Tier Product And Services Overview

We have a solution for that.®

TIER® Product and Services

Overview

TIER® Product and Services Overview

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Table of Contents

Table of Contents ....................................................................................................................... 2

Executive Summary ..................................................................................................................... 3

TIER® Differentiators .................................................................................................................. 4

Who is Sequest? .......................................................................................................................... 5

The TIER® Solution ..................................................................................................................... 6

Getting you on top of your day ................................................................................................... 7

Inquiry and Intake with less stress .............................................................................................. 8

Care Delivery ............................................................................................................................ 10

The Face Sheet .......................................................................................................................... 14

TIER® ePortal ............................................................................................................................ 15

Consoles .................................................................................................................................... 16

Reporting ................................................................................................................................... 17

Billing ......................................................................................................................................... 19

Beyond EMR .............................................................................................................................. 21

Implementation ......................................................................................................................... 23

TIER® Exchange ......................................................................................................................... 25


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Executive Summary

Today, only a few vendors in the community based health and human services industry have the

technology, resources, and skills necessary to deliver a system that spans the entire billing, clinical, and

administrative cycle. At Sequest, we have not only established ourselves among these leading

vendors, we have striven to set ourselves apart with exceptional functionality and superior standards.

We are uniquely qualified to align with your organization in achieving its main goal of implementing an

enterprise-wide, comprehensive EMR solution, which will enable your organization to accurately and

efficiently capture, track, process, share, and report any consumer services, billing, and outcomes

information. That solution – the state-of-the-art, industry leading TIER® (Totally Integrated Electronic

Record) – is customizable and fully capable of meeting the current and future needs of your

organization.

TIER® is not just another advanced technology system. It is a robust and self-directing information

solution designed for all parts of the organization. TIER® brings all the pieces together – clinical,

financial, administrative and facilities/human resource management. The TIER® solution promotes

team-based care, sharpening the focus on the consumer by coordinating the process surrounding the

consumer.

Implementing the TIER® solution will allow your organization to utilize proven technology to deliver

comprehensive software services wherever they are needed.

Sequest Technologies welcomes the opportunity to work with and to build a shared vision and

strategic partnership with you and your organization. We are pleased you have taken the time to

read this important summary document.

Sincerely,

William R. Connors Ted Wright

President and CEO Director of Business Development


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TIER® Differentiators

Adaptable platform designed to grow as your organization grows

Fully integrated, multi-dimensional billing module

Future flexibility to meet ever changing regulatory demands of the Counties and State

Improves patient care and safety through a Medication Record (MAR) and Computerized Physician Order Entry (CPOE), and e-prescribing

Optimizes business using customer designed business rules

Track Referrals, admissions and conversion ratios

Enhances communications among caregivers through an integrated email system

Provides customers with the ability to guide and enforce clinical, regulatory, and pay-for-performance/payer rules

User defined graphical image that reflect real time outcomes and key performance indicators

TIER® provides a fully loaded searchable knowledge table-library of goals, objectives, and interventions. Users may choose to use our Treatment Plan drop down menus or the customer-modifiable templates to rapidly develop individualized treatment plans

Progress notes are seamlessly connected to charge slips which comply with CMS requirements.

The ability to complete both Point of Service Scanning and Batch scanning so all staff have up to date information which includes all patient documentation

Tools shipped with the system assure all data required to be captured in staff workflows is recorded at the right time

Business, Human Resources and Environmental Management functionality for organization-wide management and reporting

First Behavioral Healthcare vendor to successfully submit the Continuity of Care Document (CCD)

First Behavioral Healthcare vendor to have a RHIO application up and running. The Sequest RHIO Interchange provides services for the Rochester RHIO which shares a range of information including the Continuity of Care Document (CCD), Lab results and Radiology results to twenty agencies

This functionality delivers an efficient and effective, integrated workflow throughout your organization, for all staff. This will further the financial strength of the organization and also give the organization the flexibility to continue as industry leaders in behavioral healthcare systems development.


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Who is Sequest?

