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Beta Software Workflow

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by

Kenneth Lanier

on 26 June 2014

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Transcript of Beta Software Workflow

Physician Consultation
Discuss changes in therapy:
Add medication
Change medication
Stop therapy
Discuss adverse reactions, drug interaction and treatment failures
Recommend
Lab test
Evaluation
Screening
Intake: Gather Information
Engage the patient
Have regular follow-ups with the patient to ensure that progress is being made toward goals
Keep track of lab results specific to health conditions and goals
Assist the patient and other members of the healthcare team through transitions in care
Synchronize care between all health programs the patient is involved in ( Weight loss, Nutrition, Financial etc.)
Help the patient adhere to prescribed therapy and care plans
Referral
We recommend products and/or services that:
Help the patient reach their health goals
Fill a gap in care
Take preventative measures to avoid adverse health
Improve quality of life
Praetorian Rx MTM Process: Details
Medication History
Prescription Medications
Over the Counter Medications (OTCs)
Vitamins, Supplements and Natural Medicines
Also include the purpose, directions and notes from each medication, vitamin and supplement
Health Conditions & Allergies
Current & previous
Diagnosed and suspected
Subjective and objective information relating to each condition
Allergies: Medicine, Food, Nature and etc
Health Strategy
Lifestyle specific goals
Questions for the pharmacist
Condition specific goals according to guidelines, treatment plans, unique characteristics of the patient and patient's personal goals
Determine patient's understanding of conditions, medications and prevention strategies
Labs and Measurements
Therapy and condition specific lab results
Drug Levels
Vital signs- Breathing Rate,Heart Rate and Blood Pressure
Physical Measurements-Height, Weight, Waist Circumference, etc
Research
Evaluate
All information is evaluated to determine:
If the patient's goals and prescribed therapy are appropriate
Gaps in care, duplications of therapy, interactions and educational needs
If an additional service such as nutritional consultation, weight loss program or pain management and etc
Identify alternatives to current therapy if necessary
Ensure that we practice according to the most current evidence based practices
Answer questions
The Next Innovative and helpful Patient Care Program...
Educate
Plan
Consult
Follow up
Complete Medication Review
Review recommendations from the plan
Ask and answer questions
Discus Lifestyle modifications and Preventative strategies to improve health
Consult with other members of the patient's health care team to discus issues with medications and to ensure that everyone is on the same page
Present Action Plan and make adjustments with the patient's input
Check patient progress:
Therapy
Conditions
Quality of life
Make sure the patient is not having any problems following treatment plans
Reassess the patient's understanding of the plan and provide additional education if necessary
Make adjustments to plan and consult other members of the health care team if necessary
Referrals
Recommend other products and services if necessary
Recommend doctor visit if necessary
Labs
Check-up
Routine screening
Need new Rx
To a specialist for more focused care
Recommend PRX-MD Consultation
Listen
Want to know what the patient's desired quality of life is
Health goals
Find out about adverse reactions
Create Plan
Consolidate all information gathered
Create plan with actionable steps
Create a simple, easy to read personal record
Self care and Wellness Store offering professional grade vitamins and natural medicines
Physician Consultation
Intake: Gather Information
Connect With The Client
Monitor and Protect
Referral
Praetorian Rx MTM Process: Steps
Research
Evaluate
The Next Innovative and Helpful Patient Care Program...
Create Plan
b
a
c
Monitor Progress
Pain Management program that involves a pain consultation by a pharmacist and a recommendation for a liposomal transdermal system designed to address the patient's pain specifically while avoiding systemic side effects.
Nurse
Clinical
Dir.
Intern
Nurse
Rph
Office
MNGR
Nurse
Rph
Information
Collaboration
Information
Information
Rph
Rph
Patient
Patient
Patient
Hyperlipidemia
Cardiovascular
Cognitive Disorders
Hypertension
Rph
Specialists

