System Overview

As illustrated in the figure below, eMedicalFusion uses a modular approach to maximize integration capability, flexibility, reliability and real-time performance. All modules are designed and built to be as open as possible, while maintaining the necessary layers of security to be HIPAA-compliant and provide the security level needed for patient and financial information.

As the industry changes, eMedicalFusion will grow and adapt to those changes, introducing new modules and functionality as needed-and all our physicians will benefit from these new features, generally at no additional charge as they are implemented in the production environment.

Figure 1 below presents the functional architecture of eMedicalFusion. We integrate modules built directly by eMedicalFusion with best-of-class commercial applications using our smart integration approach, enables by .NET, XML and HL7 technologies, all hosted in our state-of-the-art datacenter, so you don’t have to worry about hardware, software or data backups. All transactions are done over SSL encryption to ensure security during transmission, and Authorize.net provides secure gateway processing for credit card transactions.

Features and Benefits

eMedicalFusion is very rich in features that are specifically designed to meet the needs of cash, hybrid integrative and concierge practices. The table below provides a list of many of the key features and benefits of eMedicalFusion. (note use prior design that was done for this table)

Features	Benefits
Secure, web-based, hosted solution	HIPAA compliant; no hardware to purchase; highly available platform; accessible from anywhere with an internet connection.
Patient Management Portal (PMP)	Easy to use, initial point of entry for all patient demographics, fully integrated with ePatientPortal
ePatient Portal (ePP)	Provides secure access to all patient self-service functions as well as secure communications with the practice.
Secure, HIPAA- compliant online intake.	Includes demographic registration, health history (uses the Practice’s own form), HIPAA acknowledgement, payment arrangements and appointment
Secure Patient Communications	Provides secure communication (appropriate for PHI) between physicians, staff and patients. In addition, all communications are recorded and visible in the system.
eMRLite	eMRLite is an easy to use electronic clinical notes for practices that want to create electronic encounter notes without the “heaviness”, cost and learning curve of a full EMR.
Integrated Online Scheduling	Provides staff and patient interfaces that allow the scheduling, rescheduling and canceling of appointments in real time quickly and easily.
Integrated Shopping Cart	Allows the practice to easily sell nutraceuticals, compounded pharmaceuticals, ebooks, etc. The “auto-ship” order feature for those products that are required on an ongoing basis increases revenue and patient satisfaction.
eVendor Portal	Used by product distributors to view orders and enter tracking information that is immediately updated in the shopping cart and generates patient notification with tracking numbers. This allows , allowing the practice to operate with “Amazon.com-like” efficiency.
Powerful Patient Management Dashboard	Provides visibility into the full lifecycle of patient management activities including the all-important intake process.
eInquiry Management System (eIMS)	Adds value to “contact-us” page on website. With eIMS, these contacts are populated into an integrated database whereby the prospect can be communicated with easily and migrated to the PMP when appropriate.
eCommerce Payment Gateway	For patients and staff, this gateway provides a robust interface to Authorize.net to process everything from standard single payment transactions to multiple payment installment arrangements, all automatically.
Fixed Duration Program Management	For transactions that are processed through the system, eMedicalFusion totally manages the start and expiration dates and provide automated renewal management including renewal notices.

Patient Management Portal (PMP)

The PMP is the interface used by physicians and staff that provides direct access to the patient data and many critical functions including:

• Appointment scheduling
• Shopping cart purchases
• In-office checkout and payment for services rendered
• Patient communications (Secure Communications and email)
• Patient Management Dashboard.

The PMP is the “system of record” for all of the demographic data including name, addresses, phone numbers, date of birth. For practices that offer fixed duration programs for service delivery, the PMP tracks the start and expiration dates for these programs and provides complete renewal management capability.

The dashboard provides near real time visibility into the intake process, appointment activities and patient acquisition statistics. It is a powerful tool to get a quick handle on the business of the practice and the inherent benchmarks can be easily updated for each practice and can be changed easily as the business grows. The exhibit below provides a depiction of the dashboard in action.



