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Hell Week= Surprise Week

Every year we hold an agency wide Therap training for our staff. This consists of six, roughly 12 hour, days of 1.5 hour class sessions. As you might expect by day three the instructors, myself and one other, are having nightmares about the sessions. We have been doing these trainings, whether its review or new material, for the last four years and have always had the staff logging on to Therap and following along. So, for the last three years we have had trainings where the staff stare at a computer screen while myself and the other instructor drone on and on. But not this year, this year we decided to shake things up a bit.

This year we decided not to use computers and we played Therap Jeopardy. Surprises came by the truck load. First The classes were far more engaged. Second the increased engagement fostered some absolutely fantastic discussions and Ah ha! moments. Now, Therap is a web based system, so having no computers was a concern, but in the end the result was the biggest surprise, and testament to its user friendless. Several of the questions asked staff to walk through this process or that process. My socks were blown off when staff verbally using the correct terms and everything were able to explain what we were asking. Not only that, but were able to add valuable insights from a Support Staff’s position that myself and the other instructor could not have given.

When a system works in such a way that it makes it possible to recall the process without actually looking at it speaks volumes. So, I guess in short what I am trying to say is this. For staff, that have already gone through some sort of introduction to Therap, don’t be afraid to go off grid every once and a while. It breaths new life into training and gives them a sense of pride that they really do know their stuff.

To Say “HI” and my frustration with Outrageous Deadlines

So, to begin with I wanted to say, “HI!”  I am a newly (since March) Certified Trainer.  This is my first blog post.  But I am eyebrow deep in this new Therap project I have started and thought I would take a quick breath of fresh air (while madly treading my feet) and say hi.   I am guessing that someone is saying – “well, here comes the details of this new (to this blog) person” to themselves.  I would hate to disappoint, so I will tell you a little about myself and HOPE that at least ONE person said that to themselves….

I am Jessica D. Dunn.  I work at Tobosa Developmental Services in Roswell NM.  (Yes, we have aliens; and No, they are not usually green).  I thought I should just get that out of the way.  I am currently the Incident Management Coordinator.  (Of course, I could put about 4 other titles behind that, just like most of you I am sure, but I will spare you the details). I have been with Tobosa for about 3 years but in the DD field for 11 years.  I could tell you more about myself, but I am pretty sure that is not why you are reading this blog.  Maybe if I include a few details each time that I post, you will get to know me.  Or better yet, register for our Regional Conference here in NM and come meet me.

My legs are getting tired of treading, so I guess I will go on with the actual purpose of this post – Outrageous Deadlines.  I committed us to a deadline last week.  I was very passionate (for lack of a better word) that we would get all of the “Outcomes” (for everyone getting services through our program) into Therap to begin tracking electronically (vs. paper) by MAY 1, 2015.    The discussion in which I made this commitment came only after a frustrating meeting where our huge strides with Therap were being downplayed.  I was pretty heated about the lack of acknowledgment we had gotten in our efforts. I also felt like I was needing to push our acceleration.  I have this concern that when we stop pushing, we kill it.  Like when driving a standard transmission vehicle.  If you are in gear and take your foot off of the gas, for long enough, you will kill it.  So, with great conviction, in my very confident voice I made my declaration.  It wasn’t until the next day (last Thursday) that I began counting the # of people receiving services from us that I started to get a little concerned about what I had just committed.  Upon, counting the people, I then started counting days.  I am sure that in my sub-conscious I knew when May the 1st was – but definitely, I did not know that it was a week away.

So, I retook the “ISP Program and Template” Training Academy Course for the second time (I figured I had absolutely NO time to waste, making mistakes).  Then I jumped.  Luckily, the offices on either side of mine, heard my hesitation in the form of pep talks to myself and anyone who questioned the very small time frame.  I am glad to say that they have jumped in too.  So, here we sit.  Just putting it all in.  I am proud to say that we are almost half way through our list with a few days to go.

