Patient Administration System (PAS)

TrakCare PAS modules automate workflow within the Inpatient, Outpatient, and Emergency departments of healthcare organisations and community health areas. TrakCare PAS is used extensively in countries such as Thailand, where thousands of patients need to be managed and billed, and was an important tool in patient management during the aftermath of the 2004 tsunami in Phuket.

Each module assists in meeting the unique requirements for registering and managing the specific patient population. In addition, Record Tracking, Coding, and Operating Theatre functionality is available. The Tracking and Coding functionality allows the tracking of charts and coding of diagnoses and procedures. Operating Theatre allows close coordination between the theatre and bed management areas of a hospital.

TrakCare PAS can be implemented as a standalone product integrated with existing systems or in parallel with one or more TrakCare modules.

The integrative nature of TrakCare PAS provides administrative personnel with the tools to capture data and coordinate and manage patient encounters across the continuum of care in an intelligently efficient and automated way. Additionally, it means all encounters and services are available to be viewed in the EPR.

Functionality

TrakCare PAS includes a number of modules. All PAS functionality starts with the PAS – Foundation module, which includes:

• Patient Master Index
• Inpatient Management
• Outpatient Management
• Medical Records Tracking and Coding

Additional modules include:

• Maternity
• Operating Theatre Management
• Patient/Client Billing
• Waiting List/Recall

TrakCare Community, Emergency, and Outpatient modules can be implemented as part of a phased implementation or as stand-alone.

Waiting Lists is an optional module that can be used with TrakCare Inpatient or Outpatient Management.

Patient/Client Billing is an additional module that can be used with any of the TrakCare modules.

Inpatient Management

Envision a facility where a patient’s complete medical history is instantly available, up to date, and on-screen from the time his unique identifier is presented. How much easier would inpatient management become?

The TrakCare Inpatient Management (IPM) module is a comprehensive tool that can be run in any environment from a single hospital to large enterprise-wide organisations. It provides the functionality necessary to manage inpatient events.

Inpatient Management’s integration with other TrakCare modules ensures that information relating to pre-assessment, clinic attendances, emergency attendances, and past admissions are all available for viewing in the patient’s EPR. Additionally, patient medical records can be automatically or manually requested and tracked in accordance with patient movements. Where applicable, the IPM module also provides an automatic billing process for patients who have received billable services.

Core functions of IPM include:

• Registration
• Admission
• Leave includes temporary and contract patient leave.
• Movement records patient movement throughout the healthcare organisation.
• Discharge
• Condition includes patient condition, progress, and visitor status.
• Patient Enquiry
• Bookings/Pre-Admission allows the patient’s booking details to be entered directly, or selected from a waiting list.
• Ward Lists
• Bed Search
• Bed Request
• Letters includes a history of correspondence.
• Discharge Summaries
• Billing

Additional Features

• Floor Plans provides a graphical representation of the layout of the ward, including a true view of the bed activity of the area. Inpatient activity is provided using colours and icons as descriptors of the current status.
• Bed Management provides bed managers with a complete view of all beds, their current status, and prospective activity to assist with planning (including current inpatients and those expected to arrive for admission). Ward lists, status, occupancy, floor plans, bed requests, bed searches, and reports provide the bed manager with a total view to plan and allocate beds.
  The functionality of the Bed Management module serves as a tool to help individual hospitals optimise bed availability and resources at all times by providing a comprehensive and global view of bed status.
  It addresses communication issues specific to bed management and bed allocation by providing online, real-time access to constantly changing indicators.
  The Bed Management system manages:

1. Available/unavailable beds
2. Current bed occupancy
3. Bed and patient bookings
4. Time of bed availability (projected and actual)
5. Location of available beds for emergency admissions, including specific services such as paediatrics, cardiology, and intensive care
6. Proposed transfer of patients from one specialty to another
7. Transfer of patient from one bed to another (drag and drop)
8. Allocation of patient and bed status discharge times
9. Closing and reopening cubicles, beds, rooms, or even wards
10. Flagging/reserving a bed as pending for an individual patient
11. Monitoring of patient movements to temporary locations (e.g., X-ray)
12. Identification of boarders
13. Monitoring of patients on leave and their return date

