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Tier Product And Services Overview

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A look into the features and benefits of our Behavioral/Mental Health Specific EMR Enterprise Software Solution

A look into the features and benefits of our Behavioral/Mental Health Specific EMR Enterprise Software Solution

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  • 1. We have a solution for that.® ®TIER Product and Services Overview
  • 2. TIER® Product and Services OverviewTable of Contents Table of Contents ....................................................................................................................... 2 Executive Summary ..................................................................................................................... 3 TIER® Differentiators .................................................................................................................. 4 Who is Sequest? .......................................................................................................................... 5 The TIER® Solution ..................................................................................................................... 6 Getting you on top of your day ................................................................................................... 7 Inquiry and Intake with less stress .............................................................................................. 8 Care Delivery ............................................................................................................................ 10 The Face Sheet.......................................................................................................................... 14 TIER® ePortal ............................................................................................................................ 15 Consoles .................................................................................................................................... 16 Reporting ................................................................................................................................... 17 Billing ......................................................................................................................................... 19 Beyond EMR.............................................................................................................................. 21 Implementation ......................................................................................................................... 23 TIER® Exchange ......................................................................................................................... 25Page 2 of 26
  • 3. TIER® Product and Services OverviewExecutive SummaryToday, only a few vendors in the community based health and human services industry have thetechnology, resources, and skills necessary to deliver a system that spans the entire billing, clinical, andadministrative cycle. At Sequest, we have not only established ourselves among these leadingvendors, we have striven to set ourselves apart with exceptional functionality and superior standards.We are uniquely qualified to align with your organization in achieving its main goal of implementing anenterprise-wide, comprehensive EMR solution, which will enable your organization to accurately andefficiently capture, track, process, share, and report any consumer services, billing, and outcomesinformation. That solution – the state-of-the-art, industry leading TIER® (Totally Integrated ElectronicRecord) – is customizable and fully capable of meeting the current and future needs of yourorganization.TIER® is not just another advanced technology system. It is a robust and self-directing informationsolution designed for all parts of the organization. TIER® brings all the pieces together – clinical,financial, administrative and facilities/human resource management. The TIER® solution promotesteam-based care, sharpening the focus on the consumer by coordinating the process surrounding theconsumer.Implementing the TIER® solution will allow your organization to utilize proven technology to delivercomprehensive software services wherever they are needed.Sequest Technologies welcomes the opportunity to work with and to build a shared vision andstrategic partnership with you and your organization. We are pleased you have taken the time toread this important summary document.Sincerely,William R. Connors Ted WrightPresident and CEO Director of Business DevelopmentPage 3 of 26
