Products and Services

OBRA e-z produces an Enterprise Software Solution for the long-term care industry built on OBRA e-z’s powerful engine of fully integrated modules for the collection, reporting, and analysis of MDS 2.0 assessment data, resident quality indicators, physician orders, admissions information, survey and care-plan treatment data, and a patient scheduling module created by MasterLink, a recent acquisition of OBRA e-z's.  OBRA e-z’s seamless integration with its strategic partners’ products makes up OBRA e-z’s Enterprise Software Solution.  The strategic partners’ products include disease state and drug therapy management (ICPS Group), a supplies tracking system (AIMS), a data bank for personal medical data that follows the HIPPA rule (MedicalRecords.com), and a financial management accounting module produced by MedEasy.

Together with 24/7 help-desk support, OBRA e-z’s Enterprise Software Solution is a complete, turnkey management information system for the long-term care industry.

Product and Service Description

OBRA e-z sells a powerful suite of products to manage every aspect of the long-term care facility.  The suite of products include the following:

MDS Assessment Module

The MDS 2.0 screen formats mirror state specific MDS 2.0 forms. The program also prints blank form.  Through pop-up windows, users can access on-line libraries of ICD-9 diagnosis and NDC codes. Triggers from a MDS response are automatically calculated and displayed in the RAP Summary reports. Trigger RAP Keys display reason(s) a key was triggered.  The program prints full and quarterly MDS assessments, RAP summary, Resident Census & Condition, and the Roster. Users have the ability to copy the basic tracking form, full or quarterly assessment forms, and the discharge and re-entry forms. 

Summary:

• System MDS mirrors government forms

• Identifies completed sections of MDS, jumps to necessary section

• Automatically calculates RAPs

• Creates Resident Roster and Census & Condition forms

• Utilizes previous resident specific information 

• Exception Report shows MDS history & changes to MDS Reports: 

• Completed resident specific MDS forms as well as blank MDS forms

• RAP reports & RUG III reports for both Medicare and Medicaid 

• Resident Assessment Tickler List (showing past-due assessments) 

• Numerous MDS questions reports (including user defined reports)
  

Resident Quality Indicators

OBRA e-z extracts data sets from survey and care-plan treatment data known as quality indicators used to assess quality of care.

Physician Orders

The physician order module fully automates physician’s orders, medication administration records, and treatment administration records.  The software prints a multi-part form that simultaneously updates the physician’s order sheet, MAR’s, and TAR’s, and generates a paper copy for the pharmacy.

Users have the choice of printing a single plain paper form for physician’s orders to send to the pharmacy. The MAR’s and TAR’s can also be printed on plain paper. Physician orders can be entered, reviewed and modified as required. Up-to-date real-time physician orders can be printed on demand at the facility. A look-up library of drugs is included in OBRA e-z’s Enterprise Software Solution. Medication dispensing times are user-defined and can be modified on-line.

Summary:

• Fully integrated

• Look-up library of drugs

• Phone orders automatically update existing files

• MAR’s and TAR’s are user-definable to include enteral & urological orders

• All forms may be printed on plain paper eliminating the high cost of multi-part forms.

Admissions Information

Resident information is entered once and flows seamlessly throughout all the modules. Prompt screens assure that all the information necessary for complete records is captured. A comprehensive ICD-9 library is included for selecting resident diagnoses. Users can modify or add new ICD-9 codes as needed. Database archives make for instantaneous re-admissions and the daily census is updated automatically. The software tracks vital information on residents throughout their stay and provides the necessary census information for government reporting. Former residents and transferred residents can be readmitted in seconds with the complete history available.

Survey and Care

The survey module collects and automatically updates data during each full assessment, including information for Section Z of the MDS assessment that is not captured in MDS 2.0.  The survey module generates the resident roster and census and condition reports required for government surveys. 

