It has been a busy few weeks. I feel like I haven’t stopped since returning from our (super-awesome) California conference. I think it’s kind of true, too…
I have been running from southern Oregon (Brookings) with their CDDP and The Mentor Network up to Longview and Tacoma with a bunch of new Washington providers. Alaska has been hopping, too. I have been having weekly meetings and trainings with a handful of providers up there: some new, some revamping, and others getting ready to bill electronically straight to the state.
I had a great user group in Vancouver with Chris Klimas, who hosted us at his agency, VanCare. We spoke with Jan Sprow from the State of Washington and took a hard look at requirements for their ISP Reporting. Life Works thinks they have it figured out (cos they’re smart and clever); Therap can indeed do what they need. (Of course!)
Watch our site for a TON of trainings coming up from the Certified Trainer nerds, too. I just scheduled them this week.
That’s it. Laying around like normal. Making unicorns. Thanks, Julie.
Tomorrow, have a Sunday morning session with some Alaskans and then off to Ellensburg to turn Elmview on its head.
At least I have a good assistant, as you can see below!
PS: Did you see the moon last night??
So that’s it. Until I go to Connecticut. And lay around some more.
This post is waaaaaaaaaaaaaay overdue. Since returning from Alaska, I have been very busy and also been considering what to write about my recent trip to The Last Frontier. A lot of you have asked and there is so much to say so here goes…
This trip began in Fairbanks, “The Land of the Midnight Sun.” Remember, it was still light until way after midnight when I arrived at 11:30PM on August 6. Fairbanks was my primary destination; Fairbanks Resource Agency (FRA) asked for some major help and training (they shone the Bat Signal into the sky) and they were why I had come.
A full week of training of direct support staff, care coordinators and directors in all aspects of Therap. Kristi Davis, their provider administrator, was key in orchestrating this plan to finally get FRA ready to pull the lever and launch billing in October. With Catharine’s support, we turned the whole place sideways and began getting them ready.
Highlights of Fairbanks:
I was adopted by my “pack,” Kristi’s herd of Bernese Mountain Dogs.
We met a dysthymic reindeer at Santa’s house.
I finally saw a sculpture that PROVES the size of the damn mosquitos in Alaska. SEE!
I hung out with Ron, Kristi, Teri, Donna, Kaari, and others with whom I’ve become friends. It made this trip feel like a trip home more than a business trip. Thanks, as always, for your kindness and hospitality.
And then, it was time to head for Anchorage. I decided to take the Alaskan Railroad. Comparable to the cost of a flight, it was well worth it. A twelve hour voyage through small towns, over ravines, and through Denali National Park, made this one of the best things I have ever done. I don’t remember feeling quite so happy ever as I did standing on the observation deck looking out at this immense place.
Highlights of the train ride:
When I arrived in Anchorage, the sun was shining. It was much cooler than Fairbanks, by the way, which had been in the eighties and as dry as a bone. There were also wildfires in Fairbanks that had coated the city in smoke periodically during my stay. Ironic, given that as I write this, it is snowing there now…
The plan for Anchorage was a user group meeting and some meetings with new staff at The Arc of Anchorage, both of which happened and went well. I also spent some time with Hearts and Hands of Care, a new agency, that is very enthusiastic and will be diving into Therap, including billing, as soon as Pauline gets things in order.
Highlights of Anchorage:
The Arc threw me a birthday party!
I finally met Colleen. She entertained me on my birthday! (And we drank some really good beer.)
And it’s Anchorage…‘nuff said.
The final stop was Juneau. It is hard to describe Juneau but I often use the term “otherworldly.” It seems to be always coated in fog and mist, surrounded by mountains and The Mendenhall Glacier, and everything is endlessly coated in green. There is something wild and strange about it. It always reminds me of my first trip to Alaska when I drove to Valdez and went over a mountain pass, down into a valley that turned to sheer rock face and endless waterfalls. I was sure I had stumbled into Middle Earth.
The plan for Juneau was to meet with some new staff at REACH and have a user group. And we did.
Highlights in Juneau:
Bear hunting and glacier gazing with Anitra
Um, it’s Juneau, y’all
And then, after two non stop weeks, I returned home and was immediately propelled back into training in Washington with some exceptional people. So, sorry for the delay, and as I have told many of you, if you have the opportunity to go to Alaska, don’t even think about it: GO.
I miss it so when I leave. I really do.
I suppose I will just have to find a way back for Northern Lights season.
Greetings from Anchorage!
The past two weeks have been non-stop. I have a lot to tell you…so let’s start with Washington.
Archie and I went to Seattle to host a user group.
Washington is getting its Therap on and that was absolutely evident by the large turnout to the Seattle User Group. We had around twenty-five people from the Greater Seattle area, Ellensburg, Tacoma, Shoreline, and Olympia. (You’ll notice Dr. Baugh sat to my left…She is my confidante. Dr. LaCasse is also striking a pose.)
