OnTrac eHealth Platform
OnTrac Resident Manager is an electronic health record system (eHealth platform) that covers the needs of Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs).
Quick facts about OnTrac
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HIPPAA-compliant
All patient data and records are protected according to HIPAA standards.
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MDS 3.0 standart
The Minimum Data Set captures the information healthcare organizations need about patient health problems.
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Automation
Automation of procedures, processes and the sharing of data in medical facilities.
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Billing
Billing reports, invoices and other financial documents are generated automatically.
Story Behind
In 2009, Regan Chorlog took over as Project Manager of OnTrac Resident Manager. His responsibility was to find capable engineers and developers to manage new development and growth projects.
Regan hired software teams from El Paso, Singapore and Slovakia. Several developers worked with the code base, but none of them were skilled or innovative enough to take sole responsibility for the project.
As a result, the application quality reduced quickly. The application logic became over-engineered, unstable and full of run-time errors. Unit tests were abandoned. Common Rails patterns were routinely violated.
Finally, in June 2010, Regan started working with Anadea. It took some time until Anadea the relationship was strong enough whereby our team was solely responsible for the development of OnTrac Resident Manager.
In 2012, Regan Chorlog acquired the assets, code and branding of OnTrac Resident Manager, because his belief in the project was greater than co-founders who were involved earlier on. He wanted to drive forward growth, and was keen to keep working with Anadea to achieve these aims.
Minimum Data
Set 2.0
Our first major task was to work on the MDS 3.0 standard, which had a launch date of no later than 1 October, 2010. That hard deadline was set by the U.S. Center of Medicare and Medicaid (CMS) and couldn’t be changed under any circumstances.
MDS 3.0 standard was a new update for MDS 2.0, the data guidelines healthcare companies were working under. MDS stands for “Minimum Data Set”, which refers to clinical assessment and other related healthcare and patient data. MDS 3.0 is a form with more than 800 fields that need to be validated with over 200 rules.
Every resident and patient should have one or two assessments every week, and these documents need to be validated before they can be sent to the CMS.
MDS 3.0 required the application to calculate a RUG IV (Resident Utility Group), using a complicated algorithm the CMS defined and outlined to healthcare providers. The algorithm was not finalized when this project started, and the CMS changed it several times before it was finalized and approved.
We structured this algorithm, set up a test suite and developed automated tests using RUG IV logic, which proved to be an invaluable contribution to the project.
Care Plan
Another notable feature of OnTrac Resident Manager is known as Care Plan. Developing a Care Plan was one of the biggest headaches for the nurses.
Every resident needs to have a hierarchical Care Plan that can consist of between 30-60 lines of recommended procedures. Care Plans need to be often updated. Hierarchy of Care Plans has four levels: Plans, Groups, Approaches and Disciplines. Until care and residential nursing homes started using OnTrac Resident Manager, it was very difficult for users to edit Care Plans. Editing was manual, involving nurses spending a lot of time on them, when there were numerous other duties to consider.
Anadea engineers developed a special “Care Plan” webpage that is fast and easy to use for nurses, compared to legacy methods. This page was split into two parts. The first is the Care Plan itself; and the other part was a place for a CP library, which facilitated the editing. The page had a Javascript feature which allowed users to edit the plan with a minimal number of clicks without sending requests to the server.
Refactoring &
Optimization
During the development project, significant time and efforts went into optimizing the application. Before Anadea joined the project, the logic and system processes had been very slow, and full of errors. Anadea engineers were designing and developing new features, alongside improving the speed of legacy features and pages.
Initially, webpages with a list of residents and patients needed about a minute to load and recalculate all recommendations. In automated tests, this was actually taking two hours to pass.
In order to make significant improvements, engineers had to strongly follow Agile principles. Code cleanup was essential, alongside refactoring and speed optimization before every new feature went live. Testing mechanisms were updated that ensured tests only took 10-15 minutes, instead of 2 hours.
Rendering Speed Increase
List Views (of patients/residents) evolved into a feature called “TraCare view”.
A TraCare page was created to show a list of residents with information about them, enabled actions and recommendations for documents that should be created next, as part of patient Care Plans. To improve rendering speed, our engineers used fragment caching - a core Rails caching mechanism that ensured only parts of a page that are in-use are rendered.
Fragment caching increases the rendering speed of key OnTrac pages from 50 seconds to 2-3 seconds.
Design
Our task was to create a modern Web 2.0 design for every web page, with a rich feature and functionality set, that is user-friendly. The design needed to be attractive and practical.
It should show a list of all active residents that is easy for nurses to use, saving them time searching for information and performing the tasks they need. We created a user interface that satisfied these requirements, resulting in a functional application that is pleasant to use.
This included an attractive header, with smooth menus and rounded buttons. Everything modern web users expect, according to recent design innovations.
Main Features
OnTrac Resident Manager was designed to generate invoices automatically, based on procedures and physical therapy and occupational therapy data from treatments residents received. Once payment was made, either by a patient, their families, or insurance providers, receipts were integrated with those, to demonstrate a payment has been made.
We also developed several billing reports, which many facilities said were desperately needed. Along with automated Healthcare invoicing and billing, we added numerous other features. Here is a list of OnTrac key features, implemented or essentially modified by Anadea:
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- Patient and resident Census
- Care Plans
- Electronic Health Record module
- Incidents and Accidents
- Report Generation
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- Admin and Owner Dashboards
- Comprehensive MDS 3.0 and RUG IV
- TraCare - Automated Assessment
- Care Area Triggers (CAT) and Care Area Assessment (CAA)
- CAA Direct - Link to Care Planning
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- Billing: MDS Direct RUG Transfer
- Case Mix Indexing
- Automated HCPC Importing
- HIPAA 5010 Compliance
- Accounting module
Testimonials
This positive testimonial, we are pleased to say, is a natural result of working closely with the client to deliver what they need. Our work ensured this product could be initially rolled out in seven Skilled Nursing Facilities across the U.S.
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We have a long term relationship with Anadea and receive the highest quality results. We have no reason to go anywhere else for our development needs. Our reputation as a SaaS provider is highly respected and Anadea plays a big role in keeping it that way. Thank you for all your hard work!Regan Chorlog, CEO at OnTrac -
Mr. Regan, just wanted to let you know how your software has made my job easier. I have been an MDS coordinator since 1998 and have worked with several different software providers.The head nurse at one of the facilities
Solution
OnTrac is a US healthcare workflow automation system for skilled nursing facilities. The software our team has developed solves numerous difficulties that nurses are facing, and takes into account the regulations they need to adhere to according to US government guidelines. This development project included the creation of the following features: EHR/EMR, census MDS 3.0, HIPAA 5010, Care Plans, and it also included modules that lighten the work of nurses, and automate internal procedures in medical facilities.
Services &
Technologies
Design
Quality assurance
Back-end development
Front-end development
Technology stack
MySQL, Ruby on Rails, JS Frameworks, QA, DevOps, UI/UX
Project management
Contact us
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