1. ULTIMA*DCF Copyright © 2004-2010 ITC Software All rights reserved ULTIMA*DCF CHOTS (component health-care off-the- shelf) solution is dedicated to children and adolescent psychiatric care institutions of the Departments of Children and Families.

2. ULTIMA*DCF CHOTS SOLUTION ULTIMA*DCF ULTIMA*DCF CHOTS (component health-care off-the-shelf) solution is dedicated to children and adolescent psychiatric care institutions of the Departments of Children and Families.

3. Patient Administration Patient Care Available Components ULTIMA*DCF ULTIMA*DCF offers ten (10) components for all interested institutions. Five (5) are dedicated to the patient administration and five (5) to patient care, including comprehensive electronic patient/medical recording of patients treatment progress.

4. USERS SIGN ON ULTIMA*DCF access privileges Only certified physicians, psychologists, nurses and other authorized hospital/institution staff have access to the ULTIMA*DCF application. This is enabled by activating the horizontal tabs according to each users access privileges.

5. Physicians ULTIMA*DCF horizontal tabs Only certified physicians, psychiatrists or psychologists have access to the ULTIMA*DCF applications enabled by activating the horizontal tabs according to each users access privileges.

6. Nurses ULTIMA*DCF users access privileges Nurses and other authorized hospital/institution nursing staff have access to the ULTIMA*DCF application, enabled by activating the horizontal tabs according to each users access privileges.

7. Technologists/Administration hospital/institution staffULTIMA*DCF Authorized hospital/institution staff have access to the ULTIMA*DCF application, enabled by activating the horizontal tabs according to each users access privileges and HIPAA guidelines.

8. HIPAA COMPLIANT ACCESS HIPAA certified security officer The HIPAA certified security officer, usually a DBA (database administrator), is authorized to assign users roles, access to specific applications and users password.

9. SCHEDULING ULTIMA*DCFunique application The ULTIMA*DCF scheduler is a unique application seamlessly integrated with other system components.

10. SCHEDULING capture data This form is used by the clinic front desk to capture data from new patients, whos referring physician usually contacts the clinic by phone.

11. SCHEDULING Physician and Staff The Physician and Staff listing allows the booking staff the selection of the requested or least busy physician, psychologist or other mental caregiver.

12. SCHEDULING appointment calendar The appointment calendar of the selected surgeon gives the staff a number of choices: open the data entry by a click on the zoom square to the right of the appointment time (see next form to enter appointments). The daily, weekly or monthly schedules can be viewed by a single click of the mouse at the left.

13. SCHEDULING appointment entry This is the appointment entry form that allows the entry of a new appointment or the cancellation of an appointment and assigning the priority of the appointment by the established color codes.

14. SCHEDULING ULTIMA*DCFweeklymonthly The ULTIMA*DCF Scheduler features both the weekly and monthly appointment reviews.

15. SCHEDULING medical records staff This form is an online report for the medical records staff.

16. SCHEDULING ULTIMA*DCFreportsstatistical analyses ULTIMA*DCF includes a number of reports and statistical analyses for the clinic management.

17. CHILD REGISTRATION Registration A click on the Registration button displays the childs registration and admission component menu.

18. CHILDS ADMISSION hospital admission menu The hospital admission menu consists of six vertical tabs for easy access to registration components and to the room/bed allocation.

19. FAST AND EASY CAPTURE OF DATA Patient demographics Patient demographics, mailing address, phone information and patients referring physician data are entered into this form. Some of the data are selected by a simple click at the so-called LOV icon.

20. FAMILY CONTACTS Patient Family Contacts The Patient Family Contacts form captures the important family or childs guardian data.

21. CHILDS PRIMARY INSURANCE primary The information about the insurance coverage is entered in two forms, primary and secondary insurance, if any.

22. SECONDARY INSURANCE secondar The information about the insurance coverage is entered into two forms, primary and secondary insurance, if any.

23. ROOM & BED ALLOCATION wardroombed The assignment of the patient to a ward, room and bed is supported by a fully computerized bed inventory.