It is a long stride but will be so worth it.  Just the sheer satisfaction of knowing that we pulled it off will be like sweet music.  It is not very often that I make such a pointedly commitment and not stick to it.  I am proud to say that I am now very knowledgeable in creating ISP Programs and Templates.

Previous to this journey, Bill Jones, our other Therap guru was the one who would do all of the ISP Programs; forms; tracking and such – so, I didn’t have to worry about it.  I have spent the majority of my time in the TMS system as well as the other basic modules.  But I am very glad to say, that I am moving across the board.   Now, I can take this fire (that got me into the mess) and instill it in others.  That is one of my ongoing missions.  I guess any teacher wants that; to put the fire they have in themselves into others; to create that passion.   I am glad to say that in the past few days I have converted 2 others and put that little spark in them.  Hopefully, it will turn into a fire (although, I don’t know if we have enough extinguishers for every one to be as fired up as I would like to see – but I am trying)!

So, since I can tell that I have just started rambling (a writing habit of mine); I will close and get back to my project – the TIME just keeps TICKING!  Thanks for letting me ramble.

By |2016-11-03T10:15:09+00:00April 27th, 2015|Categories: Uncategorized|Tags: , , |Comments Off on To Say “HI” and my frustration with Outrageous Deadlines

Hanging my head.

I have not posted in a long while, and for that I hang my head in shame. And now to add insult to injury, I am just going to pose a question.

For those agencies using skin/wound how do you get your staff to access the tracking in the same way, since there are 3 options for accessing the data?

That being asked, all is well here in the Pacific Northwest. Several of our departments are coming more online and using more pieces of Therap. The greatness of job security…I love it.

By |2014-08-14T20:48:51+00:00August 14th, 2014|Categories: Craig Buswell's Posts|Tags: , , , , , , |Comments Off on Hanging my head.

HELP! Too Many Shared Contacts!!!

Have you ever been updating an IDF, adding an Therap appointment or adding a shared contact and think “There’s just too many!” well, this is what makes therap great. You CAN DELETE!. Now, if you just created a therap contact and realized there was another one, the best thing to do is to delete it. otherwise, when you delete a shared contact and it’s been used (such as in appointments, IDF’s etc) all that information will be Poof! Gone.

But fear not, the wonderful programmers have made their way around it. So, in order to DISCONTINUE a Shared Contact, and clean up the giant mess that shared contacts can become you must:

 

1. Have the Admin Ability assigned to you via a Super Admin in your Therap System.

2. Go to the Admin Tab on Dashboard.

3. Under General: Shared Contact: Click “List”.

This gives you the big giant list of shared contacts for your organization. Now looking at them all can all the pages can seem like they’re endless. Cleaning up your Shared Contact list is a bit tedious, but worth it in the end.

so Now that you’ve got the list, what to do?

1.  Find the Shared Contact you are no longer using and click on it.

2. At the Bottom Right corner, you’ll see 2 options.

“Update” or “delete”.

3. Click Delete. ( yes, we will discontinue it, but to get there, we have to click the Delete button :) )

4. Now therap will automatically tell you if your Shared Contact is already in use (such as any past appointments, IDF’s, etc) and where it is being used at.

For Example: If it’s an old pharmacy, it will show you all the old IDF’s it was being used in, or it is being used in (if you haven’t updated those IDF’s like you were supposed too. )

5. Now we know where the Contact is being used, on the bottom right is the Discontinue button. This is great, because it allows us to get it off the shared contact list, but still have the information available if we need it and can be found in the archives (i’ll save the archives for a later post :) )

6. You have now been transported back to the beginning and will see the long list of all your shared contacts again and at the top it will confirm that the shared contact was discontinued.

You then just repeat the process until your Shared Contact List is Short and Simple.

Hope this helps all of you out there that have a Shared Contact list longer the Pi. :)

Happy Spring Cleaning of all those Pesky unused Contacts!.

– Racheal.

