The RMM is a patented Risk Mitigation Module for integration with ED electronic medical record systems. TSG currently works with the largest EDIS vendors in the market and the RMM is deployed in over 200 U.S. Emergency Departments. The RMM contains over 20 different features, including critical data element highlights, clinical risk alerts, key information, vital sign intelligence functionality, Interactive Differential Diagnoses, Quick Consults, key clinical graphics, procedure and anatomy libraries, and evidence-based clinical decision support; all are immediately available at the point of care.

The RMM uses subtle visual highlights and access to information rather than pop-ups or hard stops in order to maximize risk and safety while minimizing practitioner interruptions. The RMM facilitates rapid diagnosis of high-risk medical conditions and assists the practitioner to create a defensible medical record.

The RMM 2.0 may be licensed directly from both Picis and MEDHOST, leading providers of electronic medical record solutions.

TSG provides vetted content for 100 physician electronic documentation templates covering both adult and pediatrics, with highlighted Risk, Safety and Quality content.

The RSQ™ CDS provides key risk, safety and quality content for physician and nursing templates, including scenarios typically overlooked by other template documentation systems.

Also provided is the logic to activate risk alerts in response to physician and nurse data input that suggests the presence of a high-risk clinical condition. No hard stops, no alert fatigue, does not write to the record.

Interactive access to the RSQ™ Knowledge Base is intelligently built into the mental workflow throughout the templates. This provides practitioners with immediate access to key clinical information that supports medical decision-making, including:

Risk Notifications - Clinical content explaining the potential risk. By voluntarily clicking on the Risk Alert, the practitioner is notified of the possibility of a certain high-risk medical condition.

Interactive Differential Diagnoses - Access to a complaint-specific differential diagnosis with immediate click-through to over 125 Quick Consults. Usually placed at the top of the HPI and PE to support the medical decision-making process.

Quick Consults - Brief, need-to-know information on over 125 clinical entities, including key history, key physical exam, graphics, clinical risk and safety pearls, etc.

RSQ™ Resources - An accumulation of key clinical information relating to the chief complaint. Resource links are usually placed at the top of every HPI and PE.

High-Quality Images depicting normal and abnormal anatomy, medical procedures and elements of the physical evaluation. A virtual textbook of clinical decision support.

Tables, charts, disease classifications and other clinical resources.

Medical Calculators and risk stratification tools integrated into the physician documentation provide practitioners with risk alerts and access to the RSQ™ Knowledge Base.

Specifications for a series of alerts, some passive, some active, that bring significant abnormalities to the ED team's awareness. TSG specifications include how the data should be presented, thresholds for alerts, algorithms for identifying trending issues, tables for looking up appropriate tracking between vital signs, location in the work flow where the alerts should occur, opportunities for providing flexibility, and client control over the notification process.

Clinical Rules creates a notification whenever a high-risk issue exists for a patient, helps identify best practices, and helps reduce the incidence of the most common medical errors.

A set of physician documentation paper templates to be used when the electronic system is unavailable (e.g., down for maintenance, outage, etc.) covering both trauma and medicine for adults and pediatrics.

An efficient set of vetted Order Set Content for adults and pediatrics with Evidence-Based Links to a useful summary of the latest clinical evidence.

TSG™ Modules may be integrated into any EMR. The Sullivan Group will work with you to integrate desired RSQ™ Modules into your EMR and customize the solutions as necessary.

Guidance so effective, it's patented.

EM practitioners don't have time to consult textbooks, notebooks or computers; when a patient presents to the ED, every second and every decision is crucial. That's why TSG has created a decision support system so instantaneous, so intuitive, and so effective that it has been awarded its own patent.

Decision Support where and when you need it.

Can you name and locate every tendon in the hand? Recall every probability formula for deep vein thrombosis or pulmonary embolism? Remember to test for a commonly overlooked variable that can mean the difference between a feverish infant's full recovery and a lifelong disability? If you can't answer any of these immediately, you're in good company. Few, if any, practitioners can.

Instead of missing critical elements, the Risk Mitigation Module (RMM) assists you through situations encountered in EDs every day. Years of research into the deficiencies in clinical practice have identified myriad causes of medical errors, missed diagnoses, patient injury and medical malpractice lawsuits. TSG's template system helps you stay a step ahead of medical malpractice, each and every time you use it. Best of all, the prompts are simple to use and never interrupt your care - there are no mandatory pop-ups to address, no hard stops, nothing but intuitive guidance when you need it.

So easy to use, you'll forget it's there-until it prevents a mistake.

How does it work? Let's look at an example.

A teenage boy presents to the ED with a swollen and painful scrotum. The triage nurse considers the case to be a low priority, but consults the RMM to avoid a possible missed diagnosis.

The RMM flags "Testicular Pain" as high risk, and recommends that the patient be seen by the emergency physician immediately.

The physician in turn is also prompted by the RMM, notifying him to the presence of this high-risk patient and the need to examine him for possible testicular torsion.

Rapid diagnosis and treatment prevent necrosis of the affected testicle, protecting not only the patient, but also the attending ED team from medical error and the hospital from possible litigation. It took the nurse and physician only seconds to consult the prompts, but the benefits will last a lifetime.

For another example, let's look at a patient suffering from a dissecting aorta that walks in the ED complaining of chest pain. Although chest pain signals a high-risk patient, it is not uncommon for a dissection to be misdiagnosed as coronary artery disease and result in both the demise of the patient and expensive litigation for everyone involved.

Appropriate use of risk factor analysis may give the practitioner an opportunity to make a diagnosis for this threatening condition. However, evidence from several large studies shows that practitioners are routinely deficient on risk factor analysis.

Why? Because without a tool to assist them, physicians simply cannot consistently remember all of the risk factors associated with high-risk conditions like thoracic aortic dissection.

The RMM provides the risk factors for such high-risk conditions to eliminate the need for the provider to rely on memory, and with a passive prompt, encourages the physician to complete and document this element of the history taking.

Elsewhere in the system, the RMM provides addition opportunities to help make a diagnosis. Documentation of "Movement of Pain" from the chest to the abdomen results in an alert to the practitioner of a potential dissection; there are also convenient links into the RSQ™ Knowledge Base that provide the physician with access to additional decision support resources such as pathophysiology, key elements of the physical exam, TAD classifications, and treatment guidelines.

The examples of these two patient encounters show that the RMM provides support for both the nurse and medical practitioner and improves communication between them, promoting a team approach that results in rapid diagnosis, appropriate treatment, and the highest quality emergency medical care.