Electronic Records

Electronic Health
Records (EHR)
in Long-Term Care

Copyright © e-Healthcare Systems 2005

Introduction
The United States is on the cusp of change in the
delivery of healthcare services. On April 27, 2004,
President George W. Bush called for the majority of
Americans to have interoperable health records
within ten years. The first step toward this
ambitious goal was to develop a vision and plan.
Under the direction of the department of Health and
Human Services (DHHS), National Coordinator for
Health Information Technology David J. Brailer,
MD, PhD, developed a framework for strategic
action.


What are Electronic Records?
Any resident information stored in a computer is, in
sense, an electronic record. However, the terms
“Continuity of Care Record (CCR)”, “Electronic Medical
Record (EMR),” and “Electronic Health record (EHR)”
imply additional characteristics and capabilities
beyond just storing data in a database. When the
record is limited to a single provider or institution, it
can be stored in any convenient format. When the data
must be shared with other providers or institutions,
standards are necessary for the sender to encode and
communicate the record, and for the recipient to
decode the record and verify its authenticity. This is an
enormously complex undertaking.

What are the Goals for
Electronic Records?
Electronic versions of records can be well safeguarded,
shared efficiently, and used to improve care and are
more patient-friendly, reducing the redundancy that
many patients perceive when asked the same question
each time they see a provider. Before widespread
adoption can be realized, however, several conditions
must be met:
• The records must be guaranteed to be authentic
• Unchanged from the time of authentication
• Unable to be repudiated by the authenticator
• The records must be available

Electronic Records? Con’t.
Moreover, the security requirements of HIPAA are
essential minimum standards to ensure that electronic
records will be safeguarded, from the technical
standpoint. In fact, with adequate system design and
maintenance, electronic records will be more secure
and available than paper. Also, a lost or destroyed
paper record cannot be re-created, while backups
permit electronic records to be retrieved.
The HIPAA privacy requirements are essential to gain
professional and public trust in the electronic record.
Electronic records will be safer from casual access
than paper records, and evolving technology will
reduce the security burden on providers to
authenticate their identity for access.

Sharing records among providers is another benefit of
the electronic record. Sharing records with other
providers requires records to meet standards that
enable the receiving system to make sense of the record
(and ensure its integrity, authentication, and non-
repudiated status). Standards for records are evolving
through groups of providers, academics, and vendors
working in structured processes to document,
standardize, and promulgate the standards.
Electronic record developments will also aid medical
research. Many of the difficulties in medical research
are a result of privacy issues, inconsistent record
keeping, and problems in accessing records.

Electronic record systems can be designed to facilitate
research while suppressing identifying information,
consistent with HIPAA access rules. With electronic
records, more attention can be devoted to study design
and data interpretation and less to the mechanics of data
access.
The most important goal for electronic record
development is improvement of healthcare. Once health
records can be accessed from anywhere by authorized
providers, providers will be better able to offer superior
care, since the patient’s history and current treatment
status will be immediately available.

How do Nursing Facilities fit
into the Electronic Record
Initiatives?
Nursing facilities will be significant beneficiaries of
electronic record development if the unique
characteristics and needs of the facilities are considered
in the development of record systems. The nature of
information needs in nursing facilities differs from those
in acute settings:
• Nursing facilities need extensive histories and
descriptive information with a relatively small amount of
treatment information and provider communication
• Acute setting –oriented systems are focused more on
diagnosis and treatment and fast, accurate
communication of orders and results.

Initiatives? Con’t.
Nursing facilities trying to implement acute hospital-
oriented systems have encountered limitations because
of the larger records and longer lengths of stays at the
nursing facility. While most standards work to date has
focused on the acute-care and ambulatory environments,
the interests of long-term care facilities are represented
on associated task forces.
Actually, the new data-management technologies being
applied by CMS, IT vendors, and standards organizations
have the potential flexibility to accommodate the needs
of all providers. Long-term care’s MDS 2.0 record was an
example of standardization using the technology
available at the time it was specified: fixed field

position records. For the upcoming MDS 3.0, CMS has
committed to using XML technology to make system
changes easier for providers to accomplish and
maintain, and vendors will do well to make the same
commitment. Also, future versions of the MDS will have
to meet the promulgated HIPAA data standards, a task
made easier by using XML technology.
Once electronic records are accepted in nursing
facilities, claims will be easier to compile and backup
documentation will be more readily accessible.
Wholesale copying of clinical records will be replaced
with an electronic transmission.