 

By |2016-11-03T10:15:12+00:00May 29th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , , |Comments Off on HELP! Too Many Shared Contacts!!!

Therap Financial module

As I’ve come to various Therap Conferences, have met my fellow trainers and spoken to various agencies I’ve discovered that everyone uses the Therap Financial Module differently. Some use it to track individual petty cash, to house petty cash to just tracking house expenses. This got me to thinking.. I want to hear everyone else’s ideas and how they use it. Below, i’ll detail out how we use Therap Financial in my houses, and how well it works.

First, We use our Therap Financials to track everything that the individual may have for financial tracking. We have quite a few individuals with our CEO as the Rep Payee. So we track all of their data in therap. From all deposits: wages, SSB, SSI, random funds, to all their expenses: Room and Board, debts, groceries, clothing purchases, etc.

We also use it to track Gift cards! For an individual who has a gift card, we can track purchases and accurately account for all the funds. We just set it up as a new checking accounts and label It with such as “walmart gift card5867” with the last 4 digits of the card number. This helps us keep track in the event that an individual may receive multiple gift cards for the same place and we can always know what was purchased.

I LOVE that we do this. I can easily see and track all expenses, the rep payee can pull reports and know that day their accounts balance without having to go into online banking. Also, I can go in and search for all items over 50.00 and be able to add them to the Personal Property list if needed as a double QA check.

For us, only DSP2’s and above have access to the financial module, as not everyone needs to be privy to the individuals personal information. It’s also great since if an individual wants to know, we can pull it up and show them. by scanning in and attaching receipts and bank statements as well, it just makes life a little easier.

 

 

Training Therap to New Employees

Hi There again,

So for those out there that face some employees that may be, for lack of a better word, Technologically Challenged, how do you have them prove that they understand the documentation that you require on Therap? Ensuring that they have those skills and are competent to be able to write a GER, run reports on Intake/Elimination, Enter ISP Data, or even the most basics of reading SComms and T-logs? Here at CSS we have a great staff that created these wonderful  things called competencies. These competencies detail out a lot of information, everything from understanding of our policies and Mission, Vision and Values, to initial trainings on ISP’s, BSP’s, financials and an understanding of using Person First Language and Person Centered Thinking. Along with all that and many other items, it also has a wonderful page that allows you to mark off their understanding of Therap. Now for us, these are all done over a 6 month period, but it’s reviewed at the 1st, 3rd, and 6th month to ensure compliance with Oregon Administrative Rules (OAR’s) and keeps it all neat and tidy in one place.

When your out there Training Therap, how does everyone do it? Therap is so user friendly with T-Girl, Live Help, and the step by step instruction sheets, it’s a wonder someone may not “get it. ” However, there are those out there in the world of Therap that may have trouble or may not be so used to computers. How do you get them there, and prove that they can demonstrate these skills? By creating a competency!! We have a one day training that is spent with anywhere from 5-10 employees and 2 Trainers (even though I’m the only certified one :)  ) that train  the new employees on how to use Therap and what we want from them in regards to documentation. For Example: Therap’s Purpose, Accessibility,What users use therap, How to access live help/My Issues, What to do when arriving on shift with Therap, Demonstration of Access to IDF’s/EDF’s, “My Account”, T-logs, GER’s, SCOMMs, Health Tracking and Running Reports, Contacts and supports, etc. …… and ANYTHING ELSE you wish to add! It’s a great place to keep everything in one place. This way no one can state that they didn’t know how, or was never trained, or never got the help (they should be accessing LIVE HELP, if not asking).

This helps prevent any error in documentation with the excuse I didn’t know how, or no one showed me, or geesh, I never knew that!. We’ve all heard the excuses I’m sure… but with these, not only to you ensure that your staff have the knowledge, but that they can demonstrate it as well! It makes lives easier all around, by knowing, and trusting that the staff you have in place are not only confident in their abilities on Therap, but they have access to help when they need it, and your job becomes easier by having competent staff that know HOW to Document what they need to, Where they need to.