• The system makes managing beds simple. Authorised staff can display all available, occupied, or booked beds for a single ward, single department (specialty), or the entire hospital. TrakCare will warn the user when hospital policies are violated.
  A ward list displays colour-coded columns corresponding to various time frames to indicate estimated discharge dates. The number of patients per time frame appears in each column. Inliers, outliers, and booked patient numbers for each ward are also displayed.
  From the Bed Management screen, staff can manage all functions, including opening and closing wards/rooms and beds, searching for available beds, and reviewing bookings and waiting list entries.
  The Bed Management module also facilitates the movement of patients from the Emergency department to available beds in wards. In the event of disaster management, the system will immediately identify bed vacancies in wards in relation to the Emergency department’s demand, allowing the department maximum access to beds.
  This module can also act as a management tool in matching open and available beds to reflect nursing staff levels per ward.
• Mental Health allows for the entry of patient details specific to and necessary for the completion of mental health data records.
• Mobile Devices (Point-of-Care Access) addresses the challenges faced when recording information at the point of care and complements the EPR, extending TrakCare to the client. It applies the latest technology to bring fast, affordable, accurate, computerized charting to the client’s home or bedside.

Outpatient Management

Imagine treating 1,000 outpatient attendances per day in just one clinic. What about handling appointments where 80% are walk-in patients presenting to clinics without appointments? TrakCare clients face both scenarios, and the TrakCare Outpatient Management (OPM) module accommodates both extremes.

The TrakCare OPM, like all other TrakCare modules, is built on the Electronic Patient Record (EPR) and allows the capture, display, and analysis of patient-centric information, thus facilitating better patient care.

The TrakCare OPM module can be used in any environment, from traditional single-site outpatient units at small or large public or private hospitals to very large multi-site enterprises. OPM enables the coordination and efficient scheduling and management of healthcare professionals and outpatient locations (rooms). The coordination and management of daily planning and activitycan be based on a centralised or decentralized booking environment. The application provides clinical and non clinical teams with clinical, location, administration, and billing functionality, and all users have access to the theatre in real time.

OPM is fully integrated with other TrakCare modules. This integration means information relating to pre-assessment, clinic attendances, emergency attendances, past admissions, and the services provided as part of these events is available for viewing in the patient’s EPR. For any clinic attendance, the patient demographic details, and admission, clinical, and billing processes are linked and allow for the real-time clinical and financial management of the patient.

OPM is a key patient administration module within TrakCare and is provided whenever TrakCare PAS Foundation is purchased. TrakCare OPM is not available as a stand-alone product. OPM functions are delivered by the core feature set and may be further enhanced through optional implementation of the additional features described below.

Core Functionality

• Registration allows the user to create a new patient record or search for an existing patient previously registered in TrakCare. Search tools include phonetic and partial search for a variety of patient identifiers. The registration workflow supports the ability to quickly create an episode “on-the-fly” if one does not already exist in the system.
• Referrals enables system users to create and view outpatient episode/referral details for the patient. Patient appointments are subsequently attached to this episode/ referral. Appointments can also be attached to inpatient and emergency episodes.
• Multi-Referral allows the user to search for outpatient episodes/referrals within a given date range, or by clinic, doctor, hospital, or admission status. Appointments can then easily be booked for those on the returned list.
• Appointment Management facilitates the scheduling of patient appointments. The system user is able to:
  1. Book single or multiple appointments
  2. Make follow-up appointments
  3. View appointment details
  4. Record and update appointment status (e.g., arrived or failed to attend)
  5. Record and update appointment outcomes (e.g., rebooked or transferred to other hospital)
  6. Reschedule appointments
  7. Cancel appointments
  8. Notify relevant service providers of the need for transport or interpreter services for an appointment
  9. Record the patient’s confirmation of attendance at an upcoming appointment
• Over Bookings allows clinics to accommodate additional planned or unplanned attendances. Users can be assigned permission to overbook as required.
• Schedule Management enables the management of outpatient clinics, including the management of appointment time slots and load levels. The ability to define and configure appointment slot service overrides, “not available” periods, services offered, and irregular sessions is included.
• Variance records details of any variance for a scheduled clinic relating to actual clinic start and end times and reasons for variance.
• Letters produces patient correspondence directed toward the patient or general practitioner, including appointment letters, notification of rescheduled appointments, cancellation letters, and waiting list notification letters. A history of correspondence is also available, detailing creation and reprint details along with the ability to view the sent documents.
• Clinical Summaries is a standard discharge summary functionality included in the OPM module. The system can automatically generate and send a clinical summary letter to the patient’s local doctor regarding an outpatient episode/referral. Please refer to the integration section for details of optional advanced clinical summaries functionality.

