MedicalCM - Medical Cost Management
Integrated computer system designed specifically for Public or Private Hospitals, available for implementation in various formats in accordance with the complexity of each medical center. The software contains multiple modules, options and applications that additionally integrate with other systems such as: ERP solution – Public or Private, Medis Laboratory and Medical Cost Management, conjointly ensuring a complete management tool for the activities developed within a Complex Medical Center.
Modules, Options and Applications of the Medical Cost Management System
Option of the MCM Integrated system that allows the managers within Reception / Admissions Office or Contracting Department to automate the process of Bidding / Contracting the Medical Service Packages that involve hospitalization. Through its variety of functionalities, this system provides the framework for defining Medical Packages and the correlated content (coverage) along with all possible variations (ex: Reserve type, Doctors, etc.) in order to be easily applied in the Bidding / Contracted process. All offers / contracts assigned to each patient are archived in the system, defining the basis for the Billing process initiated either at the time of discharge, or in other intermediate moments. The Offer and / or Contract types can be customized in the interest of exposing the desired information.
Option of the MCM Integrated system that offers a complete and precise image of all the allocated resources with the scope of sustaining the Hospitalization process (ex: Number of Free Beds / Clinical Sections, Types of Reserves) in order to plan and acquire them in accordance with the patients’ hospitalization appointments. This stage could follow the Bidding / Contracting process, at least for the Private Hospitals. In real time, the Hospital / Admission Reception coordinators will be able to rapidly identify the resources that are necessary for each appointment. Under these circumstances, they will have a precise and easily accessible record of all hospitalization appointments. The scheduling principle complies with a hotel regime, however it additionally assists the users through the pre-established proposals regarding the Number of Days necessary for the hospitalization, depending on the Contracted Services Package.
Fundamental option for Hospitals that carry out medical-surgical activities and incorporate in the functional structure an Operator Block (or Operating Rooms). By using this tool, the users have the possibility to efficiently manage the significant resources involved within surgeries and schedule the Operating Rooms for certain time intervals, generally corresponding to a number of hours automatically proposed according to the Intervention type. In addition to the main resources, the software schedules the primary Surgeon and the supplementary resources as well (ex: Doctors, Room Assistants, Equipment, instrumentation etc.), without having quantitative or typological limitations. As an extension, this option is useful for scheduling Bed resources within Day-care Hospitalization Salons. Users can easily access the appointments lists for surgeries, visualizing real-time updated information.
This module optimizes the Hospitalization and Discharge processes within the assimilated offices, providing functionalities that facilitate the patients’ identification in all stages, including: scheduled, hospitalized, discharged, scheduled for discharge. As for the covered procedures, there are provided: opening a Health Plan, Patient Discharge, Statement Issue, Invoicing and Receiving Benefits, as well as other actions (ex: Accessing Medical History). The Admission / Discharge processes are straightforward, due to the automatic completion of all information that is required over a patient’s Health Plan, the user being assisted in noting down other mandatory details – including validations and verifications that are essential for an appropriate reporting towards Health Insurance Companies. Moreover, it is assured a rapid identification of all free reserves by typology and schedules. For the reporting process, the system accelerates the validation techniques, by demanding and taking over the electronic signature unto the Health Plans at the moment of admission / discharge. Patients can be hospitalized either in a day-care regime, continuous or in a presentation mode.
Valuable software option for the Hospitals that include Emergency structures (Emergency Rooms), that sustains the automatic completion of all information necessary for an Emergency Room File, as well as the patients’ triage within the Hospital by generating Emergency Barcodes in accordance with their health status. For each Emergency Barcode, the application assigns a different color so that, along with the Emergency Room Table solution, it highlights important information about the patient’s emergency allocation (especially useful for the patient’s family) and the route further within the Hospital – information that is displayed through the televisions exposed in the waiting rooms.
WEB IT solution used in the Emergency Rooms / Waiting Rooms that displays on external terminals (televisions) the information regarding the emergencies’ classification and the patients’ triage within the Hospital, in real time. This solution is connected with the Emergency Room File option.
Web application that integrates with all IT solutions developed by Softeh Plus, which facilitates the process of elaborating particular documents regarding the Personal Data Processing Operations. This module permits text configurations and consents formulation, establishing a secure documentation takeover concerning each patient, defining the purposes for which the personal information would be collected.