Now, for everyone out there, I would like to know how you train? Do you have an easier process? A different one? A similar one? We all have so much to offer, and now I’ll be picking your brains on all the possibilities that are out there. ….

with that… I’m off… :D

-Racheal.

 

 

By |2014-03-30T06:22:36+00:00March 30th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , |Comments Off on Training Therap to New Employees

How to Complete A Quality Assurance Check with Therap.

Okay, for those that know me I LOVE the Therap MAR. I tend to keep all my ducks in one basket, so for QA checks, I didn’t want them completed elsewhere, or someplace additional that my staff would have to search for or forget about,  so I added them to the MAR itself, (as that’s what they’re QA’ing anyway). Keeps everything neat and tidy. So here it is everyone, How to complete QA checks using the Therap MAR. :) hope you find it as useful as I do.  I also have a Print outable copy, that’s picture friendly as well if anyone feels up to using it, just shoot me an email and I can zip It off into cyber space for you. :)

How to do QA (Quality Assurance) Checks on Therap

First off you will be tracking this medication on the MAR, similar to a PRN medication. To Do this you will see similar steps in the process.

  1. Click “Add New Medication”
  2. This will now take you to the Medication history page. Here is where you begin to create the QA check.
  3. Under Medication Name:
    1. This is where you enter QA and the time that you want the check done. For example:     “ QA CHECK 8AM”  This should be done at each shift change. Normally, just putting QA check is best, you’ll see later, that you can see the time that the QA was done, showing you for each shift change that It was completed.
  4. For all the medication information. Fill in the medication type for “PRN MEDICATION” and  schedule for “As Needed”.  Leaving it blank will cause the QA section to not work properly.
  5. In the comments section, add the purpose for the QA and include all the items you want staff to QA.  For Example: QA check of all MARS, Bubble packs, Intake/Elimination Data, BSL Entries, etc.
    1. This helps to ensure that staff are acknowledging that they checked to ensure that all the listed items are accurate.
  6. Now when you open the MAR you will see that it is listed in the PRN section.
  7. In order to record the QA, you need to open up the Medication up to Record Data in Detailed Mode.
  8. For the very first entry you should scroll down to “administered”. This will allow for follow ups to be completed. This should be completed by your staff only on the 1st day of the new month.
  9. You will now see that the medication has been administered. This is the VERY First and only entry that should be entered like this. You can now click “view” to see the comments.
    1. By viewing the comments, you’re able to see the time and date stamp and the staff responsible for completing the check. This ensures that they are completed accurately and on time at the beginning/end of each shift or per your QA system and does not allow staff to alter the QA check.

Happy QA’ing Everyone. :) – Racheal.

By |2016-11-03T10:15:13+00:00March 28th, 2014|Categories: Racheal Anderson's Posts|Tags: , , , , , , |Comments Off on How to Complete A Quality Assurance Check with Therap.

Therap and the Release of Information

As the QA Director, Therap Administrator, and one of the few that can spell HIPAA (no it isn’t spelled HIPPA), I was assigned the additional duties of HIPAA Privacy Officer, HIPAA Security Officer, HIPAA Compliance Officer, and HIPAA Training Officer.  So I went to HIPAA School and got educated.  With my suitable for framing HIPAA certificate in hand, I started building procedures for various HIPAA issues.  One of the first I tackled was release of information (ROI).

This blog isn’t going to be about HIPAA, but rather some thoughts on how to release Protected Health Information stored in Therap.  In my agency we serve primarily minor children so most of the discussion is going to be based on the parent requesting information or filling out an ROI.  Whether it is a parent, guardian, or individual served (client) submitting the ROI the idea is the same.  So here goes:

In my mind I separate the information we store on the individuals we serve into two categories.  The first category is what I think of as relatively static, it doesn’t get updated frequently, and doesn’t change day to day.  In Alaska we have a Plan of Care as the primary document determining the kind and amount of services an individual will receive at our agency.  And there are other documents containing diagnosis, family contact information, application for Medicaid waiver, Care Coordination/Case Management assignment, and acknowledgement statements for HIPAA, agency policies, and a host of other paperwork required to get services at our agency.  Despite my continuing efforts most of this information continues to be stored on paper files vice in Therap.  However, whether it is stored in Therap or on paper it is a finite amount of data, usually not requiring too space.  Since it is information parents usually provide us or sign for us, rarely is it the object for a ROI.  If it is requested this information is easily copied, printed and provided.

