About PTS

PTS is a cloud based patent management application that allows a Health Provider, small or big, to maintain medical records relating to all patient related activity securely. The application can be accessed from any device / platform and user friendly.

The application comes with a host of features covering a typical patient pathway from registration / referral to discharge. The intervening period includes activity relating to setting up appointments, acquiring detailed patient history, doing risk assessments, physical examination, outpatient / inpatient medication management and using outcome measures to chart progress of the patients. PTS covers all these user needs in one coherent application. The PTS offers additional features such as a patient portal for acquiring Patient Rated Outcome Measures (PROM) remotely.

For the individual user the application aims to mimic typical case notes held traditionally as a paper file with segregated sections. For the Team Manager the application provides an ability to set up teams, grant and withdraw permissions / access rights, generate performance reports relating to Key Performance Indicators of your choosing.

The team behind PTS includes highly responsive group of developers and clinician with frontline experience. They offer flexibility to deliver changes to the application to best serve your needs.

Logging in to the application:

This is no different to logging in to an email account or another application. You will as a part of deploying the system be given the URL of your choice so it reflects your business brand.

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Your Administrator will have signed you up and sent you your user ID and password. On logging in the first time, the system will prompt you to change the password and record your IP address for security reasons. Depending on the system configuration chosen, access will be denied from another device / IP address unless additional security checks are completed successfully.

Landing Page/Dashboard:

This is page you would first encounter on logging in to the system. Depending the access rights and permissions your screen may differ in the amount of menu options to the left. The space in the centre will display some key information relating to your caseload e.g. cases assigned to you, total patient activity, any missing Key Performance Indicators to notify and remind you as appropriate.

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While working on smart device, you may wish to expand your work area, this can be done by clicking on the

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Menu Bar and Options:

Your options to the menu bar will differ depending on your user role.

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The top 3 Menu options i.e. Menu Management, Master Management and User Management will typically be accessed and visible only to the System Administrator in your Organisation / Team. We recommend that the person in this given role has had a remote support session from our Team at time of deploying the application. A number of sub-menu options herein will be used very rarely and incorrect use may harm the functioning of the system and for this reason, if meta changes are needed, these are best done through our clinical and technical support teams.

A typical clinical user will thus have access to –

Patient Management / Appointment Management / Assign Patient

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Registering a patient:

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As seen above, this section can be accessed via the sub menu option –Create Patient. The user now simply completes the mandatory fields and registers the new patient on the system. Where you may not have the information for any mandatory fields, one may add TBC or where a numeric value is needed, add 0000 and update the information when it becomes available at a later time.

This patient is then enlisted on the Patient listing and depending on your role you may go on to assign the given patient to a clinician or group of clinicians (and a team if that is relevant) through the subsequent options on the menu.

Accepting patients via self-referrals or through other professionals:

The system is configured if you so wish for this intake / referral form to be made available online via your service portal at an additional cost. Any referrals generated online by third party will be listed on patient listing and assigned to a clinician and appointments set up. Alternatively, the case record of the patient will allow you to discharge patient if the case is not suitable or appropriate to your service provision.

Patient portal:

If you have subscribed a package that includes patient portal, then the service user will get a notification of patient registration by email if the email has been provided. The patient may then be prompted to log in and change their password. This portal will enable a patient to send outcome measures to their case record securely but will be hosted separately and thus no patient will have access to the patient management application or confidential information at any point in time.

Patient Listing:

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From the patient listing menu, you will be able to see a full list of cases assigned to you. You may choose to edit their registration information or add more information if you seek by clikcing on EDIT. On clicking Care Record, you will enter the patient record / notes of the given client.

Clinician Dashboard:

The clinician on logging on will land on their dashboard. This is as shown below. It allows quick access to –

  • Patient listing
  • Snapshot of your team caseload / personal caseload
  • Upcoming appointments
  • And additionally, provides a scratchpad to create to-do-lists
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Clicking Care record would take the user to the patient record.

Before we proceed to the patient record, it would be useful to consider some other menu options in following order:

  • Create User: This is an admin only facility to allow adding staff users. The interface is similar to how one may register a patient. This option is accessed via User Management module.
  • Assign User Slots:
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This allows the admin to allocate slots to each clinician – for example, if Dr Pearls offers 4 hour clinics on every Wednesday and Friday afternoon, these can be created using the Assign free slots. The reason for incorporating this facility is that patient portal could potentially allow patients to book appointments with their assigned clinician in the predetermined slots.

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  • Appointment Management:

The add appointment will take the clinician / admin user to

patient search box.

