Application Glossary

Anesthesia

LLEAP’s Anesthesia Information System includes documentation tools to support pre-procedure, intra-procedure and post-procedure workflows. The application benefits from full integration with our clinical suite – including full case integration with the OpTime OR Management System. It also uses similar documentation tools, such as the template-based Visit Navigator and NoteWriter, allowing anesthesia staff to work seamlessly with other staff within the same LLEAP user interface. Pre-op assessments can be written prior to the day of surgery using a navigator to guide users through the interview process. Patient information already in the LLEAP system is presented immediately for review. The intra-operative documentation tool is designed with a straightforward user interface that is consistent for procedural documentation – whether anesthesia staff is in the OR, in interventional radiology or in other areas such as Labor and Delivery. The system is optimized for touchscreen monitors and procedural templates to facilitate fast documentation. The system also supports capturing vitals from physiological monitors via interface. Post-procedure documentation uses a navigator to guide the user through the hand-off process, ensuring that all documentation requirements are met.

ASAP

This application supports the emergency department and urgent care users with tools for care management and instant access to up-to-date patient information. It incorporates ED and UC encounters into the seamless enterprise-wide medical record. This helps ensure smooth transitions as patients are admitted to the hospital or discharged. ASAP combines the documentation and order entry features of our enterprise clinical applications with complaint-based templates and information displays for ED and UC providers. A “mini” patient registration template quickly captures essential demographic information so patients can be triaged immediately upon entering the ED or the UC.

• Documentation tools – LLEAP’s click-driven NoteWriter creates narrative notes from a structured list of positive findings and pertinent negatives. Physicians may save additional time by pre-setting their own “normal exam” and charting observations by exception. The Nursing Narrator is a chronological view of patients that nurses can sort and filter to guide their work. It also includes support for real-time code and trauma documentation – so a more complete electronic record can accompany the patient upon admission. Both physician and nurse tools can support or even trigger appropriate charge capture directly from within the documentation workflow.
• ED map – displays an interactive color-coded floor plan; it provides click-through access to information on every bed and patient so that users can room patients efficiently. This feature is a major improvement over the traditional “grease board” management method as the information is automatically updated and confidential patient information is protected.
• ED manager – offers a summary of all of the patients in the ED and UC; it is organized by the different areas of your departments. Users can quickly and easily room patients, while reviewing which staff members are signed in and which roles they are performing.
• Track board – displays a variety of targeted lists of patients that are currently in the emergency department/ urgent Care. These lists are set up to show different subsets of patients to meet the specific needs of individual clinicians and to display important patient information such as chief complaint. The track board provides an overview of patient statuses and the amount of time patients remain at each status level. For additional perspective users can drill into an ED events log which details the visit timeline for any patient.
• ED reports – are provided in an at-a-glance dashboard for managers. Wait time trends, documentation status and other status information are presented. Role-based Reporting Workbench also puts more flexible reporting in the hands of physicians and nurses, so they can benchmark their own performance against their peers and find patients matching defined criteria.

Beacon (available after the initial go-live)

Beacon provides treatment functions to support medical oncology (pediatric and adult). Physicians can document cancer staging and manage chemotherapy by creating personalized treatment plans based on standard oncology protocols. Beacon is fully integrated with Epic’s pharmacy and electronic MAR products.

Cadence

Cadence’s rules-based scheduling engine and one-click appointment search function make it easy for users to schedule visits or procedures from anywhere in our organization. Its Schedule Scanner automatically color-codes and prioritizes schedules based on customer-defined utilization thresholds. This helps schedulers instantly identify availability, balance workloads and find same day or next day times for Open Access scheduling. Cadence also enhances our ability to keep appropriate slots open, take patient preferences into account, manage referrals and deliver high-quality service. Point of- service features notify schedulers of missing referral and ABN requirements, out-of network appointments and non-covered services based on benefit plan information. In the hospital, Cadence helps users track admitted patients and improves scheduling activities for hospital-based clinics. Working closely with our ADT system, Cadence can coordinate pre-admission testing, flag inpatients, track room/bed information and help users schedule post-discharge follow-up visits. Nurses and unit clerks can use the system to order transportation for inpatient procedures, complete events on a patient’s schedule, print itineraries and schedule orders placed in the clinical system.