Looking at the intake status section, green checkmarks indicate forms that have been received or actions that are complete. Green dots signal activities not complete, but still within the allotted time established by the practice. Yellow dots signal caution as the established time has passed and red indicates a need for action as an additional amount of time has passed (set by the practice) and the activity is still not complete.

In the remaining two sections, the fuel gages indicate the level of appointments, new patients, new program patients and other metrics that are important to the practice. The needle shows the current level of activity against the benchmarks for each color set by the practice.

From the dashboard, practice managers can determine at a glance the state of the business of the practice. Intake Coordinators can determine the exact status of all of the patients that are in the intake process and practice marketing professionals can determine the effectiveness of marketing campaigns.

Payment Application

For cash and concierge practices, the payment application is one of the most important components of a fully integrated system since this application alone is responsible for charging the patients form of payment and recording all transactions for accounting and reconciliation purposes. As eMedicalFusion systems are designed specifically for cash, concierge and hybrid practices, the eMedicalFusion "smart" Payment Application has very specific functionality for cash practices including:

• Charging for an unlimited number of product and service items
• Sales tax charging and collection and posting to QB for payment to tax authorities
• Automatic processing of payment plans
• Ability to have different services and rates for multiple practice locations
• Ability to process "offline" charges through the system to handle alternate payment methods like Care Credit or swipe terminal payments
• Ability to swipe cards using a standard USB magnetic card reader that can attach to any PC
• Scheduling of recurring automatic charges
• Email receipts and point-of-sale printable receipts
• Maintaining start and expiration dates for fixed duration "programs"
• Securely storing credit card data for later use using Authorize.net’s Customer Information Manager – an approach that allows practices to have the convenience of stored cards yet operating with PCI compliance
• Linkages with CPT codes for patient superbill generation (not for 3rd party billing)
• Fully integrated with the patient data avoiding redundant data entry of using a disconnected system

The functionality highlighted above is enabled by one of the leading internet gateway providers, Authorize.net. It will truly enable your cash practice to do business using practice specific payment programs for each service that you sell. If facilitates PCI compliance as we do NOT store credit card numbers on our systems thereby avoiding the PCI compliance issues associated with this practice. This allows you to certify your PCI compliance with a simple self-assessment when required by your merchant bank.

eMRLite

eMRLite provides an easy to use clinical notes capability for practices that want to create electronic encounter notes without the heaviness and cost of a full EMR. eMRLite provides many practices with a low-cost, easy to implement solution that gets them into the “digital” environment.

SOAP Notes:

• May be attached to secure messages, appointments or they may stand alone
• Have special note types for lab requisitions and lab results that permit attachments to the note
• Uses drop down menus for selection of the Chief Complaint, Patient Compliance with treatment and Progress
• Features the ability to setup pre-written note templates for the text portion of the note
• Includes a followup management feature that prompts practices when it is time to followup with each patient
• Allows providers to add the diagnostic codes to the note that will populate the Superbill
• May be viewed from the SOAP notes interface or by following links in linked secure messages or appointments

Easy ePrescribing with Rx Manager:

• The first eMR to present an easy to use interface for prescribing compounded medications
• Features a formulary is maintained by the linked compounding pharmacies so there is no need for prescribers to have to add and manage new formulations manually
• Easy to use transmission options including our proprietary electronic transmission and secure fax
• Interface provides generic and therapeutic alternatives for standard meds with the click of a checkbox

Easy to use online refill request for patients:

• Patients have a view of their current/active prescriptions and have one click access to order medications that have been prescribed and request a prescription refill
• System tracks remaining refills to provide better refill workflow

ePatientPortal

Now available as part of the eMedicalFusion Software Suite or as a Stand Alone Portal

ePatient Portal, available both as part of the eMedicalFusion Practice Management Suite and as a Standalone Product, provides real benefits for patients and practices by leveraging an existing trend – Self Service. With ePatient Portal, your patients will finally feel like medicine has joined the 21st century. Patients will appreciate the 24×7 self-service convenience as it saves them time and enables them to perform a number of tasks without picking up the phone or sending an email. And practices can use the ePatientPortal to help achieve HIPAA compliance.