The CCR is an intermediate step toward electronic
records that can have an immediate impact on nursing
facilities. A group of clinicians, health information
specialists, and information technology personnel
under the auspices of the American Society for Testing
and Materials (ASTM International) has developed a
draft standard of the CCR that will be reviewed and
voted on. The CCR could be implemented in stages –
first on paper and then electronically in local
communities. This could facilitate communication
between hospitals and nursing facilities during transfers
and to other providers involved in the referral.

What Standards will Nursing
Facilities have to meet?
Nursing facilities will have to meet all of the HIPAA
requirements for electronic records. Some of these are
already in place (transactions and code sets, privacy,
and security), while others are still under development
(electronic signature, record structure). Since all nursing
facilities have at least some clinical data in electronic
format, the evolution to electronic records may be less
difficult for them than for all-paper healthcare
organizations.


A Special case: The Electronic
MDS
The MDS systems in most nursing facilities contain all
MDSs in an electronic format. However, as the
situation stands now, the paper copy is the only
version of an MDS that is legal for payment or forensic
purposes, since no standard exists to:
2. Verify the integrity of the electronic version;
3. Ensure that the person attributed to having signed the
MDS actually signed it; and
4. Ensure that the person signing the record cannot deny
that the record is the exact record he/she signed.


A Special case: The Electronic
MDS Con’t.
It is worth noting that HIPAA requires the Department of
Health and Human Services (DHHS) to develop an
electronic signature policy, and CMS verified that they
are close to publishing a proposed standard for this.


What Issues need to be
addressed?
Technology has evolved to the point that hardware is not
the limiting factor for electronic health records. While
additional development will continue to improve speed
and capacity, the current environment of new
processors and equipment for memory, storage, and
communication is an adequate starting point. Further
development of voice recognition, portable devices, and
authentication methods will serve to enhance the
acceptance of electronic records.
Software programs are the major limiting technical
factor. Current systems are vendor-unique, which many
vendors trying to offer comprehensive solutions in their
own ways. For each product, the user interfaces, data

addressed? Con’t.
structures, and processing flow are closely guarded
proprietary property.
Professional acceptance of electronic systems has been
problematic for all but the most adventuresome or
technological sophisticated clinicians. Several large
systems for computerized physician order entry have
failed recently because physicians reject them as too
cumbersome to use. New approaches to system
interfaces must be explored. Methods to facilitate the
drafting of content, signing the content (authenticating),
and correcting errors will have to developed and
certified.
Public acceptance also must be considered. Patients

addressed? Con’t.
are unhappy if they perceive their clinician spending more
time at the keyboard than listening to them! Assurances of
the privacy of their information will continue to be
necessary, as well.
Before facilities can entrust their clinical information to
electronic systems, methodology must be developed to
certify the trustworthiness of such systems. Questions of
liability will have to be addressed – e.g., who is
responsible if a resident is harmed by a system failure?
Furthermore, the system standards being developed must
be implemented by vendors and then certified by an
outside agency. Currently, only the HIPAA Transaction
and Code Sets standard has a certification mechanism.

addressed? Con’t.
Cost will also be a factor. Current budgets in nursing
facilities devote less than 2% of operating costs to
information technology, while the hospital sector spends
about 5%, and other service industries much more.
Lawmakers have proposed various approaches to
increasing the use of technology and anticipating
significant reduction of medical errors and other
savings. However, the savings claimed will not
necessarily go to the facility making the investment –
insurance companies and fiscal agents experience the
most financial benefit from some systems. Nursing
facilities can expect to benefit from the use of electronic
records through increased efficiency, reduced claim
rejections, improved documentation, and more

addressed? Con’t.
informed and coordinated clinical processes. Information
technology budgets must be part of the strategic plan for
all facilities.


What can Nursing Facilities do
now?
Nursing facilities will inevitably become a part of the
evolving national system of electronic records. President
Bush has appointed a health information technology
“czar” (David Brailer, MD, PhD) with the mission of
developing a strategic plan to upgrade use of healthcare
information technology and announced a deadline of ten
years for an all-electronic healthcare system; DHHS
confirmed this mission.
Meanwhile, facility managers and information specialists
can participate in local initiatives involving information
systems, such as collaborations among hospitals,
nursing facilities, and physician offices.
When shopping for replacement systems, consider,

What can Nursing Facilities do
now? Con’t.
plans, and actual accomplishments of potential vendors.
Ensure that the vendors you’ve considered have the
attitude, commitment, knowledge, and resources to
evolve in the changing world of electronic systems
standards. Budgets for information systems, including
hardware, programs, and personnel, should be reviewed
and increased.