EpicCare Ambulatory

EpicCare is an active clinical assistant that can actually learn our preferences while we work. It organizes patient information, suggests actions and eases disease management.

• MyEpic integration – allows physicians to start the workday on a role-based personal portal that presents the day’s schedule, In Basket messages and relevant reports – from the simplest “find my patients who…” reports to more-involved productivity comparisons against peers.
• Problem-oriented care – suggests information and templates relevant to conditions entered on the chronic problem list. When chosen, the selected templates can drive documentation, decision support, orders and billing. Physicians can track a problem over time by linking it to an episode of care and use specialty problem lists to more easily track particular problems.
• E-prescribing and medication management – provides important information at the point of ordering, easing communication among physician, patient and pharmacist. EpicCare sends secure electronic prescriptions to pharmacies and automatically updates the patient’s medication list. Before sending an order to the pharmacy, the physician can identify a patient’s preferred formulary medications, prior authorization requirements and copay amounts (for participating health plans). Physicians can also review a dispense history to check the patient’s compliance.
• Closed-loop results management and communication – ensure that test results are linked to the originating order and routed to the right recipients as soon as the results are available. Abnormal and other high-priority results prompt timely review by generating on-screen flags and pager messages. Without leaving the result report, clinicians can take action on the results – like compare current result values with previous results, place reflex orders, create a notification letter, release results to MyChart or initiate a telephone encounter.
• Episodes of care – functionality groups clinically related encounters, such as a patient’s prenatal care visits or surgical, follow-up and rehab visits related to a traumatic injury. This valuable context simplifies review and management of related events over time.
• After visit summary - pulls together information regarding the patient visit, including diagnoses, an up-to-date medication list and follow-up instructions. The After Visit Summary becomes a part of the patient’s electronic chart and this information is also available to the patient for reference via MyChart.

EpicCare Link

EpicCare Link makes our organization an attractive choice for referring physicians by giving them secure, web-based access to information about the care you provide their patients. With EpicCare Link, external providers can access progress notes, lab results, discharge instructions, consult notes and other portions of patients’ LLEAP charts. Sharing patient specific information helps providers follow the progress of care for patients they refer to our organization and improves their ability to coordinate ongoing care – resulting in better overall care delivery. Patient events can trigger generic e-mail notifications to EpicCare Link users that alert them to log in to the system. Patient privacy is maintained by sharing charts with external providers only when they have a recorded relationship in LLEAP such as referring the patient for an appointment. Secure messaging functions allow external physicians to offer electronic consults. Procedure order entry allows external physicians to electronically request laboratory and radiology studies. EpicCare Link also makes the entire referral process faster and more efficient, giving users convenient features for submitting referral requests and scheduling appointments.

Haiku for iPhone

Haiku connects physicians to the EMR wherever they are. Whether in the office, in the hospital, or away from work, physicians have access to chart review, patient lists, schedule, search, messaging and dictation.

Health Information Management (HIM)

Epic’s HIM system works in conjunction with our clinical and revenue cycle applications to simplify HIM management tasks.

• Deficiency tracking – ensures that medical charts contain the critical information needed for patient care, regulatory requirements reimbursement. Because they’re integrated, the same criteria are applied during EpicCare chart completion as are used in HIM deficiency tracking. The system tracks deficiencies related to Open Encounters and Unsigned Transcription
• Release of information – allows users to track and fill requests, generate charges and collect payments for this service. Easy-to-use tools help staff scan and track authorizations, while comprehensive safeguards prevent users from accidentally releasing information without patient consent. Organizations can send patient information to an authorized requester electronically with the Save to File feature, the Release Inspector feature, or the EpicCare Link application – in addition to traditional printer or fax options. The system supports compliance with HIPAA-mandated “accounting of disclosure” requirements.
• Paper chart and film tracking – helps users track the movement of hardcopy patient information through your facilities. The system can handle folders, film and fiche, as well as different paper chart types and volumes – automatically pulling the correct volume and type based on your settings. Tracking functions are integrated seamlessly into Epic’s appointment scheduling and ADT workflows.
• Identity - Identity is Epic's Enterprise Master Patient Index. An enterprise master patient index (also known as the EMPI or MPI) controls ID management and lets you correctly identify records in a setting where each record might have more than one type of ID.