And they had a lot to say.
The biggest discussions surrounded two things: auditors and the Washington IISP. Thus far, the feedback from agencies having gone through an audit is very good. The issues primarily revolve around getting the licensing staff familiar with Therap. Aside from that, it looks like we’re passing the grade. And that’s awesome.
The other was discussing the WACs and requirements around their (I)ISP (they have an extra “I” because they are extra special). This discussion began in earnest with SOLA a couple of weeks ago and is continuing throughout the rest of Washington. We reviewed the Therap suite of ISP tools and it appeared to me (and others–it is not just me, really) that the Washington (I)ISP process can be migrated into Therap without much fuss. As Carol Kirk would urge you to do, it just has to be thought out and systemic across your agency. Flow charts help with this.
Thanks goes out to Tom Haupt and The Arc of King County for hosting this group AND catering it with bagels, fruit, coffee, veggies and juice…quite a spread. He is one of the nicest guys in Seattle, there is no doubt.
Um, there was one small problem though. Parking tickets…Seattle has some strange rules and we had some parking felons amongst us. Drat! ($47…are you kidding me??)
Watch your email as we will be having a giant Washington user group online to discuss the (I)ISP soon. And there will be another onsite group in The ‘Couve in October.
And, as I segue into the Alaska part of this whole story, it turns out Archie’s Aunt Barb from The Arc of Anchorage was in Bellevue that very day. They met for the first time and it was a very happy meeting. I know, I know…he just needs to come with me to Alaska!!
More later on Fairbanks and the Alaska Railroad!
I’m headed back to Alaska in the next ten days-ish and am looking forward greatly to seeing my friends in Fairbanks, Anchorage and Juneau.
There are two user groups open to the universe and feel free to come by, if you happen to be around.
Colleen from The Arc of Anchorage did a great overview of user access today, revealing the flexibility of super roles, security profiles and a mixture of constructed caseloads. This is a good session for idea-gathering for agencies with varied needs when it comes to user access.
Have a look see!
Washington is part of the “corridor of awesomeness,” as defined by ME. This corridor includes Alaska, Washington, and Oregon. Lately, the one in the middle, right above Oregon, is hopping!!
I have spent the past few days with providers onsite and virtually (from the entire corridor) but primarily Washington. We have a handful of new providers in eastern and northern Washington, had a user group in Tri -Cities where twenty people showed up (I expected a handful), and I am currently on the outskirts of Seattle preparing to do some mad training tomorrow morning.
Aside from a detour to Cicely, Alaska, I have been driving up, down, back and forth amidst the early spring in the NW, with dashes of mountain snow. I’m on the road until the end of the week, making miles.
See you soon!
I have been scheduling sessions exclusively for Certified Trainers from various experts, vendors and just plain smart people. The latest was a session from Paul Andrew regarding a new model of service delivery being developed in Arkansas called “health homes.” Interesting stuff for sure.
Have a look.
This is the follow up to the previous breakdown on super roles. For new provider administrators, the second session of their initial training covers super roles and caseloads as they begin to learn about access control. The other dimension within assigning user access are these Agency Wide and Administrative Roles. These privileges are controlled user by user, allowing for finer control than the broader, group-oriented super roles.
ADMINISTRATIVE ROLES: These roles are roles corresponding to provider administration functions. Within a given agency, there is usually one or two “super admins” who can do anything within the system, including creating other super admins and doling out bits and pieces of provider administration. This allows you to have varying levels of provider administrators within an agency. Granting some of these privileges to management makes sense, especially for residential providers that run 24 hours per day. Does it make sense that the only person who can change passwords works 8-4 in the main office (and none of the direct support professionals know them)? Um, no.
I often suggest that password changes and privilege adjustments be given to management staff who can then deal with the calls after hours immediately for their respective staff. This makes it easier all around.
MODULE ROLES: These are roles associated with both individual supports modules, as well as agency wide reports. For example, the ISP Template Library allow the user to create templates and/or interact with previously created templates. The Report Library allows users to pull system-wide reports about individuals, staff, privileges, and a host of other details. Essentially, these roles are non-individual specific privileges acquainted with different parts of Therap.
TMS ROLES: The Training Management System (TMS) will track your staff members’ training history, as well as allowing you to schedule training sessions right through Therap. These are the various roles that can be broken out between, for example, a “training administrator,” who may construct and maintain your system and a “training instructor,” who conducts training sessions and publishes results. For more on TMS, click here.
SCOMM ROLES: Remember, SComm is Secure Communication, Therap’s secure email system. The box for “Enable SComm” is checked automatically, which allows the given user to send or receive messages to and from anyone in your system. This is fine for most users within most agencies, however, there are more options for SComm for both internal communication and communication with other agencies.
Multi-Provider SComm: This is for systems with an “oversight” account attached to them. For example, the State of Oregon has an account linked to its providers. For those users with this box selected, they can send and receive SComms to and from the users in the oversight account. This allows for the state licensing team to communicate securely and directly with agency staff.
