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HISTORY WARDMANAGER™ was created by residents for residents. Despite advances in Electronic Medical Record systems, documentation remains timeconsuming and inefficient. Clinicians are required to complete signout, progress notes, medication reconciliation and discharge prescriptions — often by hand or on disparate information systems. These daily tasks burden the clinician and introduce system errors. WARDMANAGER™ streamlines the documentation process from admission to discharge. The WARDMANAGER™ precursor went live at George Washington University Hospital in 2005. While initially created for the fast-paced cardiology service, the popularity of the time-saving system spread quickly throughout the hospital. Two years later WARDMANAGER™ has processed 17,000 patients — on the Internal Medicine service alone — by 220 individual attendings, residents, and students. WARDMANAGER™ has generated over 150,000 documents and is an now an integral part of patient care at GW. On average, residents quote 45-60 minutes of daily time savings. WARDMANAGER™ has been customized to meet the needs of subspecialty services including divisions of Infectious Diseases, Nephrology, CT Surgery, Neurology and most recently the non-teaching hospitalist service. After its success at GW, WARDMANAGER™ was integrated into the Veterans Affairs Hospital signout system. WARDMANAGER™ was founded by Daniel Rosenthal MD MSc MPH, after an NIH Biomedical Informatics Fellowship at the Massachusetts General Hospital Laboratory of Computer Science, during which time he completed a Masters in Science in Biomedical Informatics from the Massachusetts Institute of Technology and a Masters in Public Health from the Harvard School of Public Health. Collaboration with top physician informaticians has been an essential component of WARDMANAGER™ development.


DOCUMENTATION TASKS

NEW ADMISSION

WARDMANAGER™ reports are automatically created from patient information. The user-friendly software is designed to mirror the workflow of admitting clinicians. Beginning with a new admission, WARDMANAGER™ guides the clinician through the medication reconciliation process and then transfers the final medication list to all other documents, including the signout/handoff, census, progress note, discharge reconciliation and outpatient prescriptions.

add patient information

add/hold medications

add home medications

reconcile

copy to inpatient

print


DAILY UPDATES WARDMANAGER™ displays daily update information on a single screen, giving the clinician an at-a-glance view of the patient and the entire team (left panel). From these data, WARDMANAGER™ prints the team census, signout/handoff and progress notes.

print census

print signout

Daily information includes HPI/hospital course, study results, problem list, consults, allergies, code status, medications, social/contact information, pending team tasks, and overnight/signout to-do.

The Clinical decision support system (CDSS) analyzes the diagnoses and medications and presents timely, point-of-care reminders . For example, deep vein thrombosis (DVT) prophylaxis reminders are presented in the medication area (above), as well as on the team census, signout, and progress notes. The CDSS can be customized to meet the needs of any specialty or hospital quality indicator.


PROGRESS NOTES WARDMANAGER™ creates progress notes by transferring all relevant information from the patient signout. WARDMANAGER™ accounts for clinician preferences and provides a choice between typing or partially handwriting progress notes. Both note types automatically include typed patient name, room number, MRN, hospital day, team name, attending, allergies, medications, problem list, and pertinent studies. If the clinician preference is to print skeleton notes and complete them on rounds, WARDMANAGER™ provides blank lines for the subjective, objective, assessment and plan (SOAP). Alternatively, the clinician may choose to type the SOAP note (below). Typed notes are then stored for future use and modification.

print progress notes


DISCHARGE Since WARDMANAGER™ remembers home medications from admission and knows the current medications, discharge medication reconciliation is a single-click. All medications and indications are translated into plain language and printed in a large type-setting for easy readability. WARDMANAGER™ then prints prescriptions directly from the discharge medication reconciliation list. All relevant patient information, including allergies and indications, are clearly printed on each prescription reducing outpatient pharmacy errors.