This module sustains the automation of all billing processes, including: calculations, cashing the provided medical services within the hospital, issuing the Fiscal Documentation, tracking the uncollected services for each patient, and generating the necessary records. It integrates with the cash registers in order to automatically issue the tax receipt. This process is initiated at the moment of generating the Financial Statement corresponding to each Health Plan. Additionally, this module ensures the mechanisms of invoicing and tracking the collected deposits, in accordance with the patients’ established contracts.
The central component of the integrated Medical Cost Management System that provides (without any limitation) the registration of the following elements, for each hospitalized patient’s Health Plan: Diagnoses; Procedures; Surgical Interventions; Transfers; Issuing Medical / Non-medical templates; Prescribed Medical Leave; Service Consumptions; Laboratory Investigations requests; Medical Investigations requests; Appointments for clinical investigations and/or Radiological investigations; Operating Protocols; Prescriptions for Compensated and Free Pharmaceuticals; Medicine / Sanitary Materials / Devices Consumption, Intensive Care Units Files, etc. Additionally, this software supplies the entire suite of Statistical Records specific for each department (ex: Movement File, Nutrition File, Patients Centralizers etc.) and a real-time tracking possibility for all the consumptions involved within a hospitalization action, without any further alterations being necessary.
WEB application integrated with all medical solutions developed by Softeh Plus that automates the process of completing Consumption Forms for each patient, ensuring an adequate analysis and stock management over the offices. Moreover, the application provides the transfer of all primary documents generated from consumption operations towards the ERP-PAA solution, the latter being mandatory for a proper functionality.
WEB application integrated with all medical solutions developed by Softeh Plus that automates the process of generating and finalizing medical prescriptions with reference to the compensated and free medication, in accordance with the legislation in force, ensuring the online reporting process towards the Health Insurance Companies as well. The integration with other medical solutions simplifies the documents’ elaboration, by using the required information from the entire system, ensuring an option to duplicate an existing prescription (a technique widely used in the chronic patients’ case). Furthermore, the application allows the generation of medical prescriptions in an offline mode (a particular case in which the connection with the Insurance Companies’ servers is not working properly).
Provides the framework for developing and printing the medical leave prescribed for a patient, as well as the reporting process towards the Health Insurance Companies for one or multiple conventions regardless of the number of doctors.
Module that integrates with the entire suite of medical applications developed by Softeh Plus that provides the possibility of appending several documents (text, images or any other files) on the patient level, depending on certain criteria (such as the investigation type), having extension opportunities. Various documents can be viewed concurrently (for example: several images on different panels). The solution performs by storing in a logical system all the documents that are generated through medical practices (for example: scanning a medical note and attaching it on the patient’s investigation for a rapid subsequent identification).
Solution designed for the Hospitals that undertake Nursery activities and their associated Centralization / Tracing processes, activities recommended by doctors for certain hospitalized patients. Its interface is easily accessible by users (staff responsible with patients’ bed care) by highlighting the scheduled activities in each case (ex: Medicine administration, Collection of biological samples, Measurements, Procedures, Investigations, Surgery Preparation), having the possibility to mark the executions and notice the non-executed actions. By integrating an extensive set of reports and situations, the Nursing Plan can be automatically generated, serving as a real support in identifying and analyzing the cases over each Ward through the visual interface provided by the system.
This module is mainly used in Hospitals that reimburse several provided services to the patients that are insured by Health Insurance Companies on a case-by-case basis. Sustains the automatic calculation of the Case Complexity Index for each Health Plan, based on the provided information (diagnostics and procedures). Upholds the immediate calculation as often as needed, constituting a real help in the coding process as well. Additionally, having an integration option with other Coding solutions confers both validation possibilities, pointing out warnings when necessary and guidance in relation to the optimal coding mode (ex: Medicode integration).
Centralizes and consolidates the information registered at the level of Medical CM system in order to expose it in well-defined reports, which can be accessed at any time for analysis and decision support. By using this option, the users can easily create underlying reports and statistical statements that are required by Health Insurance Companies. Through the wizard assistant, any user, regardless of the level of training, can create real-time reports on several dimensions. By using these options, the periodic reporting towards DRG, SIUI, Electronic Medical File and Medical Leave is automatically executed, by establishing a direct connection with the SIUI servers, holding an automatic response retrieval and analysis as regards corrections and re-reporting.