Patient Scheduling

MasterLink, an OBRA e-z Inc., Enterprise Software Solution module is a powerful and flexible scheduling tool that allows the customer to determine the visits and or tasks to be scheduled, confirmed and reported on, from MD visits, to transportation, to home health care. It allows for the creation and automatic rollover of permanent patient schedules, as

well as temporary schedule overrides based on date/date ranges of service. MasterLink walks the user through a logical progression of setting up a patient schedule, (hourly, daily, weekly, monthly tasks and services), generating 'to do lists' by date, staff, patient, task, location, etc., with an automatic feed to a confirmation screen which allows for quick and accurate documentation of services. Confirmation gives the customer the

ability to compare scheduled versus actual utilization as well as create a wide variety of utilization and cost reports. MasterLink's success lies in its flexibility and intuitive screens that make sense to the user and the daily operations of a long-term care facility.

OBRA e-z has contracted with the Technology and Operations Solutions Group of Milliman & Robinson, Inc. to upgrade the MasterLink link software for seamless interface with OBRA e-z’s Enterprise Software Solution.  Milliman & Robinson  is one of the ten largest actuarial consulting firms in the United States with over 1600 employees worldwide and more than 50 years experience in business.

Disease State and Drug Therapy Management

The OBRA e-z suite of software will blend seamlessly with ICPS Group’s disease state and drug therapy management modules.  These modules were developed to help pharmacists provided federally mandated drug regimen review services to residents living in nursing homes.  ICPS currently has modules for patients taking clozapine and tacrine and patients with Parkinson’s disease, osteoporosis, Alzheimer’s, dementia and pain management treatments.

Full-Featured Ancillary Supplies Tracking System

This software produced by AIMS contains comprehensive inventory control, resident billing and purchase order functions. The program is barcode driven allowing users to print barcode labels for tracking inventory or print a barcode catalog of inventory items. The program supports non-portable and portable barcode readers. AIMS can import Resident data and export inventory transaction data.

Medical Records

This is the health care industry’s equivalent of the finance industry’s collection and reporting of credit data.  OBRA e-z has secured a strategic alliance with MedicalRecords.com, whose features include the following:   

• Registration— The registration process can enable a visitor to sign up as a new user, a pre-designated individual to sign up as a new user, and an already registered user to access the site. The secure login process will consist of a username and personal password, and can include other identifiers in the event that a user has forgotten his or her password.

• Adult Health Interview— MedicalRecords.com’s proprietary Health Interview, developed by physicians at Harvard Medical School, captures an individual’s medical and health data and stores it in a personal medical record. The Health Interview is designed as a “dynamic decision tree” that knows the right questions to ask at the right time.

• Personal Medical Record— All data captured from the user is stored in a personal medical record. Users will be able to view self-reported health and medical histories as well as data pulled from existing client databases, as allowed. Data in the personal medical record includes (but not limited to):

*Personal information (including name, date of birth, gender, height, weight, lifestyle information, safety information, and health and fitness information)

*Medical conditions and tests

*Family health history

*Medications and allergies

*Immunizations

*Hospitalizations and surgeries

*Insurance information

• Planner— Users will have the ability to maintain their own, personal health and wellness calendar to store and remind them about medication schedules, doctor appointments, community health events, and any other event. Connectivity to MS Outlook and Palm devices can be added with third-party software products.

• Address Book— This module provides users a simple contact manager and reminder service. Users are able to save important contact information, such as phone numbers and e-mail addresses. Essential contacts such as primary care physician and physician office can be saved and displayed here. Connectivity to MS Outlook and Palm devices can be added.

• Curriculum— A case manager can establish a curriculum for single or groups of users that identifies programs areas of content that users are prompted to visit. A progress bar shows a condensed description of suggested steps, with checkboxes indicating which steps have already been visited. This module can drive the monitoring of self-care goals and personalized diet and/or health recommendations.