print reconciliation

new or changed Rx

print prescriptions

renewed Rx


REPORTS SUMMARY REPORTS

PATIENT INFORMATION

pre disc scri h ar adm ptio g e ns i ssi o med n rec pro med gres rec team s no sign te out cen / ha sus n do ff

patient name

3

3

3

3

3

medical record number

3

3

3

3

3

hospital day

3

3

3

room number

3

3

3

3

3

allergies

3

3

3

3

3

code status

3

3

hospital team

3

3

3

attending

3

3

3

primary care provider

3

3

intern/resident

3

3

student

3

3

HPI / hospital course

3

3

social history

3

3

medications

3

3

3

3

3

3

3

3

3

3

3

3

3

3 3

- discontinued / held - continued

3

3

- new / changed

3

3

medication indications

3

team tasks

3

signout/handoff tasks

3

vitals/labs skeleton

3 3

problem list dvt prophylaxis

3 3

3

3

3

3

studies/labs/radiology

3

physical exam

3

attending addendum

3


CHIEF DASHBOARD In addition to managing individual patients, WARDMANAGER™ also provides tools to manage teams. WARDMANAGER™ analyzes daily and cumulative admission statistics from all ward teams and calculates census size and average lengths-of-stay. Chiefs can easily view cases of any ward team for teaching rounds.

team census totals and admission rates for the past week

team cases at-a-glance


SECURITY Security is the highest priority of WARDMANAGER™. Every aspect of WARDMANAGER™ has been designed to provide industry-standard, high-level HIPAA security to protect patient information. SOFTWARE SECURITY 1. individual sign-on & passwords: Clinicians are given a unique passcode that allows them to create a WARDMANAGER™ account. All users have their own login with strong passwords. The administrative control panel allows easy creation and deletion of accounts including auto-deletion after a set time (e.g. end of rotation for students, end of residency for residents). 2. audit trail: WARDMANAGER™ records and backs-up all changes to patient information. Additionally, all viewing of patient information is time-stamped and logged for future reference. 3. shared account blocking: WARDMANAGER™ tracks all logins. Simultaneous logins of the same individual to two different computers, a sign of password sharing, is automatically blocked. 4. automatic logoff: WARDMANAGER™ closes patient information if it is left unattended for one minute and completely logs the user out after three minutes. 5. isolated database: Each WARDMANAGER™ account has its own separate database for an additional layer of data protection. 6. data backup: WARDMANAGER™ saves all patient information including audit trails for at least three years.

NETWORK & PHYSICAL SECURITY 1. encrypted communication: All WARDMANAGER™ data are transferred over HTTPS with 256-bit SSL encryption. 2. high-grade secured data center: WARDMANAGER™ partners with the Equinix Internet Data Center in Northern Virginia, called “the Fort Knox of the Internet,” with 24x365 on-site security, digital camera surveillance, and entry guarded by biometic hand scanners and motion-detection systems. Equinix houses servers for Google, IBM, Merrill Lynch, AT&T, GE and Yahoo. 3. intrusion detection & managed firewall: WARDMANAGER™ partners with BlackMesh Managed Technology Solutions to provide 24x7 network, hardware and software support.


LICENSING WARDMANAGER™ services are managed on HIPAA industry-standard, highly secured servers. All installation and data-management are managed at the WARDMANAGER™ data center. Annual licensing options are either by individual teams or unlimited teams for a single hospital.

Service

Team

Hospital

data storage 3 years

3 3 3 3 3 3 3 3 3 3

3 3 3 3 3 3 3 3 3 3

chief/admin admission overview dashboard

3

3

customizable intelligent reminders

3

3

installation

1 month

$849

cancellation

no fee

no fee

12 members

no limit

customizable reports

$249 per form

$199 per form

monthly fee

$89 per team

$1349 unlimited

signout / handoff medication reconciliation team census progress notes prescriptions individual login HIPAA-secure data hosting daily data backup detailed audit trails

team limit

ward manager  

testing issuu