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Medical Documentation |













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| MEDICAL DOCUMENTATION |
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Sigmund™ offers comprehensive functionality designed to meet the needs of all of your medical staff. Highly integrated, work-flow oriented modules streamline assessments, vital signs monitoring, prescribing, order entry, medication administration and more. Nurses and doctors benefit from multiple timesaving and compliance-oriented features, including features such as batch order entry, electronic prescribing and medication titration templates.
Selected Features Summary
- Assessments and Vital Signs
- Perform and report on medical and nursing assessments
- Create user-defined History and Physicals as well as other assessments
- Automatically import assessment information into progress notes and summaries
- Track biometric information: BP, Pulse, respirations etc.
- Track glucose levels
- Track Blood Alcohol levels
- Track heights and weights
- Track patient allergies and fully integrate with prescribing and administration modules
- Computerized Physician Order Entry (CPOE)
- Document all internal and external medical orders and precautions and associate patient alerts
- Create user defined orders for medications, lab work, consults etc.
- Notify physicians and queue labs, consults etc. for viewing
- Record verbal, telephone and written orders
- Create batch orders
- Enter orders and queue for physician approval
- Track clinical precautions, privileges and visitation orders
- Prescribing / Pharmacy Management
- Record, Track and report on all current and historical medications prescribed
- Send Electronic prescriptions directly to pharmacies or print to watermarked Rx paper
- Track medication education information
- Establish titration schedules to avoid redundant data entry
- Automatically populate the Medication Administration Record in real-time
- Capture comments and reasons for medication start, change and discontinuation
- Automatically write and renew prescriptions refills
- Enter prescriptions and queue for physician approval
- Automatically generate narrative progress notes when medications are changed
- Track, view and search entire medication change histories
- Manage multiple pharmacies across patients and continuum of care
- Track and manage multiple medication distribution methodologies (e.g. blister-packs, vials etc.)
- Empirically track and report on all patient symptoms filtered by medication dosage and start and end date.
- Medication Administration Record (MAR)
- Track all medications administered
- Record is automatically populated based on prescription entry with optional approval process
- Model complex dosing regimes with sophisticated logic to prevent double dosing, premature administration, administration outside of windows of time etc.
- Filter and order by name, site, program building etc. to speed administration
- Track medication education
- Track medications self-administered, administered off-site etc.
- Track medication side-effects, comments, partial doses etc. and notes
- Secure patient and staff signatures and viewing multiple patient identifiers
- Empirically track and report on all patient symptoms filtered by medication dosage and start and end date.
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