Justin's Blog

 Posts Tagged ‘Health Tracking’

Having spent a couple of days in Albuquerque, I have been thinking about and talking about Care Plans quite a bit.

What makes the module really exciting for me is the idea of a high quality, moderated library of care plans.

This will only work though with your help, so dig out those care plans and start submitting them to our library.

Note: They will only show up there when we have approved them.

For instructions on submitting care plans, click here.

If you have any questions, let me know.

Don’t forget to come and discuss care plans in our Special Interest Group

:: Justin ::

I spent the last couple of days in New Mexico working with them on the latest updates to the eCHAT (Electronic Comprehensive Health Assessment Tool) and the upcoming state-wide implementation of General Event Reports. The next set of updates are going to be very exciting. We’ll have some functionality and data changes based on what we have learned so far and look to be taking advantage of Individual Unification to provide some very cool sharing capabilities.

Based on the work we did, providers in New Mexico should look forward to receiving extra guidance in using the eCHAT, using Health Tracking, and transferring individuals in the next week or so.

It is very exciting seeing the vision that the folks in New Mexico had when they brought us in coming to fruition.  We had some serious fun with the data and a few pivot tables!

:: Justin ::

Over the past months, and again this week, there have been awful, frightening stories coming out of the New York State developmental disability system, and in particular their institutions.

These stories have been highlighted by the New York Times and I would encourage you to go and read them, even though you won’t enjoy the experience.

There is no doubt in my mind, based on a lifetime of experience working both in institutional, community, and family based settings supporting people with diabilites that institutions by their very design are, at best, an inappropriate model for supporting people with disabilities.  However, while the environment undoubtedly contributed to the horrors in these stories, I really don’t think it is the sole casue.

The problem here is a complete lack of accountability and transparancy.  In fact I think that the two are so closely linked that they are almost the same.

When someone is able to deny that they saw something, knew something, or said something you end up with the situation where people are debating what it means to be hit by a stick, or whether something was actually or accurately reported.

A number of years ago, we had quite a cool poster out entitled “10 Reasons not to use Therap“.  Reason number 10 was “You want to be able to deny you saw it so you don’t have to take action.”  Once documentation is completed in Therap it is not going anywhere.  There may be a perfectly legitimate need to edit it or even delete it, but even if that is the case there will always be a full audit trail there showing what was there before and who did what to it.  You will also have a full list of who looked at it and when.

Not only do I find stories like these (which unfortunately are not confined to New York, or institutions) heartbreakiing and infuriating, I also find them increadibly frustrating as I know that there are simple, cost effective ways of providing tools that can stop this happening.

Take the following example from the story:

During one visit, an employee told the Careys to take home a duffel bag they had never used. They discovered a logbook inside the bag detailing startling changes to Jonathan’s treatment plan. Among other things, the school was withholding food from Jonathan to punish him for taking off his shirt at inappropriate times.

In this case, the family found out information (by accident) and immediately acted upon it.  How much better would care have been if the family saw all the documentation as it was written?

Was is most frustrating is that we and many agencies across New York and across the country know the answer to this and are actively making themselves more transparent and accountable while at the same time becoming more person centered, efficient, and effective.

When an agency uses Therap they have the option of giving controlled, recorded, HIPAA secure access to parents so that they can see exactly what is written about their child as it happens.  I have heard so many stories of how this not only improves the quality of supports, it also improves the relationship between the family and the agency.  If you’d like some examples, give me a call.

By using Therap, there are now 700 or so agencies across the country supporting more than 70,000 individuals who have taken steps to address the lack of accountability and transparancy that comes from keeping data hidden away in books and filing cabinets.  Combined these agencies are witing more than 1,000,000 progress notes each month in Therap (along with countless other items).  Each one of those notes is read on average 12 times.  That is 12,000,000 opportunities each month for someone to see something going wrong and address it.

No system in the world can completely prevent abuse from taking place, but by becoming open and accountable, while maintaining security and privacy, states and agencies can involve entire circles of support in the prevention effort.

:: Justin ::

This morning I had the pleasure of being walked through a few of the features that you can expect to see in Therap 9.0

Currently we are targeting April 10th as a release date (as you know, this may well change)

Here’s a quick glimpse

Time Tracking is looking really good.  I am particularly excited abotu the reporting screen: (you can click on the picture to see a full size version)

If you weren’t at Fishkill and didn’t get a chance to play with this, it’s a generic, timebased data tracker for things like sleep or mood or positioning.