COIS SComm: Two agencies with separate Therap systems can elect to communicate using SComm when they support the same individual. So, if you have an individual that works with one provider and gets residential supports from another, the staff in the respective agencies can be given this option to send messages back and forth between systems. For more information on COIS, click here.
The latter two options allow you to limit the user’s access to your user list; they can only interact with either a list of people you build manually or the individual-based option will limit them to users who share access to their assigned individuals.
1. Enable…Search: The default is that a user can search about a year back. Many providers will add this to management, clinical and administrative staff so their searches are not limited.
2. Enable Calendar: This is checked automatically. There is a calendar that is program-based that is available for all staff with access to that program. You may disable this for outside entities (i.e., guardians, case managers), depending on how you are using the calendar. You may also have to revisit using the calendar at all if you move to individual-based caseloads as all programs that individuals are enrolled in become viewable to the user. This can be confusing and difficult to manage.
3. Enable GER Abuse and Neglect: Checking this selection will give the user the ability to view any General Event Report (GER) that has been flagged with either of those options. GERs that are flagged with one or both of these options will be invisible to all users with the exception of users with this box selected. Choose carefully.
4. Create Access…: If someone passes away or leaves your agency, the provider administrator will discharge them. Some staff may need to enter information or review data, especially if someone passes away suddenly. This box allows the given user to view and enter information even if the person has been discharged (NOTE: Leave the person in their program when discharging if you want to be able to ENTER data…Ask me if you want more details.)
5. Access to Multi-Individual Event: Read this.
And the BILLING box is only for those of you using billing and is especially for those of you doing direct electronic billing through Therap.
Drop me a note if you need help with any of these things.
New providers using Therap usually have the hardest time sorting out super roles and caseloads. During the first couple of training sessions, we explain how they will control their users’ access levels by who they can see (caseloads) and what they can do (super roles). Super Roles are the sets of privileges developed by each agency to define the level of access for each group of staff members (i.e., managers, direct care staff, quality assurance, etc.). Each user account will have at least one security profile that contains a super role and one or more caseloads.
When starting out, I would recommend ONLY checking off privileges that are attached to the modules you plan on rolling out first. The more check boxes selected, the more your staff will see. The more your staff see initially
will completely freak them out can be very daunting which is why, if you are only beginning with Tlogs, GERs, and SComm, you will only create roles by checking off options under those specific boxes. The idea is to not overwhelm your staff!
As your implementation progresses, each super role can be edited and more boxes selected; the system is then opened in a controlled way and people will be prepared for the additions after they have received supplemental training. You also will prevent data being from entered in the wrong spot.
Here is a summary of roles that is pretty standard across the system:
SUBMIT: This means that a given user can enter data. If this were the only option selected, the user would not even be able to see what they had written once submitted. When someone can submit, they usually are given the option to save their item as well, putting it onto a worklist to finish later. The distinction between saving and submitting is something that should be emphasized during training, especially with General Event Reports (GERs).
VIEW: The view role means viewing and can be given in conjunction with other roles or not. Viewing only is a common privilege granted in roles for outside entities such as case managers, guardians, or auditors. This option allows them to look at any necessary data but they cannot enter material into your system.
UPDATE: Updating means altering, editing, correcting. All updates are recorded and tracked by the system. This role is typically reserved for clinical or managerial staff members. And remember, update would allow the user to update any data that they have access to, not just their own (this is a common misconception for new users). Updates can be seen by those with the update privilege in any form’s update history which is displayed as a blue link, either on the top or bottom of the form, depending on where you are in the system.
DELETE: You can delete?? (Scary, right?) Not really so not scary at all. Deleting material is impossible. Delete is simply tossing something into a trash can where it will remain forever intact, also revealing when it was removed, by whom and the reason for its removal. Those with delete as a privilege can view deleted items. And as with update, this is usually something only assigned to provider administrators and/or management staff.
APPROVE: This role manifests a little differently dependent on where you are in Therap, however, approve always means finalize. If someone can approve, I would also typically give them update as that allows them to correct anything they may erroneously approve (with the exception of GERs, as once they are approved, there is no reverting back to an editable state). I usually use an analogy like this: whoever can put something in place on paper (like an ISP program) or sign off on an incident and send it to the county or state (a GER), those are your approvers.
You will notice in some modules, additional roles such as “healthcare report” or “MAR configuration.” Those listed above are simply the most common. Some pieces of Therap have some necessary differences based on functionality. There are also Agency-Wide and Administrative Roles which are configured uniquely in each user account. Watch for a future breakdown on those.
For more information, click here for a summary of roles from our Help and Support!
Ken Slavin did a nice overview of changes within HIPAA and HiTECH, as well as reviewing the meaning surrounding CCHIT’s and ONC’s definitions of EHRs.