The SQL Data Model is a third-normal-form based model, with nearly all tables using large integer Identity based keys, providing performance and referential integrity.  The Data Model began with our Clinical Data Repository (CDR-Web), focusing on the primary portions of a patient record: Demographics, Procedures, Diagnoses, Lab Results and so on.  In CDR-Web’s product evolution, this expanded to include Order Entry, Medications, Pharmacy Order Entry, and Scanned Documents. 

During our partnership with HFHS for EXR/CPNG, our data model was chosen for the basis of the new product, and was enhanced to support Teams, Work Queues, Clinical Documentation, Pathways/Protocols, and much more.  At one point, out of curiosity, one of the HFHS data model team printed the entire logical model. It took up his entire wall.

We continued to expand EXR to be certified as a complete Inpatient and Outpatient EHR, and the Data Model was further enhanced to support some of the feature points, and encryption methods required for certification.

When we created Arcana, we enhanced the Data Model for all of our external sourced data tables and expanded them to fully accept any sourced data. This allows us to accept data from any combination of source systems, and be properly aggregated, preserving the original while at the same time being able to easily map it to any known Point-of-Truth (i.e. CPT, ICD and similar codesets).  With it, Arcana is able to assess patients realtime and have reaction situations for any number of use cases, including aiding in insurance reporting of HEDIS matching patients and their related data points.

Our partner Clinical Architecture has white-label licensed our Alchemy product, wrappering it with their own specialized feature set to help analyze and clean clinical data, in their PIVOT product.

Read more about it here.

Order Entry software for hospital-based and provider-based patient orders

Read more about it here.

In a joint partnership with the South East Michigan Health Information Exchange (SEMHIE), we brought our expertise on the CCD format to assist in being the first in the country to complete the Social Security Administration’s (SSA) E-Disability CCD Exchange. In this project, we and our partners, worked with local hospitals, including Henry Ford Health Systems and the Beaumont Health System, to obtain a CCD Summary of Care document from each for a given patient, and then generate a single aggregated CCD to be submitted to the SSA. This endeavor was proposed to reduce the overall approval process from an average of over 450 days of obtaining and reviewing paper charts and billing statements, to approximately 6 hours of requesting and reviewing a single CCD.

Read more about it here.

Code named ”BRANDON” (Batch Runner and Network Diagnositics tool), this is a .Net application engine that allows for building complex command-line executables using simple XML configuration files and leveraging the multiple extensions available, including HTTP, SQL, and simple File based operations, as well as leveraging X2TL and the overall X2A2 architecture.

An XML-safe templating language created for manipulating blocks of XML using string-based templates.

X2TL is an XML-safe “mustache” templating language, written in C# .Net. It was written as a software development tool, now being offered open-source. This library has been tested and used in several enterprise production applications.

Made open source by the author, August 2016 under the MIT License. Now available at: https://github.com/openAirWare/X2TL and https://bitbucket.org/openAirWare/x2tl

Our take on a Universal Health Record (UHR), or more popularly as a Patient Health Record (PHR).

Based on 20 year fortified CDR-Web base data model

Facebook like user-interface for ease-of-access and entry

built to replace the outdated Visual Basic (VB6) WebClass Architecture

Tested and Certified by Microsoft as a .Net Application Engine

Ran EXR/CPNG for dozens of interface engines as well as the main web-based application engine.

Read more about it here.

In 2004, we partnered with the Henry Ford Health System to rewrite their internally built electronic health record application, known as “Care Plus.”  We were at a technological point with CDR-Web, where we also wanted to do a rewrite, utilizing Microsoft’s new .Net technology.  

With this partnership, we worked with their teams plan and facilitate a zero-data-loss migration of 10 years of clinical data, as well as write a new world-class Electronic Medical Record.  The end result was known at HFHS as CPNG or “Care Plus Next Generation” and commercially as RelWare’s EXR.

EXR was Certified for “Complete EHR, Inpatient” and “Modular EHR, Ambulatory” by InfoGard Laboratories EHR Certification Body under Meaningful Use January 2011.

Read more about it here.

In 1998, we released CDR-Web, the first commercially available web-based Clinical Data Repository, as our flagship product.  A Clinical Data Repository is a “patient-based” database that is focused on clinical healthcare data, allowing users to view patient records electronically.  In the time where large paper charts were brought up from the Records Room to the patient’s nursing station for the physician and clinical staff to review, CDR-Web made that same information immediately available via laptops and mobile workstations, directly in the patient’s room, using a powerful SQL Database and Web Application. It turns out that both Web Applications and Electronic Paper Charts were relatively new territory for corporate America in 1998.

Over the next 7 years, additional modules were added to CDR-Web, each just as revolutionary as the product itself.  These included web-based document scanning, prescription order entry with real-time interaction checking, and a personal view to a patient’s own record (later becoming known in the industry as a PHR, or Patient Health Record).  On top of that, CDR-Web itself had multi-tier permissions and preferences, allowing the user experience to be customized at the facility, user’s role and down to the individual user.

For over a decade, CDR-Web was installed and operated as the primary medical record for several Michigan Hospitals, including Providence Hospital of Southfield and its partner Providence Park of Novi, Botsford Hospital of Farmington, and Central Michigan Hospital as well as Bay Medical in Florida.

To date, some still refer to CDR-Web as “the most easy-to-use and intuitive” application they have ever used.