Hyperspace

Epic’s focus on workflow is reflected in multiple aspects of the system, starting with a shared user interface. Hyperspace provides a single LLEAP access point for end users throughout LLUHS. When users log in, Hyperspace presents them with the targeted information that they need to complete daily tasks. Depending on role, Hyperspace can link them to clinical, registration, scheduling, billing and other functionality – without the need to log in and out of multiple applications. Hyperspace is a system that adapts to users while promoting efficient workflows – leading to increased user satisfaction and better overall care quality. For example, nurses can document patient transfers without exiting the clinical chart. Front desk employees can perform scheduling, registration and billing functions. Individuals in a variety of clinical roles – such as physicians, nurses, therapists and dieticians – have instant access to information and features targeted to their specific needs. 

My LLU Health 

This patient portal gives patients access to portions of the same medical records their physicians use. The conveniences patients love are available, such as online scheduling, child immunization history and bill pay, save staff time and reduce physician phone calls.  These self-serve online functions allow patients to take an active role in their care and reduce the costs of providing excellent service:

• View test results
• View upcoming and past appointments
• Schedule/Request appointments
• Solve simple medical issues with online e-visits
• Refill prescriptions
• Send and receive secure
• messages with providers
• View a child’s records and
• Print growth charts
• Manage the care of elderly parents

OpTime

Combines robust clinical tools and decision support with an integrated scheduling component that can help LLUHS manage any number of hospital operating rooms and ambulatory surgical centers. OpTime gives users better access to comprehensive patient information throughout the perioperative episode while offering streamlined workflows that increase productivity and room utilization. OpTime’s perioperative record benefits from integration at critical points across the continuum of care. This integration includes one electronic medication administration record (eMAR) for the entire admission and integrated flowsheet data that incorporates vitals, intake/output, assessments and line/drain/airway information. Orders for the surgical episode of care can be managed across the series of events, from the consult in the surgeon’s office through the day of surgery. This integrated approach to planning also allows for coordination with the patient’s schedule regarding pre-operative and post-operative testing that needs to be performed. OpTime’s Charge Router functionality provides a single processing point for all chargeable events in the OR – both technical and professional.

• Streamlined pre-day-of-surgery planning – Integrating the outpatient scheduling and clinical applications of LLEAP with OpTime allows you to maintain a seamless continuity of care from the consult visit to the day of the procedure. Surgical services staff can electronically track all pre-procedure requirements, including the interval H&P, e-consent and pre-admission lab work. Additionally, procedure-specific patient handouts and education materials can be printed or viewed online from the patient’s My LLU Health account.
• Efficient documentation tools – OpTime offers streamlined preoperative, intraoperative and postoperative documentation capabilities to capture all necessary data and reduce the time spent entering redundant information. One perioperative record is viewable by all users simultaneously. The system features workflows that follow a logical path, so that a user’s focus is on the task at hand rather than on navigation. OpTime’s intraoperative record is designed for documentation by exception, so that users must only enter data that has changed since the surgical case request. Barcode entry of implants and supplies further shorten the time spent searching for and documenting items.
• A scheduling component that improves resource utilization – OpTime makes scheduling cases easy and straightforward. Using extensive scheduling rules and conflict-checking functionality, OpTime coordinates surgeons, staff, inventory and equipment to automatically identify the best times for a procedure. OpTime ensures that required staff and resources are available and enforces surgeon-specific preferences and restrictions. When you schedule a procedure for a surgeon, OpTime defaults the most recent average procedure length for the surgeon – improving scheduling accuracy and resource utilization.
• Real-time case tracking – Track the progress of cases real-time with the Status Boards. Status Boards display all of the patients scheduled for surgery on a given day and tracks their case progress in real time. Status Board views and workflows are tailored to each patient care group providing key case information at the fingertips.