We are Sequest Technologies, Inc., a recognized leader in innovative solutions and software

products for the Health and Human services industry. Our expertise in streamlining financial,

clinical, and management processes greatly improves efficiencies and ultimately enhances patient

care. The people who make up Sequest have over 150 years of clinical experience and now

serve a broad sector that includes mental health and substance abuse clinics, psychiatric

hospitals, and social services organizations.

Sequest is highly respected by both CEOs and

practitioners alike. We have over 25 years in

the industry and we are renowned for our

innovative solutions and our customer-centric

approach. Our long and successful relationships

provide us with valuable and expert insight into

the ever-changing needs of the industry. At

Sequest, we develop more than just Electronic

Health Record Systems, we develop

partnerships. This core focus on providing value

to our partners is embedded in our company

DNA and has long been the reason people

continue to choose Sequest.

Our Vision is to become the

premier software and services

Solutions Company for the

health and human services

industry. We will establish

unmatched industry standards

of excellence that will advance

the clinical and related services

offered by our customers.


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The TIER® Solution

Total integration: that’s what makes electronic record keeping so valuable. The ability to

streamline workflow, eliminate cumbersome paper records, and track data with ease and

flexibility – that’s what you want.

TIER® – the Totally Integrated Electronic Record – was created to be exactly what the name

implies. The TIER® Solution is a set of seamlessly integrated software modules that allow you to

consolidate all of your organization’s record keeping in a single, accessible information system.

Our sophisticated design tool empowers you to customize the application and create new

software tools so that TIER® adapts to your organization’s workflow across the entire

continuum of care.

The clinical workflow in TIER® was designed by clinicians, and as the flagship product of a

company whose leaders have over 150 years of combined experience in the health and human

services industry, TIER® is much more than just a piece of software, it’s a partnership. Sequest is

focused on helping healthcare providers elevate patient care, while at the same time reducing

the cost of services.

What we want TIER® to become

for your organization is a tailor

made electronic record, allowing

you to meet certification

requirements, maximize efficiency,

and ultimately improve the quality

and efficacy of care delivery.

We know choosing an EMR can be

difficult, but using one shouldn’t be. To give you a better idea of how TIER® can work for you,

we’ve created a workflow narrative full of examples of how you might use the system. Of

course, the workflow at your organization might be a little different, but that’s the beauty of

TIER®: it was designed to adapt to your organization, rather than the other way around.

‘You’re only limited by your own imagination and

your own willingness level to climb outside the box.’

Dave Gerick. Vice-President, Quality & Information Systems.

Father Martin’s Ashley


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Getting you on top of your day

The first thing you’ll see when you log into TIER® is your personal TMail page. TMail is an

electronic messaging system that lives within TIER® and allows users to send confidential

material while maintaining HIPAA compliance. Correspondence stays within TIER®, so there’s

no danger of leaking Personal Health Information.

Living alongside TMail is the DocWatch, TIER®’s adaptable personal alert system. A

DocWatch can be set up for any time sensitive material – for example, an expiring Treatment

Plan or Provider Credential – and the system will generate a proactive warning on the TMail

page. When you open the warning message, you will be provided with a link to the location in

the software from which the warning was generated. Say TIER® sends you a DocWatch alert

that says you have to sign a Progress Note. You click on the link, sign your note and save it, and

you’re done. No more

fluorescent sticky notes.

DocWatch alerts can be applied

to any field within the TIER®

system. Use it to stay on top of

compliance mandates, ensure

evidence-based practices are

implemented, track

authorizations, notify staff that

they have been assigned new

clients, monitor risk factors, alert

users that reports are ready, and

much more.

The best part about DocWatch is

that it’s persistent. The warning

will continue to generate until the

task has been completed or the

business rule fulfilled. If the issue isn’t resolved after a specified period of time, the system can

notify a supervisor, or even that supervisor’s supervisor. By taking advantage of hierarchical

accountability, DocWatch can keep important tasks from slipping through the cracks.

Keep in mind, these proactive alerts are system generated. No one has to make a phone call or

send an email. With TMail and DocWatch, you’ll be able to get on top of your day before you

finish your first cup of coffee.