• Graphing— This is a module for generating bar charts. Graphing functions can be added to any data set, such as A1C and weight, to display a visual representation of that data. For example, an Insulin Level Poll and Graph will prompt a user for daily insulin readings and then graph those results over time.

• News Feeds— This module receives and presents (and expires) news feeds and allows the publisher to be selective about what gets posted, how many news items appear at one time, and how long they stay visible. Content can be pulled from client’s sources.

• Newsletter— This module will post current newsletter materials in electronic form on the website and archive past newsletters for on-line viewing. Newsletters can also be e-mailed in standard text, html, or PDF formats. Content is derived from client’s sources.

• FAQ— This is a flat list of Frequently Asked Questions (FAQ) with content generated by client.

• Resources— Resources for users can be displayed and archived in this area. The Resources area can also display and archive links to other suggested websites.

• Email handler— MedicalRecords.com can build a gateway for incoming email messages for a site, which will accept an incoming email message from the mailer and insert its contents into a queue table in the database. This queue can be linked to a specific clinician. In turn, this module can help generate email replies based on email question class for unified customer support. The Messaging capability is not for clinical or urgent questions, but rather for appointment scheduling and technical questions. Like the entire site, this CFE must adhere to upcoming HIPAA guidelines.

• Access Controls and Permissions— Through this module, the primary user is allowed to specify who has permission to see account information and control what information is available to each specified person.

• Account Maintenance— Through a primary account, the primary user can manage multiple accounts for his/her spouses, children, and other family members.

• Polling— This module allows a site administrator or case manager to solicit data, experiences, or opinions from users by means of polls. These polls are configurable in terms of publication dates, formats for choices and results presentation.

• Content Sections— allows the administrator to create and manage different content sections of the site. This module supports four different types of content sections: admin (administration pages), system (news, bulletin board etc.), custom (URL directories) and static (html pages).

• User Groups/User Administration— A site administrator can select a class of users and oversee what can then be done with that class. This is a general mechanism for lumping users together in groups, which is vital to group-based modules (such as Calendar, News, and many others). This module then allows a site administrator to set up an access control system by choosing from a palette of options, fine-tuning access according to group membership and role within group, and directing content specific to a group.

• New on Site— This is a central area for identifying new content posted by the client across the entire site. The module is useful for the site administrator (might want to delete), for the surfing user (might want to see the new material), and for generating email summaries of new material.

• Reports— MedicalRecords.com can print out a range of reports based on the health data stored in the personal medical records. The Full Report will produce a printable copy of all medical and health histories and other information stored in the personal medical record. The Emergency Report will compile and print all the necessary emergency information for a user that can be extremely helpful in a time when such information is needed.

• Dynamic Messaging Areas (DMA)— A site administrator or case manager can place small text and/or graphic “banners” randomly on pages to either entice readers to click to a different, potentially unrelated page, or for simple information dissemination without further links. For example, Tips DMA will display helpful health tips and Quotes DMA will display inspiring health and wellness quotes. These banners can also be tied into personalization functions to display content that is relevant and specific to a user or group of users. This is not necessarily a function for placing advertisements, but rather for dynamic content.

• CRM— A site administrator or case manager can track customer relationships over time through various “states” such as “new user” to “great customer” to “slipping customer.” These states can then be used to target actions at particular classes of users.

• Dynamic Publishing System— This module is a full-featured publishing system for managing content and design templates. (through release of ACS 4.1)

• Member Value— A site administrator or case manager can monitor the accumulation of charges for users and then either calculate internal costing, a transfer price, or a bill that is sent out at the end of each month.

• File Storage— Users can upload and maintain a set of files on the server via (potentially SSL-encrypted) secure web pages (without giving FTP access to a Web-accessible directory, which is a big security risk). The saved files can sit on the server in a hierarchical directory structure that users create and control or be tagged to specific portions of their personal medical record.

• FAQ— Different from the flat list of Frequently Asked Questions (FAQ), this module provides a simple interface for creating and maintaining FAQ in which maintenance may be shared by specific people,

• Download— This module manages and monitors download activity. It also generates reports and enables emailing of users who have downloaded a file or software from the site.