24. ELECTRONIC RECORDS MENU Electronic Records The Electronic Records component consists of two groups of applications: 1) EPR and 2) Patient Intake Form.

25. The wards/nursing stations applications are a hub of all patient care information. UNITS WARDS/NURSING UNITS

26. wards structure The Ward Organization form is a convenient overview of the wards structure, by listing all rooms and beds of each ward, selected from the hospital ward listing. WARDS/NURSING UNITS

27. Ward Staff Scheduling The top block of the Ward Staff Scheduling form displays the managers of each ward, i.e., the chief physician and head nurse. Changes in the management staff are made by the hospital chief-of-staff who has been authorized to update this list. Note The second block is a list of the staff of each ward, their main responsibilities (Note), and the current shift. The head nurse usually maintains the wards schedule. Ward Staff Scheduling The top block of the Ward Staff Scheduling form displays the managers of each ward, i.e., the chief physician and head nurse. Changes in the management staff are made by the hospital chief-of-staff who has been authorized to update this list. Note The second block is a list of the staff of each ward, their main responsibilities (Note), and the current shift. The head nurse usually maintains the wards schedule.

28. summary view of each roomname of each patient The first block is a summary view of each room. The second block displays the name of each patient, admission date, and expected length of stay (LOS). An LOV button selects the name and unique ID of the patients attending physician. Then the severity rate, patient diet and differential diagnoses are entered, marking the primary diagnosis. patients discharge The third block is used for a patients discharge; indicating the reason and discharge summary. The command button Discharge activates a number of important transactions, namely the transfer of all patient electronic records into an ARCH_ database for billing, reporting and statistics, as well as updating the electronic bed inventory. summary view of each roomname of each patient The first block is a summary view of each room. The second block displays the name of each patient, admission date, and expected length of stay (LOS). An LOV button selects the name and unique ID of the patients attending physician. Then the severity rate, patient diet and differential diagnoses are entered, marking the primary diagnosis. patients discharge The third block is used for a patients discharge; indicating the reason and discharge summary. The command button Discharge activates a number of important transactions, namely the transfer of all patient electronic records into an ARCH_ database for billing, reporting and statistics, as well as updating the electronic bed inventory.

29. Patient Treatment Progress Notes The S-O-A-PE methodology and format are used as a common denominator for every wards electronic recording. In this manner it is possible to enter all Patient Treatment Progress Notes generally, yet specific to each ward.The Open S-O-A-PE button enables the ward staff to have fast, online access to the patients treatments, orders and results. The powerful Oracle 9i/10g database technology acts as an integrator of the current legacy systems throughout your hospital. Patient Treatment Progress Notes The S-O-A-PE methodology and format are used as a common denominator for every wards electronic recording. In this manner it is possible to enter all Patient Treatment Progress Notes generally, yet specific to each ward.The Open S-O-A-PE button enables the ward staff to have fast, online access to the patients treatments, orders and results. The powerful Oracle 9i/10g database technology acts as an integrator of the current legacy systems throughout your hospital.

30. Patients chart and name, selected from the List of Resident Patients are displayed automatically. The date and time are displayed by default. The purpose of the Subjective notes is to record a patients subjective communication or complaints to the nursing staff (remember: what is not recorded – does not exist). subjective The entry of these subjective data are supported by two options: 1) the use of an LOV (list of value) button which displays a pull-down list of the most frequently used subjective patient complaints, and 2) the display of an edit window (called modal) for the entry of additional, specific subjective information. The date, time, and the nurses internal code are mandatory items for each entry. The name of the nurse responsible for the entry is displayed when the nurses code is entered. The Save button secures the entry of the information into the database. Patients chart and name, selected from the List of Resident Patients are displayed automatically. The date and time are displayed by default. The purpose of the Subjective notes is to record a patients subjective communication or complaints to the nursing staff (remember: what is not recorded – does not exist). subjective The entry of these subjective data are supported by two options: 1) the use of an LOV (list of value) button which displays a pull-down list of the most frequently used subjective patient complaints, and 2) the display of an edit window (called modal) for the entry of additional, specific subjective information. The date, time, and the nurses internal code are mandatory items for each entry. The name of the nurse responsible for the entry is displayed when the nurses code is entered. The Save button secures the entry of the information into the database.