Automates the calculation and distribution actions regarding the Patients’ Compensation procedure in line with the regulations in force. For the Private Environment (in the Uninsured Patients’ case) this module provides the automatic calculation of payment amounts, based on the contractual provisions concluded anterior to the hospitalization action for each patient (Service Package Contracts). Shores up several reporting options, including: Consumption Compensation – according to the legislative regulations in force, condensed or detailed; or Financial Statement – medical services invoicing. As content, it presents all the information concerning the quantitative consumption, prices and value over different chapters: Hospitalization Expenses (Hospitalized Days by Reserve Type in Ward), Food Expenses, Laboratory investigations Expenses, Other medical services Expenses, Miscellaneous Expenses, Transportation Expenses, Medicine and Sanitary Materials Expenses, etc. Starting from the Financial Statement Reporting, along with the integration with PAA Billing solution, this module ensures the transfer and automation of all service invoicing and collection processes.
Presents the interface for completing the services specific to Intensive Care Units over each Health Plan, in order to determine the OMEGA score.
For an advanced usage of the Hospital software, it is highly important to ensure an interface with the Laboratory, the Specialist Ambulatory and Radiology sections, starting from the Health Plan level for each hospitalized patient. Through this interface it is assured the traceability, the common information resources’ usage, a direct interdepartmental communication process and the benefit of avoiding the double operation. From the level of the Health Plan, several Laboratory Investigations Requests could be deployed in an assisted manner and transmitted digitally towards the Specialized Laboratories (internal and / or external), validating the registration of all consumptions as well. Moreover, there could be uploaded Medical Investigations and / or Radiological Investigations on the same principle, as well as regulating the Medical Interventions’ Appointments within ambulatories for the hospitalized patients. Any corresponding result would be accessible in the Patient’s Health Plan without the need for additional requests. This interface ensures a two-way communication pattern between the Clinical and Hospital structures, based on the principle of requesting – receiving results.
In order to ensure the administration of Medicine / Sanitary Materials over patients, any hospital must organize a Closed-Circuit Pharmacy Management. In the extent of covering this desideratum, it has been developed a complex and complete management tool for Medicine Stock movements within the Closed-Circuit Pharmacies (Hospital Pharmacies). This tool permits the registration of all medicine inputs / outputs (according to the Health Insurance Companies’ lists) based on batches and expiration dates, and a simultaneous update for both the medicine stock and medicine record management, integrating all the outputs (Record File, Invoices, Return etc.). Moreover, as for the applications’ facilities there could be mentioned: Medicine Stock Inventory, Maximum Prices Check, Issuing the necessary accounting documents (NIR, transfer note, consumption receipt, etc.) and all the related accounting records; Automatic Stock Unloading – according to the methods imposed by the legislation in force, Medical Record Calculation – per doctor / ward / Health Plan, preserving the stock evolutions’ history; Consumption Records by Wards and Health Plan; Introducing the Registry Files from wards and / or Consulting the Pharmacies’ Medicine Stock by wards, through the Medication – Electronic Registry File interface. Furthermore, this software ensures the automatic consumption reporting of FARMCI and NHPCJ Medications, generating movement reports and consumption centralizations for analysis purposes. Besides, it is interfaced with the OSMR Hub as well – within the medicine serialization project. It natively integrates with the ERP-PAA solution shaping up a complete solution (applicable in both Public / Private Medical Centers), ensuring data processing up to the level of an accounting registration.
This component has as main purpose the collection, storage and presentation of all medical information processed within the computer system on different levels: patient level, medical investigation, investigation requests and health plans. Provides a real support for the specialized doctors in terms of quick access to a patient’s medical history. Due to adaptability, any processed medical information, regardless of medical specialty, can be presented in an organized and structured form over the solution’s interfaces.
Patient Web Portal – Health Portal, an up-to-date alternative for classic patients’ health records. The online platform provides access for each patient over their own medical information, with respect to: identification data, performed investigations and medical reports, laboratory analysis and the related medical results, list of appointments, hospitalizations details – including adjacent documents, electronic prescriptions, as well as financial information resulting from the offered medical interventions.