However, once an individual has been receiving services with us for six months or so, the amount of information stored in Therap is HUGE!  For example, we have individuals who get four detailed ISP Data inputs daily, including weekends.  To provide all of this information for an ROI can be a major undertaking.  That is going to be my focus.

My first step is try to figure out the who, what, and why of the ROI.  In my short term as the agency HIPAA guru these are the broad categories of ROIs I’ve addressed:

  • Involved Parent.  The involved parent is just trying to keep abreast of the services their child or dependent is receiving.  At my agency we are very much in favor of enabling the parent to have access to daily records to read the daily events.  Pre-Therap our agency had the parents sign the individual paper note prior to turning them in.  During the transition from paper notes to Therap one of the key points raised by the parents was visibility to the daily notes.  To give the same visibility to the daily notes the parents had with paper notes, we gave Therap access to each parent/guardian.  There was some significant work giving every parent/guardian (mother, father, step parent and guardian in some cases) access as we transitioned to Therap but it was what the parents asked for.  Each involved parent was given a Therap User account, read only, to view their child’s Therap entries.  In practice, most parents (97%) lost interest after a brief period and quit checking notes.  Now we only give that level of access to parents/guardians if they requested it.  Giving a parent a Therap account, Therap training, and access to their child’s information is our preferred solution to answer a ROI by a parent/guardian.  There is no cost to the agency or parent/guardian for this ROI.
  • Parent Requesting Bulk Data.  For a variety of reasons occasionally we have parents submitting a ROI for data covering a long period.  This is where a little detective work is needed to figure out what the parent/guardian is really looking for.  Sometimes the parent/guardian just want to know that the agency is responsive to their needs.  With a little hand holding and training, giving the parent Therap access will work.  Sometimes it isn’t the daily notes that are the concern but rather a trend of improvement is more what the parent is looking for.  In that case the answer is an easy report to generate from Therap and it usually will meet their needs.  In addition we are happy to teach parents how to print individual notes from Therap or export bulk data to Excel.  We are also happy to export the data at the office and burn it to a CD/DVD or copy it to a thumb drive they provide.  However, the real challenge is the parent with little or no computer skills.  For parents without confident computer skills giving them Therap access (or reports) is not going to work.  They want paper!  Now what format should we provide the data?  The parent’s typical expectation is something that looks like the paper notes they received prior to our move to Therap and electronic notes.  Therap will let you print out individual notes that the parent is looking for.  But when the parent wants all the notes from the start of the fiscal year, printing out individual notes is going to be very time consuming.  Again I ask what is the information going to be used for, the answer helps me better provide what they want.  If all they want is the basics of what type service and when, we provide them ISP data exported to Excel.  But if they want the information to justify additional or different services they will need detailed data exported to Excel.  A typical example is a family wanting to justify broadening their home and community based services to include nursing.  In this case the family asked for paper copies of all the Therap notes for the current fiscal year, about 5 months worth of data.  Their child receives a variety of services with us and usually has three to four Therap notes per day.  We determined the most efficient means of providing the information they wanted was ISP Data with a detailed export to Excel, then that spreadsheet was organized, sized, and printed for the parent.  A five minute discussion with the parent of how the data was displayed usually ensured they were happy with what they received.  HIPAA regulations state that parents have an absolute right to the information, and that we cannot charge for the man-hours required gather or print the information, but we can charge for the cost of the copies.  So, while the agency could bill the parent for the cost of copies, we don’t.  Our copier/printer company charges us 1.4¢ a page for black and white copies and we buy many cases of paper reams. So, in this case, a 300 page report would cost us approximately $6 and is not worth the time and effort to try to collect.  And for our computer challenged parents, who have been with us for a long time and remembered paper notes, billing them any amount for computer generated information would be an insult and a potential reason to move to another agency.
  • Parent Requesting Release to Third Party.  Again for a variety of reasons we have parents who want their child’s information to be released to a third party.  If a parent wants to provide information to another agency, or their physician, or another type of medical agency, they rarely really want each and every day habilitation note for the last three years, for example.  I usually start with a phone call to the third party to try and find out what type of information they want and in what format.  Most other agencies and physicians are happy with basic data or a report that shows a trend of data, rather than each and every note.  And, thankfully, they usually want it in some type of electronic format.  After the phone call it is a no brainer to provide the data.  However, since we provide services to children, occasionally we get a ROI during a custody battle.  Again, I call the third party to try to figure out what type information they are looking for and in what format.  But some of those phone calls have taken an ugly turn.  One particular law office seemed to think I was trying to hide something and forcibly insisted they had a right to have a copy of “each and every sheet of paper.”  …So I oblige them…  You want all the ISP data for the last two and half years, with a detail export to Excel?  You got it.  For the parents in the above paragraph I spend time working on making sure it is readable, the unused columns are deleted, and I show them how to read it.  For the law office I just put all the columns on one page and hit print.  As for billing, for other agencies and physicians we provide it for free as a professional courtesy.  For that difficult law office… HIPAA allows me to charge them for our actual cost.  Now how much is my time and effort worth?  Not only cost of each piece of paper, but wear and tear on the printer, cost of electricity for the machine and the lights, heat in the building, part of our rent, small piece of our annual Therap bill…  Oh my, I had an enormous bill for them…  But cooler heads prevailed, and pointed out that the law office would just pass the cost off to the parent, with a hefty percentage added.  We charged them for our employee’s wages and the cost of paper and printing.

