The BioEthx™ consult management service provides a centralized repository for recording all of the important information related to an ethics consultation request and the complete process carried out to achieve the most appropriate outcome.
With minimal training, hospital and clinic staff can create a record of an expressed concern or a request for action. Thereafter, the system becomes a valuable tool to guide the workflow required to properly handle the issue, supporting the inclusion of additional specialists and promoting collaboration among consultation team members to work towards an optimal outcome.
BioEthx is a complete tool that helps healthcare organizations to ensure that appropriate ethics protocols needed to provide quality healthcare and mitigate risks are applied to both clinical and organizational ethics cases.
Primary features of the service include: (click by topic)
Users and Roles
Each organization (hospital, healthcare system, clinic, etc.) is set up as a unique Facility which contains only the consult information relevant to that organization. Ethics consultants and other system users are assigned specific roles within the system depending on their area of functional responsibility; ethics consultation, consultation evaluation or system administration. Roles provide for various levels of information visibility and access to system functions. Privileges and navigational authorizations are assigned to user sessions based on their specification of a facility ID and functional role at system login.
The system maintains a roster of all individuals that are qualified and eligible to become involved in ethics consultations. An Administrator or Consultant can create a new consultation and, as appropriate, choose one or more individuals from the roster for inclusion on the consultation team. This shared access to a common repository of consult details can streamline communications among consult team members and allow the inclusion of consultants that may be at a remote location. The system supports the issuance of notifications via email to ensure timely response and coordination of consult management by advising consultants of referrals, reminders and planned activities.
Clinical Consultations that involve provision of care to a specific patient are typically the most challenging because they involve multiple internal and external stakeholders, requirements for short-term decision making regarding patient care, and sometimes-difficult moral deliberations that lead to greater complexity.
The clinical consultation in BioEthx is presented as a flexible, multi-step workflow process designed to foster efficiency, accuracy and completeness in reaching the best possible outcome for patients. Through the presentation of screen-to-screen navigation options, the system suggests a workflow process for the orderly execution of activities that typically lead to well-managed ethics consults. There is also significant flexibility in the system to navigate among the steps of the ethics consultation process in a more ad-hoc fashion to support real-time and/or collaborative input and participation by multiple participants and, for more experienced consultants, a streamlined process is available to support efficient provision of core, required information more efficiently.
The system supports a separate workflow process for organizational consultations; those less complex ethics-related situations that involve systemic issues rather than specific patient care. The system ensures that a required minimum level of input is provided before a consultation can be closed to ensure documentation completeness.
The system creates a repository of information on how specific cases were handled and allows for the classification of cases based on categories of consultation focus and more detailed topics within each category. This provides a convenient mechanism for retrospective identification of past consults that may serve to inform current activities and help to improve ethics education and policy setting.
The workflow includes a final step, once an active consultation is closed, during which an assigned evaluator reviews the consultation record and optionally interacts with stakeholders in the consultation to ensure quality control, staff accountability and identification of opportunities for improvement.
The system offers a contact log to track outreach activity while attempting to connect with a stakeholder. Once contact is made, an evaluation form is presented to guide the evaluator through the interview process and capture key information. Evaluation results are then also stored with the consultation record.
Report setup features support the selection of three report options: date range, record type and report type. Date range selection allows filtering of records based on dates of consultation requests and the calendar year quarter(s) for which records should be shown. Record type selection is based upon the type of consultation (clinical, organizational or both) and the current status of consultations (open, closed, pending evaluation, evaluated, no evaluation response, or all).
Report type selection offers options for Standard Report, Process Report, or Evaluation Report, each of which presents a pre-determined combination of content. A user may also choose the Custom Report option, which displays all possible content fields with check boxes to allow selection of any number of report fields.
Support tools assist consultants in the management of consult information. List and Search functions facilitate concise display of only those consultations authorized to be accessed by any particular user.
Of particular importance is the ability to upload documents to the server in common electronic formats (e.g., PDF, Word, Excel and image files) for later reference during the consultation process. Uploaded documents may take the form of Attachments, specific to an individual consult, which may include legal documents such as advance directives. Uploaded documents may also be stored as Resources, which reside in a private repository for reference by all consultants within a facility. These might be published reference materials or internal organizational documents that describe policies or procedures.
Consultants may utilize a tool for generation of a comprehensive ethics consultation note for inclusion into a patient's medical record. Notes are generated as Microsoft Word documents.
The viewing of consult information is restricted to a minimal subset of users that have legitimate “need to know” information in order to fulfill their responsibilities. Each Facility contains only the consult information related to a pre-defined organizational entity established at account setup. Within each Facility, a user can view and manipulate only consult records in which he or she has been authorized to participate.
The BioEthx web service is fully protected through Intrusion Prevention Systems (IPS), Intrusion Detection Systems (IDS), DoS/DDoS mitigation, Web application and traditional firewall protection, website vulnerability monitoring, and 24x7x365 operational monitoring and response services. The hosting facility maintains certified compliance with all relevant industry security standards including the payment card industry PCI/DSS standard, and the SAS70 and SSAE 16 service auditing standards.
Network transmissions are protected by the same HTTP/SSL encryption technology used today in e-commerce, online banking, and healthcare applications. It is widely accepted as an effective mechanism for transmission of Private Health Information (PHI) as defined by HIPAA regulations in the US. Should local policies of a healthcare organization call for alternative methods for encrypting network traffic, BioEthx can offer multiple options to fulfill those requirements, including SSL VPN and IPSEC VPN capabilities.
BioEthx is a HIPAA-compliant company and expects to establish HIPAA Business Associate Agreements with each of its customers to protect their interests.