• Message Boards and Chat Rooms— MedicalRecords.com provides web-based, with HTML and JavaScript options, for message boards and chat rooms. Chat is configurable per-room; for instance, the administrator can set chat to be moderated/unmoderated and open or restricted by group.

• Bulletin Boards— Users can post to public bulletin boards, create private discussion groups, attach photos to postings, and do keyword searches of all postings using this discussion forum system.

• Group Emailer— MedicalRecords.com can build a gateway for incoming email messages for a site, which will accept an incoming email message from the mailer and insert its contents into a queue table in the database. In turn, this module can help generate email replies based on email question class for unified customer support. Spam enables a site administrator or case manager to broadcast email messages to a class of users, or to periodically send mail from a script or file repository.

• Bookmarks— Users can save bookmarks of favorite web links or resources and potentially share those bookmarks with other people. Users can access the bookmarks from any web browser.

• Meta Tags— The insertion of Meta Tags containing the appropriate words and in the appropriate places ensures that search engines will find specific pages in the site.

• Robot Detection— This is a system for making sure that the entire site gets indexed by web-crawlers (search engine indexing agents).

• Portals— This module allows the site administrator or case manager to anticipate what a specific type of user would like to see, and then construct or choose the data-feeds and do page layout tailored to that type of user. The system can also be configured to allow each user to act as his/her own manager, by specifying preferred data-components and layout options.

• My Workspace— This module works as an expanded preferences section.

• Press (PR/IR)— allows the site administrator to list, chronologically, articles in newspapers, magazines, etc. where the site or company is featured.

OBRA e-z’s Enterprise Software Solution is designed to be a fully integrated, turnkey product for the long-term care industry.  The Enterprise Software Solution will improve efficiencies, reduce costs, increase margins, and create a work environment that is accessible from remote locations where the Internet or PDA is available.  The PDA will be equipped with software to display and gather critical resident data.  Data collected during resident visits can later be uploaded to the central resident database.

Competitive Comparison

The top three competitors are Achieve, MDI and Keane.  Licensing fees range from $10,000 to $15,000 with monthly maintenance averaging about $1,500.  Middle market solutions include Monnette Information Systems, Mylex Corporation and Advanced Information Management.  Licensing fees range from $8,000 to $10,000 with monthly maintenance averaging from $1,000 to $1,500.  Lower market solutions include RH Positive, American Healthtech and SOS.  Licensing fees range from $3,000 to $6,000 with monthly maintenance averaging from $375 to $1,000.

The OBRA e-z Enterprise Software Solution will include all the functionality offered by competitors plus the MedicalRecords.com suite of products and its alliance with the ICPS Group to include the pharmacists in the healthcare equation.  Our price is only $1,000 licensing fee and $500 monthly maintenance. 

In addition to the significant price advantage, OBRA e-z offers ease of use.  Most competitors require training sessions of from two days to a week.  Our experience has been that new customers can install the OBRA e-z software and on the same day admit a resident and transmit the required data to the state.  Our 24/7/365 help desk is available to assist customers.  Many of our customers have learned on their own; others require minimum help desk support.

Sales Literature

We will be developing new sales literature to describe the OBRA e-z Enterprise Software Solution.  Our current mailing has produced excellent results.

Technology

The current version of OBRA e-z runs on the DOS operating system.  The Enterprise Software Solution will run on Windows and Windows CE.  Microsoft operating systems are solid technology with universal appeal and virtually no risk of disappearing.

Future Products and Services

OBRA e-z views the home healthcare market as one that will require sophisticated software solutions.  Demographics show a large number of people will be living longer and desiring to remain in a home or homelike environment.  These people will be subject to reporting requirements not yet developed by governmental agencies, and OBRA e-z will develop user-friendly software to satisfy those requirements.