Radiant

Radiant streamlines radiology workflows and optimizes department resource utilization. The system enables timely, efficient communication among radiologists, technologists and ordering clinicians. Designed for ease of use and fully integrated with our clinical systems (such as AGFA PACS), Radiant offers industry-leading capabilities for rules-based scheduling, contrast administration, clinical decision support, results reporting and statistical reporting.

Resolute Professional Billing

Resolute Professional Billing provides the tools and information needed to manage a large billing office. Managers benefit from a dashboard driven network of role-based workqueues where resources can be targeted to high priority accounts and staff can specialize for better efficiency. At the user level, Resolute streamlines charge entry, payment posting and follow-up activities while supporting paperless collection processes. Complex organizations can track revenue from individual facilities and departments while supporting multiple coverage classes. Resolute functionality includes support for:

• Point-of-service collection
• Point of sale system (POS) interfacing
• Online credit/debit card processing interfacing
• Cash drawer capabilities
• Retroadjudication
• Third-party predictive dialer linkage
• Benefits engine
• Anesthesia billing
• Dental billing
• Hospital professional fee billing
• Case rate billing
• Charge correction module
• Automated charge capture
• Standard charge and claim edits
• Third-party CCI/LCD checks
• Industry-standard claim formats
• Online bill payment (via MyChart)
• Online reimbursement contracts
• No-response, denial and payment variance follow-up
• Account drilldown via dashboard
• Workqueue routing for charges, claims, collections and credit
• Refund approval

Stork

Stork supports the specialized needs of maternity care environments. It supports the continuum of care through different phases of pregnancy with vital integration between the spheres of prenatal, antepartum, intrapartum and postpartum care. Physicians can collect and view details from the complete course of obstetric care, including labor and delivery, when used in conjunction with EpicCare Ambulatory and EpicCare Inpatient.  Automatic linkage between a mother’s and newborn’s charts lets users efficiently document and review information for both patients within one chart. Best practice advisories can be triggered in a newborn’s chart based on data in the mother’s record. At delivery, relevant information can be automatically filed to the mother’s obstetrics history, the newborn’s birth history and the newborn’s family history.

Tapestry Health Plan Operations for Payors

Tapestry streamlines operations and helps you realize cost savings while providing better care and service for your members. Tapestry has a robust set of modules described below to run all aspects of your health plan.

• Member liability determination – Tapestry supports a wide variety of benefit designs from basic copay and co-insurance to elaborate consumer-directed health plans. We have built riders, individual and family deductible options, tracking methods for lifetime maximum and limited/incremental benefits, tiers, prior authorizations, multi-level provider networks, coverage to coverage carryovers, fourth quarter carryovers and much more.
• Membership enrollment – Electronic and manual enrollment tools give you an efficient way to load and update member and coverage information. They allow for EDI, online and manual enrollment processing. The system collects/maintains member demographics, coverages, PCP and primary locations. It also manages dependent cut-off ages, COB tracking, COBRA status, and much more.
• Utilization management – This module helps you improve the quality of care, manage the cost of treatment options, and analyze patterns and productivity. A sophisticated automation engine approves or denies referrals based on rules you build along with third-party medical necessity criteria. The provider steering module reduces outside medical costs by directing referrals back inside your organization. The notification engine automates approval and denial letters as well as their distribution.
• Claims adjudication & payment – Tapestry receives claims electronically and manually then adjudicates them through a sophisticated engine that checks eligibility, benefits, referral requirements, COB savings, claims rules, and incentive withholds before determining the correct amount. It provides electronic remittance, subrogation, retroactivity, third-party pricing, code editing and check writing with EOBs, RAs and 1099s. You can build contracts with complex reimbursement methodologies including fee schedules, Medicare/Medicaid, U&C, RVS, RBRVS, DRGs, APCs, global tiers, tiered per diems, percent of billed, outliers, capitation with fee-for-service equivalency tracking and penalties.
• Web portals – Members can log in from home via MyChart to access detailed health plan information. They can verify coverage information, update demographic information, select or change PCPs and primary locations, print out temporary ID cards and confirm referral statuses. In addition, with the advent of more HSAs, members can print out current and past EOBs for reimbursement. Contracted providers can use PlanLink to access referral and claim data over the Web. They can verify a patient’s eligibility, benefits and confirm a referral status. If a referral is not present, they can enter a referral and receive real-time auto-approval. Additionally, providers can review claim statuses, print RAs and submit customer service communications directly to the health plan. Employers can utilize PlanLink to manage their premium bills. They can receive their invoices real time and maintain their employee rosters with the health plan and create/update employee demographics, coverage information, as well as add/term members and dependents.
• Financial case management – You can identify and monitor the progress and cost of episodic care for members. You can flag particular situations that you want to proactively manage and then document case reviews and track integrated financial information related to each case.