A DocWatch Alert Message


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Inquiry and Intake with less stress

Calls centers gather invaluable client data, but with paper record keeping, and even with some

EMRs, redundant data entry and duplicate records are a common occurrence.

The TIER® Inquiry Module is designed to simplify the work of a call center with easy client and

potential client search functionality and single point data entry. The search screen drives the

inquiry process, allowing the user to search for records by first and last name, social security

number, and date of birth. When a contact is recorded, any data captured only has to be

entered once and the system will then auto-populate that data wherever pertinent.

These screens allow the user to capture incoming and outgoing referrals, identification

information, contacts, demographic information, presenting problem, insurance, treatment

certification, medications, as well as offering a variety of pre-admission assessments. And

because of the product’s integrated structure, all of the documentation done from this part of

the software has functional implications elsewhere. Presenting problems and intake notes can

be set up to link to future treatment plans or referrals. Insurance information will be transferred

to the billing module and, on the clinical side, will be used against authorizations to help

determine the services for which a client has been approved. If a client is deemed a suicide or

homicide risk the system automatically generates a risk assessment and, based on the outcome

of that assessment, alerts can be generated to the appropriate staff. TIER® handles the tasks of

Medication Reconciliation right from the point of inquiry. Current medication information

collected on the inquiry and intake screens is used against any future medication administration

to ensure proper reconciliation. For returning clients, the electronic record is automatically

carried over into new admissions and can be easily updated to reflect any changes.

All of this functionality is adaptable to your organization’s existing workflow. Fields can be added

or changed, assessments revised, and screens rearranged to ensure that the TIER® Inquiry

Module captures exactly the information you need with the greatest possible economy and

accuracy. For organizations like Marworth of Waverly, PA – one of the leading substance abuse

treatment centers in the United States – TIER® has cut admission time in half.1

1 Based on a 2008 Marworth impact study.


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When the decision is made to admit a new client, the next piece of software you are likely to

encounter is the TIER® Scheduler. The Scheduler gives you the ability to manage staff, clients,

group treatment, resources, facility space, and equipment from a single location with various

schedule

views. From

here you can

look up

provider

availability,

find a

provider that

meets specific

client needs,

and set up

appointments.

To schedule a

client

appointment

simply search

for the

appropriate

staff – the

Scheduler’s search functionality allows you to search based on varying criteria, like credential

type, availability, location, and you can create customized teams to easily locate staff with

specializations. Appointment type, needed resources, location, and meeting recurrence can all

be established from the same screen. Once the schedule item has been saved, it will appear on

the unique schedule of any individuals to which that item pertains. In the case of particularly

important schedule items, the DocWatch can generate alerts.

Scheduler Month View


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Care Delivery

Once an initial appointment has been scheduled for a new client, you need to be able to track

care delivery and be assured that the right information pertaining to a client record gets to the

right people. TIER® captures every aspect of client contact electronically, from Assessments, to

Treatment Planning, to Services and

Progress Notes, to Medication

Administration, to discharge and post-

discharge follow-up, all of which is captured

in TIER®’s Service Delivery Module.

The Service Delivery Module was

developed out of Sequest’s extensive

experience in quality planning and program consultation to several hundred organizations across

the U.S. The model is also based on the following philosophical principles:

Treatment services should address the priorities and needs of individuals served. Services should be provided within the least restrictive treatment setting. Services should be completed within appropriate time frames. Clinical record documentation should closely reflect program design and service delivery

processes.

As part of this module, TIER®

comes loaded with two distinct

sets of Assessments, Base Line

Assessments and Special

Assessments. The Base Line

Assessments are like building

blocks from which your

organization can construct

more robust, custom

assessments. They can be

combined, rearranged, or the

fields can be completely

changed. TIER®’s Special

Assessments were designed

based on years of successfully

‘From the perspective of clinical records, we’ve

absolutely gotten the total value we’d hoped for.’

