EMAR Module to Upgrade the Assisted Living Software

Customer

A US company providing hospitals, ancillary providers and assisted living organizations with operational technology and electronic health record solutions to collect, process and analyze clinical data including patient, treatment and medication information.

Challenge

The Customer needed an electronic medication administration record (EMAR) module to upgrade the assisted living software. The solution was to help the caregivers to track medication count and delivery records, as well as order medications from pharmacies in real time.

Solution

ScienceSoft's healthcare IT team has designed and developed the needed EMAR module. The key entities inside the EMAR module are residents, employees / providers, medications / treatments and pharmacies. The solution consists of the following submodules:

Residents

A patient’s health information, including diagnoses, allergies and treatments, goes here. This functionality allows the staff appropriately treat the assisted living facility resident:

• Health monitoring
• Diagnoses / Allergies
• Medications / Treatments
• Billing
• Equipment (wheelchair, cane, hearing aid and more )
• Code / Evacuation status

Medication administration

This submodule contains records about medications in stock, treatments ordered and delivered. Employees can specify the average consumption of medication, set the low stock date and compose an HL7 order for refill to ensure continuous treatment process. The elements forming this submodule are:

• Medication pass (6 rights of medication administration: resident, drug, dose, route, time, documentation)
• Medication library (brand / generic name, photos, contraindications, diagnosis / disease profiles, side effects and more)
• Medication inventory (including narcotic count and disposing medications upon the expiry date)

Medications / Treatments

To track the medication administration effectively, the submodule allows to create the detailed treatment description, including photos, barcodes, shapes, quantity, color and more. The description is also complemented by current patient’s health status tab, where a nurse or other caregiver can input blood pressure, pulse, temperature, behavior, level of pain, etc. This submodule offers the elements below:

• Prescription # / Dates
• Scheduled / PRN
• Dosage / Route
• Diagnosis / Symptom
• Pharmacy
• Special instructions

To ensure that the facility’s residents get their medication on time (which is especially important for chronic care management), the system allows setting up passing windows. For example, if the treatment is to be delivered at 9 am, the passing window can be from 8 to 10 am. If this time frame is passed, and staff didn’t make any attempt to deliver the treatment, it is considered missed. The missed medications get into alerts section, which triggers notifications to the authorized personnel. Then the medication incident is created and investigated.

Other treatment delivery gaps include the following statuses:

• Attempted (e.g. if the nurse couldn’t find the resident)
• Given
• Not given (e.g. patient felt sick, thus the medication wasn’t given)
• Held (e.g. the medication delivery was postponed due certain reasons)

Employees

The employees submodule allows to synchronize the workflows of an in-house staff and third-party primary care physicians via the following elements:

• Regular / nurse providers
• Continuous providers shift coverage
• Duplicate assignment exclusion

Results

The resulting EMAR module allows its users to enable electronic medication administration, order medication refills in real time, assign and administrate treatments according to a patient’s diagnose and symptoms, track medication delivery and narcotic count.

Technologies and Tools

Ext JS, SASS, Java 8, Spring, Hibernate, Apache Maven, Apache Tomcat, MS SQL Server 2012