The Coalese solution is a data aggregation and medical record access tool which makes EMR/EHR data more accessible to the health care team including homecare, paramedic/EMT, pharmacist, physicians, hospital staff and other authorized healthcare workers, using any browser-enabled access point, including mobile devices.
Coalese leverages existing investments in EMR/EHR systems and the large body of patient medical records information that is stored in such systems. The use of the Coalese product facilitates team collaboration/communication and enables improved patient outcomes.
Coalese is NOT a shrink-wrapped solution. It is a configurable integration appliance that can adapt to any situation, any hardware specifications and any IP-enabled mobile device.
Coalese Open Standards
The Coalese products and solutions make extensive use of open healthcare, IT and internet standards, tools and best-practices to ensure that the solution is extensible, maintainable, and evolvable in the long term such that it will preserve solution investments in the future.
Customers can leverage existing hardware and mobile device investments, or to choose new and innovative devices that suite their particular needs, preferences and budget.
Running Metrics and Performance Indicator reports using Coalese employs a simple and intuitive user interface that requires no training. Because there is no learning curve, physicians, clinic administrators and even PCN/LHINS/Regional staff can quickly produce full-features metrics reports.
Coalese Raven also includes role-based access controls, so that only personnel authorized by the clinic/physicians are allowed to run Metrics and Performance Indicator reports. The Coalese Advanced Metrics Management system can be accessed securely from any web browser.
Advanced Metrics provides a wealth of real-time panel reports and metrics, including, Hypertension, Diabetes, Cervical Cancer Risk Screening, COPD, Cardiac Disease and Smokers At Risk, to name a few. These reports quickly and easily identify patients that have or are at risk of contracting specific conditions, thus allowing the collaborative care team to institute preventative measures, which greatly improves patient welfare and reduces systemic healthcare costs dramatically. Integrated graphing and charting provides "at a glance" summary information to the practitioner.
Coalese uses sophisticated algorithms to determine if a patient "has" or "is at risk of" specific chronic condition. These algorithms evaluate observations, lab results, prescribed medications and perform advanced pattern matching on free form text encounter notes. Many physicians using EMR systems enter the bulk of their key diagnostic and assessment information in free form text, so Coalese has implemented multi-faceted pattern matching to extract diagnostic information from different sources.
Coalese takes a step beyond just identifying positive and negative indicators and diagnoses: it also identifies patients that are at risk of developing a chronic condition. This capability allows physicians to pro-actively assist in the preventative management of their patient's health, thus improving patient welfare and reducing systemic healthcare costs. Taking steps to prevent "at risk" patients from developing debilitating chronic conditions such as diabetes, hypertension, cervical cancer and COPD holds out the promise of huge benefits to the patients, the healthcare system and society as a whole.
The user can also show the detailed reasons why a patient was flagged with specific indicators by simply clicking on the "Show Rationale" button beside the patient entry they wish to validate.
Coalese has been optimized for touch-sensitive screens and provides an exceptionally intuitive and friendly way for paper-based physicians to access their electronic patient medical records.
Coalese, in conjunction with an EMR/EHR, can make it easier and more attractive for paper-based physicians to move to an electronic medical records management system, while maximizing the benefits of automation, by following a hybrid implementation process:
This hybrid approach of combining Coalese an EMR/EHR system addresses the typical challenges and objections by paper-based physicians, and makes it easier to provide an electronic alternative.
Advanced features such as multi-factor graphing & chronological timeline view, patient access to medical records using Patient Portal and Secure Messaging provide the physician and clinic staff with easy to use yet powerful capabilities to further improve the healthcare services that they can provide to their patients.
The combination of Coalese capabilities with an EMR / EHR system can be the impetus for sceptical paper-based physicians to make the transition and automate their clinical medical records.
With privacy and legal matters top of mind, Coalese allows for custom disclaimers and one-time click-through agreements for patient access, with an example shown below. Appropriate legal verbiage and disclaimers would typically be provided by the provider and customized during the installation and configuration to address privacy and liability limitation needs.
Coalese provides strong authentication and authorization features to ensure that a patient can only access their own patient record, or those records for patients for whom they are authorized caregivers. Role-based, physician level filtering can be used to limit what information a patient is allowed to view and to also suppress access to categories of information, for example: STDs/HIV, mental illness, drug abuse and other areas designated as "sensitive" and "suppressed" by the physician owning the medical record.
Role-based access controls also allow a clinic to set up tiered subscription levels for Patient Portal subscribers and control what optional features will be made available to various subscription tiers. For example, a &basic& subscription might only allow the subscriber to view limited portions of their patient record and only use the icon-based, intuitive Raven interface. A "premium" subscription would allow the patient to see more of their medical record and add the ability to display Timelines, Graph observations and generate PDF output. Finally, with a "concierge& quot subscription, the subscriber would receive all "basic" and "premium" features along with secure two-way messaging to their physician for consultations and the like.