The Vision
The framework layout of four goals to achieve the
President’s vision are:
• Introduce information tools into clinical practice
• Electronically connect clinicians to other clinicians
• Use information tools to personalize care delivery
• Advance surveillance and reporting for population

health improvement
We will focus on the framework’s strategies from the
point of view of post-acute and long-term care (PA/LTC)
providers. All nursing facilities and home care providers
already have made investments in information
technology (IT) to meet regulatory and payer demands.

The Vision – Con’t.
Managing the current investments and planning for the
additional required investments will be key to providers’
future success. Each provider must ensure that its
vendors or IT staff can evolve to meet the emerging
conceptual, technical, and operational requirements that
interoperable health records will demand.
The relevant standards are being developed and tested as
we speak. New standards will be proposed, and new
technologies will compete for inclusion in the developing
system. Providers must budget time, money, and other
resources to acquire, operate. And maintain the new
systems necessary to continue providing care and billing
for services. It is essential to understand the full scope of
this massive undertaking to guide the strategic plan for

The Vision – Con’t.
each healthcare provider organization. Premature action
and/or action without a well-considered and researched
plan may be costly.


The Strategy
Goal #1:
Inform Clinical Practices
Informing clinical practice is fundamental to improving care
and making health care delivery more efficient. This goal
centers largely around efforts to bring EHRs (electronic
health records) directly into clinical practice. This will reduce
medical errors and duplicate work, and enable clinicians to
focus their efforts more directly on improved patient care.
Three strategies for realizing this goal are:
Strategy 1: Incentive EHR adoption
The transition to safe, more consumer-friendly and regionally
integrated care delivery will require shared investments in
information tools and changes to current

The Strategy – Con’t.
clinical practice.
PA/LTC providers will need to ensure their needs are
considered in planning for the shared investments.
Inclusion of PA/LTC in creating legislation and
regulations is essential. Private foundation grants also
may be sources of support for the transition.
Strategy 2: Reduce risk of EHR investment
Clinicians who purchase EHRs and who attempt to change
their clinical practices and office operations face a variety of
risks that make this decision unduly challenging. Low-cost
support systems that reduce risk, failure, and partial use of
EHRs are needed.

The Strategy – Con’t
PA/LTC actually has models for low-cost support
systems: the Centers for Medicare & Medicaid Services’
(CMS) excellent RAVEN and OASIS systems, supplied at
no cost to providers. These or similar products could
provide PA/LTC the minimal support needed at a low
cost. Steps could be taken to prevent states from
mandating requirements that make the use of federally
developed systems impossible in some states, as is the
current situation with RAVEN. The government and
private organizations can reduce risks by moving
aggressively in developing and testing standards for data
representation and communication to minimize
confusion and changes in direction of systems.


Strategy 2: Promote EHR diffusion in rural and
underserved areas
Practices and hospitals in rural and other underserved areas
lag in EHR adoption. Technology transfer and other support
efforts are needed to ensure widespread adoption.
Goal #2:
Interconnect Clinicians
Interconnecting clinicians will allow information to be portable
and to move with consumers from one point of care to
another. This will require an interoperable infrastructure to
help clinicians get access to critical health care information
when their clinical and/or treatment decisions are being
made. Copyright © e-Healthcare Systems 2005

For PA/LTC facilities to benefit, their clinical systems will
have to become interoperable with physician-order
systems and hospital systems. The reduction in medical
errors will accrue when current orders are available for
residents transferred in and new physician orders are
available from physicians’ order-entry systems. Mutually
recognized standards for data representation and
communication are the keys to success.
The three strategies for realizing this goal are:
Strategy 1: Foster regional collaborations
Local oversight of health information exchange that reflects
the needs and goals of a population should be developed.
Local health information networks can begin to be

developed now with cooperation among healthcare
organizations in geographic areas, even though the
comprehensive standards needed for national adoption
still are being developed. The national system will have
to be based on evolutions of current standards. The
local benefits both to consumers/residents/patients and
to providers could be very positive: reduced errors,
more timely care, and reduced costs of documentation
and claims processing. Local implementation of the
Continuity of Care Record (CCR) would make a
difference immediately in transferring patients to and
from PA/LTC facilities.
Strategy 2: Develop a national health information
network