Additional Features

• Bulk Transfer allows the user to select a number of appointments for a given schedule, and then cycle through these appointments by transferring them to another clinic or clinic session using the appointment booking function. Alternatively, a number of appointments for a given schedule may be selected and automatically transferred to the next available appointments in a single action.
• Worklist for OPM displays the daily or weekly clinics and appointments for any polyclinic care provider. Many of the functions required for dayto-day management of clinics and appointments are available from the worklist, including “updating” an appointment status, changing the available appointment slots for a clinic session, or “updating” patient, appointment, and episode details. Users can also define their clinic preferences. Clinic preferences allows the user to define a list of regularly accessed clinics that he needs to manage.
• Schedule Calendar displays a calendar view for a selected care provider/clinic, and shows his/its workload for a given month. The calendar may be configured to display summary information or details.
• Flexible Session Management enables outpatient clinic details, such as appointment slot availability, services offered, or load levels to be controlled at both a session and a day level, thus allowing maximum flexibility.
• Schedule Transfer and Copy allows “schedule templates” to be copied from one care provider or resource to another to reduce set up time. The schedule template and all future appointments attached to the schedule can also easily be transferred from one care provider or resource to another.
• Medical Record Management allows medical records to be automatically requested in preparation for the patient attendance at a particular clinic.
• Labels and Forms produces a variety of printed documentation, including client labels and registration forms.

Medical Records Tracking and Coding

The TrakCare Medical Records Tracking and Coding modules solve the particular requirements of managing medical records and allocating clinical classifications to episodes of care. TrakCare Medical Records operates across the spectrum of healthcare environments, from single, stand-alone healthcare organisations to multifacility arrangements.

Integrated with other TrakCare modules, they assist those involved with managing the tracking of paper medical records and clinical classifications by facilitating the capture, display, and analysis of patient-centric information.

• Medical Record Management System provides a facility for tracking patient documents, including the patient’s medical records, dental charts, psychiatric records, and radiology films. In fact, any document that can be linked to the patient can be tracked.
• Document Tracking Facility helps to significantly reduce the time it takes to perform these clerical procedures.
  Each record is defined by both a document type and a volume number. There is no limit to the number of records that can be linked to a patient. Episodes can also be allocated to specific document types or volumes.
  The system will track records both within the Medical Records department and to external locations. It maintains a history of all movements for later analysis.
  Functions include:
  1. Outstanding Medical Record Requests
  2. Single Request
  3. Single and Bulk Movement (Manual and Automatic)
  4. Bulk Request
  5. Outstanding Records List
• The Coding System provides a facility for capturing the diagnosis and procedure codes assigned for each inpatient episode. The system can accommodate the range of versions of the WHO International Classification of Diseases and Procedures (ICD). With an interface to third-party grouping software, TrakCare can also record the Diagnosis Related Group (DRG) for that episode.
  Functions include:
  1. Coding
  2. Coding Search
  3. Cancer Registration