Click here to understand how you can use our standalone patient portal to help achieve HIPAA Compliance

The ePatientPortal is delivered via a secure web site (https://) that allows patients to accomplish the following:

• Create and update their demographic profile
• Complete a 5 step online intake process including filling a health history form and HIPAA Acknowledgement
• Schedule appointments
• Bidirectional Secure Communications with the physicians and staff
• Make payments for services
• Access the shopping cart
• Link components of their clinical file with their own personal health record via Microsoft Health Vault. This feature requires a free subscription to Quest Care 360.

The Patient Experience with the eMedicalFusion ePatient Portal (Cash Practice)
Future patients self-register to start the intake process. The patient inputs all of the key demographic information, selects a username and password and downloads, then completes the remaining steps of the online intake process including making payment (if required by the practice) and scheduling the initial appointment. As the patient proceeds through the online intake, the practice intake coordinator watches the dashboard as each form is submitted. After all forms are submitted to the office, the practices that require pre-visit lab work develops the lab requisition and sends the requisition to the patient using eMedicalFusion’s secure messaging capability. The patient receives an email notice that new secure messages are ready to be viewed and logs into the portal to retrieve the message and the lab requisition. The patient heads to the lab as instructed by the doctor.

At the initial appointment, the patient agrees to commence with one of the concierge-type programs that the practice offers and the staff inputs the program into the eMedicalFusion payment application that allows the patient to pay for the program in monthly or quarterly installments, which are completely automated and require no further action from the staff. Then the doctor has recommend several nutraceuticals and these are entered into the shopping cart along with a recurring order so that the products will be shipped to the patient automatically in the chosen frequencies. At the end of the month, the patient enters the ePatientPortal to review their statement of charges and payments and prints this statement for submission to their flexible spending reimbursement account. In some cases, this statement may need to be augmented by a medically coded invoice.

Achieve HIPAA Compliance with the eMedicalFusion ePatient Portal (All Practices)

Recently, the federal government has discovered that HIPAA compliance audits are profitable so they have doubled their staff assigned to HIPAA compliance audits. The fines for non-compliance are significant with large organizations being fined hundreds of thousands of dollars for non-compliance issues and small practices being fined tens of thousands of dollars. Many of these violations can be avoided with a patient portal combined with solid office procedures. Keep reading to understand a few of the HIPAA Compliance issues and how the ePatientPortal resolves these issues:

1. Communicating with patients involving Protected Health Information (PHI). Currently many practices use email as a mode of communication with patients. Based on the HIPAA regulations and HI-TECH ammendment to the act, email is not a secure form of communication. Importantly patients may NOT waive HIPAA so even if you have them sign a document agreeing to communicate by email, you are still in violation
   • Solution: Bidirectional Secure Communications with the ePatientPortal. The server-based secure communication is similar to the methods employed by banks and other security consciouus organizations whereby you may receive an email communication directing you to the portal to get the message content.
2. Acquiring patient’s intake information. Traditionally, most practices have required patients to fill out multiple forms when they arrive at the office for their initial appointment. Some practices have adoped slightly more modern practices where they make the forms available on the web or by email. Upto this point, the slightly modern approach is fine. The problem comes when they direct patients to submit the forms by email. Based on the existing HIPAA/HI-TECH regulations email is not deemed a secure communication method, therefore PHI may not be submitted in this way. Practices vioulating this regulation are subject to significant fines and penalties.
   • Solution: Secure online intake with ePatientPortal. Using our secure online intake, patients fill forms on our secure servers and submit them making them immediately accessible to the practice. Since the forms are filled and submitted on a secure web site (https://), this process supports HIPAA compliance for the practices. Plus, patients appreciate the convenience of filling forms online and tend to provide more complete information.