31. objective SearchEdit The entry of the objective data is similar to entry of the S section data; the nurses are aided by two buttons, Search (LOV pull-down list) and Edit, in order to make the recording of data acceptable and simplistic. The purpose of the Objective notes is to record all objective data (remember again: what is not recorded – does not exist), mainly vital signs and measurements, and important patients behavioral and abnormal test results. Each nurse has convenient access to a patients laboratory test results, thus having a more comprehensive understanding of a patients medical situation, usually reserved for physicians.

32. There are two options for the capture of laboratory test results: 1) transferred from the clinical laboratories, and 2) entered by the ward staff (e.g., a ward clerk) from the paper printouts. LABORATORY TESTS

33. The patients attending physician, after reviewing and assessing the subjective and objective data, both in his/her home office or at the time of the visit, has a considerable amount of pertinent information at his/her finger tips – just a click away for the following: 1) patient health care history, 2) patient physical examination/review of systems, 3) medication orders and administration, and 4) orders of laboratory tests, diagnostic examinations and treatments, as well as physiotherapy and other therapies. attending physicians comments and instructions Search Edit The entry of the attending physicians comments and instructions to nursing teams are aided by easy to use, and ward care specific, pull-down lists of free text (Search). The physician and the ward staff do not need to know the numerical/alphanumerical codes that are used, therefore they are not displayed. These are listed only as unique identifiers and primary keys in the Oracle database. An Edit button displays a special zoom window for the entry of a specific physicians treatment notes. The patients attending physician, after reviewing and assessing the subjective and objective data, both in his/her home office or at the time of the visit, has a considerable amount of pertinent information at his/her finger tips – just a click away for the following: 1) patient health care history, 2) patient physical examination/review of systems, 3) medication orders and administration, and 4) orders of laboratory tests, diagnostic examinations and treatments, as well as physiotherapy and other therapies. attending physicians comments and instructions Search Edit The entry of the attending physicians comments and instructions to nursing teams are aided by easy to use, and ward care specific, pull-down lists of free text (Search). The physician and the ward staff do not need to know the numerical/alphanumerical codes that are used, therefore they are not displayed. These are listed only as unique identifiers and primary keys in the Oracle database. An Edit button displays a special zoom window for the entry of a specific physicians treatment notes.

34. medical history The patients medical history form, displayed by a click on the Pt Health History button, consists of four blocks: 1) Patient identification (the chart number and full patient name are displayed automatically), 2) Past diseases (the name and ICD9 code are entered by the ward staff from the LOV – list of values – pull down listing of codes entered during the installation of the system), 3) Medications are entered based on the patients own recollection, and 4) As well as Allergies - mainly drug and food adverse reactions. All entered data and updates are stored in the patients electronic record by a click of the Save button. PATIENTS ASSESSMENT

35. review of systems Zoom The structure and contents of the block ROS (review of systems) is adjustable for each specialty. A click on the Zoom square displays a window, called a modal, that enables the entry of longer text. The length of the text is also flexible depending upon the needs of each medical specialty. Entry and Review of PE

36. hospital drug formulary The physician selects the drug from the approved list of drugs – hospital drug formulary – from a pull down list. The National Drug Code (NDC), generic name, strength and dosage are displayed automatically. The physician enters only the quantity, frequency and route of drug administration. Medication Administration RecordMAR Drug Consultant A check off box informs the pharmacy if there is a requirement to prepare a Medication Administration Record (MAR) for this prescription. The physician is able to access the preferred Drug Consultant available on the Internet or hospitals intranet before approval is given to print the MAR or to send the prescription to the hospital pharmacy. The physicians electronic signature (full name) is mandatory data to be entered. Without it the Save button will not function and the prescription(s) will not be saved in the patients electronic medication profile. hospital drug formulary The physician selects the drug from the approved list of drugs – hospital drug formulary – from a pull down list. The National Drug Code (NDC), generic name, strength and dosage are displayed automatically. The physician enters only the quantity, frequency and route of drug administration. Medication Administration RecordMAR Drug Consultant A check off box informs the pharmacy if there is a requirement to prepare a Medication Administration Record (MAR) for this prescription. The physician is able to access the preferred Drug Consultant available on the Internet or hospitals intranet before approval is given to print the MAR or to send the prescription to the hospital pharmacy. The physicians electronic signature (full name) is mandatory data to be entered. Without it the Save button will not function and the prescription(s) will not be saved in the patients electronic medication profile.