Additional Features

• Automatic Record Request features Medical Record Management that allows for medical records to be auto-requested for inpatient, outpatient, and emergency patient attendances.
• Barcoding/Scanning can be used as a tool to move or request medical records within the system. It allows for timely processing of medical record requests and movements within a busy medical records department.
• Microfilm Entry (Single and Bulk) allows the organisation to record the roll number and position of information pertaining to a patient’s microfilm entry. This can be recorded individually for a patient or in bulk.
• Medical Record Types may be created, moved, and requested for patients. Multiple types may include a main medical record, community health record, X-ray record, dental record, and microfilm record, to name a few.
• Auto Coding allows the user to assign a pre-determined set of codes to a number of episodes. These codes are automatically assigned to the episodes and are best used when particular episodes at the hospital routinely require the same code sets (e.g., renal dialysis and chemotherapy).
• Copy Coding allows coders to “copy” codes between episodes for a patient. This saves valuable time when coding patients with many co-morbidities or coding patients who frequently present for the same condition/ treatment.
• Coding Edits assists in the accurate selection of ICD codes and reporting of coded data. The system allows for ICD edits to be defined against codes. Validations are activated upon update of the coding screen.
• Batch Grouping can be performed to automatically assign a DRG to an episode or a number of episodes according to a defined date range.
• Cancer Registration functionality exists to collect cancer/tumor details at the patient level, depending on the hospital’s data collection requirements. The Cancer Registration screen allows for episode details and clinical cancer details to be recorded. These can be extracted and reported manually or automatically to the relevant authority.
• Record Completeness allows the user to assign the level of completeness/status of a medical record at any time. For example, icons can display details at the patient level for any outstanding discharge summaries.

Maternity

Prior to a woman’s delivery episode, on average she will have had around nine antenatal appointments. Subsequent to giving birth she will have multiple community interactions for either early discharge support and/or baby clinic, and vaccination services.

So it’s important that the care provider with whom she is engaged has access to a dynamic module that captures both administration and clinical data during the antenatal, intrapartum, and postnatal periods of a pregnancy. The TrakCare Maternity module does just this with its Pregnancy Events Concepts.

TrakCare Maternity is built on the EPR. It provides a complete obstetric history for TrakCare clients, including planning and progress of care for both the mother and the baby.

The integrative nature of TrakCare Maternity provides administrative personnel the tools to capture data, coordinate and manage mother and baby encounters across the continuum of care in an intelligently efficient and automated way, and manage clinical data from pre-assessment, clinic attendances, emergency attendances, past admissions (obstetric and other), and services.

Core functions of TrakCare Maternity include:

• Pregnancy Events captures and displays past and current obstetric history, previous non-TrakCare obstetric history, and key risk management details.
• Mother/Baby Link provides a bi-directional link between mother and baby. It provides a list of babies associated with the mother and ensures that maternal details also appear on the baby’s record. The link captures such information as:
  1. Baby’s registered name
  2. Billing requirements
  3. Discharge data
• Labour/Delivery facilitates recording of delivery details, baby clinical details, and placental details for single or multiple births. It provides a complete history of the first, second, and third stages of labour. Other information can include baby birth details; Apgar scores; baby specifications such as weight, resuscitation, and abnormalities; personnel present at birth; placenta details; and perineum details. It is also possible to link delivery details to the EPR. On completion of delivery, baby clinical, placental, and labour details are calculated and displayed. A number of validations are also available (e.g., validation of baby weight and gestation).
• Registration allows creation of a new patient record or the ability to search for an existing patient who has been registered into the TrakCare module.
• Admissions admits the patient into the hospital.
• Discharge handles mother and baby discharge together or separately.
• Obstetric Enquiry provides users with an online Obstetric Data Enquiry tool. The user is able to select query criteria such as neonatal morbidity, delivery method, delivery outcome, and puerperium complications.

Specific to the Maternity module is the ability to:

• Configure the system to automatically trigger newborn registration and admission on update of the baby clinical details screen.
• Default fields on the baby registration screen. Some fields are defaulted from either the mother or the delivery screen.

Operating Theater Management

What if staff could instantaneously identify the whereabouts of any given patient, at any time, as he travels from pre-op to post-op? Or what if when a patient is booked for surgery and the surgeon’s name is entered into the system, the booking automatically called up and allocated the surgeon’s preferences for that specific type of operation – everything from assisting staff to surgical equipment and even music?