Peripheral Pharmacist Network
Specialists
Information
Case
Bob is a 55 year old male who's a sales manager at Widgets 4 You. He has a high stress desk job and works more than 60 hours a week leaving him little time to do anything other than work. He has hypertension, hyperlipidemia, and type 2 diabetes mellitus . He takes 4 medications and claims to have a good understanding of his medical conditions and how his medications work; however he does desire to improve the of his quality of life.
Clinical
Dir.
Identify Sources of Stress
Long shifts
High Pressure (threat of termination, economy, etc)
Infectious Disease
Social conditions
Workplace safety
Employer Solutions
Changing Employer behavior to increase Positive-Affectivity
Providing relief from sources of stress:
Non-monetary benefits relevant to employee goals
Targeted solutions to extrarole stressors (outside issues)
Sadri, G. (2012). Conflict's here. What now?. Industrial Management, 54(3), 20-25.
Gilbert, M., & Samra, J. (2010). Guarding Minds @ Work: A Workplace Guide to Psychological Safety and Health. Canadian Benefits & Compensation Digest, 28(4), 10-12.
Grawitch, M. J., Ledford, G. r., Ballard, D. W., & Barber, L. K. (2009). Leading the healthy workforce: The integral role of employee involvement. Consulting Psychology Journal: Practice And Research, 61(2), 122-135. doi:10.1037/a0015288
Gupta, P. P., Weirich, T. R., & Turner, L. E. (2013). Sarbanes-Oxley and Public Reporting on Internal Control: Hasty Reaction or Delayed Action?. Accounting Horizons, 27(2), 371-408. doi:10.2308/acch-50425
Narayanaswamy, R., Grover, V., & Henry, R. M. (2013). The Impact of Influence Tactics in Information System Development Projects: A Control-Loss Perspective. Journal Of Management Information Systems, 30(1), 191-226. doi:10.2753/MIS0742-1222300106
Naumann, S. E., Bennett, N., Bies, R. J., & Martin, C. L. (1998). LAID OFF, BUT STILL LOYAL: THE INFLUENCE OF PERCEIVED JUSTICE AND ORGANIZATIONAL SUPPORT. International Journal Of Conflict Management, 9(4), 356-368.
SADRI, G. (2013). Choosing conflict resolution by culture. Industrial Management, 55(5), 10-15.
Wong, K. W., Kumaraswamy, M., Mahesh, G., & Thomas Ng, S. S. (2012). Utilizing Societal Engagement as a Vehicle for Enhancing the Image and Sustainability of the Construction Industry. Sustainable Development, 20(3), 222-229. doi:10.1002/sd.1538

Office
MNGR
Nurse
Rph
What is Engagement?
A function of Employee-Organization need/goal alignment (
Path-congruence
)
AND
Perception (
Affectivity
).
Low Path-Congruence + Negative Affectivity = Low engagement.
Disengaged/Active Disengaged (D/AD) employees "Bad?"
They are trying to resolve conflict of perception and motivation
Maybe a bad fit, but more likely contextually out of sync
Points to unexploited opportunities
What is the Organization doing to convert D/AD employees?
Active Engagement:
Occurs when employee's motivational path is in congruence with the path of the organization.
30%
Disengagement:
The lack of sufficient path congruence to sustain employee interest in organizational goals or purposes
Active Disengagement:
Subversive and/or destructive employee action meant to counteract contextual or group pressures in an attempt to maintain emotional/motivational equilibrium.
52%
18%
A Psychologically healthy workplace counteracts stressors with solutions...
Job Stressors
are work conditions that require an adaptive response on part of the employee. Negative reactions to these stressors create
Job Strain
Workplace Heath
Concerns
Environmental Conditions
Management Commitment
Nonwork Stress
Production Vs. Safety Emphasis
Interaction (Coworker-Coworker)
Workload
Role Ambiguity/Conflict
Job Security
Scheduling
Physical
Psychological
Sustained exposure to Job Strains can lead to negative physiological responses
Long shifts
High Pressure
Infectious Disease
Social conditions
Workplace safety
Decreased sleep
Hypertension, anxiety
Reduced immune response
headache, GI issues, depression
Physical injury, PTSD
+
Organizational Analysis Process
Observe
Inquire
Analyze
Report
Why add Organizational Analysis to an employee health and wellness program?
Work is a major source of stress for many people. While research continually shows that productivity increases with healthy employees, research also shows that the implementation of large-scale programs has a high chance to fail. Failure is most often attributed to lack of commitment and cultural misalignment.
Organizational Analysis BEFORE implementation can increase the chance of a successful implementation.
How?
Most organizations are Complex Adaptive Systems with discrete characteristics that influence the acceptance or rejection of new things (people, practices, ideas, etc).
So, before we meet Bob, we already know what he and his fellow coworkers value at the system level. We also understand the work environment and the conditions that can lead to stress,
specifically at Widgets 4 U
.

This knowledge translates into a powerful, targeted, selling tool, a way to boost employer commitment, and a way to quantify ROI at the process level.
Commitment to change plans increase with knowledge of discernible steps and processes
Forehand knowledge of challenges to implementation will save both parties time and money resulting in a higher quality product and greater satisfaction
Ongoing commitment hinges on compatibility and specificity
This means it is possible to evaluate and address "hidden" systemic barriers that would otherwise derail a successful implementation.
Vision
Mission
To offer and to connect people with personalized health services that improve health outcomes and optimize care while saving clients time, money and life.

For people to have convenient access to meaningful health services tailored to meet their individualized needs and improve the quality of their life.