37. Internet www.rxlist.com is an example of a free of charge Internet RxList. In addition to the Rxlist Web site, there are a number of highly reliable drug consultant sites, such as Medscape, Electronic Medicines Compendium (eMC), Scholz Healthcare, Drug InfoNet, RxMed, RxCentric, Drugs.com, Consumer-Oriented Databases, etc. www.rxlist.com Internet www.rxlist.com is an example of a free of charge Internet RxList. In addition to the Rxlist Web site, there are a number of highly reliable drug consultant sites, such as Medscape, Electronic Medicines Compendium (eMC), Scholz Healthcare, Drug InfoNet, RxMed, RxCentric, Drugs.com, Consumer-Oriented Databases, etc. www.rxlist.com DRUG WEB CONSULTANT OPTION

38. Laboratory Tests A simple click on the Treatment Orders button displays a menu with three vertical tabs of the most frequently ordered tests and examinations, namely Laboratory Tests, X-ray/Diagnostic Imaging, and Therapy Orders. Each of the order forms/requisitions has an identical layout of two blocks: 1) A list of approved tests, examinations and therapies, 2) A list of all orders placed for the selected/designated patient during his/her hospitalization. A check off box indicates if the results have arrived or are available.

39. X-ray/Diagnostic Imaging A single click on the Treatment Orders button displays a menu with three vertical tabs of the most frequently ordered tests and examinations, namely Laboratory Tests, X-ray/Diagnostic Imaging, and Therapy Orders. Each of the order forms/requisitions has an identical layout of two blocks: 1) A list of approved tests, examinations and therapies, 2) A list of all orders placed for the selected/designated patient during his/her hospitalization. A check off box indicates if the results have arrived or are available.

40. Therapy Orders A simple click on the Treatment Orders button displays a menu with three vertical tabs of the most frequently ordered tests and examinations, namely Laboratory Tests, X-ray/Diagnostic Imaging, and Therapy Orders. Each of the order forms/requisitions has an identical layout of two blocks: 1) A list of approved tests, examinations and therapies, 2) A list of all orders placed for the selected/designated patient during his/her hospitalization. A check off box indicates if the results have arrived or are available.

41. Patient Plan and Education The last form of the S-O-A-PE electronic records is the Patient Plan and Education (PE) section. The entry of the Nursing care plan based on NANDA nursing diagnosis is optional. For more information visit: http://www.nanda.org/ http://www.nanda.org/ Patient Plan and Education The last form of the S-O-A-PE electronic records is the Patient Plan and Education (PE) section. The entry of the Nursing care plan based on NANDA nursing diagnosis is optional. For more information visit: http://www.nanda.org/ http://www.nanda.org/ PATIENT CARE PLANS & EDUCATION

42. simplified four groups of codesCode Menu In all ULTIMA*DCF forms the entry of data is simplified by the deployment of pull-down list of values (LOV). A single click at the LOV icon attached to most fields, activates the underlying coding structure - database schemas - to enable the operator the selection of data for the field. There are four groups of codes included in the ULTIMA*DCF Code Menu. ULTIMA*DCF - Codes

43. Citizenship Ethnic/Race General codes used by the registration staff are simple to maintain. Here are examples of Citizenship and Ethnic/Race codes. ULTIMA*DCF – General Codes

