Ascribe Symphony - Emergency Department and Minor Injuries

"Graphically rich, intuitive and user friendly", Ascribe Symphony is an Electronic Patient Record (EPR) system designed to improve patient flow through the department by providing ED clinical, management and administrative staff with a simple yet comprehensive information access and documentation solution at the point of care. Ascribe Symphony includes:

• Patient administration system (can be interfaced to hospital PAS or stand alone)
• Patient triage and tracking
• Clinical documentation and nursing notes
• Order management and elecronic prescribing
• Decision support and conditional data collection
• Electronic discharge summary and patient advice letters
• Document scanning and imaging
• Highly configurable to suit the workflow of individual departments
• DAD interface engine for integration with third party systems

All areas of the Emergency Department are viewable with a unique tracking display of the location and status of each patient. The system also displays the attending clinician along with the status of investigations or any treatments pending. Data entry is done directly from the tracking grid, with the configuration of the tracking screen configurable by each user to show their preferred layout and data set.

The system was designed by ED clinicians and developed by Ascribe to improve patient outcomes, increase throughput, reduce risk and cut patient waiting times. Symphony provides clinicians and administrative staff with a point of care solution for comprehensive documentation, access to patient information and retrieval of real-time clinical data. The system can operate on a stand-alone basis or it can be integrated with your existing patient administration, diagnostic and/or finance systems.

Electronic Patient Record, Triage and Tracking: "Electronic White Board"

The Ascribe Symphony tracking screen or "electronic white board" provides an on-screen display of all the clinical data relating to each patient. This includes full identification of the patient and all records in connection with the patient's current and previous attendances. An on-screen audit of who recorded the information and when is also available so as to facilitate further investigation if necessary. The records collected, and the data with them, can be defined by the system manager so as to build up an EPR that is both pertinent and practical.

Ascribe Symphony can be used across multiple departments and locations, allowing monitoring and management of department workload, access to patient records in multiple locations. Patient lists may be filtered by any number of status indicators including by clinician, waiting for treatment, time in department, triage category, unit or bed location. The use of customized icons on the tracking screen provide users with a quick, visual tool to identify the patient triage category, location, what they are waiting on and if they are approaching or have exceeded wait times for their progress through the department.

Electronic Prescribing and Order Management System

Ascribe Symphony provides and electronic prescribing and clinical order management system for real-time clinical and patient care orders at the point of care. Clinical decision support tools support the clinician in making the best decisions in clinical orders, combined with audit and system alerts to improve clinical quality and patient safety.

Diagnostic Systems Integration

Ascribe Symphony can be integrated with Radiology and Pathology information systems for electronic distribution of orders and results receipt directly out of and back into the Symphony patient record.

Clinical Decision Support

The system provides clinical decision support at the point of care via web links to decision support databases, hospital or department guidelines on an intranet or documentation built within Ascribe Symphony. This ensures clinicians always have access to the latest clinical guidelines at the point of care. Conditionality may also be built into the clinical documentation tools to prompt users to take the next appropriate action in patient care according to the clinical guideline used for the presenting problem.

Clinical Documentation

Document Progress Notes, Nursing notes and clinical outcomes to produce an Electronic Discharge Summary for printing or electronic distribution.

Clinical Audit and Research

How do you record, measure and interpret clinical and operational risk, quality and patient care outcomes? Ascribe Symphony will enable data capture throughout the course of patient care rather than requiring additional data entry tasks for busy ED staff. The powerful e-AUDIT reporting tool within the system allows you to research and report on any combination of data held on the system in order to identify outcomes, evaluate and plan effectively and efficiently.

Manage Clinical Risk - Patient Alerts and Risk Indicators

If the patient has an allergy or there is a clinical alert entry such as history of violence, Ascribe Symphony provides an immediate on-screen warning. Special needs such as sight impairments or clinical risk indicators are highlighted so that before you reach the patient, you are aware of any special care considerations. Should you wish to focus on a particular category of patient, such as children or the elderly, Symphony allows you to identify all such groups and prioritise them as necessary and perform full clinical and management reporting by patient or risk group.

Major Incident Management

Ascribe Symphony is provides your department with the ability to manage major incidents with high volume/multi-patient registration, department alerts and the ability to link patients involved in the same incident for management and clinical reporting. The system is able to handle any number of concurrent major incidents across different departments

Improve Workplace Efficiency

Ascribe Symphony enables you to monitor the efficiency of support services. How long are specialty medical teams taking to deal with referred patients? Easy-to-produce reports across each specialty provide the answer and will help with negotiations for improvements in service when desirable. View a list of patients that have been in your department over a certain length of time - then make the decisions needed to clear the backlog. Symphony is the ideal means of reducing workload, managing waiting times and improving patient care.

Rank Patients by Clinical Priority

Ascribe Symphony is configured to allow you maximum control over the display of your case load. For instance, a click of the mouse will present a list of patients ranked by Clinical Priority allowing you to focus attention on the most urgent cases or review less urgent ones for satisfactory progress.