Harriet Hall, Jefferson Center for Mental Health

President and CEO

Behavioral Health Screening


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adhering to Joint Commission accreditation standards. Alternately, any third-party assessments,

whether eminent domain or purchased, can be imported into TIER®.

When a Diagnosis is made, TIER® records DSM IV-TR for all five axes. Any medication or lab

orders are handled electronically – TIER® has full HL7 compatibility – and with the addition of

signature pads the need for paper documentation can be eliminated from the order process.

TIER® has partnered with Dr. First, a recognized leader in the industry of e-prescribing, to

further reduce dependency on paper, increase savings, and provide access to sophisticated

electronic medication databases complete with information pertaining to allergies and drug

interactions.

If, as in our earlier example, a client is determined a suicide risk during pre-admission

assessments, the software could be adapted to automatically execute several proactive steps

following an emergency screening. The DocWatch could generate, in addition to the suicide

risk alert, a Doctor alert stating that a new client is ready for emergency hospitalization that

requires his/her signing off. The Presenting Problem recorded on the assessment can be

selected to carry over to the Initial Treatment Plan, so that when, as a next step, an Initial

Treatment Plan is created, the data is accessible from the Treatment Plan screen – the user

doesn’t have to return to the assessment to gather the data manually. The interaction between

the Assessments, Treatment Planning, and beyond allows you to trace the client’s progress from

the initial care to the point of after care.

Treatment Planning in TIER® is comprehensive, but easily managed. The philosophy behind the

TIER® approach to

Treatment Planning is

based on the work of Dr.

Benjamin Bloom and relies

on instructional objectives

and goals, which are tied to

specific problems. The

TIER® Treatment Plan

supports JCAHO and other

accreditation organization

requirements. It contains

the ability to create

unlimited problems, goals,

and objectives. Within the

highly customizable drop

down menus any item can

be appended or revised directly from the Treatment Plan without the need to navigate to a

A Treatment Plan Outline


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separate editing screen. An updated plan can be created via a simple cloning process, which

allows the user to make necessary changes while creating an archival record of the original plan.

You can choose from standard drop downs or create individualized ones, thus preventing

“cookie cutter” treatment plans.

After the point of intake and assessment, an initial short term plan can be established quickly and

easily using the linkages established during the intake assessments, including presenting

problems, diagnosis, and notes. Rather than creating Treatment Plans from additional steps,

they are developed directly out of care, from data identified during assessments.

This Initial Treatment Plan will allow your organization to establish and administer care, while a

Master Treatment Plan is developed. The Master Treatment Plan takes advantage of the same

linkages as the Initial Treatment Plan, with additional linkages being added as the clinical record

grows, so once again data entry is minimized and integration assures that client data is consistent

and accurate.

The documentation

of patient

encounters is

captured in a variety

of customizable

notes which record

service information

and, when

appropriate,

automatically

generate charge

slips. We adapt our

stock notes to your

needs; whether

your formats follow

SOAP or DAP

standards, our

individual, group, and other notes seamlessly initialize with problems and goals from treatment

plans. This ensures integration and compliance to treatment objectives. Included are Individual

Progress Notes, Group Notes, Activity Notes, Patient Education Notes, and General Free Form

Notes, all of which are adaptable to your organization’s specific documentation needs. Group

Notes present a particular advantage because they can be created for each group member from

a single screen, with a single point of data entry for the group portion of the note. Individual

note portions are then easily added by highlighting group members from a group list.

A Medication Administration Record (MAR)


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TIER® Physician and Nursing flows were designed by our clients. Our process friendly screens

allow medical staff to document medications, establish protocols, and take vitals as well as order,

verify, and administer medications. TIER®’s Computerized Physician Order Entry (CPOE) and

Medication Administration Record (MAR) have been successfully and safely managing

medications for over 10 years. Nurse Administration functionality allows nursing staff to

document medications and vitals which populate the Medication Administration Record (MAR).

The MAR further supports reconciliation with patient photographs, allergies or special needs,

most recent vital signs, and medication tracking which automatically records overlooked

medications.