44. Language School Grade General codes used by the registration staff are simple to maintain. Here are examples of Language and School Grade codes ULTIMA*DCF – General Codes

45. Religion State General codes used by the registration staff are simple to maintain. Here are examples of Religion and State codes ULTIMA*DCF – General Codes

46. Ward and room codes Ward and room codes maintain the list of all hospital units and rooms including the charge/diem. ULTIMA*DCF – Spec. Codes

47. physiciansspecialties List of physicians licensed (approved) by the hospital and their specialties are maintained by these two forms. ULTIMA*DCF - Spec. Codes

48. Nursing staff Nursing staff and their certified/official specializations are entered and maintained by these forms. ULTIMA*DCF - Spec. Codes

49. Nursing position Nursing position codes could be expanded for the HR and payroll applications. ULTIMA*DCF - Spec. Codes

50. SubjectiveObjective These are examples of subjective and objective typical statements or complaints used for entry into the Subjective and Objective sections of S-O-A-PE electronic patient treatment progress notes. ULTIMA*DCF - Spec. Codes

51. AssessmentPE Medical assessments and nursing plans, as well as patient education statements, are used for entry into the Assessment and PE sections of the S-O-A-PE electronic patient treatment progress notes. ULTIMA*DCF - Spec. Codes

52. ICD-9 CMCPT ICD-9 CM codes as well as CPT (Current Procedural Terminology by the American Medical Association) are maintained for the US institutions. For installations outside the US the system coding schemes include ICD-10 and other codes for reimbursement, e.g., fee codes. ULTIMA*DCF – Diag. Codes

53. ONLINE CHILDS INTAKE FORM patients intake The patients intake form is a unique component of ULTIMA*DCF. Its main goal is to enable a thorough assessment of the childs or adolescents status and admission to the treatment facility. It also creates a powerful database for statistics and research as well as flexible adjustment of the questionnaire for each psychiatric facility.

54. ONLINE CHILDS INTAKE FORM demographic data, The Patient Intake Forms first tab opens the section of the patients demographic data, usually already entered during the childs registration. If the registration has not been done, the data from the data captured here will be available at the time of registration/admission.

55. ONLINE CHILDS INTAKE FORM primary The information about the insurance coverage is entered in two forms, primary and secondary insurance, if any.

56. ONLINE CHILDS INTAKE FORM primary The information about the insurance coverage is entered in two forms, primary and secondary insurance, if any. Note that the date, chart number and childs name are displayed by default.

57. ONLINE CHILDS INTAKE FORM mother father The fourth data entry tab opens the section of patients information about parents, mother and father in two separate blocks.

58. ONLINE CHILDS INTAKE FORM Siblings The Siblings data entry tab opens the section of the patients information about any siblings, as well as about other members of the household.

59. ONLINE CHILDS INTAKE FORM birthmother pregnancy problems The birthmother pregnancy problems required answers are aided by lists of optional statements (e.g., YES, NO) that are displayed by a click on the down arrow icon. Note that the date, chart number and childs name are displayed by default.

60. ONLINE CHILDS INTAKE FORM childs delivery The childs delivery required answers are aided by lists of optional statements (e.g., YES, NO, NATURAL, HOSPITAL, etc.) that are displayed by a click on the down arrow icon.

61. ONLINE CHILDS INTAKE FORM infants data entry The infants data entry is also aided by lists of optional statements (e.g., YES, NO) that are displayed by a click on the down arrow icon.

62. ONLINE CHILDS INTAKE FORM infants development data entry The infants development data entry is also aided by lists of optional statements (e.g., YES, NO) that are displayed by a click on the down arrow icon.

63. ONLINE CHILDS INTAKE FORM childs behavior The childs behavior data entry is also aided by lists of optional statements (e.g., YES, NO) that are displayed by a click on the down arrow icon.

64. ONLINE CHILDS INTAKE FORM medical history A childs medical history covers mainly allergies and adverse drug reactions. A childs physician as well as the diagnosis are included in this section of the intake questionnaire.

