MOANA Electronic Health Record (EHR)
Complete User & Technical Operations Manual • Version 2.0
Welcome to the comprehensive user manual for MOANA EHR—a multi-role, offline-first Electronic Health Record and Hospital Information System (HIS).
MOANA connects all clinical, administrative, diagnostic, pharmaceutical, and financial operations around a single, longitudinal patient record. Rather than maintaining disjointed departmental silos, MOANA links patient registration, outpatient triage, doctor consultations, computerized order entry (CPOE), laboratory analyzers (LIS), radiology PACS imaging, clinical pharmacy dispensing, inpatient ward command centers, nursing eMAR, surgical operating theatres, morgue management, and financial billing into one continuous, auditable, and resilient ecosystem.
Architectural & Clinical Principles
- One Patient, One Longitudinal Record: Every patient is identified across the Master Patient Index (MPI) with a single lifetime medical record number (Moana ID), preventing dangerous fragmented records.
- Connected Departmental Handoffs: Clinical documentation recorded in one unit (e.g., emergency triage) flows immediately to consulting physicians, laboratory technicians, pharmacists, and ward nurses.
- Offline-First Resilience: Operating with dual local storage caches (Scoped LocalStorage and IndexedDB / Dexie), workstations continue full clinical operations during network blackouts and automatically synchronize when connectivity returns.
- Role-Isolated Multi-Dashboard Architecture: Clinical, pharmaceutical, diagnostic, and administrative workflows run inside dedicated desktop dashboard applications with strict Two-Level Role-Based Access Control (RBAC).
- Immutable Security & Audit Trail: Every patient chart access, clinical order, breakglass override, medication administration, and financial transaction is permanently recorded in the system audit log.
System Architecture & Multi-Dashboard Suite
MOANA EHR is built on an offline-first desktop architecture designed for high reliability in hospital and clinic environments. Clinical staff log into a specialized dashboard tailored to their healthcare discipline:
graph LR
A[Staff Login] --> B[Role & Facility Verification]
B --> C[Specialized Clinical Dashboard]
C --> D[Local Offline Database]
C --> E[Central Hospital Server Sync]
Connected Moana Services & Architecture
| Moana Service | Technology & Function | Operational Status |
|---|---|---|
| Moana EHR (Core) | Patient administration, clinical documentation, orders, pharmacy, billing, reporting | ✓ Active / Operational |
| Moana-LIS | Dedicated Laboratory Information System — specimen tracking, result entry, critical value alerting | ✓ Active / Operational |
| Orthanc PACS | Medical imaging storage — DICOM images from X-ray, CT, Ultrasound | ✓ Active / Operational |
| OHIF Viewer | Browser-based DICOM image viewer integrated directly with the Radiology module | ✓ Active / Operational |
| HAPI FHIR Server | International healthcare data standards (HL7 FHIR R4) for all clinical and surveillance data exchange | ✓ Active / Operational |
| Moana Desktop | Windows/Mac desktop application used at hospital workstations with offline caching | ✓ Active / Operational |
Platform Capabilities & Operational Setup
| Platform Capability | Operational Status | Configuration & Hospital Rules |
|---|---|---|
| Patient Registration / MPI | ✓ Active | Aligned with National Health ID standards; probabilistic duplicate detection active. |
| Doctor Clinical Workflow | ✓ Active | ICD-10 diagnosis coding; 3-step SOAP clinical notes; computerized order entry (CPOE). |
| Nursing Operations | ✓ Active | Ward assignments; NEWS2 automated deterioration alerting; eMAR; ICU/NICU care paths. |
| Pharmacy & Medication Safety | ✓ Active | Hospital formulary loaded; drug-allergy checking; dual-witness controlled drug register. |
| Laboratory (Moana-LIS) | ✓ Active | LOINC-coded test catalog; critical value thresholds confirmed with clinical lead. |
| Radiology / PACS (Orthanc) | ✓ Active | DICOM C-STORE configured for hospital imaging equipment; structured report editor. |
| Inpatient & Bed Management | ✓ Active | Ward structures; visual bed registry; ward-to-ward transfer lockouts. |
| Billing & Finance | ✓ Active | Hospital fee schedule loaded; automatic bed & pharmacy charges; manual lab/procedure capture. |
| Reporting & Analytics | ✓ Active | Clinical, operational, and Ministry of Health (MOH) executive dashboards configured. |
| Role-Based Access Control | ✓ Active | Named individual accounts provisioned; department-level scoping active. |
| Audit & Compliance | ✓ Active | Immutable security audit trail; every action permanently logged with timestamps. |
| Offline / Low-Connectivity | ✓ Active | Offline queue and local synchronization configured for resilient 24/7 hospital operations. |
What This Manual Covers
This user manual is structured into 13 comprehensive sections:
- Getting Started — System access, facility context, roles, offline resilience, and implementation gates.
- Patient Management — Master Patient Index (MPI), biometrics, registration, and OPD/ED triage.
- Clinical Care — Doctor consultation, SOAP charting, ICD-10 coding, CPOE orders, and patient safety.
- Admissions & Beds — Live Bed Command Center, ward allocations, transfers, and operating theatres.
- Nursing — Ward census, eMAR medication administration (Given/Held/Missed), batch vitals, and handovers.
- Laboratory — LIS worklist, specimen barcoding, analyzer runs, QC Levey-Jennings, and blood banking.
- Pharmacy — Clinical review, barcode dispensing, dual-witness controlled drugs, and stock inventory.
- Radiology — Worklists, modality slots, DICOM PACS review, and structured radiological reporting.
- Billing — Encounter folio consolidation, insurance claims, advance deposits, credit notes, and receipts.
- Staff Management — Staff profiles, credentials, shift directories, and clinical task delegation.
- Morgue — Deceased registration, automatic bed release, refrigerated bay allocation, and body release.
- Reports — Operational dashboards, clinical analytics, and Ministry of Health public health surveillance.
- Administration — Hospital vs. Clinic mode gating, department configuration, RBAC, and audit logs.
How to Navigate This Documentation
- Sidebar Navigation: Expand categories on the left to navigate directly to any hospital department or workflow.
- Search: Press
Ctrl + K(Windows) orCmd + K(Mac) or click the search bar to locate specific forms, buttons, or error codes. - Visual Workflows: Step-by-step instructions clearly delineate user roles, inputs, buttons, and expected outcomes.
- Admonitions & Safety Callouts: Pay close attention to visual alert containers:
Information boxes provide practical operational advice, configuration tips, and clinical context.
Warning boxes denote mandatory patient safety rules, drug contraindication hard-stops, or transfer lockouts.
Important boxes document prerequisite roles, required permissions, or dual-signature requirements.
Expected Results define the successful end-state and departmental data handoff of a completed task.