Medication administration can be further enhanced with TIER® eRx, our new electronic

prescribing tool. TIER® eRx is a web based application that opens from within the client record

and allows you to enter prescriptions, track them, and send them to pharmacies. Data is

exchanged between TIER® eRx and the TIER® application automatically. That means TIER® eRx

will warn you if

you try to

prescribe that

medication to

which a client

has a known

allergy, and any

prescriptions you

do make will

populate the

client’s MAR.

You also benefit

from a vast drug

interaction

database.

TIER® was

designed by clinicians for clinicians. We understand the need for data collection to adhere to

organizational and discipline standards. We provide Help functionality within our software from

Guideline buttons. Guidelines and on-screen Help support staff are to complete documentation

accurately as well as support data collection consistency. Our Guideline buttons on the

Behavioral Health Screening define attributes of dangerous behavior-thus all staff utilize the same

view of such observation. In addition TIER® offers access to the CLIMATE clinical help system.

CLIMATE is published by the Clinical Research Unit for Anxiety Disorders and presented in the

form of clinical algorithms. CLIMATE can aid you in making care delivery decisions by delivering

assessment strategies, diagnostic supports, and clinical management guidelines.

TIER® eRx


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The Face Sheet

One of the tremendous advantages of an EMR is the ability to collect and store a huge amount of

data for each client. This valuable TIER® data will determine how treatment is tailored, allow

your organization to assess quality of care, insure that clients receive the right medication at the

right dosage levels, and

illustrate the client’s

progress throughout the

term of admission and long

after in your TIER®

outcome reporting.

In TIER® each client’s

comprehensive electronic

record is managed from a

single screen, modeled

after a face sheet. From

the Face Sheet, all client

documentation is accessible

from an on screen menu

that functions like folder

tabs, each menu item

representing the consolidation of related information, like Diagnosis, Treatment Plans, Services,

Assessments, Identifying Information, Billing and Insurance, and more. Clicking a menu item will

open up all records that would be stored under the corresponding tab in a paper system. In

fact, every aspect of client documentation is accessible within a few mouse clicks from this

screen.

TIER® can even capture paper documentation and make it accessible from the client record.

Our partnership with CAPSYS, a browser-based application that allows you to capture

documents from any location and import them into TIER®, enables you to collect any volume of

scanned documentation, sort it, and attach it to the proper client record.

A Client ‘Face Sheet’


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TIER® ePortal

The electronic age has allowed us to pass information with speed and ease we never could have

dreamed of before. In the behavioral health sciences industry, patient records can be sent back

and forth between providers, claims sent instantly to payor sources, and prescription

information can be securely transferred to pharmacies. Oh, and by the way, TIER® happens to

excel at all these things.

But what about the clients? The client record belongs to the client, so shouldn’t clients be able

to ride the electronic wave and access their own records? With Meaningful Use regulations

being implemented in 2011, not only should clients have electronic access to their health

records, they must.

TIER® ePortal allows your organization to provide clients electronic access to their personal

health information over the web. Clients can examine their records for accuracy, review their

medications, and access other areas of their health record from an easily navigable menu. The

Message Center gives clients the ability

to send and receive correspondence to

their providers over a secure email,

request a prescription renewal, and

even contact customer service. Clients

can also schedule an appointment,

cancel an appointment, and view their

appointment schedules and visit

summaries in the ePortal.

TIER® ePortal


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Consoles

As advantageous as a comprehensive clinical record can be, if your job only requires you to

access certain parts of the client record, navigating through the entire chart can be cumbersome.

Wouldn’t it be convenient if you had a way to take the parts of the clinical record that your job

requires you to regularly access and put them in one place?

TIER® Consoles were designed to do exactly that.

The TIER® Consoles consolidate all of your work on a single screen. Consoles for Clinical,

Nursing, and Physician staff allow the user to point to the name of a client, then the work to be

performed, enter and save data and continue working without having to open the full client

record. For example, if a

clinician opens TIER® to

enter progress notes, he

or she doesn’t have to

navigate to each

individual’s client record,

enter the note, and then

navigate to the next

record. Instead, client

names and actions are

available on the Console.

