Anatomy of a Care Plan

2015 User Conference
Care Plan Customization
User Conference 2015
Presented by:
Rena Lefkowitz PA-C
Director of Training
EHR Session
End Goal:
Utilize the existing Triggers and Actions
delivered with OP to modify and create new Care
Plans.
2015 Office Practicum User Conference
Objectives
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Add Triggers and Actions to Care Plans
Utilize Cloning Feature
Define Recall Schedules for Care Plan Items
Create New Care Plans
Import/Export Care Plans
2015 Office Practicum User Conference
Where do Care Plans Live?
Utilities→ Manage Clinical Features→ Care Plans
2015 Office Practicum User Conference
Anatomy of a Care Plan:
Definition
Triggers
Actions
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Anatomy of a Care Plan: Definition
Activated?
Auto Enroll?
Who Can View?
Who Can Enroll?
Source?
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Anatomy of a Care Plan: Triggers
Who will be included?
Based On:
Age
Gender
Insurance
Problem List
Lab Value
Vitals
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Anatomy of a Care Plan: Actions
What Should be Done?
Labs?
Vitals?
Type of Visit?
Referral?
Survey?
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Anatomy of a Care Plan: Actions
Triggers + Actions = Care Plan
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Hands On #1
Create a New Action and add
to an Existing Care Plan
We would like to add the TB Risk Assessment Survey to
our Bright Futures Care Plan. The recall for this will be
annually.
Objectives
Hands On #1
Define the Triggers_________
Same as Bright Futures
Define the Action__________
TB Survey
Define the Recall Schedule______
ObjectivesEvery 12 months
Hands On #1: Add a Survey to BF
Utilities→ Manage Clinical Features→ Care Plans→ Care Plan Items
Step 1: Create TB Survey Care Plan Item
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Click on
Enter:
▪ Item Name = TB Survey
▪ Item Type = Survey
▪ Check “Is Action”
▪ Default Interval = 12
▪ Action SQL= like’%Tub%’
2015 Office Practicum User Conference
Hands On #1: Add a Survey to BF
Now that we have created the TB Survey Care Plan
Item, we can add it to the Bright Futures Care Plan:
Step 2: Add Action
▪ Select Care Plans Tab
▪ Highlight Bright Futures Care Plan
▪ Add to Actions:
▪ Click in Item Name
▪ Select TB Survey from Dropdown List
▪ Select Action Type as “Add”
▪ Save with Green Checkmark
2015 Office Practicum User Conference
Hands On #1: Add a Survey to BF
2015 Office Practicum User Conference
Hands On #1: Add a Survey to BF
Check
it out...
Open a Chart go to the Care Plan Tab and
look for your TB Survey.
Is it there?
Does it say Due?
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Cloning
Cloning is a powerful tool:
▪ You can clone:
▪ Care Plan Items
▪ Care Plans
▪Create new items without worrying about
the format.
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Hands On #2
Create a New Care Plan by Cloning an
Existing Action
We would like to create a Care Plan to follow our patients
whose Lead Levels are between 5 and 10 or have a
Problem List entry of Elevated Lead Level.
For these patients we would like to do a lead level every
3 months.
Objectives
Hands On #2
Define the Triggers_________
Lead Level between 5 AND 10
OR
Problem List SNOMED = '407151008'
Define the Action__________
Lead level
Define the Recall Schedule______
Objectives
Every 3 months
Hands On #2
Utilities→ Manage Clinical Features→ Care Plans→ Care
Plan Items
Step 1: Add new Care Plan Item for lead every 3 months:
▪ Care Plan Items Tab
▪ Highlight Lead
▪ Click Clone button:
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Hands On #2
A new line item for Lead will appear:
Step 2: Define Recall Schedule
▪ Rename to Lead q 3 months
▪ Uncheck “is Trigger”
▪ Change recall to:
▪ Begin Age: 0
▪ Interval 3 months
▪ Recall as per interval
2015 Office Practicum User Conference
Hands On #2
Now that we have created the Lead every 3 months Care
Plan Item, we can create a new Care Plan.
Step 3: Create New Care Plan
▪ Select Care Plans Tab
▪ Click
in lower left hand corner
▪ Enter name of new Care Plan: Elevated Lead
▪ Complete items in Definition section:
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Purpose
Auto Enroll = Yes
Active as of = Today
Contrary days = 30
View Privacy = Any Staff Member
Source Information
Save with Green Checkmark
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Hands On #2
Completed Definition Section:
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Hands On #2
Step 4: Add Triggers:
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Hands On #2
Step 5: Add Action:
▪ Add Lead q 3 months
▪ Suppress Routine Lead Screening
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Hands On #2:
Check
it out...
Open a Chart for a child who has an
elevated lead.