A set of common intercommunication tools such as mobile
authentication, Web services architecture, and security
technologies are needed to support data movement that is
inexpensive and secure. A national health information
network that can provide low-cost and secure data
movements is needed, along with a public-private oversight or
management function to ensure adherence to public policy
objectives.
Strategy 3: Coordinate federal health information
systems
There is a need for federal health information systems to be
interoperable and to exchange data so that federal care
delivery, reimbursement, and oversight are more efficient and
cost-effective. Federal health information systems will be

interoperable and consistent with the national health
information network.
Considerable work has been done by the Department of
Defense (CHCS I and II) and the Department of Veterans
Affairs (DHCP and VistA) with comprehensive systems
deployed to more than 500 sites. The agencies are active
participants in the standards organizations and freely
share their experience with developing clinical support
systems. As recognized in the framework, their experience
will benefit the national goal and, specifically PA/LTC.
Goal #3:
Personalize Care

Consumer-centric information helps individuals manage their
own wellness and assists with their personal health care
decisions. The ability to personalize care is a critical
component of using health care information in a meaningful
manner. The three strategies for realizing this goal are:
Strategy 1: Encourage use of Personal Health Records
(PHRs)
Consumers are increasingly seeking information about their
care as a means of getting better control over their health care
experience, and PHRs that provide customized facts and
guidance to them are needed.
PA/LTC settings would be great proving grounds for
PHRs since residents/clients tend to be recurrent and
eventually long term. Communications among the

various providers involved in a consumer’s care tend to
be local in nature, which allows for building on Goal #2’s
regional collaboration strategy. Issues of proxy for
cognitively impaired clients would have to be worked
through, but these clients’ care could benefit greatly from
the PHR.
Strategy 2: Enhance informed consumer choice
Consumers should have the ability to select clinicians and
institutions based on what they value and the information to
guide their choice, including but not limited to, the quality of
care providers deliver.
Strategy 3: Promote use of Telehealth (Telemedicine)
systems

The use of Telehealth remote Communication Technologies
can provide access to health services for consumers and
clinicians in rural and underserved areas. Telehealth systems
that can support the delivery of health care services when the
participants are in different locations are needed.
PA/LTC would also be excellent proving grounds for
these technologies. Reducing the burden on residents
traveling to physician offices when remote access could
adequately serve them will reduce costs and improve
care. Emergency care will be better coordinated. And
staff will be less likely to err in not contacting physicians
on questionable issues.
Goal #4:
Improve Population Health

Population health improvement requires the collection of
timely, accurate, and detailed clinical information to allow for
the evaluation of health care delivery and the reporting of
critical findings to public health officials, clinical trials and
other research, and feedback to clinicians. Three strategies
for realizing this goal are:
Strategy 1: Unify public health surveillance architectures
An interoperable public health surveillance system is needed
that will allow exchange of information, consistent with current
laws, between provider organizations, organizations they
contract with, and state and federal agencies.
Strategy 2: Streamline quality and health status
monitoring

Many different states and local organizations collect subsets of
data for specific purposes and use it in different ways. A
streamlined quality-monitoring infrastructure that will allow for a
complete look at quality and other issues in real time and at
the point of care is needed.
Strategy 3: Accelerate research and dissemination of
evidence
Information tools are needed that can accelerate scientific
discoveries and their translation into clinically useful products,
applications, and knowledge.
Systems already are in use in academic settings that
assist clinicians with prescribing. Additional tools will be
developed that will bring best practices to PA/LTC, as well

as make information available for research to constantly
improve practices of other clinicians, such as nurses
and therapists. Development and dissemination of best
practices will be improved.