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Simply add client Id or first name and a list of patients is pulled up.

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Select the patient or multiple patients (if conducting a group session). And click GO

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  • Use the date/time icon and access and choose the calendar date and time.
  • The Booking system allows you to add multiple patients as well as multiple clinicians (see above).
  • You need to choose duration of the meeting, add Appointment Type and urgency levels
  • There is an option select location (allowing allocation of pre-designated rooms / office / venue)
  • And also create repeat appointments if you were seeing a patient daily, weekly, fortnightly, monthly for specified number of weeks (above example shows 3 weeks)
  • Add appointment by clicking SAVE

NOTE: APPOINTMENTS CAN ONLY BE BOOKED PROSPECTIVELY. An email is sent to clinician / patient. Text reminders can be added at additional costs.

Appointment Listing:

This shows all FUTURE appointments as under

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Errors: When booking appointments, the system will advise you if you are –

  • Double booking a room
  • Double booking a patient
  • Double booking a clinician at the same time
  • Or booking without a slot having previously being allocated to the clinician by an admin user (appointment can still be booked and this error may be ignored in case the clinician is offering ad-hoc additional sessions).

Appointment History

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Clicking on Outcome allows user to choose is patient attended or not. Once this is done the Outcome status changes to Complete.

Appointment Cancelled:

This will list all the appointments that were booked and cancelled.

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Calendar View

This allows a user to get a daily, weekly or month view of the calendar as shown below.

Assigning / re-assigning patients to clinicians

If you have been granted these rights, the clinician will be able to create (register) patients and then assign the patient to themselves or to a colleague in their team.

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remove a patient from your case list, go to Assign Listing and click delete

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Patient Customer Id

The unique patient ID generated by the system automatically is also found in this section i.e. Assign Listing

Site Log:

The user with Admin rights will also have access to the activity log for ensuring accountability, the screenshot below shows this interface

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The system log can be searched by date range, patient or specific clinician.

Reports:

As seen in the screenshot below, the system allows Admin user (unless rights were granted) to pull data for the following parameters, the data can then be exported to CSV, Excel, PDF file formats for further analysis / incorporation in audits and KPI reporting.

  • Clinician wise activity
  • Team wise activity
  • Outcome measures wise activity

Bespoke reporting in addition to that already provided can be made available at an additional cost.

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Additional Master Management Modules

Finally, before moving to patient records, the system allows Admin User (only) to make changes to certain sections such as –

This facility allows a user to add / edit / delete categories of Ethnicity they may have in the drop down list under patient registration form.

Similarly, the system allows the above changes to patient notes types or creating letter templates and adding patient information documentation to a library allowing any clinical user to send this information from the application to the patients directly.

Within this interface, we would typically disable some features such as Questionnaire / RCADS as these relate to outcome measures and automated calculations done in the backend database. This is to protect and prevent the system from malfunctioning. These sections as a consequence will be available only to system owners and developers.

We would also recommend that the users consider seeking bespoke additional changes to some sections like letter templates with the help of the product support services at additional costs, please get in touch for a quotation if need be.

Adding Questionnaires / Rating scales

We would be happy to consider adding more outcome measures on basis of following principles –

  1. The copyrights allow this or copyright owner has confirmed in writing their agreement allowing incorporation of the given measures / questionnaire in the application.
  2. Users will be given a quote for the work depending on complexity and time required to incorporate the measures.
  3. We would expect the module developed to be incorporated for use by other users of the application.
  4. We have incorporated outcome measures on the basis that unless otherwise specified, they are free to use any number of times and no costs are passed on to or recovered from patients.

Patient Care Records

We will now go over the different sections of a typical care record. You would reach this by clicking on the ‘care record’ either via patient listing or the one available on clinician dashboard as seen below.

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Once clicked, you will reach the patient dashboard as seen below –

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The patient dashboard gives a quick overview of some key information –

  1. Allergies
  2. Appointment snapshot
  3. Legal status and when it may expire (with link to documents if uploaded)
  4. Outcome measures used for given patient with first date / last date with score – allowing you to decide if you needed an updated measure (thus also acting as a reminder).

We will now run through the different sections of the care record for the given patient as seen in the left hand panel in the above image starting with consent to share.

Consent to Share:

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The main features of the above provision in the application is that either at the meeting itself or subsequently, the service user / parent consent can be confirmed through their signature using a stylus on a smart device. The submitted form then is preserved as a ‘read only’ and accessed via the History tab at the top of the screenshot above. The last submitted form is available for quick edition and re-submission saving time.