The TrakCare Operating Theatre Management module provides a comprehensive tool that can be used in a single day surgery unit, private hospitals or large, public, enterprise-wide organisations. This module enables the coordination and efficient management of the theatres, resources, and clinical staff. The coordination and management of daily planning and activities can be based on a centralised or decentralized booking environment. It also provides the clinical and non clinical teams with clinical, location, administration, and billing functionality – where all users have access to the theatre in real time.

Core functions of Operating Theatre Management include:

• Theatre Requests and Booking allows authorised staff to request or book a theatre slot for a patient for a particular operating theatre or surgeon.
• Booking Management facilitates the scheduling of patient theatre bookings.
• Schedule Management enables management of operating theatre rooms, including the management of theatre allocations and defining of irregular sessions.
• Schedule Variance records details of any variance for a theatre relating to actual schedule start and end times, and reasons for variance.
• Theatre Enquiry allows staff to make general theatre enquiries by procedure, surgeon, anaesthetist, resource, location, and patient.
• Care Provider Activity Tool enables the user to search for available session times. Time slots can then be assigned or offered to a surgeon and/or anaesthetist requesting additional operating times.
• Surgical, Anaesthetic, and Staff Preferences supports surgeon and anaesthetist preferences in terms of allocation of items to be used, staff and special equipment required for surgical/anaesthetic planning, and patient billing. The preference list for each of the perioperative phases provides a list of usual items required for that procedure, based on surgeon and/or aneasthetist and type of procedure selected.
• Anaesthetic and Operation Details allows the healthcare professional to enter specific details about anaesthetics given and procedures performed. Both of these screens are viewable via the EPR.
• Orders pertaining to specific procedures are defaulted automatically as per surgical preference definitions.
• Movements records a patient’s moves from ward to operating theatre, from operating theatre to recovery, and from recovery back to ward.
• Billing captures and records any procedures performed and/or services rendered as part of the surgical event.

Additional Features

• Bulk Transfer allows the user to select a number of theatre bookings for a given theatre and cycle through them, transferring the bookings to another theatre or surgeon.
• Worklist shows theatres, surgeons, or anaesthetists their daily, weekly, and monthly bookings. Many of the functions that enable day-to-day management of the theatre and the bookings are available from this worklist (e.g., changing a booking status or updating patient, booking, or episode details).
• Schedule Calendar displays a calendar view for a selected theatre showing utilisation for a given month. The calendar may be configured to display summary information or details.
• Schedule Transfer and Copy allows schedule templates to be copied to reduce setup time. Also, the schedule template and all future appointments attached to the schedule can be easily transferred.

Patient Billing

Billing can be extremely complex. Rules vary markedly throughout facilities, states, and countries. Conditions differ from patient to patient (e.g., throughout much of the world, nationals face different billing requirements than foreign visitors). TrakCare Patient Billing is an eminently flexible module. Used in more than 25 countries around the world, it is designed to handle the most challenging billing arrangements. It automates the billing process, produces on-demand billing, and reduces the time required to discharge a patient.

The TrakCare Patient Billing module enables staff to coordinate and manage bills for different patient types, including inpatients, sameday patients, outpatients, emergency patients, and various services such as allied health, community, radiology, and dental. It allows billing to be controlled from a central point or in decentralised environments. Rules may be defined so bills can be generated according to different payers, payment agreements, contracts, and currencies. For enterprise configurations this means elimination of duplicate data capture and a complete financial and clinical history of patients regardless of which sites they have visited.

For those healthcare organisations that need to provide informed financial consent on behalf of the patient, TrakCare provides an estimate-of-cost tool. Estimates of cost can be derived and calculated prior to services being rendered or on arrival, and can be stored for retrieval, review, comparison, and update.