  • 4. TIER® Product and Services OverviewTIER® Differentiators Adaptable platform designed to grow as your organization grows Fully integrated, multi-dimensional billing module Future flexibility to meet ever changing regulatory demands of the Counties and State Improves patient care and safety through a Medication Record (MAR) and Computerized Physician Order Entry (CPOE), and e-prescribing Optimizes business using customer designed business rules Track Referrals, admissions and conversion ratios Enhances communications among caregivers through an integrated email system Provides customers with the ability to guide and enforce clinical, regulatory, and pay-for- performance/payer rules User defined graphical image that reflect real time outcomes and key performance indicators TIER® provides a fully loaded searchable knowledge table-library of goals, objectives, and interventions. Users may choose to use our Treatment Plan drop down menus or the customer-modifiable templates to rapidly develop individualized treatment plans Progress notes are seamlessly connected to charge slips which comply with CMS requirements. The ability to complete both Point of Service Scanning and Batch scanning so all staff have up to date information which includes all patient documentation Tools shipped with the system assure all data required to be captured in staff workflows is recorded at the right time Business, Human Resources and Environmental Management functionality for organization- wide management and reporting First Behavioral Healthcare vendor to successfully submit the Continuity of Care Document (CCD) First Behavioral Healthcare vendor to have a RHIO application up and running. The Sequest RHIO Interchange provides services for the Rochester RHIO which shares a range of information including the Continuity of Care Document (CCD), Lab results and Radiology results to twenty agenciesThis functionality delivers an efficient and effective, integrated workflow throughout your organization,for all staff. This will further the financial strength of the organization and also give the organization theflexibility to continue as industry leaders in behavioral healthcare systems development.Page 4 of 26
  • 5. TIER® Product and Services OverviewWho is Sequest?We are Sequest Technologies, Inc., a recognized leader in innovative solutions and softwareproducts for the Health and Human services industry. Our expertise in streamlining financial,clinical, and management processes greatly improves efficiencies and ultimately enhances patientcare. The people who make up Sequest have over 150 years of clinical experience and nowserve a broad sector that includes mental health and substance abuse clinics, psychiatrichospitals, and social services organizations.Sequest is highly respected by both CEOs andpractitioners alike. We have over 25 years inthe industry and we are renowned for our Our Vision is to become theinnovative solutions and our customer-centric premier software and servicesapproach. Our long and successful relationshipsprovide us with valuable and expert insight into Solutions Company for thethe ever-changing needs of the industry. At health and human servicesSequest, we develop more than just ElectronicHealth Record Systems, we develop industry. We will establishpartnerships. This core focus on providing value unmatched industry standardsto our partners is embedded in our companyDNA and has long been the reason people of excellence that will advancecontinue to choose Sequest. the clinical and related services offered by our customers.Page 5 of 26
  • 6. TIER® Product and Services Overview The TIER® Solution Total integration: that’s what makes electronic record keeping so valuable. The ability to streamline workflow, eliminate cumbersome paper records, and track data with ease and flexibility – that’s what you want. TIER® – the Totally Integrated Electronic Record – was created to be exactly what the name implies. The TIER® Solution is a set of seamlessly integrated software modules that allow you to consolidate all of your organization’s record keeping in a single, accessible information system. Our sophisticated design tool empowers you to customize the application and create new software tools so that TIER® adapts to your organization’s workflow across the entire continuum of care. The clinical workflow in TIER® was designed by clinicians, and as the flagship product of a company whose leaders have over 150 years of combined experience in the health and human services industry, TIER® is much more than just a piece of software, it’s a partnership. Sequest is focused on helping healthcare providers elevate patient care, while at the same time reducing the cost of services. What we want TIER® to become for your organization is a tailor‘You’re only limited by your own imagination and made electronic record, allowing your own willingness level to climb outside the box.’ you to meet certification requirements, maximize efficiency,Dave Gerick. Vice-President, Quality & Information Systems. and ultimately improve the qualityFather Martin’s Ashley and efficacy of care delivery. We know choosing an EMR can be difficult, but using one shouldn’t be. To give you a better idea of how TIER® can work for you, we’ve created a workflow narrative full of examples of how you might use the system. Of course, the workflow at your organization might be a little different, but that’s the beauty of TIER®: it was designed to adapt to your organization, rather than the other way around. Page 6 of 26