Care Record: Demographics

This tab essentially lets the clinician quick glance the referral information including demographics. If this needs to be amended, this can be done quickly by changing only the relevant fields and hitting submit at the bottom of this page.

Again, as you will find consistently through most of the care record sections, the previous and newly submitted information is available via the ‘history tab’ – this ensures a clear audit trail and accountability. The system automatically captures information as to who (which clinician made the changes).

Care Record: Assessment Summary

This is a standard assessment format used typically in most mental health settings. If you insert lot of detail, a scroll bar will appear. At the end when you click submit, the form is saved in read only version accessed via History tab. A PDF is also generated automatically and can be attached to standardised letters / emails either via the application or using a separate email provider allowing flexibility to users.

Users are able to make add some basic styling as well as numbering to highlight the significant text / key words.

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Care Record: Risk Assessment

This a simplified risk assessment form capturing key information. The application is designed to reduce complexity and clutter. A similar interface will be in use here as well, once saved the form is saved as a read only accessed via history tab, and a PDF generated.

Care Record: Clinical Coding

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The above section allows a user to record diagnosis including comorbidities. The key features –

  1. Supports ICD 10 and includes Z codes
  2. By simply typing a key word or the ICD code, a drop down becomes available allowing user to quickly select the relevant diagnosis.
  3. Iterative – If the user was likely to use DAMP - deficits in attention, motor control and perception – the user can type this, once saved this diagnosis will become available to the user at a later stage.
  4. Add multiple diagnosis and archive / delete previous diagnosis if they did not hold true due to syndrome shifts
  5. Any deleted / archived information remains available for governance reasons in history tab.

Care Record: Patient Notes

This section allows one to add a narrative of the sessions / meetings pertaining to the patient following each appointment. A number of entry types can be chosen to categorise the information making it easy to search for it later.

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Once added, the clinician is able to view all entries starting with most recent at the top.

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Hitting search lets one zoom in on specific type of entries

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Clicking PDF generates a PDF file of all the patient notes entries.

As users can amend or delete entries, the history section captures this and identifies the deleted, edited and old entries using the tags seen in red below.

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Care Record: Medication

This section can be enabled or disabled depending on the clinician role allowing access only to those who are deemed as prescribers in the service.

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Click New to add new medication, you would need to populate the information as exemplified below

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It’s vital to ensure that Frequency / timing is inserted as a numeric value.

When a user starts typing a drug name, a pre-populated list becomes available to choose from.

Iterative – The system is designed to learn and if a new medication was to become available and it was typed and saved, it should become available in the future in the list for ease.

Inpatient Medication & Dispensing charts :

The interface for adding REGULAR or VARIABLE inpatient medication is same as the out-patient medication module.

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Once added, the doctor will require to suggest the timings when the nurse would dispense the medication.

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The nurse dispensing the medication can then add exact time of dispensation, and status of whether the treatment was taken or not and add comments as appropriate if need be.

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The medication chart would thus look as under –

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If the medication was prescribed for 7 days, only those many dates would be enabled and each date would be active on the given date.

Repeat Prescribing

Both the inpatient and outpatient allow for choosing ‘repeat’ for ease and speed.

Consent to Treatment :

The medication management section includes a section to record consent to treatment as shown below

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Once recorded, this information becomes available on the patient dashboard as seen below and placement of cursor over the labels brings up comments and additional detail as seen below. This works on laptops / PC and may not work on smart devices.

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Variable medication in an inpatient setting :

This is offered in addition to above to record any intra-procedure medications given as one-off’s and as a sequence of events that do not need regular or PRN medication.

Electro Convulsive Treatment :

This allows recording of each ECT treatment on the stipulated date.

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Care Plans :

The medication information that is current across either outpatient or inpatient modules above is automatically pulled in to the care plan section as seen below.

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The clinician can then add the non-pharmacological treatments as well as crisis plan / relapse indicators and click submit. Doing so is vital if the information is to pull through to editable documents and prescribing facility offered by the application.

Physical Examination

As seen below, vital parameters as well as height / weight can be recorded here – the BMI is calculated automatically.

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A full physical examination can be detailed using a further section as under –

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Documentation / Investigations :

Both these sections allow a facility to upload images, other electronic records / reports as appropriate.

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Outcome measures :

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The above measures have been made available for FREE and users should only use them in keeping with principles outlined below –

Not charge patients a fee for using the measures, use in keeping with copyright holders notices where indicated.

The outcome measures can be done in session / during meeting with patients – to do so click start.