Core functions of Patient Billing include:

• Deposits records a deposit from a patient.
• Receipts Enquiry displays/tracks payment receipts through a date range search.
• Patient/Payer Bills (Total and Interim) displays all bill-related information as well as performs patient-related transactions (e.g., receipting, deposits, invoicing, journal adjustments, and general comments).
• Batch Invoicing allows invoices to be raised in groups on selected episodes.
• Batch Receipting allows the receipt of multiple invoices for an insurance fund or payer.
• Letter Statement generates letters or statements to either the patient or payer using several search criteria.
• Billing Comments/Notes records both billing and patient comments.
• Adjustments
• Payer Contractors

Additional Features

• Payers features a table defined within TrakCare that records the payers (health funds, government departments, and insurance companies) that can be involved in paying a patient’s account.
• Plan allows multiple plans to be defined for each payer. For each plan, there is an associated payment agreement.
• Contracts supports various billing arrangements (e.g., patient, payer, government, or combination via the system set-up of payer/plan, contracts, and billing rules) because healthcare providers/hospitals are generally funded on a contract basis. Contracts and billing rules are maintained by the client (i.e., in-house) and govern how the patient episode is billed.
• Payment Agreement defines leve ls of thecontract. For each contract, the following can be set up:
  1. Accommodation charges
  2. Room/bed charges
  3. Same-day charges
  4. Step-downs
  5. Theatre banding
  6. Multiple theatre percentages
  7. Tariffs (price list)
  8. DRG/episodic billing

For each payment agreement, the bundled or unbundled information in the agreement can also be defined.

• Co-Payment is an amount a patient has agreed to pay as part of his level of insurance coverage should the patient be hospitalised.
• Excess is an amount the patient has agreed to pay as part of his level of fund coverage in the event of hospitalisation.
• Step-Downs pertain to accommodation rates (private room, or shared room) for various patient types (medical, surgical, or advance surgical) for a defined number of days. Generally, the charge decreases as the length of stay increases.
• Incremental Charges pertain to services, such as theatre or the intensive care unit where an initial base fee is levied along with an incremental charge according to duration of use.
• Multiple Same-Day Procedures allows payers in their contracts to define the amount to charge when more than one procedure is performed under the same anaesthetic (i.e., multiple procedures).
• Taxes allows for a tax (e.g., GST/VAT is levied in some countries on particular services provided in healthcare) to be either automatically applied when the service is provided or manually added.
• Multiple Payers Per Episode allows many payers to be associated on one episode (if this is the billing logic for that client and/or country), allowing the patient’s bill to be apportioned between the nominated payers (e.g., an insurance provider and a patient).
• Variable Room Rates allows the user/client to define different room rates (if applicable) based on the type of room the patient is occupying.
• Interim Billing is used in association with long-stay inpatient care. Invoices can be raised for a part of the inpatient stay prior to discharge, allowing reimbursement on an incremental basis from the payer.
• Recording Charges includes the following capabilities:
  1. Charges can be generated manually and automatically
  2. Manual charges can be added based on the user’s security level
  3. Charges can be modified by the user (assuming appropriate privilege level)
  4. Corrections to invoices are allowed, provided the invoice is still in a draft or pro forma state
  5. Audit trail of activity is associated with the bill
  6. Records allocation of charges based on payer contracts
• Recording Deposits captures information related to deposits to be received from a patient and/or payer and deposits to be allocated against selected invoices. It also allows refunds of deposits if necessary.
• Raising Invoices includes the following capabilities:
  1. Invoices may be created either as a single invoice or as batch invoices
  2. Invoice printing history is recorded
  3. Invoices can be in a draft or pro forma state, allowing a user to review, modify, and finalise the bill prior to printing
  4. Invoices may be generated showing patient portion and/or payer portion
  5. Aging of outstanding invoices
  6. Collection and allocation of invoice payments are managed at an invoice level or a service/order level
  7. Partial payments
  8. Cancellation of invoices
  9. Records associated billing comments to a specific invoice
  10. Invoices may be placed on hold
• Journal Adjustments includes the following capabilities:
  1. Allows adjustments to an invoice
  2. Captures adjustment reasons
  3. Offers the ability to transfer a portion to the patient or payer depending on requirements
  4. Lists all adjustments against that invoice
  5. Enables adjustment allocation to the invoice level or to the service/order level
• Recording Receipts includes the following capabilities:
  1. Generation/printing of receipts
  2. Recording of receipt details/mode of payment
• Recording Information includes the following capabilities:
  1. Recording of details against the invoice for inclusion on invoice
  2. Recording of details to billing notes
• EDI Transmissions includes the following capabilities:
  1. Creating, managing, and auditing invoices sent electronically (by EDI) to selected payers
  2. Sending invoices to particular payers (as defined in reference/code tables) via an EDI extract, rather than printed as a paper invoice
• Letters provides the functionality to produce correspondence such as “aged debtor” letters to send to patients. The form of the letters is defined by the hospital; InterSystems can provide an initial set of templates. A history of correspondence showing creation details and reprint information, and the ability to view sent documents are also available.