These are just two important processes whereby the ePatientPortal by eMedicalFusion helps your practice achieve HIPAA compliance.

Consider the following advantages of our ePatientPortal:

• eMedicalFusion offers you the advantage of proven commercial software delivered as a service combined with the ability to extend our standard functionality as needed to create additional efficiencies in your office
• Our patient portal is available as a standalone to help practices meet HIPAA requirements without a total replacement of systems that you have already invested in heavily
• Our online intake process provides secure registration of demographic data, health history and HIPAA Acknowledgement. The health history portion uses either one of our standard forms or the client’s form for a small one-time form development fee
• Our secure managed communications not only meets HIPAA requirements for secure messaging with patients where PHI is involved, but helps make the office more efficient by segregating the patients inquiries into client-selected "departments
• Our HL7 demographic integration can easily be leveraged to integrate with any HL7-compliant EMR/EHR, not just the ones that we have worked with previously
• With the eMedicalFusion ePatient Portal, you can be live in 2-3 days with the high-priority practice and start providing these patients with the benefits and security of secure messaging, online intake and online scheduling if desired
  

eVendorPortal

The eVendorPortal combined with a very robust shopping cart delivers an “Amazon.com-like” shopping experience for patients and a profit center for practices. And this profit center works 24×7 even when the doctor is not in the office. The practice chooses which vitamins, supplements and products to offer from our list of preferred vendors or ones of your choosing. Then patients can log into the ePatientPortal and purchase these products using a familiar shopping cart interface all without using staff to take the orders and process credit cards. The practice doesn’t have to hold inventory, process orders or ship a thing. This is truly operating in the 21st century.

The integrated eVendor Portal includes an order management system that supports multiple dropshippers with real-time integration with the shopping cart. Support for multiple dropshippers means that the practice can use as many vendors as they choose as opposed to the vendor-provided shopping carts that generally support selling only a single product line. The order management component provides a secure web-based interface for vendors to receive orders, update orders status and enter shipping/tracking information. As this occurs, the shopping cart is updated in real time and patients receive real time status and shipping confirmation emails with tracking numbers. If you have ordered from Amazon.com, you understand the power of this efficiency and communications.

With eMedicalFusion eVendor Portal, every practice can enjoy the revenue and profits of offering patients the products they need in a convenient, familiar shopping cart interface.

Now a bit about the technology. The shopping cart is powered by 3dCart and is one of the leading shopping carts offered today with several thousand active sites. The technology is powerful and eMedicalFusion, LLC has been selected as a 3dCart Platinum Partner, their highest level of partnership. The award is based not only on the number of active 3dCart sites that we have today but also due to the innovation in our application of 3dCart. Recurring orders, Single sign-on from the ePatient Portal and Patient Management Portal, support for multiple drop ship vendors and more are the compelling reasons why eMedicalFusion, LLC has been honored with 3dCart’s highest level of partnership. If you want to leverage the power of shoppign cart technology and 3DCart technology in particular, then eMedicalFusion is the right choice. eMedicalFusion –a 3DCart Platinum Partner.

Inquiry Management

Most practices have a website that includes a “contact us” page that allows prospective patients to submit inquiries to the practice. The problem is that these inquiries are generally delivered to the practice by email. As the number of inquiries increases, managing these inquiries is difficult in an email environment. That is where the eMedicalFusion Inquiry Management system (eIMS) steps in to help practices manage these inquiries more effective thereby converting more prospective patients to patients than possible with the email-based system.

With the eIMS, inquiries submitted through the web contact us page as well as inquiries that originate from calls to the office can all be managed with the eIMS. From the eIMS, practices can make notes for other staff persons to see or just a tickler note to self for later followup, send managed emails to the patient and send the links with instructions for the online intake process. As leads are converted or lost, they are removed from the active list so that the staff responsible for managing the inquiries can focus on the relevant/active leads.

With the eIMS, practices use eMedicalFusion to manage the entire lifecycle of interactions from prospective patient to patients and beyond.