  • 7. TIER® Product and Services OverviewGetting you on top of your dayThe first thing you’ll see when you log into TIER® is your personal TMail page. TMail is anelectronic messaging system that lives within TIER® and allows users to send confidentialmaterial while maintaining HIPAA compliance. Correspondence stays within TIER®, so there’sno danger of leaking Personal Health Information.Living alongside TMail is the DocWatch, TIER®’s adaptable personal alert system. ADocWatch can be set up for any time sensitive material – for example, an expiring TreatmentPlan or Provider Credential – and the system will generate a proactive warning on the TMailpage. When you open the warning message, you will be provided with a link to the location inthe software from which the warning was generated. Say TIER® sends you a DocWatch alertthat says you have to sign a Progress Note. You click on the link, sign your note and save it, andyou’re done. No morefluorescent sticky notes.DocWatch alerts can be appliedto any field within the TIER®system. Use it to stay on top ofcompliance mandates, ensureevidence-based practices areimplemented, trackauthorizations, notify staff thatthey have been assigned newclients, monitor risk factors, alertusers that reports are ready, andmuch more.The best part about DocWatch isthat it’s persistent. The warningwill continue to generate until the A DocWatch Alert Messagetask has been completed or thebusiness rule fulfilled. If the issue isn’t resolved after a specified period of time, the system cannotify a supervisor, or even that supervisor’s supervisor. By taking advantage of hierarchicalaccountability, DocWatch can keep important tasks from slipping through the cracks.Keep in mind, these proactive alerts are system generated. No one has to make a phone call orsend an email. With TMail and DocWatch, you’ll be able to get on top of your day before youfinish your first cup of coffee.Page 7 of 26
  • 8. TIER® Product and Services OverviewInquiry and Intake with less stressCalls centers gather invaluable client data, but with paper record keeping, and even with someEMRs, redundant data entry and duplicate records are a common occurrence.The TIER® Inquiry Module is designed to simplify the work of a call center with easy client andpotential client search functionality and single point data entry. The search screen drives theinquiry process, allowing the user to search for records by first and last name, social securitynumber, and date of birth. When a contact is recorded, any data captured only has to beentered once and the system will then auto-populate that data wherever pertinent.These screens allow the user to capture incoming and outgoing referrals, identificationinformation, contacts, demographic information, presenting problem, insurance, treatmentcertification, medications, as well as offering a variety of pre-admission assessments. Andbecause of the product’s integrated structure, all of the documentation done from this part ofthe software has functional implications elsewhere. Presenting problems and intake notes canbe set up to link to future treatment plans or referrals. Insurance information will be transferredto the billing module and, on the clinical side, will be used against authorizations to helpdetermine the services for which a client has been approved. If a client is deemed a suicide orhomicide risk the system automatically generates a risk assessment and, based on the outcomeof that assessment, alerts can be generated to the appropriate staff. TIER® handles the tasks ofMedication Reconciliation right from the point of inquiry. Current medication informationcollected on the inquiry and intake screens is used against any future medication administrationto ensure proper reconciliation. For returning clients, the electronic record is automaticallycarried over into new admissions and can be easily updated to reflect any changes.All of this functionality is adaptable to your organization’s existing workflow. Fields can be addedor changed, assessments revised, and screens rearranged to ensure that the TIER ® InquiryModule captures exactly the information you need with the greatest possible economy andaccuracy. For organizations like Marworth of Waverly, PA – one of the leading substance abusetreatment centers in the United States – TIER® has cut admission time in half.11 Based on a 2008 Marworth impact study.Page 8 of 26
  • 9. TIER® Product and Services OverviewWhen the decision is made to admit a new client, the next piece of software you are likely toencounter is the TIER® Scheduler. The Scheduler gives you the ability to manage staff, clients,group treatment, resources, facility space, and equipment from a single location with variousscheduleviews. Fromhere you canlook upprovideravailability,find aprovider thatmeets specificclient needs,and set upappointments.To schedule aclientappointmentsimply searchfor theappropriate Scheduler Month Viewstaff – theScheduler’s search functionality allows you to search based on varying criteria, like credentialtype, availability, location, and you can create customized teams to easily locate staff withspecializations. Appointment type, needed resources, location, and meeting recurrence can allbe established from the same screen. Once the schedule item has been saved, it will appear onthe unique schedule of any individuals to which that item pertains. In the case of particularlyimportant schedule items, the DocWatch can generate alerts.Page 9 of 26