The note can be entered

and saved on the

Console screen.

Consoles reduce

navigation through the

software to a bare

minimum but don’t

restrict access to the client record. Linkages within the Console allow the user to drill down to

specific areas of the record, or return to the face sheet. The ability to access all of your clients

and add documentation to their records from a single screen drastically reduces documentation

time – one screen for all your daily tasks, personalized to meet financial, medical, clinical, or

managerial duties.

Entering a Group Note from the Clinician Console


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Reporting

Reporting used to be like pulling teeth. In paper systems, tracking down all the requisite

paperwork and manually creating reports

was almost prohibitively time consuming.

Early EMRs were a marked improvement,

but you still had to wait for scheduled

report runs, print paper reports, and if you

needed a new report you had to go to the

vendor and have them create it for you,

usually for a cost.

TIER® is designed to capture and

consolidate a tremendous amount of data,

but that data is only useful to you if you

can see it. So TIER® Reporting tools were

designed to give you virtually unrestricted

access to your database, on the screen and

in real-time, so you can make decisions

based on the most current data available.

There are a number of canned reports in

TIER®, all of which are customizable and

can be exported to third party applications

like Microsoft® Excel™, and if you need to

print them out you can do that too.

In addition to our canned reports, TIER®

provides full ad hoc reporting capabilities using the TIER® Report Builder, which works like a

wizard for creating new report templates. With the Report Builder, you can create a report to

your own specifications and create access to that report from any part of the system. Custom

reports can also be created using Crystal Reports® and SQL® Reports, so you can create any

reports you want, any time you want.

TIER® also has the capacity to produce Drilldowns, providing you with real-time summarizations

of program performance on the screen. This functionality allows you to make decisions without

having to wait for end of the month reports. The content of Drilldowns can be adjusted by

dragging and dropping identifiers into a content organization feature, thereby adjusting report

parameters on the fly.

An Admission Summary Report


Page 18 of 26

The TIER® Decision Cube provides management with a powerful but user friendly analytics tool

for viewing client and

staff data. Variables

can be filtered on the

fly to produce

graphical reports in

real-time, all on one

screen. The concept

behind the Decision

Cube, as with other

TIER® Reporting tools,

is to expedite decision

making by providing

access to real-time

data and to eliminate

dependence on

unnecessary paper

reporting, thereby

reducing HIPAA

violations.

The Decision Cube


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Billing

All across the continuum of care, TIER® is collecting the data necessary for billing to function.

Basic client data, demographic information, and insurance and other payment sources are

captured during Inquiry and Intake. When the clinicians enter their progress notes and

corresponding service data, charge slips are automatically generated, which ensures that billed

services are properly documented.

The TIER® Billing Module does

the work of collecting all this

information and offers a powerful

and efficient way to document

chargeable events and transactions,

including adaptable reporting

functionality.

The charge slip automatically initializes requisite data, such as the insurance payer, payer plan,

and prior authorizations. It monitors utilization and calculates the remaining number of

authorized services. If authorizations or benefits are expiring, the DocWatch will notify the

appropriate staff, thereby preempting any future billing issues. The system will even

automatically compare standard agency charges to contract rates and establish contractual

adjustments.

Waterfall billing allows you to assign payer ranking so that the Billing Module can automatically

assign charges based on those rankings. The system can accomodate an unlimited amount of

payer sources. As remittances are received, any remaining charges are applied to the next

sequential payer source, and so on down the payer rankings until the charge is satisfied.

The Billing Module documents transactions from the

point of Initial Charge – created when a Charge Slip is generated from a Progress Note – to

Request for Payment, Payment, Adjustments, and Write-offs. This documentation can be

viewed in a series of robust reports, including:

Aging reports Client deposit log Closing report

Transaction logs Client deposit allocation report Client balances

Batch billing reports Client audit report Cash control log

Pending rebilling report Void / reissue log Case aging report

Transaction register Non signed charge slips

‘We have very much enjoyed our partnership with Sequest.

We wonder how we ever operated without TIER®.’