Mission
Goals
Optimization
Risk Reduction
Improve Outcomes
Increase Access to Care
Vision
So far this is all I can think of at the moment. the closes examples of what I'm talking about are software's provided by Outcomes (http://www.outcomesmtm.com/), Mirixa (mirixia.com), Medication Pathfinder (https://www.medicationpathfinder.com/)
8. Cost avoidance calculator- We'll talk about this later but in general we would like to measure the amount of money we help our patients or insurance companies by avoiding unnecessary medical and health expenses such as hospitalizations. This exists but is not commercially available.
7. Scheduling function so we can schedule patients for consultations and send out reminders.
6. Communication- We would like to be able to have conversations with our patients via video or email portals. We would also like to host web based patient education seminars with larger groups of patients
5. Printable forms- we would like to be able to produce and print/ email forms and templates to patients and other healthcare providers.
4. integrate insurance claims data. We thought that the vendor that provides the software we have now was going to provide access to this info for us but it turns out that we would have to get it ourselves. once we get this data We would like the ability to apply algorithms to select patients that are candidates for our services. For example patients that take more than 8 medications, or have certain disease states.
3. Interface with Electronic health records (EHR).... this is going to be very challenging as there are so many EHR programs on the market an non of them speak directly to each other.
2. We would also like the software to perform clinical support functions such as check for drug interactions. there are several interaction "Engines" available to be leases as SAS bundles available form ( Facts and comparisons, Micromedex, and clinical pharmacology)
Manage, store and analyze clinical outcomes data (blood pressure, blood sugar, cholesterol and other lab results). It is important that we can easily record this data for each patient and generate reports to monitor their progress. The current programs do not do a great job of analyzing the data.
Dashboard
Notifications
Billing/ Payment Processing
Medication List
Case/ Consultations
Scheduling
Consultations/ Allergies
Health Data/ Goals
Authorization/ Billing
Notes
Make adaptive so info can be pulled from this page and incorporated into the appropriate fields
Interface With TBC
Can have recommendations sent directly to the patient and products can be ordered if necessary
Can add thing into the patient's cart if necessary/ requested
Communication
Email can be sent directly to the patient
Can engage in a video conference with the patient
Send secure messages with with the patient without giving doctor/pharmacist number out
Send secure messages back and forth between providers
Can collaborate on a case of to discus guidelines
Misc. Functions
Pharmacy/ Medical Spell Checker
Can use clinical databases as a reference
Scan written form and upload data in respective field
App that allows us to collect pre consult info.
Can export data
Primarily into CRM
Analytic
Research
Documents
Analyze trends in data
Correlation analysis
Cost Avoidance calculator
Drug interaction checker
Personal Medication Record (PMR)
Physician Authorization
Medication Action Plan (MAP)
Can send to appropriate party from the software
Store Patient Specific Documents
Provider Documents
Personal Medication Record
Medication Action Plan (MAP)
Want to be able to submit payment info to:
Insurance companies
Clients
Private Patients
Payment gateway
Pay pal, credit card etc.
Can import and store clinical documents
Journal articles
Guidelines
Pharmacist's Dashboard
Clinical Templates
Questionnaires that ask questions based on certain disease states
Physician DashBoard

EHR

Caregiver Dashboard
Your Natural State
Side Effects
Treatment Areas
Symptoms
Symptom Symbol legend
Profile
Inputs
Prescriber Information

Pharmacy Information
Allergies
Personal Medical Record
Peanuts, Penicillin and codeine
Emergency Contact Information
Wife:Shannon Doe 321-555-1235
Alerts:
There is significant potential for a drug food interaction if you eat green leafy vegetables. Please consult your physician if you have questions regarding this interaction.
Pharmacy Information
Goals
Prescriber Information

Pharmacy Information
Allergies
Personal Medical Record
Peanuts, Penicillin and codeine
Emergency Contact Information
Wife:Shannon Doe 321-555-1235
Alerts:
There is significant potential for a drug food interaction if you eat green leafy vegetables. Please consult your physician if you have questions regarding this interaction.
Prescriber Information

Pharmacy Information
Allergies
Personal Medical Record
Peanuts, Penicillin and codeine
Emergency Contact Information
Wife:Shannon Doe 321-555-1235
Alerts:
There is significant potential for a drug food interaction if you eat green leafy vegetables. Please consult your physician if you have questions regarding this interaction.
Goals
Platforms
Desktop
Tablet
Mobile
BodyMed Map
Oxycodone
Areas of Relief
Tramadol
Profile
Prescriber Information

Pharmacy Information
Allergies
Personal Medical Record
Peanuts, Penicillin and codeine
Emergency Contact Information
Wife:Shannon Doe 321-555-1235
Alerts:
There is significant potential for a drug food interaction if you eat green leafy vegetables. Please consult your physician if you have questions regarding this interaction.
Pharmacy Information
Goals
BodyMed Map
Oxycodone
Areas of Relief
Tramadol
Health Monitoring Devices
Fitness Trackers
PBM Data
EHR Data
ecommerce
Barcodes
Clinical Support Dashboards
Profile
Prescriber Information

Pharmacy Information
Allergies
Personal Medical Record
Peanuts, Penicillin and codeine
Emergency Contact Information
Wife:Shannon Doe 321-555-1235
Alerts:
There is significant potential for a drug food interaction if you eat green leafy vegetables. Please consult your physician if you have questions regarding this interaction.
Pharmacy Information
Goals
BodyMed Map
Oxycodone
Areas of Relief
Tramadol
Full transcript