  • 10. TIER® Product and Services Overview Care Delivery Once an initial appointment has been scheduled for a new client, you need to be able to track care delivery and be assured that the right information pertaining to a client record gets to the right people. TIER® captures every aspect of client contact electronically, from Assessments, to Treatment Planning, to Services and‘From the perspective of clinical records, we’ve Progress Notes, to Medication absolutely gotten the total value we’d hoped for.’ Administration, to discharge and post- discharge follow-up, all of which is capturedHarriet Hall, Jefferson Center for Mental Health in TIER®’s Service Delivery Module.President and CEO The Service Delivery Module was developed out of Sequest’s extensive experience in quality planning and program consultation to several hundred organizations across the U.S. The model is also based on the following philosophical principles: Treatment services should address the priorities and needs of individuals served. Services should be provided within the least restrictive treatment setting. Services should be completed within appropriate time frames. Clinical record documentation should closely reflect program design and service delivery processes. As part of this module, TIER® comes loaded with two distinct sets of Assessments, Base Line Assessments and Special Assessments. The Base Line Assessments are like building blocks from which your organization can construct more robust, custom assessments. They can be combined, rearranged, or the fields can be completely changed. TIER®’s Special Assessments were designed based on years of successfully Behavioral Health Screening Page 10 of 26
  • 11. TIER® Product and Services Overviewadhering to Joint Commission accreditation standards. Alternately, any third-party assessments,whether eminent domain or purchased, can be imported into TIER®.When a Diagnosis is made, TIER® records DSM IV-TR for all five axes. Any medication or laborders are handled electronically – TIER® has full HL7 compatibility – and with the addition ofsignature pads the need for paper documentation can be eliminated from the order process.TIER® has partnered with Dr. First, a recognized leader in the industry of e-prescribing, tofurther reduce dependency on paper, increase savings, and provide access to sophisticatedelectronic medication databases complete with information pertaining to allergies and druginteractions.If, as in our earlier example, a client is determined a suicide risk during pre-admissionassessments, the software could be adapted to automatically execute several proactive stepsfollowing an emergency screening. The DocWatch could generate, in addition to the suiciderisk alert, a Doctor alert stating that a new client is ready for emergency hospitalization thatrequires his/her signing off. The Presenting Problem recorded on the assessment can beselected to carry over to the Initial Treatment Plan, so that when, as a next step, an InitialTreatment Plan is created, the data is accessible from the Treatment Plan screen – the userdoesn’t have to return to the assessment to gather the data manually. The interaction betweenthe Assessments, Treatment Planning, and beyond allows you to trace the client’s progress fromthe initial care to the point of after care.Treatment Planning in TIER® is comprehensive, but easily managed. The philosophy behind theTIER® approach toTreatment Planning isbased on the work of Dr.Benjamin Bloom and relieson instructional objectivesand goals, which are tied tospecific problems. TheTIER® Treatment Plansupports JCAHO and otheraccreditation organizationrequirements. It containsthe ability to createunlimited problems, goals,and objectives. Within thehighly customizable drop A Treatment Plan Outlinedown menus any item canbe appended or revised directly from the Treatment Plan without the need to navigate to aPage 11 of 26
  • 12. TIER® Product and Services Overviewseparate editing screen. An updated plan can be created via a simple cloning process, whichallows the user to make necessary changes while creating an archival record of the original plan.You can choose from standard drop downs or create individualized ones, thus preventing“cookie cutter” treatment plans.After the point of intake and assessment, an initial short term plan can be established quickly andeasily using the linkages established during the intake assessments, including presentingproblems, diagnosis, and notes. Rather than creating Treatment Plans from additional steps,they are developed directly out of care, from data identified during assessments.This Initial Treatment Plan will allow your organization to establish and administer care, while aMaster Treatment Plan is developed. The Master Treatment Plan takes advantage of the samelinkages as the Initial Treatment Plan, with additional linkages being added as the clinical recordgrows, so once again data entry is minimized and integration assures that client data is consistentand accurate.The documentationof patientencounters iscaptured in a varietyof customizablenotes which recordservice informationand, whenappropriate,automaticallygenerate chargeslips. We adapt ourstock notes to yourneeds; whetheryour formats follow A Medication Administration Record (MAR)SOAP or DAPstandards, ourindividual, group, and other notes seamlessly initialize with problems and goals from treatmentplans. This ensures integration and compliance to treatment objectives. Included are IndividualProgress Notes, Group Notes, Activity Notes, Patient Education Notes, and General Free FormNotes, all of which are adaptable to your organization’s specific documentation needs. GroupNotes present a particular advantage because they can be created for each group member froma single screen, with a single point of data entry for the group portion of the note. Individualnote portions are then easily added by highlighting group members from a group list.Page 12 of 26