Waiting List / Recall

TrakCare Waiting List is a dynamic module that allows the capture of both administrative and some clinical data prior to the patient attending the facility or appointment.

The Waiting List module is fully integrated with both the Inpatient and Outpatient modules.

The term “waiting list” is generally associated with public facilities for those patients requiring an inpatient surgical attendance, while “recall” is associated with outpatient attendance (e.g., an annual pap smear or general follow-up appointment that is booked more than six weeks in advance).

Core functions of Waiting List/Recall include:

• Registration
• Referrals allows the user to create and view referral details for the patient. Patients’ Waiting List entries in terms of various bookings are then associated with that referral.
• Add to Waiting List allows the user to add a new patient record to the system and create a Waiting List entry, or add a Waiting List entry to an existing patient record.
• Bookings/Pre-Admission provides the ability to record a patient’s prospective admission details, including expected date of admission and where the patient will be admitted, with a direct link to the Waiting List entry. This tool interacts with Waiting List calculations and facilitates speedy processing of the patient on the day of admission. Alternatively, a user with the appropriate authorisation can cancel a pre-admission (to come in) episode.
• Pre-Assessment Bookings allows appointments for pre-surgical work-up/ assessment clinic visits prior to the inpatient admission. This booking is linked to the Waiting List entry.
• Waiting List/Recall Management includes the following capabilities:
  1. Placing a patient on one or multiple waiting lists
  2. Making pre-assessment clinic appointments
  3. Viewing appointment details
  4. Recording/updating waiting list status (i.e., initiated, booked, admitted, or cancelled)
  5. Recording/updating waiting list outcomes
  6. Transferring from one waiting list to another
  7. Linking waiting lists
  8. Cancelling
  9. Recording patient confirmation of attendance
• Variance records details of any variance for a waiting list and reasons for variance. Variance includes suspensions, cancellations, reinstatements, and transfers.
• Enquiry allows the user to search for a waiting list using Waiting List-specific criteria such as total days waiting, priority, and waiting list status. This enquiry results in a list of matches allowing the user to view existing Waiting List details and/or conduct other Waiting List management activities.
• Transfers allows the user to transfer single or multiple Waiting List entries to a different care provider, specialty, or hospital.
• Suspend allows the user to suspend a Waiting List with a status of “Initial” (Active Awaiting Booking). A suspension is used when a procedure or admission is postponed for a period of time for a medical or other reason. This is linked to Waiting List calculation times.
• Remove/Reinstate allows the user to remove a Waiting List with a status of “Initial” (Active Awaiting Booking) or “Suspend.” It allows the user to reinstate a Waiting List with a status of “Removed.”
• Waiting List History records transactions for any changes to the associated Waiting List status, creation/deletion of reviews, list transfers, and cancellation/completions.
• Days on List features auto-population from calculations made by a routine to determine the number of days a patient has been waiting on a specific list/ service.
• Letters enables production of correspondence to the patient. The form of the letters is defined by the hospital; InterSystems can provide an initial set of templates. A history of correspondence showing creation details, and reprint information, and the ability to view sent documents are also available.

The NHS Scotland Patient Management System program for hospitals gives authorized users immediate access to better clinical and administration information from one standard healthcare information system. It is a strategic part of the Scottish Government’s e-health transformation to empower a 21st century Scottish NHS to provide effective, fair, and affordable care.