This document describes an integrated virtual clinic workflow solution that incorporates various TiaMD platforms including TiaMD Rapid Responz, TiaCoder, TiaCare, and modular ERP services. The solution provides a holistic, scalable health management system for care providers of all sizes. It allows for telehealth appointments, emergency response, coding and billing, patient engagement, and quality metrics tracking through an integrated suite of mobile and web applications.

1. • Integrated virtual clinic
• Workflow enabled management solution that incorporates TiaMD Rapid Responz, TiaCoder, TiaCare, and modular
enterprise resource planning (ERP) services to provide a holistic, scalable health management system (HMS) for
care providers of all sizes. (TiaConcierge service has been bundled into this platform)
TiaMD
NUMR

2. WORKFLOW
Scheduling Office Visits

3. Patient requests for appointment from TiaCare mobile app

4. Doctor’s office confirms appointment on TiaMD NUMR web portal
and emails Intake form to TiaCare mobile app

5. Medical Assistant checks Insurance Eligibility* and collects Copay
* Interfaced with Navicure

6. During office visit, Medical Assistant records vitals using
wireless medical devices to updates patient information in TiaMD NUMR
web portal or mobile app

7. Doctor evaluates patient and documents information on
TiaMD NUMR web portal or mobile app
• Patient Visit History
• Clinical Assessment
• Auto-filled Notes
• Nuance Dragon tool
• IMO Database for ICD10, SNOMED
codes
• Favorite templates for problem &
procedure
• Lab & Radiology orders
• E-Prescription using Dr. First
• Referral to external labs and other
specialists
• Document management
• Active medication and allergies
• Messaging
• Emergency Protocol setting

8. Virtual Visit:
Tele Appointment for follow-ups from TiaCare and TiaMD NUMR / Rapid
Responz mobile app and web portal

9. Coding and billing:
Patient encounters sent for billing to TiaBilling web portal + secure excel in
email

10. WORKFLOW
Pre-hospital Care & Care Coordination

11. Patient initiates call to emergency medical team (EMT)

12. EMT receives call and identifies patient location

13. EMT evaluates patient and records vitals

14. EMT connects to On-Call Doctor

15. Doctor or medical assistant records patient condition severity using
scales like NIHSS

16. • Virtual Mobile / web based Telehealth platform
• Emergency Protocol Setting & performance reports
• Integrated real-time schedule for on-call physicians
• Send and receive secure video, audio, and text messages
• Utilize TiaMD NuMR integrated EHR platform for virtual or
conventional care
• DICOM viewer (TiaImage)
• Equipped with TiaHealth Peripherals with Tele Medicine
carts
• E-prescription platform
• Equipped with TiaCoder functionality
• Encrypted & HIPAA protected cloud service
TiaMD Rapid Responz

17. EMT broadcasts emergency to stroke doctors

18. Doctor connects to patient in emergency room or ICU

19. Option1: Click Cart Option2: Click Connect ED Option3: Menu- Click Cart
Options for doctor to connect to Telemedicine cart from mobile app

20. Press Hold
Swipe To Draw
Box – Enables
Camera Zoom
In On Selected
Area
Pinch Zoom
Out/In
Swipe
Left/Right And
Up/Down
Doctor to use camera controls from mobile app and web portal

21. Doctor records problem and procedure*
* Interfaced with IMO for ICD10

22. Doctor creates notes
• Template setting based on
doctor requirement
• Auto-population of contents –
Patient Details, Problem,
Procedure, Medication etc.
• Integrated with Nuance Dragon
for voice to text

23. Doctor gives orders for lab and radiology
• Template setting for order list
• Send to external lab/radiology centers
• HL7 Interface to other hospital systems

24. Doctor creates prescription* and sends to pharmacy electronically
* Interfaced with Dr. First
• Template setting for medication list
based on problem
• E-Prescriptions

25. Doctor views Patient Images (MRI, CT…)
• Integrate with PACS
• Image comparison tools

26. • Modular mobile or web based Charge Capture program
with the following interfaces:
• Virtual scribes will eliminate corrections and improve
efficiency
• Partner with third party coding and billing agencies with
VR technology
• Real time audits and dashboard reports
• Operates with IMO ICD10 & CPT interface
• Utilizes Nuance Dragon dictation system
• Incorporates transcription services
• Enables Navicure clearing house
• Rounding mobile application
• Physician Group Patient Assignment Management
TiaCoder

27. TiaCoder Workflow

28. Doctor follows Inpatient Rounding list and created encounters
• Fax to PCP
• Copy
previous
codes in
one-click
• Hand-off
patients to
doctor(s) in
a group
• Faster
sharing of
encounters
for billing
• Integrated
with IO for
ICD10 codes

29. TiaCoder
Dashboard
Advanced
Clinical Search
on patient
data based on
problem,
procedure,
Age, Gender

30. • Patient’s mobile app
• Encrypted & HIPAA protected portable health record
• Schedule an appointment
• Requesting refills
• Schedule payments
• Utilize TiaMD’s EHR ecosystem (TiaMD NuMR)
• Utilize Intelligent Health Exchange (TiaAlert)
• DICOM viewer (TiaImage)
• Communication portal (secure text, AV portal and secure
email)
• Customize patient portfolios
• Share health summary with doctors
• Emergency calls
TiaCare

31. Patient maintains health summary and connects with doctor

32. Quality Metrics: Access Patient Clinical Evaluation

33. Access Clinical Guidelines

34. Primary Stroke Measures

35. Quality
Metrics
Data
Collection
Attributes-
example
Anticoagulation Therapy Prescribed at Discharge
Antithrombotic Therapy Administered by End of
Hospital Day 2
Antithrombotic Therapy Prescribed at Discharge
Arrival Date
Arrival Time
Assessed for Rehabilitation Services
Atrial Fibrillation/Flutter
Clinical Trial
Comfort Measures Only
Date Last Known Well
Discharge Disposition
ED Patient
Education Addresses Activation of Emergency
Medical System
Education Addresses Follow-up After Discharge
Education Addresses Medication Prescribed at
Discharge
Education Addresses Risk Factors for Stroke
Education Addresses Warning Signs and Symptoms
of Stroke
Elective Carotid Intervention
IV OR IA Thrombolytic (t-PA) Therapy Administered
at This Hospital or Within 24 Hours Prior to Arrival
IV Thrombolytic Initiation
IV Thrombolytic Initiation Date
IV Thrombolytic Initiation Time
Last Known Well
Reason for Extending the Initiation of IV
Thrombolytic
Reason for No VTE Prophylaxis – Hospital Admission
Reason for Not Administering Antithrombotic
Therapy by End of Hospital Day 2
Reason for Not Initiating IV Thrombolytic
Reason for Not Prescribing Anticoagulation Therapy
at Discharge
Reason for Not Prescribing Antithrombotic Therapy
at Discharge
Reason for Not Prescribing Statin Medication at
Discharge
Reason for Oral Factor Xa Inhibitor
Statin Medication Prescribed at Discharge
Time Last Known Well
VTE Prophylaxis
VTE Prophylaxis Date
Admission Date
Birthdate
Discharge Date
Health Care Organization Identifier
Hispanic Ethnicity
ICD-10-CM Other Diagnosis Codes
ICD-10-CM Principal Diagnosis Code
ICD-10-PCS Other Procedure Codes
ICD-10-PCS Other Procedure Dates
ICD-10-PCS Principal Procedure Code
ICD-10-PCS Principal Procedure Date
Payment Source
Race
Sex

36. Quality Metrics: Monthly Metrics Dashboard

37. Mobile Apps
TiaAlerts
TiaMD NUMR
TiaEmergency TiaCoder
TiaCare