  • 13. TIER® Product and Services OverviewTIER® Physician and Nursing flows were designed by our clients. Our process friendly screensallow medical staff to document medications, establish protocols, and take vitals as well as order,verify, and administer medications. TIER®’s Computerized Physician Order Entry (CPOE) andMedication Administration Record (MAR) have been successfully and safely managingmedications for over 10 years. Nurse Administration functionality allows nursing staff todocument medications and vitals which populate the Medication Administration Record (MAR).The MAR further supports reconciliation with patient photographs, allergies or special needs,most recent vital signs, and medication tracking which automatically records overlookedmedications.Medication administration can be further enhanced with TIER® eRx, our new electronicprescribing tool. TIER® eRx is a web based application that opens from within the client recordand allows you to enter prescriptions, track them, and send them to pharmacies. Data isexchanged between TIER® eRx and the TIER® application automatically. That means TIER® eRxwill warn you ifyou try toprescribe thatmedication towhich a clienthas a knownallergy, and anyprescriptions youdo make willpopulate theclient’s MAR.You also benefitfrom a vast druginteractiondatabase. ® TIER eRx ®TIER wasdesigned by clinicians for clinicians. We understand the need for data collection to adhere toorganizational and discipline standards. We provide Help functionality within our software fromGuideline buttons. Guidelines and on-screen Help support staff are to complete documentationaccurately as well as support data collection consistency. Our Guideline buttons on theBehavioral Health Screening define attributes of dangerous behavior-thus all staff utilize the sameview of such observation. In addition TIER® offers access to the CLIMATE clinical help system.CLIMATE is published by the Clinical Research Unit for Anxiety Disorders and presented in theform of clinical algorithms. CLIMATE can aid you in making care delivery decisions by deliveringassessment strategies, diagnostic supports, and clinical management guidelines.Page 13 of 26
  • 14. TIER® Product and Services OverviewThe Face SheetOne of the tremendous advantages of an EMR is the ability to collect and store a huge amount ofdata for each client. This valuable TIER® data will determine how treatment is tailored, allowyour organization to assess quality of care, insure that clients receive the right medication at theright dosage levels, andillustrate the client’sprogress throughout theterm of admission and longafter in your TIER®outcome reporting.In TIER® each client’scomprehensive electronicrecord is managed from asingle screen, modeledafter a face sheet. Fromthe Face Sheet, all clientdocumentation is accessiblefrom an on screen menuthat functions like folder A Client ‘Face Sheet’tabs, each menu itemrepresenting the consolidation of related information, like Diagnosis, Treatment Plans, Services,Assessments, Identifying Information, Billing and Insurance, and more. Clicking a menu item willopen up all records that would be stored under the corresponding tab in a paper system. Infact, every aspect of client documentation is accessible within a few mouse clicks from thisscreen.TIER® can even capture paper documentation and make it accessible from the client record.Our partnership with CAPSYS, a browser-based application that allows you to capturedocuments from any location and import them into TIER®, enables you to collect any volume ofscanned documentation, sort it, and attach it to the proper client record.Page 14 of 26
  • 15. TIER® Product and Services OverviewTIER® ePortalThe electronic age has allowed us to pass information with speed and ease we never could havedreamed of before. In the behavioral health sciences industry, patient records can be sent backand forth between providers, claims sent instantly to payor sources, and prescriptioninformation can be securely transferred to pharmacies. Oh, and by the way, TIER® happens toexcel at all these things.But what about the clients? The client record belongs to the client, so shouldn’t clients be ableto ride the electronic wave and access their own records? With Meaningful Use regulationsbeing implemented in 2011, not only should clients have electronic access to their healthrecords, they must.TIER® ePortal allows your organization to provide clients electronic access to their personalhealth information over the web. Clients can examine their records for accuracy, review theirmedications, and access other areas of their health record from an easily navigable menu. TheMessage Center gives clients the abilityto send and receive correspondence totheir providers over a secure email,request a prescription renewal, andeven contact customer service. Clientscan also schedule an appointment,cancel an appointment, and view theirappointment schedules and visitsummaries in the ePortal. TIER® ePortalPage 15 of 26