65. ONLINE CHILDS INTAKE FORM family treehealth status This section of the Patient Intake Form covers the childs family tree and the health status of each family member.

66. ULTIMA*DCF PHARMACY Pharmacy The Pharmacy component is an option for larger hospitals. This menu – Introduction - consists of nine applications accessed by a click on the vertical tabs.

67. ULTIMA*DCF PHARMACY Patient Data Entry The Patient Data Entry form is a duplicate copy of the patient registration form. This is an option for a stand-alone pharmacy.

68. ULTIMA*DCF PHARMACY Incoming Drug Orders The Incoming Drug Orders form lists all prescriptions sent from the hospital wards.

69. ULTIMA*DCF PHARMACY dispensing approval All orders/prescriptions of drugs are listed for the dispensing approval (OK box) by the pharmacist. Details of each approved item are displayed in the second block.

70. ULTIMA*DCF PHARMACY The Patient Medication Profile, consists of four blocks of important information: 1) Patients ID code and full name, 2) Patients allergies and adverse drug reactions, 3) Listing of all current drugs and medications with three check off boxes: A = approved, D = dispensed, X = not approved, 4) Item details.

71. ULTIMA*DCF PHARMACY medication administration record plan The medication administration record (MAR) is prepared by the hospital pharmacy at the request of the physician who prescribed the medication. The form consists of four blocks: 1) Patients ID, 2) A list of current patients drugs/medications, 3) MAR plan prepared by the pharmacy 4) Actual administration. Note fields could be displayed in full by a click on the Zoom icon.

72. ULTIMA*DCF PHARMACY Inventory Stock Controlonline The Inventory Stock Control offers the hospital pharmacy a powerful online review of all items including the quantity on hand (QOH) and quantity on order (QOO) as well as the total inventory value based on the hospital internal costing guidelines. Details of each stock item are displayed in the second section of the form.

73. ULTIMA*DCF PHARMACY complete log of all transactions stock movement A complete log of all transactions (opening balance, issued, received, returned, physical inventory count + -) enables the pharmacy management an online review of the stock movement.

74. ULTIMA*DCF PHARMACY listing of all items on order Act The Review of Drug Orders is a listing of all items on order from suppliers. The entry of new orders and the electronic order, electronic data interface (EDI), deployment is done by a check off of the Act (activate) box. Details of each purchase order are displayed in the lower section of this form.

75. ULTIMA*DCF PHARMACY - Codes entry and maintenance The hospital pharmacy is responsible for the entry and maintenance of coding schemes of all applications.

76. ULTIMA*DCF PHARMACY - Codes list of approved drugs and medications The Drug Formulary, i.e., a list of approved drugs and medications, is the foundation of the hospital pharmacy management, as well as drug orders/prescription from physicians. It contains all information for drug orders from suppliers, plus the maintenance of stock.

77. ULTIMA*DCF PHARMACY - Codes The pharmacy has an option of using traditional abbreviations derived from Latin or their own codes, e.g., instead of ACL – BL = Before lunch, etc.

78. ULTIMA*DCF PHARMACY - Codes Drug Administration Route unique The Drug Administration Route codes are based on the pharmacy internal coding, e.g., RTE01, etc. It is important to note that these alpha-numerical codes are only for the database unique items identification.

79. ULTIMA*DCF PHARMACY - Codes This is an example of drug manufacturers codes, usually well established within the pharmaceutical professional community.

80. ULTIMA*DCF PHARMACY - Codes details of drug suppliers The details of drug suppliers (primary, secondary, etc.) are captured and maintained by this form.

81. POWERFUL ORACLE9i/10g DATABASE database systems One of the most important issues of any electronic hospital system is the reliability and confidentiality of the sensitive patient information. Oracle9i/10g database systems are one of the, if not the best in the world and fully compliant with HIPAA requirements.

82. THANK YOU ! ITC Software Tel.: +1 978 287 4855 info@itcsoftware.com www.itcsoftware.com THANK YOU ! ITC Software Tel.: +1 978 287 4855 info@itcsoftware.com www.itcsoftware.com