Next up is vital signs.  As part of our move towards CCHIT compliance, we are providing notifications if vital signs are our of range (according to CCHIT standards, these ranges will be based on age and gender).  Staff will get a warning as they enter the data and the form itself will be made high notification level (so off-site staff can be notified)

Also on the CCHIT we are adding the ability to record Advance Directives:

These will display in the IDF and Medical Information areas.

These are a couple of examples of benefits that all existing Therap users will get as we transition to CCHIT Compliance.  The fully compliant version of Therap will include additional functionality and certification as an “Approved Electronic Health Record”.  We will be announcing pricing for the CCHIT version of Therap in the future.

Much more to come…

:: Justin ::

Thanks to a bunch of conversations that we had in Fishkill, we have now dropped the restriction in Medication History that a prescriber be a Physician or a Dentist.

Your full range of shared contacts is now available.

Thanks for the input!

:: Justin ::

We are in the final stages of testing Therap 8.15.  If you have been paying close attention, you will know that our original plan was to have the release tomorrow, however, as often happens in application development, their have been some unexpected hitches in final testing and we are going to put back the release (we hope to have it out this weekend)

There are a whole bunch of things included (this is probably the last major release before Therap 9.0) which I will cover as the week goes on.

As part of our ongoing move towards CCHIT Compliance, we are redesigning the way we track diagnoses.  This will now be much more comprehensive allowing for Axes, start dates, end dates, physicians, and comments.

See below for some screenshots:

Much more to come in what is a very exciting release!

:: Justin ::

When we introduced the MAR and First DataBank drug database, we changed the way that users accessed Medication History to be based around the individual rather than through the program and then the individual.  If you click on “New” under Medication History you will see how this works for Medication History.

In an upcoming release (scheduled for February 2nd) we will be applying this same mechanism to all of Health Tracking as you can see in the screenshots below: (Click on each one to see a bigger version)

On clicking “New” in any Health Tracking section you will be taken directly to the form where you can select the individual using auto-complete.

Similarly, from the “Done” page you will be able to go straight to your next form.

Finally, reports will now include all data about an individual, regardless of the program it was filed under.

This should make life a lot simpler for everyone and hopefully make your caseload management easier too.

:: Justin ::

Kristen Thompson on Creating a Shared Health Tracking Record

Kristen Thompson is the Washington County Director, and Therap Provider Administrator for Danville Services of Oregon

Want to share health tracking information created by multiple programs within your agency? Learn how one agency created a single Health Tracking program that allows staff from any program to enter and view all the health tracking information related to the people they serve.

In August 2010, Danville Services of Oregon created a dynamic program called Health Tracking, which allowed all staff involved to see and contribute to a complete picture of an individual throughout any given day. Prior to this, we struggled with duplicate health tracking information for those people that we served in both a day program and residentially. By creating a new health tracking program, new health tracking caseloads and a new health tracking super role we were able to have all health tracking information unified. We were also able to prevent confusion for the direct care staff by removing health tracking privileges from their direct care super role, thus the staff do not have to choose a program when creating new records. One of the main obstacles we had to overcome to achieve this is due to all previous health tracking information no longer being available to staff. Initially, we prepared for this by T-Logging all current tracking information in an attempt to bridge the gap between old and new health tracking records. Also, we continue to allow managers access to both old and new health tracking records. Unforeseen issues included appointments; all previously entered medical appointments were no longer visible to the staff that only have access to the new health tracking program. I propose to give an informal seminar type presentation which outlines the steps I took to create the unified health tracking record, to answer any questions regarding the switch and to possibly brainstorm solutions for some of the obstacles created by making this switch.

02/08/2011, Tuesday, 2:45pm – 3:45pm

Related:
The Health Tracking Guide

List of Users’ Presentations
National Conference’s Page
Registration

Here’s something else I am really excited about:

What you have here is a quick walkthrough of the new eCHAT or Electronic Comprehensive Health Assessment Tool that we have developed in conjunction with the State of New Mexico.

Not only does it provide a thorough and easy to use assessment tool, but it also calculates an overall acuity level and publishes a summary with recommendations for where care plans may be required.

Also, within the assessments are links to resources to help with supports in that area.

Take a look, let me know what you think.

When it is publicly available beyond New Mexico, it will be a premium service.  However we are looking for some beta testers.  Interested?

:: Justin ::