  • 16. TIER® Product and Services OverviewConsolesAs advantageous as a comprehensive clinical record can be, if your job only requires you toaccess certain parts of the client record, navigating through the entire chart can be cumbersome.Wouldn’t it be convenient if you had a way to take the parts of the clinical record that your jobrequires you to regularly access and put them in one place?TIER® Consoles were designed to do exactly that.The TIER® Consoles consolidate all of your work on a single screen. Consoles for Clinical,Nursing, and Physician staff allow the user to point to the name of a client, then the work to beperformed, enter and save data and continue working without having to open the full clientrecord. For example, if aclinician opens TIER® toenter progress notes, heor she doesn’t have tonavigate to eachindividual’s client record,enter the note, and thennavigate to the nextrecord. Instead, clientnames and actions areavailable on the Console.The note can be enteredand saved on theConsole screen.Consoles reducenavigation through thesoftware to a bare Entering a Group Note from the Clinician Consoleminimum but don’trestrict access to the client record. Linkages within the Console allow the user to drill down tospecific areas of the record, or return to the face sheet. The ability to access all of your clientsand add documentation to their records from a single screen drastically reduces documentationtime – one screen for all your daily tasks, personalized to meet financial, medical, clinical, ormanagerial duties.Page 16 of 26
  • 17. TIER® Product and Services OverviewReportingReporting used to be like pulling teeth. In paper systems, tracking down all the requisitepaperwork and manually creating reportswas almost prohibitively time consuming.Early EMRs were a marked improvement,but you still had to wait for scheduledreport runs, print paper reports, and if youneeded a new report you had to go to thevendor and have them create it for you,usually for a cost.TIER® is designed to capture andconsolidate a tremendous amount of data,but that data is only useful to you if youcan see it. So TIER® Reporting tools weredesigned to give you virtually unrestrictedaccess to your database, on the screen andin real-time, so you can make decisionsbased on the most current data available.There are a number of canned reports inTIER®, all of which are customizable andcan be exported to third party applicationslike Microsoft® Excel™, and if you need toprint them out you can do that too. An Admission Summary ReportIn addition to our canned reports, TIER®provides full ad hoc reporting capabilities using the TIER® Report Builder, which works like awizard for creating new report templates. With the Report Builder, you can create a report toyour own specifications and create access to that report from any part of the system. Customreports can also be created using Crystal Reports® and SQL® Reports, so you can create anyreports you want, any time you want.TIER® also has the capacity to produce Drilldowns, providing you with real-time summarizationsof program performance on the screen. This functionality allows you to make decisions withouthaving to wait for end of the month reports. The content of Drilldowns can be adjusted bydragging and dropping identifiers into a content organization feature, thereby adjusting reportparameters on the fly.Page 17 of 26
  • 18. TIER® Product and Services OverviewThe TIER® Decision Cube provides management with a powerful but user friendly analytics toolfor viewing client andstaff data. Variablescan be filtered on thefly to producegraphical reports inreal-time, all on onescreen. The conceptbehind the DecisionCube, as with otherTIER® Reporting tools,is to expedite decisionmaking by providingaccess to real-timedata and to eliminatedependence onunnecessary paperreporting, thereby The Decision Cubereducing HIPAAviolations.Page 18 of 26
  • 19. TIER® Product and Services Overview Billing All across the continuum of care, TIER® is collecting the data necessary for billing to function. Basic client data, demographic information, and insurance and other payment sources are captured during Inquiry and Intake. When the clinicians enter their progress notes and corresponding service data, charge slips are automatically generated, which ensures that billed services are properly documented. The TIER® Billing Module does the work of collecting all this‘We have very much enjoyed our partnership with Sequest. information and offers a powerful We wonder how we ever operated without TIER®.’ and efficient way to document chargeable events and transactions,Howard Spanbock, Luke-Dorf CEO including adaptable reporting functionality. The charge slip automatically initializes requisite data, such as the insurance payer, payer plan, and prior authorizations. It monitors utilization and calculates the remaining number of authorized services. If authorizations or benefits are expiring, the DocWatch will notify the appropriate staff, thereby preempting any future billing issues. The system will even automatically compare standard agency charges to contract rates and establish contractual adjustments. Waterfall billing allows you to assign payer ranking so that the Billing Module can automatically assign charges based on those rankings. The system can accomodate an unlimited amount of payer sources. As remittances are received, any remaining charges are applied to the next sequential payer source, and so on down the payer rankings until the charge is satisfied. The Billing Module documents transactions from the point of Initial Charge – created when a Charge Slip is generated from a Progress Note – to Request for Payment, Payment, Adjustments, and Write-offs. This documentation can be viewed in a series of robust reports, including: Aging reports Client deposit log Closing report Transaction logs Client deposit allocation report Client balances Batch billing reports Client audit report Cash control log Pending rebilling report Void / reissue log Case aging report Transaction register Non signed charge slips Page 19 of 26
  • 20. TIER® Product and Services OverviewThese reports all allow for easy customization to your specific organizational needs. The BillingModule also incorporates the system’s Drilldown feature which allows you to access real-timefinancial data and graphical representations at the click of a button. You can instantly report onthings like payer mix, reimbursement by payer, census by unit, and any other combination ofvariables, and easilyexport both dataand graphics intoMicrosoft Officeproducts.Transaction activitycan also be viewedfrom theAccountingConsole. From asingle screen youcan search for aclient, select from alist of charges thatcan be sorted byCharge ID, Date,Service Code, Payment AllocationDescription,Amount, or Provider, and view any transactions pertaining to that charge as well as any clinicaldocumentation, therefore providing detailed financial information coupled with the clinicalinformation required to create a charge.As mentioned in the previous section, there are several options for ad hoc reporting, and, ofcourse, all of the features vital to effective billing are part of the module, including Batch Billingfor claims submission, Automatic Rebilling, and Electronic Eligibility Verification. The moduleprovides a HIPAA certified EDI File 837 X12N for both Medicare and Medicaid and CMS 1500and UB04 templates for Medicare, Medicaid, and Private Insurance.Page 20 of 26
  • 21. TIER® Product and Services OverviewBeyond EMRSecurity is paramount when it comes to Personal Health Information and electronic recordkeeping. TIER® provides security on every level, from secure login and software access based onuser groups all the way down to field level security to make sure you maintain HIPAAcompliance and keep your records safe.TIER® also contains a number of modules designed to help you get more out of your EMR.TIER® Human Resources allows you to capture and track data related to staff, includingcredentials, user rights, and checklists to verify the completion of the personnel managementprocess and related documentation requirements. The module also includes fully customizablestaff evaluations and anemployee performanceevaluation form.Your organization can trackand document facilities withthe TIER® EnvironmentalManagement Module. Thismodule is designed to facilitateyour ability to comply with theJCAHO and CARFaccreditation requirementsand also to supportcompliance with statelicensing requirements by The Environmental Management Moduleallowing you to track thefollowing resources: Building profiles Space allocation Environmental inspections Maintenance orders Preventative maintenance Vehicle maintenance Documentation of drills Orientation and annual safety training Systems inspections and management Incident reportingPage 21 of 26
  • 22. TIER® Product and Services OverviewTIER®’s Complete Quality Management (CQM) component is a comprehensive, dynamicresource that automates your organization’s complete quality management system. CQM isdesigned for medical and behavioral health organizations and consists of three core components: Process Improvement - This component incorporates the principles of process improvement through the use of project teams using the structured approach of plan, do, check, act (PDCA) for quality improvement. Performance Measurement - This quality management activity assists your organization in monitoring costs vs. benefits of processes on an ongoing basis. It allows you to continually monitor important aspects of your operations and create reports regarding findings. Outcomes Measurement - This component is designed to allow you to collect and analyze outcome measurement data. Two essential outcome measurement activities are evaluation of service effectiveness and organization evaluation including completion of special studies and accreditation requirements.TIER® provides you with the ability to plan and manage your business development activitieswith the Business Development Module. From here you have ability to view real-time volumestatistics regarding referrals from your referral sources. Your business development staff havethe ability to create referral source service plans and record contact follow-up activities witheach of their clients. The Business Development Module is incorporated into the TIER®database. This integration provides you with a powerful tool to manage referral developmentactivities, since all referral source information collected in the service delivery process isintegrated into the business development function.You can also link the Business Development Module with TIER® CQM, making it possible toproduce outcomes reports specific to funding. The referral sources allow it to support evidencebased practice processes.Page 22 of 26