Implications for PA/LTC
PA/LTC providers are included as special cases within the
framework and have already had significant attention paid
to some of their unique needs. A study funded by the
DHHS Office of the Assistant Secretary for Planning and
Evaluation (ASPE) carried out by the University of
Colorado Health Sciences Center examined the current
state of use of EHRs in leading-edge nursing facilities.
This study found that all of the facilities studied used
stand-alone MDS systems, with the EHR based on hospital
information systems used by host acute hospital
organizations. There is significant opportunity for
evolution on the part of nursing facility vendors with new
product development.
The nature of many PA/LTC residents will require

Implications for PA/LTC Con’t.
special accommodations to the framework’s consumer-
centric goals. Residents with compromised cognitive
abilities cannot fully participate in the personal choice
aspects of the future system. And proxies will have to be
found to ensure all residents’ welfare. The same residents
stand to gain in improved care when information about
their current and past health status is electronically
communicated among appropriate providers.
The regulatory instruments used in PA/LTC require
special attention: The MDS used in nursing facilities and
the OASIS used in home care do not comply with any of
the existing proposed standards for data interchange.
ASPE and CMS recognize this and are awarding a contract
to study the issue.

Implications for PA/LTC Con’t.
The national program’s major impacts on nursing
facilities and home care agencies will be the ability to
electronically receive medical orders and results of
laboratory and imaging procedures. In addition,
receiving or transferring a resident will be improved
through electronic interchange of information, resulting
in more timely care with less opportunity for incomplete
information and missed therapeutic actions. Claims will
be more accurate and timely, with no record copying to
back up claims.


What “Interoperable” actually
means
The ability to securely exchange clinical, demographic,
and financial data that are understood the same way by
all users is predicated upon having a method of
capturing, storing, and securely transmitting and
receiving data. The different users can be using data
systems from different vendors on different computer
platforms with different user interfaces, but the data’s
meaning and format are standardized upon
transmission to allow use by other systems as if they
were entered from within the system.
For example. A nursing facility that may be using a
Pentium-based microcomputer network running
NetWare with Windows XP workstations, a proprietary

means Con’t.
software package, and an Oracle database could receive
medication orders from a physician using a Palm
handheld computer running the Palm operating system
and another proprietary software package. The order is
entered and formatted on the physician’s system and
transmitted to the nursing facility’s system, where it can
be verified and acted on by the facility nurses without
having to reenter the order. The nursing facility could
forward the order to the supporting pharmacy, which may
be running other software on another hardware, but it
doesn’t matter – the pharmacy can receive and act on the
order as if it were entered from within its system, fill the
order, and deliver the supply to the nursing facility.

means Con’t.
The chances of error are decreased, the speed of action
increased, and the resident’s safety improved.
Standardization of data meaning and communication
makes interoperability possible.


Basic Criteria for Software
• User-friendliness
• A Windows-based operating system
• Flexibility
• A capability for generating reports
• Vendor support services
• Reasonable hardware requirements
• Good technical support
• Affordable purchase and maintenance fees
• HIPAA compliance


Qualifications for outside
project coordinator
• An intimate knowledge of clinical processes
• A thorough understanding of the MDS
• A big-picture vision and the ability to add the details
• An understanding of clinical impact on financials
• Independence and initiative
• Excellent communication and relationship skills for
interaction with internal and external customers and
colleagues
• The ability to learn quickly
• A broad understanding of reimbursement systems

Qualifications for outside
project coordinator Con’t.
• Excellent computer skills
• prior use of a clinical EHR system
• Knowledge of CNA documentation


Heartbeat Clinical
Its Time Has Come!

- Heartbeat -
e-Healthcare Systems


Heartbeat Clinical
Its Time Has Come!
Heartbeat Clinical introduces you to the future of
software, offering your facility a total management
program that will never need rewriting or replacing. As
technology changes Heartbeat Clinical software will only
need to continue evolving alongside of these
developments updating your facility via Internet
uploading with the newest forms of communication and
information systems as soon as they become available.

Heartbeat Clinical is a 21st century software program for
the clinical documentation in the Long Term Care
Industry.


Heartbeat Clinical
Its Time Has Come! Cont.
Presently 65,000 nursing care facilities in the United
States face the 21st century. Competing for new
residents, a facility needs to be on the cutting edge of
technology.

Heartbeat Clinical offers you a new software program that
will change the way you work, enabling you to be more
productive and to cut support and training costs, saving
you time and money.

Our new software includes many features that will
astound you and yet be simple enough for easy learning
by your staff.

Heartbeat Clinical
A leading-edge “help” technology is incorporated to
better aid your staff in understanding screen performance
and functionality.

Open Source Software

Health care leaders now are considering open source
software because it allows different IT systems to operate
compatibly and gives health care providers more options
and flexibility. It helps healthcare providers overcome the
problem of incompatible IT Systems that can disrupt the
smooth exchange of information.