Coalese has developed and deployed a solution that ensures specific program criteria is met and generates reports for the physician and patient based on program guidelines. This subsequently enables the health care team to follow a guideline based plan with specific goals for each aspect of patient care. The priority of providing a comprehensive and yet easy to deploy solution means that minimal staff and no technical resources are required from the clinic perspective. Coalese applies sophisticated search criteria to formulate an assessment of a physician patient panel utilizing established clinical practice guidelines. An important aspect of this solution is that Coalese searches include advanced free text and natural language searching capabilities to ensure that physicians not consistently utilizing the EMR field structure, such as those who dictate clinical encounters, will obtain accurate results.
Once a physician or clinic agrees to participate in the program with Coalese, a full practice and clinic review is completed and patient candidates are presented in a report for the clinic staff to begin scheduling appointments. Automation of the call schedules, patient reports and identification of eligible patients are included. Once the patient and physician sign off on the plan, the collaborative team transitions in to manage the patient going forward with the physician providing oversight.
For further information, click her to see the full Complex Care Program case study.
This solution is unique in that it avoids conversion of historical patient record information into a new EMR/EHR system by giving physicians the ability to view archived historical records and perform trend analysis, graphing and other advanced analytical techniques using the Coalese visualization tools. Physicians also gain the ability to share designated portions of their historical patient records with the wider clinical care team, including homecare nurses, EMT/Paramedics, pharmacists, specialists and other authorized healthcare workers.
This solution reduces conversion risk and costs, eliminating the need to translate/transform historical patient record data into a new EMR/EHR where coding and nomenclature issues can be problematic. Physicians can perform longer-term trend analysis and retain access to historical information, as required by law.
Another key benefit is that access to historical records is available early on in the migration process so total migration timelines/costs can be dramatically reduced and the need for physician retraining is reduced.
As an example, a homecare nurse might be allowed to view physician encounter notes, whereas a Paramedic/EMT might be prevented from seeing such notes. There are no limitations on the number of permission groups and roles within each group or configurations.
User driven interface tools allow for specification of both keyword based and period based designated access permissions. For example, encounter notes that have sensitive terms such as "HIV" or "Cognitive Impairment" can be easily suppressed from being viewed by any or all roles. Similarly, permissions can be set so that, for example, only the most recent 10 lab results or lab results for the past 6 months would be displayed for specific roles.
A high-level, easy to use, browser-based User and Permissions Administration interface provides a "self-service" capability to clinic staff to manage authorized Raven users and to set both clinic and physician level role-based designated access permissions for those users.
The Coalese authentication key is a hardware USB device that works on multiple platforms which does not need any client software. With a simple touch on the key, it sends the user's identity and a unique, encrypted pass code every time it is used.
The hardware key combats common ID theft issues including phishing, key loggers and other means of eavesdropping. Users that have been issued keys employ a two-factor authentication/login process were they enter their User_ID / password and touch the hardware key to generate additional one-time credentialsEasy
Identification and authentication is performed in seconds without the hassle and risk of error when typing. Log-on is simple - the user plugs their key into a USB slot and touches the illuminated circle on the keyPortable
Works on all computers and devices with USB ports, platforms and browsers with no client software needed. Works with legacy login and requires no re-design of current website layout.Green
The robust, ultra-thin and battery-free design increases lifetime and reduces environmental impactFlexible
Coalese authentication keys can be selectively issued to appropriate users. For example, a clinic may elect to use built in 2 factor authentication for normal users, but require hardware authentication keys to be used by administrators.Ease of Administration
It is easy for clinic administrators to issue, revoke or replace Coalese Raven authentication keys using an intuitive web-based user interfaceLow Cost
Authentication keys are inexpensive and thus affordable to issue to a large number of users, including patients accessing the Patient Portal
Specific sections of the patient record are accessed using visually distinct icons/buttons that provide "at a glance" recognition and selection of sought-after information without the need to search the entire medical record. All the user needs to do is to click or tap the desired button. The intuitive user interface requires no training. Users become proficient within a few minutes of starting to use the tool.
The timeline and graph views are integrated with the Coalese user interface, making it easy and quick to change between the toolbar, timeline and graph views of a patient record. The user can also select which items they wish to see on the timeline, which can be very useful for patients with chronic illnesses and charts with a large quantity of events on a regular basis.
The timeline and graphing advanced visualization features build on the robust role-based, designated access capabilities. The timeline and graph views can be made available to patients who have been authorized to view a subset of their patient record with patient Portal.
Since these optional timeline and graphing features are integrated with the role-based access control mechanisms, it's a simple matter to allow only certain roles access to these advanced visualization tools.
The PDF feature builds on the robust role-based, designated access capabilities, and thus the user will only be able to select and/or see items in the PDF output report or summary that they are authorized to access.
With the inclusion of branding in the PDF report, such as clinic logos and contact information, printed output can be perceived as a more "credible" rendering of a patient's medical record by other medical professionals.
Using the Coalese Patient Portal feature, clinics could allow a patient to generate their own PDF report for their own records or to take with them for other appointments.
Raven allows for customization and branding of the PDF output. Clinic logos, contact information, disclaimers and other text or images can be included in the output. Appropriate legal verbiage and disclaimers would typically be provided by the clinic's legal counsel and customized during the installation and configuration of Raven to address privacy and liability limitation needs.
Here is a sample of a condensed Patient Medical History Summary report, created with a single click: