Paperless Process for Charting and Tracking Care Delivery

NetSolutions Point of Care software increases the quality and quantity of information charted by caregivers in long-term care. We understand that nurses often have busy, erratic schedules – and that resident care should take priority over administrative tasks.

Nevertheless, proper documentation during the Point of Care is essential to delivering optimal treatments and ensuring proper reimbursements. That’s why we offer a centralized way to capture POC insights and activities, without disrupting clinicians’ workflows. POC reduces the likelihood of missed information, errors, and staff overtime by replacing paper-based or non-configurable solutions.

Data Collection Made Easy

The NetSolutions Point of Care application makes it easy for clinicians to collect data about any care activity including CNA/ADLs, Restorative Nursing, Therapy, and Mood Observation – as well as information from the NetSolutions Care Plan module. Plus, we’ve made POC easy for all authorized staff to access. From a PC, wall-mounted kiosk, or your tablet, you can check on residents’ vitals, ADLs, reports of pain, and how much breakfast they consumed, for instance.

User-Defined Tools for Custom Data Collection

Set up user-defined events, complete with graphics and labels, to capture items per your facility’s requirements. Logical tools simplify the process of defining a button including timeframe, language, correlations to MDS 3.0 and Vitals, plus more. You can also generate reports on data captured through user-defined buttons, including aggregate trends for your entire census with a convenient “select all residents” option.

Advanced Reporting

NetSolutions Point of Care offers advanced reporting capabilities to help empower better care outcomes, streamline critical processes, and yield accurate reimbursements. Examples include:

• Shift confirmation and incomplete documentation reports with visual indicators: Spot missing entries to help ensure data integrity and remediate oversights.
• KPI-driven dashboards: Monitor resident activity (meal intake, fluid intake, bathing patterns, etc.), optimize care plans, and expedite residents’ progress rates.
• Resident maintenance reports: Proactively complete required documentation prior to discharge.
• MDS 3.0 Item Report: Achieve financial and operational success in the PDPM era.

Charting for MDS 3.0, ADLs, and PDPM Payment Rates

NetSolutions Point of Care can capture data and calculate totals for almost all MDS 3.0 items and import them to NetSolutions MDS 3.0 software. Pre-loaded buttons with correlations are ready to go for items in eight MDS 3.0 sections, including ADLs for MDS 3.0 Section G, Section GG, Section C, Section H, Section D, Section E, Section M, and Section O.

Using data collected at the point of care, POC calculates totals for MDS 3.0 responses and exports them to NetSolutions MDS 3.0 software. The software is pre-loaded with correlations to eight MDS sections. You can set up additional correlations between POC items and almost all MDS 3.0 items. Easy-to-use tools assist you in setting up POC buttons that will export responses.

Pre-Loaded With Correlations

NetSolutions POC is pre-loaded with correlations to these MDS 3.0 items:

• ADLs – MDS 3.0 Section G – G0110 A thru J, G0120
• Functional Abilities – MDS 3.0 Section GG
• Cognitive – MDS 3.0 Section C – C0700, C1000
• Mood Observation – MDS 3.0 Section D0500A1 – D0500J2
• Toileting – MDS 3.0 Section H0200C, H0300, H0400, H0500
• Behaviors – MDS 3.0 Section E – E0100, E0200, E0800, E0900
• Skin Conditions – MDS 3.0 Section M – M1200 A, B, C
• Pain – MDS 3.0 Section J – O800 A, B, C, D
• Therapy – MDS 3.0 Section O – O400 A, B, C
• Restorative Nursing – MDS 3.0 Section O – O500 A thru J

Data entry is user-friendly, with simple navigation, icons, and language that paraphrases what is used in MDS 3.0. Responses are saved automatically. Items are color-coded to show when completed.

By making charting easier, caregivers document more information more often, reducing the risk of missing important data, such as a 1-person assist during the day but a 2-person assist on the night shift. This results in more accurate ADLs, a significant component of PDPM scoring. A one-point difference in an ADL score can mean a loss of $10 to $40 per day/per resident in payment by Medicare Part A and by Medicaid in several states.

POC can record multiple occurrences in a shift and gives you the ability to view all entries as well as add and strike entries as appropriate along with the reason for the change. Time/date and the user is recorded automatically. These functions help in capturing the highest level of ADLs.

Tailor Your POC Data with User-Defined Buttons and Icons

Set up user-defined buttons, complete with graphics and labels, to capture items per your facility’s preferences. Logical tools simplify the process of defining a button including timeframe, language, correlations to MDS 3.0 and Vitals, response format (yes/no, single response, multiple choice), and any conditional responses. You can generate reports on data captured through user-defined buttons.

POC gives you additional control over data collected with the ability to set items as “required.” Required items are color-coded, showing caregivers which are required, and showing at a glance whether required items have been captured. Further customize your POC system with graphic images that can be added to buttons in addition to text labels and text in other languages; the software is delivered with Spanish.

Capture Data in Spanish and Other Languages

Increase accuracy by capturing data in your caregivers’ preferred language. The sample above shows ADLs in Spanish. Language can be set up in caregivers’ profiles, so it displays automatically.

Efficient Data Entry Saves Time

By making data entry quick and easy NetSolutions POC encourages caregivers to chart completely. Features that enhance efficiency include:

• Automatic saves, just click your response and move to the next
• Ability to document the same type of care for multiple residents in one session. Stay on a topic page such as weight or morning snack consumption and select the next resident
• Supports your facility’s workflow, you can enter responses in the order you prefer
• Questions are set up so they require data entry only for responses different from the default

Selecting Residents for Charting

NetSolutions POC gives you flexibility in building lists of residents to include in a session. You can chart on every resident for every shift. And you can filter the list, such as:

• According to residents’ assessment schedules for Medicare PPS, Medicare OBRA, Medicaid, and Medicare Advantage plans
• For all shifts/all residents, as a mechanism to manage daily resident conditions
• By location/station
• For individual residents who need monitoring for specific needs
• To identify trends and check on outcomes of Quality Assurance activities

By MDS Schedule

MDS Coordinators can set up future assessment dates including lookback dates. When the dates arrive, the residents’ names will be color-coded as a prompt for CNAs.

The Benefit Sensitive Fields report gives MDS Coordinators an overall view of a resident’s MDS 3.0 responses on items used to calculate PDPM scores. To view different scenarios, MDS Coordinators can change dates and view the corresponding changes in responses to assist in selecting the most beneficial Assessment Reference Date (ARD).

Pinpoint Location on Graphic of Body

NetSolutions gives your facility’s staff the option of associating items such as pain with a specific part of the body on a graphic. The Signs of Pain button is pre-loaded in NetSolutions Point of Care.

Key Features of NetSolutions Point of Care

• User-defined buttons can be set up to collect additional data
• Icons can be added to buttons in addition to labels
• Text can display in multiple languages; Spanish is delivered with the software
• Includes conditional responses to provide more information depending on the first response. For example, if you set up a button for Swelling, and the response was Yes, then another set of responses could display, such as Applied Ice and Applied Heat
• Start a charting session by clicking the subject area that corresponds to your job title in the security setup, such as CNA, Restorative Nursing, Therapy, or Mood Observation
• As charting is completed, a summary of responses is available with a separate table for ADLs
• Supports review and edit of multiple charting occurrences in a shift
• A handy table shows how complete charting is for all or some residents. Change the criteria and see one resident’s responses on topics such as wandering. An on-demand report shows completion compliance by CNA.
• Click the Help button in non-ADL categories for definitions written in clear language
• Security is assured with required master setups for each user that control the pages available to each user according to their needs
• Caregivers’ list of residents can be saved and re-used
• Calculates the totals to be entered for MDS 3.0 sections based on the individual responses entered for shifts and days. In NetSolutions MDS software, click the Import button to view data before adding it to the assessment
• Entries from the previous shift are not visible to the current shift to prevent copying
• Help is available at the kiosk, PC, and tablet
• Information can be added with a body graphic
• Items can be set as required, with color-coding, including showing completion
• Text for items and labels can be displayed in multiple languages; Spanish is delivered. Preferred language can be set up in caregivers’ profiles so it is displayed when the caregiver enters a POC session

Reports: On-Demand and User-Defined

Reports give you a behind-the-scenes look at the data being collected for the MDS. They provide vital data for residents’ care plans as well as management information.

• ADL Tracking Log – for 7 days. Results that will go to MDS 3.0. Shows variances over shifts/days that could indicate a change in resident status or issues with charting or staffing
• Shifts Received by Date of Service – informs staff of any residents for whom data was not collected in the past 24 hours. A tool to monitor and manage compliance on a day-to-day basis
• CNA Compliance by shift for a 7-day or 31-day period – all residents. A management tool that shows the percentage of compliance by shift
• Flow Sheet Reports – multiple reports are delivered with the software and additional Flow Sheet Reports can be added, based on user-defined Documentation Types
• 7-Day Bowel Report and a Bowel Movement Report
• Benefit Sensitive Fields – shows responses to MDS 3.0 items used for PDPM scoring that are exported to MDS 3.0 from NetSolutions Point of Care

Hardware and Specifications

NetSolutions® POC gives providers a choice of hardware. The software runs on-wall-mounted touchscreen kiosks as well as Windows desktops, laptops, and tablets. The requirements for kiosks include Windows compatibility with 2g ram and IE10 or higher. Also required is administrator access to configure devices, load the activeX print control, and modify IE settings.

Point of Care Options

With NetSolutions you have a choice of vendors for point-of-care charting. We offer you the NetSolutions POC application and interfaces to specialist vendors, CareTracker, Dart Chart, and AccuNurse.

Point-of-Care Application

The NetSolutions Point of Care application runs on PCs and wall-mounted kiosks to give your facility control over hardware expenses. Data collected at the point of care generates totals that are exported to NetSolutions MDS 3.0 software for responses to specific MDS 3.0 items. The software also can use the data collected to calculate PDPM scores before MDS 3.0 completion and billing.

NetSolutions Point-of-Care solution provides significant benefits to Long-Term and Post-Acute Care providers by improving performance in:

• Accuracy of data used for MDS 3.0
• Speed of MDS completion
• Accuracy of ADL charting for appropriate PDPM scores
• Communication of resident status – a direct path from caregiver to authorized staff
• Quality of care by reporting problems and providing data to measure QA activities

Documentation is recorded in these general subject areas:

• CNA Care – ADLs for MDS 3.0 Section G, Eating/Drinking, Mood, Pain, Skin/Hygiene/Body Check, Toileting, Vitals/Safety, Weight
• Restorative Nursing – MDS 3.0 Section O – 0500
• Therapy – MDS 3.0 Section O – 0400
• Mood Observation – MDS 3.0 Section D, Mood Interview – MDS 3.0 Section D

Data entry is user-friendly, with simple navigation and language that paraphrases that used in MDS 3.0. Green checkmarks show instantly that an item has been completed.

Check on how complete charting is for all or some residents in a handy table. Or change the criteria and see one resident’s responses on topics such as wandering. This valuable POC feature provides instant information for measuring staff compliance and resident care.

CareTracker

CareTracker by Cerner Extended Care collects charting data through wall-mounted touch-screen devices that encourage direct-care staff to document all the care they provide.

Touchscreens make charting user-friendly by showing choices in pictures and words. CareTracker uses the data to calculate totals for MDS 3.0, alerts, clinical and management reports.

CareTracker serves several purposes in Long-Term and Post-Acute Care facilities, including:

• Point-of-care charting of care delivery
• Calculating totals for MDS 3.0 items and exporting them to MDS software
• Staff messaging
• Alerts through a Clinical Intelligence dashboard

CareTracker kiosks encourage staff over all shifts to document all assistance provided with Activities of Daily Living (ADL) and other critical items. Those items significantly contribute to PDPM calculations – the scoring system used for payment of Medicare, and Medicaid in more than half the states.

Prevent Undercoding

Undercoding happens when staff copy from shift to shift, fail to chart, or wait until the end of shift when details can be forgotten. CareTracker solves these problems by clearing data from the prior shift, offering point-of-care charting, and enforcing the same charting expectations for all shifts.

Cantata Health offers an interface between CareTracker and Cantata Health software for seamless efficiency.

The interface delivers:

• Resident and census information exported to CareTracker from ADT
• Totals imported to Cantata Health MDS 3.0 software for six MDS 3.0 Sections: D – Mood, E – Behavior, G – ADLs, H – Bladder & Bowel, K – Height/Weight, Weight Loss, and O – Restorative Nursing

Learn more about CareTracker at www.resourcesystems.net/LongTermCare/CareTracker.aspx

Dart Chart

Dart Chart’s point-of-care system captures data entered by direct-care staff with PCs and kiosks. It uses that data to calculate PDPM scores before MDS submission and billing. PDPM scores determine Medicare Part A and Medicaid payment in many states.

Direct caregivers can enter responses at the point of care for the 157 MDS 3.0 responses that generate PDPM scores. With that data and minutes of therapy, Dart Chart provides management information to reduce the risk of underpayment in Long-Term and Post-Acute care.

Dart Chart generates reports that can show you the expected PDPM scores for all beneficiaries every day. The reports break down findings to show scores anticipated for therapy and nursing components, plus ADL scores.

All The Data to Score PDPM

Dart Chart brings all the data collected together to score the PDPM, select the best Assessment Reference Date, and OMRA assessment. It offers caregivers a simpler version of MDS wording and a proprietary process for capturing the ADLs called “Talk, Touch, and Take the Weight”™ that clarifies the language for point-of-care charting and recording frequencies of assistance.

Dart Chart’s software is compatible with touchscreen technology used by kiosks and it can run on portable and desktop PCs connected to your network. With Dart Chart, you have choices to ensure your hardware expenses match your budget.

The NetSolution interface sends resident demographic data from Cantata Health software to Dart Chart to increase efficiency.

For more information on Dart Chart, visit their Website: www.dartchart.com

AccuNurse

AccuNurse uses structured voice-recognition technology for real-time documentation of care. Nursing staff can hear a resident’s care plan at any time including their assignments and real-time updates. Through their headsets, they can document care delivered, and discreetly page fellow staff members.

With AccuNurse, direct-care staff access individualized care plan interventions for instructions such as “turn and reposition every two hours.” Then, as caregivers walk to the next room they chart the assistance, simply by speaking into their headset.

Privacy is maintained by AccuNurse’s structured content that asks for yes/no responses and uses room numbers instead of names.

Changes in resident condition are communicated in real-time via automated care plan updates.

Point-of-care charting prevents end-of-shift charting with its potential for error and memory lapses.

By simplifying charting, AccuNurse encourages staff to chart all the care provided and ensures facilities receive full payment from Medicare and from Medicaid in case-mix states.

AccuNurse can eliminate:

• Paper charting of ADLs, vitals, and care plan interventions
• Pages for assistance that others can hear
• Leaving a resident unattended while seeking assistance
• Searching for a resident’s care plan interventions
• Risk of CNA not having most current information
• Undercoding of ADLs for Medicare and Medicaid payment

Cantata Health’s interface with AccuNurse exports resident demographic information to AccuNurse. Learn more about AccuNurse at their Website: www.accunurse.com