Does it show the Lead q 3 months?
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Hands On #3
Create a New Care Plan by Cloning an
Existing Care Plan
For our patients enrolled in Medicaid, in addition to the
items routinely recommended by Bright Futures, we
would like to add Fluoride Varnish to be applied every 6
months between the ages of 6 and 36 months.
Objectives
Hands On #3
Define the Triggers_________
Medicaid Insurance
Define the Action__________
Fluoride Varnish
Define the Recall Schedule______
ObjectivesBegin Age = 6 months
Interval = 6 months
Recurrence Rule = As per Interval
Begin Age = 36 months
Recurrence Rule = Suppress Display
Hands On #3:
Utilities→ Manage Clinical Features→ Care Plans→ Care Plan Items
Step 1: Add Fluoride Varnish
▪ Click on
▪ Enter:
▪ Item Name = Fluoride Varnish
▪ Item Type = Procedure by LOINC
▪ Check “Is Action”
▪ Default Interval = leave blank
▪ Action SQL= like'%FLOURVA%'
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Hands On #3:
Step 2: Add Recall Schedule for Fluoride Varnish
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Highlight Fluoride Varnish
▪ Begin Age = 6 months
▪ Interval = 6 months
▪ Recurrence Rule = As per interval
▪ Begin Age = 36 months
▪ Interval = 6 months
▪ Recurrence Rule = Suppress Display
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Hands On #3
Now that we have created the Fluoride Varnish Care
Plan Item, we create our new Care Plan by Cloning the
Bright Futures Care Plan.
Step 3: Clone BF Care Plan
▪ Select Care Plans Tab
▪ Highlight Bright Futures
▪ Click on the Clone
2015 Office Practicum User Conference
Hands On #3
We now have a new Care Plan named:
Copy of Bright Futures with the same Triggers and
Actions.
Step 4:
▪ Rename Care Plan to Bright Futures
Preventive_MCD
▪ Complete items in Definition section:
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Purpose
Auto Enroll = Yes
Active as of = Today
Contrary days = 30
View Privacy = Any Staff Member
Enroll Privacy = Any Staff Member
Save with Green Checkmark
2015 Office Practicum User Conference
Hands On #3
Step 5: Add Medicaid as Trigger:
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Click Green
Grouping Rules = And
Item Name = Primary Payer
Condition = Contains
Value = like’%MCD%’
Green Checkmark to Save
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Hands On #3
Step 6: Add Trigger:
▪ Add Fluoride Varnish
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Demo: Importing Care Plans
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Next Steps:
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Practice the features in this session
Evaluate existing Care Plans
Modify existing Care Plans
Develop new Care Plans
Run Demographic Analysis and Recall
Utilize the Care Plans to support your
Clinical Decision making
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Reference: Care Plans to Import
Will be available on Conference Website:
▪ Diabetes
▪ ADHD Visits
▪ Primary Language
Please refer to Instruction provided along with Care
Plans.
2015 Office Practicum User Conference
2015 Office Practicum User Conference
Reference: Trigger Conditions
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between: BETWEEN Value - Value must be formatted like 10 AND 20
contains: LIKE ‘%Value%’
does not contain: NOT LIKE‘%Value%
begins with: LIKE’%Value%’
is in list: IN (Value) - Value must be formatted like 10,12,14 (referring
to numeric field) or “10”,”12”,”14” (referring to string field)
is normal: operation not supported at this time
is abnormal: operation not supported at this time
2015 Office Practicum User Conference
Reference: Creating Statements
▪ When creating statements: (like or =)
▪ If using a LOINC: copy from Diagnostic
Tests
▪ If using a Survey Name: copy from Survey
Administrator
▪ Statements are case sensitive
▪ Make sure you included enough information so
it captures only the item you want.
2015 Office Practicum User Conference
Reference: Recurrence Rules Definitions
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Display only, no recall needed: displays on care plan, but never “due”
Recall per interval as of begin-at age: start at begin age and repeats
Once after begin-at age: once item is completed will not show as due
Suppress display after begin-at age: typically used for Items that are not
indicated after a certain age
Same schedule as associated item: set a schedule for another item and then
refer to that item. Useful for complex items and Preventive Care
2015 Office Practicum User Conference
OP Help: Care Plans Customization
OP Help: Care Plan Enrollment
Instructions for Importing and Exporting Care Plans
Care Plan Webinar Recording
OP 14 What's New Care Plan Video
OP 14 What's New Care Plan Administration Video
And don’t forget to check our ongoing monthly
Webinars offerings:
Webinar Schedule
2015 Office Practicum User Conference
We want your feedback!
Reports to download:
ADHD Care Plan
Diabetes Care Plan
Primary Language
Handout:
Instructions for Importing Care Plans
2015 Office Practicum User Conference