Heartbeat Clinical
The potential advantages of open source software in health
care are many. One of these is that it ensures correct and
timely implementation of standards. The creation of
technology standards that define how information is
structured, defined, and exchanged is critical because
successful health care information exchange depends on
them.

The mandate for Health Level 7 (HL7) in electronic medical
records has enabled different computer systems to work in a
compatible environment. Open source software is truly
compatible with HL7 for electronic medical record systems.
Open source software generally supports standards whenever
and wherever they are relevant.

Heartbeat Clinical
Other benefits of open source software are the opportunity to
innovate, provide higher quality, improved efficiency, and
effective software for the healthcare industry.

Conditions are fertile for open source solutions to take root in
health care. Awareness of open source development models
has become widespread among health care providers.

It is our effort to create mature, rational, shared components
that work with each other and to promote a common
understanding of essential data structures in a context
institutions will nurture.


Heartbeat Clinical
Internet-Intranet Approach

The Health Care industry has been traditionally slow to
embrace new technologies, but this is now changing:
Contemporary Long Term Care, a trade magazine for the
Long Term Care industry, dedicated an entire section in the
October 1999 issue to the integration of new computer
technologies to improve the flow of information.

Internet technology makes software more user friendly. A
browser offers a familiar user interface that is easy to learn
and can cut training and technical support costs.


Heartbeat Clinical
Heartbeat Clinical is able to take advantage of instant
software updates through the Internet, user intervention,
thereby eliminating installation costs.

Government regulations and requirements are changing
constantly, so a timely software -update is crucial for a health
care facility.

All software will be ultimately based on Internet-Intranet
technology.


Heartbeat Clinical
Nursing Homes across America are becoming better
equipped with computer technology but the lack of
sophisticated software systems have been a barrier to
justifying the need and cost for this technology. Sophisticated
Intranet software is yet to be offered by the majority of
software vendors.

THE SOFTWARE PRODUCT

Heartbeat Clinical is an innovative Clinical Records
software product for the Health Care Industry.


Heartbeat Clinical
Heartbeat Clinical is built on Open Source PHP, HTML
(Hyper Text Mark-up Language), XML, Perl, Java and uses
Macromedia's Flash for it's unique interface. The program is
optimized for Microsoft's Internet Explorer or Mozilla FireFox,
but can run theoretically in any browser.

The software will be supplied as a stand-alone, SaaS and/or
ASP. The program will require an Intranet (a local Internet
that can only be used by authorized users and is not
accessible by the public) consisting of a dedicated server. As
a database we will be utilizing the MySQL compliant
database.


Heartbeat Clinical
Because of the Heartbeat Clinical Internet architecture which
is fully scalable there is no limit to the number of clients.

Heartbeat Clinical is a software program that is unique in the
way it utilizes the latest advances in internet technology. Its
flexible architecture allows for easy integration of newly
mandated government regulations and facility specified
requirements.


Heartbeat Clinical
Many Features:

• Open Source
• Permission Based
• HIPAA Compliant
• User ID & Password Protected
• Over 300+ Forms
• Policy & Procedure Documents
• Resident Picture on all screens & forms
• Color Coding of MDS
• Color Coding of RAPS
• MDS Triggers
• MDS Transmission

Heartbeat Clinical
Many Features: Continued

• Faxing & email capabilities
• Quality Assurance
• HIPAA Risk-Gap Analysis
• Quality Indicator Profiles
• F-Tag Documentation
• Nursing Math
• Intravenous Drug Specifications
• Drug Therapy
• Drug Interactions
• CNA Documentation


Heartbeat Clinical

• EMR (Electronic Medical Records)
• Dietary Tables
• Vial Expiration Dating
• Physician Orders
• Care Plans
• ICD9/10 Coding
• Inventory Control
• Staff Scheduling
• Staff In-Services Documentation
• Educational Courses
• Vitals Documentation

Heartbeat Clinical

• Resident Trust Fund
• Financials
• Database Entry/Edit (MySQL)
• Procedure Videos
• HL7 Compliant
• Length of Stay
• Weight Log
• Resident Discharges, Archiving, Re-admit
• Task Manager
• Risk Management
• Wound Care
• Many other features!

Heartbeat Clinical
Its Time Has Come!

- Heartbeat -
e-Healthcare Systems

Electronic Records

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (9)

Similar to Electronic Records

Similar to Electronic Records (20)

Recently uploaded

Recently uploaded (20)

Electronic Records