My bottom line is that with a phone call ahead of time, most ROIs are more accurately and easily handled.

Happy Holidays!

Rob

 

By |2016-11-03T10:15:19+00:00December 14th, 2013|Categories: Rob Sterling's Posts|Tags: , , , , , , , |Comments Off on Therap and the Release of Information

Billing Progress Report

Hi Everyone,

We are moving forward with billing.  We have our pilot groups selected (2 departments from Hab, 3 houses from Residential, and 6 MSCs). I just finished making the screen shots for our admin assistants who will be setting up the service authorizations for us. Now I will be working on the screen shots for the attendance tracking. The pilot groups will start billing in Therap by December 2013. We are hoping to have all programs billing in Therap by February 2014. I figured I would get my blog done today as I am off all next week. Emoticon showing smiley face Happy Halloween everyone! Thanksgiving will be here before we know it.

Settling in For a Long Winter

It is a busy time of year here in Alaska as we all scurry around finishing all those outside projects before everything is buried in ice or snow. Yards cleaned, tools put away, toys winterized and covered, it is a lot to do and the temperatures are already dipping below freezing at night and some days.

I recently had knee surgery and was able to work from home while I recovered, we are trying to get all departments up and running doing ISPs so that we can move to electronic billing. I was able to get a lot accomplished working from home without all the regular interruptions of my attention being pulled 20 different directions. We are still not ready but partly because of IT issues with hardware.
We were looking into Chrome books but then there was some IT conference so that may all be changing again. We have bypassed our original date to have all departments go live and pushed it out due to hardware for the remote staff. I do feel like we are making great progress in training all staff and input of data.

Now I am looking forward to the National Conference, hope ot see you all there!!

By |2016-11-03T10:15:20+00:00October 10th, 2013|Categories: Kristine Davis's Posts|Tags: , , , , , |Comments Off on Settling in For a Long Winter