If you wish to acquire patient feedback between appointments – click on the Send link and ensure the user’s correct email ID is inserted on registration or add this manually.

The application creates graphs and automatically calculates the scores total and sub-scales as applicable. The application vendors do not take responsibility for accuracy of these calculations and users should verify these as appropriate. If any errors are noted, please notify the vendor and we would offer to rectify this without obligations.

Example graphs

RCADS

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PHQ 9

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Legal Status :

This section allows users to 3 different options to work with.

Option 1: The Service can produce standardised legal templates such as T&C or Consent to off-label treatment. The Admin user is responsible for creating these templates that can be used by all clinicians.

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Clicking the above leads to the following screenshot and either the patient reads, accepts/rejects and signs at the face-face appointment or alternatively this form can be sent to patient by way of link to their email ID. The patient then needs to access the form from their smart device and accept/reject, sign and submit the form.

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Option 2 in legal forms allows a user to create a form that would apply to given patient only. For instance, one could draft bespoke therapeutic contract/s and get the patient to sign at meeting or a link sent to them to do so at their convenience from their personal smart device.

Step 1: Click New Legal Form as below

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Then use the interface below, give the form a title. Draft the contract and if the patient is in the meeting, the service user is given the option to accept/reject and sign → save.

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If the patient is not available face-face, create the contract, click save. On doing so the contract is saved as seen below

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The clinician can now click the link and open the contract at the time of the next face-face meeting with patient of send the link to patient for them to accept/reject and sign the contract and send this information back to their care record securely.

Option 3: Legal Status

This section allows a user to record statutory status, e.g. if a patient is subject to Mental Health Act and detained under Section 2 from a certain date, the provision as shown below allows one to work out the end date.

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This information becomes available with the end date on the patient dashboard as a distinct reminder to all clinicians accessing the care record of the given patient. This should help prompt the clinician about need to plan renewal or change to S3 or discharge from the S2 if appropriate.

If the statutory provision is no longer valid or applies, it is easily possible to archive it as seen below.

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Discharging patients :

The ‘discharge’ tabs takes us to the screenshot seen next.

Users can identify reasons for discharge.

Once discharged, the records for the given patient becomes ‘read only’ and stored in keeping with typical data protection legislation and not deleted. No further information can be added to the record once a patient is discharged until the patient is -readmitted or another record created (depending on the policies and procedures of the given setting/service).

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PDF Files section

This section stores PDF’s versions of most sections of the care records when saved. This allows a user to download individual files or attach them to emails or send alongside letters via the application itself as shown in the next section.

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The PDF files can be shortlisted using the drop down menu to show all as per date/time of creation or the user may pull up PDF’s of all previously saved care plans for perusal, downloading, attaching the email letters or communication via the application straight to patient email ID or that of their GP / referrer with consents.

Letters :

The Admin User is responsible for creating standard templates. This requires some training and we recommend users consider using the vendors support system at a small additional cost to create bespoke templates. The interface is used as under –

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Choosing a type of letter from drop down menu allows the user / clinician to save time as the templates can pre-populate the required information. For example, while creating the template related to CPA, the CPA entry from patient notes can be pulled through automatically. A typical medication update to GP can pull through information of the current medication / care plan. All letter templates can be exported for use on the PC word processor (it is not possible to use this facility on a Mac). The screenshots below suggest how this works.

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The above templates can carry your service logo, address, etc. Further One may send the prescription electronically to a pharmacy. Or a letter may be sent directly to a GP from the application with additional PDF attachments referred to in the previous section. Further there is the ability to export to A4 or A5 (prescriptions only) – add additional information is need be and the MS Word Document saved, uploaded, printed, emailed or faxed as appropriate.

Note: An exported document needs saving as under –

  1. Save to given folder
  2. Open document
  3. Save As
  4. By default, the exported document is saved as a web page
  5. Change this to Word Doc as shown below.
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Security :

  1. We recommend using a ISO 27001 certified or HIPPA compliant hosting server (prices vary provider to provider).
  2. We suggest getting a plan that includes server level security and backup
  3. Each Service / inidividual subscriber should have a written policy for managing information governance
  4. We suggest, users secure their devices with passwrods
  5. Avoid lettting the browser to remember your passwords and log in ID
  6. We can configure the system to include – auto-log off after X idle time.
  7. We can configure the system to include 2 step authentication process (additional cost to cover use of an SMS gateway).
  8. We recommend use of SSL certification to encrypt data in transit
  9. We suggest th system is configured to require clinician to change password every week / fixed number of days.