Care Team Coordination Application for 120+ Caregivers

Customer

A US company providing hospitals, ancillary providers and assisted living organizations with first-rate solutions to collect, process and analyze clinical data including patient, treatment and medication information. The end customers are over 120 caregivers using the Customer’s services.

Challenge

The end customers’ ultimate goal was to provide patients with care teams that would be connected to each other and ready to react quickly. To help them fulfill this goal, the Customer commissioned ScienceSoft to create an application that would organize care teams around each patient’s medical condition with the ability to exchange information on the changes in the patient’s current health status.

Solution

The solution is implemented as a care coordination module in a software that was also created by ScienceSoft’s medical app development team. The application allows storing and exchanging medical documents in the CCD format (with clinical, demographic and administrative patient data) among physicians, nurses and other care team members.

The main function of the care coordination module is to receive and process information about patients’ conditions and notify care team members about the following specific ‘Events’:

  • Serious Injury
  • Medical emergency
  • Suspected abuse
  • Medication errors
  • Adverse reaction to medication
  • Sexual activity involving force/coercion
  • Unexpected serious illness
  • Accident requiring treatment
  • Fire or force-majeure event requiring a relocation of services for more than 24 hours
  • Circumstances involving a law enforcement agency or a fire department and related to the health, safety or supervision of an individual
  • Hospitalization
  • ER Visit
  • Suspected exploitation of a vulnerable adult
  • Physical aggression towards another resulting in pain, injury or emotional distress
  • Life events (i.e. change in guardianship, started a new job)
  • Demonstrating signs of depression
  • Change in behavior
  • Medication non-compliance
  • Experienced barrier to service (i.e. lack of transportation)
  • General change in functioning

In the application, a care team includes both clinical and nonclinical members, and each member has its own role, for example:

Care Coordinator is responsible for ensuring that a patient receives the needed health and social services.

Case Manager is a person administratively responsible for a particular case.

Parent/Guardian is an official patient’s representative – a first-contact person and the main decision maker in critical situations.

Primary Physician a physician, doctor or nurse providing care on an outpatient basis.

Behavioral Health is a specialist treating patients’ behavioral health issues, such as stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders or other psychological concerns.

So, how does it work?

During the care cycle, different care team members track each patient’s health status. When a patient experiences one of the above-mentioned conditions (‘events’), a health specialist (i.e. a surgeon, physician, nurse and so on) creates a new event and describes the issue. The event can be created in the EHR, PMS, LIS, RIS or other system as well as in the module itself.

The created event is then sent to the care team members according to the RACI matrix – a set of automatic rules defining the caregivers that are subject to each event type and their responsibility level.

For example, a patient has suffered a serious injury. An event is sent to the Case Manager, Care Coordinator, Parent/Guardian, Primary Physician and Behavioral Health, however, only the Care Coordinator and Primary Physician are accountable and expected to take actions.

Each member can be notified via SMS, email, secure in-app messages or fax. The team members can edit their channel preferences according to their roles.

Results

More than 120 hospitals, assisted living organizations and health systems can now integrate the application to offer better care to their patients. In particular, each patient acquires their own care team that is aware of the person’s overall health status and well-being in near real time. By receiving timely notifications about the patient ‘events’, the care team can proactively intervene or respond to a situation appropriately.

To ensure intuitive user experience for medical staff, the application includes the following settings:

  • Patients management – a list of patients associated with a particular system user (care team member), patient details (personal and contacts), patient care team members, patient events and the preferred notification type
  • Care team members management – a list of care team members for a particular patient and details
  • Events management – a list of events and details (time range, event type, contact, organization)
  • Notifications history – a list of messages and details (time range, event type, communication channel, patient, organization)
  • Contacts management – a list of contacts and details (general data, address, phones, preferred notifications)

The app navigation is supported by filtering and text search to enable a fast and seamless workflow.

Technologies and Tools

HTML, CSS, JavaScript, jQuery, Twitter Bootstrap, Java EE 8, Java Spring, Hibernate ORM, Microsoft SQL Server.