing interfaces, physiological monitors and CDRs. Vital signs interface support an optional Remote Chart Access module that allows e-mail notification to patient's primary physician of the patient's visit to ED and provides a Web link to the patient's chart for viewing.
Track record: How many implementations have you done for emergency departments? HealthMatics ED has been implemented in 50 emergency departments.

Cerner
Cerner EDIS EMtrack / EMstation (formerly VitalWorks ED)
KLAS Rank 6
Features: Cerner recently acquired the EMtrack and EMstation solutions—solutions that have been successfully deployed in EDs across the United States. EMstation is one of the first ED-specific medical record systems on the market, while EMtrack is an electronic patient tracking solution. Together, these solutions revolutionize patient management in emergency medicine, enabling EDs around the nation to set higher standards for care quality, operating efficiency and patient and staff satisfaction.
Functionality: Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Cerner EDIS EMtrack and EMstation solutions provide the following functionality: Order entry; lab results, nurse documentation and charting; physician documentation and charting; prescription writing and discharge instructions.
Integration: Does your system integrate/interface with other hospital systems? Cerner EDIS EMtrack and EMstation connect with HIS, lab, radiology and other order entry systems via HL-7 compliant interfaces. Years of experience have allowed Cerner to become expert at sharing data between disparate applications, systems and devices.
Track record: How many implementations have you done for emergency departments?The Cerner EDIS EMtrack/EMstation solution is live at more than 40 sites.

Cerner
FirstNet
KLAS Rank 7
Features: With FirstNet, organizations will improve ED workflow from triage through discharge. Care providers can support clinical care needs and make better decisions by drawing on increased volumes of immediately available information. This allows organizations to deliver and document high-quality care while improving patient satisfaction and the bottom line. Key features of FirstNet include the ability to track patients and view charts from multiple locations; improvement of accounts receivable, cash flow and billing accuracy; time savings and elimination of redundancy; maximized physician productivity; and the creation of a complete EMR.
Do you or will you have the following capabilities: order entry, nurse documentation and charting, physician documentation and charting? Cerner FirstNet is a complete EDIS that supports the following functionality: triage and tracking; nurse documentation and charting; order entry; physician documentation and charting; facility and professional coding and charge assignment; and the patient discharge process, including educational materials, follow-up instructions and prescriptions.
Integration: Does your system integrate/interface with other hospital systems? FirstNet is built upon the Cerner Millennium database—allowing this solution to be the most complete and fully integrated EDIS on the market today. While FirstNet is designed to work with other Cerner solutions it is also possible to interface to other hospitals systems. To date, Cerner has built and put into production literally thousands of interfaces.
Track record: How many implementations have you done for emergency departments?Cerner FirstNet is live at more than 140 sites.

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