Howard Spanbock, Luke-Dorf CEO


Page 20 of 26

These reports all allow for easy customization to your specific organizational needs. The Billing

Module also incorporates the system’s Drilldown feature which allows you to access real-time

financial data and graphical representations at the click of a button. You can instantly report on

things like payer mix, reimbursement by payer, census by unit, and any other combination of

variables, and easily

export both data

and graphics into

Microsoft Office

products.

Transaction activity

can also be viewed

from the

Accounting

Console. From a

single screen you

can search for a

client, select from a

list of charges that

can be sorted by

Charge ID, Date,

Service Code,

Description,

Amount, or Provider, and view any transactions pertaining to that charge as well as any clinical

documentation, therefore providing detailed financial information coupled with the clinical

information required to create a charge.

As mentioned in the previous section, there are several options for ad hoc reporting, and, of

course, all of the features vital to effective billing are part of the module, including Batch Billing

for claims submission, Automatic Rebilling, and Electronic Eligibility Verification. The module

provides a HIPAA certified EDI File 837 X12N for both Medicare and Medicaid and CMS 1500

and UB04 templates for Medicare, Medicaid, and Private Insurance.

Payment Allocation


Page 21 of 26

Beyond EMR

Security is paramount when it comes to Personal Health Information and electronic record

keeping. TIER® provides security on every level, from secure login and software access based on

user groups all the way down to field level security to make sure you maintain HIPAA

compliance and keep your records safe.

TIER® also contains a number of modules designed to help you get more out of your EMR.

TIER® Human Resources allows you to capture and track data related to staff, including

credentials, user rights, and checklists to verify the completion of the personnel management

process and related documentation requirements. The module also includes fully customizable

staff evaluations and an

employee performance

evaluation form.

Your organization can track

and document facilities with

the TIER® Environmental

Management Module. This

module is designed to facilitate

your ability to comply with the

JCAHO and CARF

accreditation requirements

and also to support

compliance with state

licensing requirements by

allowing you to track the

following resources:

Building profiles Space allocation Environmental inspections Maintenance orders Preventative maintenance Vehicle maintenance Documentation of drills Orientation and annual safety training Systems inspections and management Incident reporting

The Environmental Management Module


Page 22 of 26

TIER®’s Complete Quality Management (CQM) component is a comprehensive, dynamic

resource that automates your organization’s complete quality management system. CQM is

designed for medical and behavioral health organizations and consists of three core components:

Process Improvement - This component incorporates the principles of process improvement through the use of project teams using the structured approach of plan, do, check, act (PDCA) for quality improvement.

Performance Measurement - This quality management activity assists your organization in monitoring costs vs. benefits of processes on an ongoing basis. It allows you to continually monitor important aspects of your operations and create reports regarding findings.

Outcomes Measurement - This component is designed to allow you to collect and analyze outcome measurement data. Two essential outcome measurement activities are evaluation of service effectiveness and organization evaluation including completion of special studies and accreditation requirements.

TIER® provides you with the ability to plan and manage your business development activities

with the Business Development Module. From here you have ability to view real-time volume

statistics regarding referrals from your referral sources. Your business development staff have

the ability to create referral source service plans and record contact follow-up activities with

each of their clients. The Business Development Module is incorporated into the TIER®

database. This integration provides you with a powerful tool to manage referral development

activities, since all referral source information collected in the service delivery process is

integrated into the business development function.

You can also link the Business Development Module with TIER® CQM, making it possible to

produce outcomes reports specific to funding. The referral sources allow it to support evidence

based practice processes.


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Implementation

Nervous about the prospect of a large scale Implementation? We have a solution for that.®

History is full of IT projects that fail to meet the customer’s expectations, miss scheduled

deadlines, and exceed allocated budgets. These are rarely failures of technology, talent, or effort,

but are instead failures of management and leadership. But don’t panic. Instead, consider the

following questions:

What are we trying to achieve?

How are we going to achieve our goals? Who is going to do what? When are we going to be finished? What is our definition of success?

The essence of effective Project Management is to provide the answers to these questions. For

this reason, Sequest uses a disciplined, industry proven project management methodology

developed over years of successful experience.