Tapestry Managed Care Administration

Tapestry streamlines operations and helps you realize cost savings while providing better care and service for your delegated members. Tapestry has a robust set of modules described below to run all aspects of your delegated responsibilities from multiple payors.

• Membership eligibility – Electronic eligibility tools give you an efficient way to load and update membership information from your various payors. You can load files automatically and collect member demographics, coverage information, coverage attributes, PCP and primary locations. The system also manages dependent and student cut-off ages, COB tracking, COBRA status, Medicaid Casehead information and much more.
• Member liability determination – Tapestry supports a wide variety of benefit designs from basic copay and co-insurance to elaborate consumer-directed health plans. The system also supports copay override and waiver configuration, custom calculation of patient liability and imports of benefit bucket information. All these options give you a powerful, flexible system to track and administer benefit offerings of every flavor.
• Utilization management – This module helps you improve the quality of care, manage the cost of treatment options, and analyze patterns and productivity. A sophisticated automation engine approves or denies referrals based on rules you build along with third-party medical necessity criteria. The provider steering module reduces outside medical costs by directing referrals back inside your organization. The notification engine automates approval and denial letters as well as their distribution.
• Claims adjudication & payment – Tapestry’s Claims module uses a sophisticated adjudication engine to check eligibility, duplicates, benefits, referral requirements, claims rules and incentive withholds before determining the correct payment amount. It provides electronic remittance, retroactivity, third-party pricing, code editing and check writing with EOBs, RAs and 1099s. Tapestry supports complex reimbursement methodologies including fee schedules, Medicare/Medicaid, U&C, RVS, RBRVS, DRGs, APCs, global tiers, tiered per diems, percent of billed, outliers, capitation with fee-forservice equivalency tracking and penalties.
• Customer relationship management – Tapestry users can use this module to track calls, letters, complaints and other correspondence. It’s a workqueue-based system that ensures your users complete their tasks efficiently. You can automate issue escalation and route tasks and questions to other system users.
• Web portals – Members can log in from home via MyChart to access detailed managed care information. They can verify coverage, update demographic information, view PCP and primary location and confirm referral statuses. In addition, with the advent of more HSAs, members can print out current and past EOBs for reimbursement. Contracted providers can use PlanLink to access referral and claim data over the Web. They can verify a patient’s eligibility, benefits and confirm a referral status. If a referral is not present, they can enter a referral and receive real-time auto-approval. Additionally, providers can review claim statuses, print RAs, and submit customer service communications directly to the health plan.
• Financial case management – You can identify and monitor the progress and cost of episodic care for members. You can flag particular situations that you want to proactively manage and then document case reviews and track integrated financial information related to each case.

Willow Inpatient

Willow is a key component of Epic’s medication ordering and administration process, linking pharmacists, ordering providers and nurses to a single order record. With Willow, pharmacists can monitor medication treatment and improve medical outcomes, improving patient safety, minimizing adverse effects and helping control costs. Orders made from LLEAP flow directly to Willow for verification and dispensing and also appear automatically on the MAR.