  • 23. TIER® Product and Services OverviewImplementationNervous about the prospect of a large scale Implementation? We have a solution for that.®History is full of IT projects that fail to meet the customer’s expectations, miss scheduleddeadlines, and exceed allocated budgets. These are rarely failures of technology, talent, or effort,but are instead failures of management and leadership. But don’t panic. Instead, consider thefollowing questions: What are we trying to achieve? How are we going to achieve our goals? Who is going to do what? When are we going to be finished? What is our definition of success?The essence of effective Project Management is to provide the answers to these questions. Forthis reason, Sequest uses a disciplined, industry proven project management methodologydeveloped over years of successful experience.Sequest will tailor the implementation processes and procedures as necessary to meet yourorganization’s needs and augment those processes and procedures with a variety of softwaredevelopment and implementation models for a comprehensive delivery framework. Astechnology evolves, so do the frameworks – incorporating new methods and processes whilebuilding upon previous success stories and lessons learned is a key to the success of ourmethodology. The major stages of our implementation process, developed under thisphilosophy, are as follows:Project PlanningProject Planning provides the Agency-customized framework to specify detailed activities,desired goals, and target dates relative to implementing an EMR solution and is founded on thesuccess of other installations. We base our project plans on a rigorous set of scheduling practicesdetermined by your organization’s goals, RFP requirements, and the deliverable timeline. AtSequest, we recognize that project success is often determined by the effectiveness with whichwe establish and govern this process.TrainingIn order for TIER® to be used to its full potential, it is critical that users are able to understandand accept the product. Comprehensive, hands-on training and a strong partnership betweenyour organization and Sequest is vital to accomplishing this. Over the course of training, TIER®users will become self-sufficient as the knowledge of our training staff is transferred on.Page 23 of 26
  • 24. TIER® Product and Services Overview Integration The success of an EMR solution depends on much more than the installation, configuration, development, and testing of TIER®; it must be fully integrated into the complex business and technology infrastructures of today’s health and human services organizations. Our integration strategy includes the development of a detailed, tactical plan to seamlessly integrate TIER® within your organization’s system of care and technical environment, including the critical interfaces with Medicare and Medicaid to support the eligibility, claim, and financial reconciliation process. We schedule our integration activities to commence early in the project to provide sufficient time for the necessary inter-agency coordination and agreements and we place a special emphasis on tracking and recording the status of these activities throughout the project. Testing Each testing activity is aligned in a logical progression, starting with joint development of an effective test plan to support module tests, reporting tool tests, integration tests, and system performance tests. Data Conversion Because data conversion is a high-risk endeavor, our proposed EMR data conversion strategy leverages best practices and lessons learned from the nine-step approach. Maintenance and Support We see our commitment to your organization going beyond our demonstrated excellent preventative and corrective maintenance. Sequest will continue to include a progressive release strategy for TIER® combined with effective annual planning that anticipates and responds to future healthcare and technology trends. We will leverage our experience and knowledge in the industry to continue to provide exceptional service and a commitment to ongoing improvement. Our implementation process is grounded in two core values – building and maintaining our partnerships throughout and beyond the project lifecycle and applying appropriate and rigorous management methods during “solution” refinement, project management, and implementation. Our commitment to partnership goes hand-in-hand with our commitment to engagement success. Our adherence to structured methodologies ensures that every project is conducted within a proven framework that will minimize risk, maximize benefits, and achieve the‘This relationship is like a marriage, it requires greatest level of quality. that level of commitment and care.’ Strong partnerships produce stronger, betterJim Dougherty, Vice President, Marworth adapted products, and we all benefit from that. Page 24 of 26
  • 25. TIER® Product and Services OverviewTIER® ExchangeThe landscape of Health and Human Services is always shifting, and coping with changes inindustry practices, technology, and state and federal regulations can be overwhelming.We have a solution for that.®Once a month, Sequest hosts the TIER®Exchange, a series of forums designed toaddress the industry and how it’schanging. The TIER® Exchange is achance for us to bring our knowledge andinsight to you – from CCHIT andMeaningful Use to state specific topicsand much more – and the Exchange isopen to anyone.We also host an annual national users’ TIER® Exchange ®conference in Illinois – the National TIERExchange – in order to establish interaction between TIER® users from all over the country.Our goal is to create a dialogue, not just between our Exchange presenters and the audience,but between organizations, one that will continue beyond the Exchange.Page 25 of 26
  • 26. CONTACT Sequest 801 Warrenville Rd, Suite 350 Lisle, IL 60532 877-630-TIER (8437)solutions@sequest.net www.sequest.net