Sequest will tailor the implementation processes and procedures as necessary to meet your

organization’s needs and augment those processes and procedures with a variety of software

development and implementation models for a comprehensive delivery framework. As

technology evolves, so do the frameworks – incorporating new methods and processes while

building upon previous success stories and lessons learned is a key to the success of our

methodology. The major stages of our implementation process, developed under this

philosophy, are as follows:

Project Planning

Project Planning provides the Agency-customized framework to specify detailed activities,

desired goals, and target dates relative to implementing an EMR solution and is founded on the

success of other installations. We base our project plans on a rigorous set of scheduling practices

determined by your organization’s goals, RFP requirements, and the deliverable timeline. At

Sequest, we recognize that project success is often determined by the effectiveness with which

we establish and govern this process.

Training

In order for TIER® to be used to its full potential, it is critical that users are able to understand

and accept the product. Comprehensive, hands-on training and a strong partnership between

your organization and Sequest is vital to accomplishing this. Over the course of training, TIER®

users will become self-sufficient as the knowledge of our training staff is transferred on.


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Integration

The success of an EMR solution depends on much more than the installation, configuration,

development, and testing of TIER®; it must be fully integrated into the complex business and

technology infrastructures of today’s health and human services organizations. Our integration

strategy includes the development of a detailed, tactical plan to seamlessly integrate TIER®

within your organization’s system of care and technical environment, including the critical

interfaces with Medicare and Medicaid to support the eligibility, claim, and financial reconciliation

process. We schedule our integration activities to commence early in the project to provide

sufficient time for the necessary inter-agency coordination and agreements and we place a

special emphasis on tracking and recording the status of these activities throughout the project.

Testing

Each testing activity is aligned in a logical progression, starting with joint development of an

effective test plan to support module tests, reporting tool tests, integration tests, and system

performance tests.

Data Conversion

Because data conversion is a high-risk endeavor, our proposed EMR data conversion strategy

leverages best practices and lessons learned from the nine-step approach.

Maintenance and Support

We see our commitment to your organization going beyond our demonstrated excellent

preventative and corrective maintenance. Sequest will continue to include a progressive release

strategy for TIER® combined with effective annual planning that anticipates and responds to

future healthcare and technology trends. We will leverage our experience and knowledge in the

industry to continue to provide exceptional service and a commitment to ongoing improvement.

Our implementation process is grounded in two core values – building and maintaining our

partnerships throughout and beyond the project lifecycle and applying appropriate and rigorous

management methods during “solution” refinement, project management, and implementation.

Our commitment to partnership goes hand-in-hand with our commitment to engagement

success. Our adherence to structured methodologies ensures that every project is conducted

within a proven framework that will minimize

risk, maximize benefits, and achieve the

greatest level of quality.

Strong partnerships produce stronger, better

adapted products, and we all benefit from

that.

‘This relationship is like a marriage, it requires

that level of commitment and care.’

Jim Dougherty, Vice President, Marworth


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TIER® Exchange

TIER® Exchange

The landscape of Health and Human Services is always shifting, and coping with changes in

industry practices, technology, and state and federal regulations can be overwhelming.

We have a solution for that.®

Once a month, Sequest hosts the TIER®

Exchange, a series of forums designed to

address the industry and how it’s

changing. The TIER® Exchange is a

chance for us to bring our knowledge and

insight to you – from CCHIT and

Meaningful Use to state specific topics

and much more – and the Exchange is

open to anyone.

We also host an annual national users’

conference in Illinois – the National TIER®

Exchange – in order to establish interaction between TIER® users from all over the country.

Our goal is to create a dialogue, not just between our Exchange presenters and the audience,

but between organizations, one that will continue beyond the Exchange.

CONTACT

Sequest

801 Warrenville Rd,

Suite 350

Lisle, IL 60532

877-630-TIER (8437)

[email protected]

www.sequest.net

mailto:[email protected]

http://www.sequest.net/

Economy & Finance

Tier Product And Services Overview