Key Performance Indicator Targets

No more surprises when your KPI results are announced. Whether it's a 30 minute wait in Outpatients, a 4 hour wait in A+E or a 6 month limit on a waiting list, Ascribe Symphony allows you to define the target maximum times between any two records on the system, and set off a warning if any patients approach these target times. With Ascribe Symphony, you get to manage and control activity as it takes place and are no longer limited to waiting for after-the-event reports to discover whether you have met your performance targets.


Integrated System Tools Supporting Clinical Workflow

e-NOTEs

e-NOTEs functionality is designed to take users to the paperless environment often aspired to in the modern emergency department. The e-NOTEs facility may be set up to record all clinical data (Presentation, History, Examinations and Findings) using coded, standardised, auditable text and/or free text data that you collect in the process of assessing and treating the patient.

MIDAs - the Medical Document Imaging system

MIDAs provides the ability to scan in and store attendance cards and other paper documents associated with the patient episode and retrieve these over the network. This provides for rapid access to previous attendance cards, eliminates on or off-site storage difficulties, and reduces the risk of loss of cards and other documents. MDIAS software is included with the Symphony software.

PALs - Tailored Patient Advice Letters

Patient advice letters provides the department with the ability to produce patient advice letters tailored and addressed to individual patients quickly and easily. The information contained within a PALs letter is about the specific illness or injury, and the specific treatment and follow up for that episode: the letter is individualised for the patient's need. PALs is supplied with medical text covering the majority of diagnoses and treatments
for a large A&E department. Drug and discharge medical text is provided. Adding free text, and amending text supplied to fit with department practice and protocols is a simple process that can be done locally by the system administrator.

Draw-No-More(TM) - Diagnosis, with pictures

Draw-No-More provides doctors and other clinical staff with the ability to access images of body parts and quickly and easily record one or more diagnosis against them by clicking and or drawing with a mouse or light pen.

The output of this process includes diagnosis as well as the associated images, where an image is recorded.

At its very least, Draw-No More replaces the pictures currently used on many casualty cards as well as the rubber stamps used in some departments. Used to its full potential, the system makes a paperless environment real option for the modern Emergency Department.

Draw-No-More is provided as an integral part of the Ascribe Symphony suite, or as a standalone product in its own right, capable of integration with other clinical information systems.

Management Reporting

Ascribe Symphony includes a full suite of management, operational and clinical reports available for scheduled and ad hoc reporting. Reports may be customized by user, department or hospital to include any data element recorded in the system.

Additionally, with Automate, the user need never request a print out of a standard monthly report again. Automate enables users to set up reports to run at scheduled times in the future. Reports can be set to run at night on a PC that is not otherwise being used then simply be picked up on arrival in
the morning.

The system is supplied with Crystal Reports reporting suite software included in the purchase price.

Triage 

  
Ascribe Symphony can easily be configured to meet the local needs for streaming or for formal triage. The system can support a number of triage scales, including the national 5 point scale used to determine clinical priorities.

Emergency Triage is designed to record the application of a robust, standard and auditable triage process, whilst allowing for the skills of the trained assessment nurse to be applied to the triage process.

The Emergency Triage system is provided as an integral part of the Symphony suite, or as a stand-alone product in its own right, capable of integration with other A&E systems.

Australasian Triage Scale

The system has been localized with the Australasian Triage categories. These may be used instead of or in addition to the Manchester Triage Protocols.

e-PICs - incorporating digital photography into the patient record

The system is provided with e-PICs, the digital photography application developed by Ascribe.

e-PICs allows the user to store a digital photographic image against a patient record. Images can be annotated and marked prior to storage.

By saving the electronic photo as part of the patient record, users are able to view these within the electronic record and identify them by the indices
associated to them for analysis or staff training purposes. e-PICs is provided as an integral part of the Symphony suite. ePICS is particularly useful for clinical care areas such as trauma and minor injury, wound clinics and mental health (for patient ID).

Ascribe Symphony DAD

Ascribe Symphony DAD ('Data Acquisition & Dispersal') is an optional tool kit provided with the system designed to allow the System Manager to set
up interfaces to other systems without need for technical involvement from Ascribe.

In practice this means that if your ambulance service is able to send you advance notice of a patient electronically, then you can use DAD to set up an inbound message that will use this data to automatically open the attendance on Symphony using the data sent from the ambulance service.

Within the attendance, in and outbound Pathology, Radiology and other service department messages and results may be set up.

For the technically minded, DAD enables you to define the method of connection - for example TCPIP, Socket or shared file, set up HL7 or other format message headers using a defined form such as ASCII or XML to configure your interface as required.

Information Access At The Point Of Care

All areas of the Emergency Department are viewable with a unique tracking display of the location and status of each patient. The system also displays the attending clinician along with the status of investigations or any treatments pending. The same screen also shows the tracking grid and allows for direct data entry.