1. 2015 User Conference Care Plan Customization User Conference 2015 Presented by: Rena Lefkowitz PA-C Director of Training EHR Session

2. 2015 Office Practicum User Conference End Goal: Utilize the existing Triggers and Actions delivered with OP to modify and create new Care Plans.

3. 2015 Office Practicum User Conference Objectives ▪ 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

4. 2015 Office Practicum User Conference Where do Care Plans Live? Utilities→ Manage Clinical Features→ Care Plans

5. 2015 Office Practicum User Conference Anatomy of a Care Plan: Definition Triggers Actions

6. 2015 Office Practicum User Conference Anatomy of a Care Plan: Definition Activated? Auto Enroll? Who Can View? Who Can Enroll? Source?

7. 2015 Office Practicum User Conference Anatomy of a Care Plan: Triggers Based On: Age Gender Insurance Problem List Lab Value Vitals Who will be included?

8. 2015 Office Practicum User Conference Anatomy of a Care Plan: Actions Labs? Vitals? Type of Visit? Referral? Survey? What Should be Done? Action!

9. 2015 Office Practicum User Conference Anatomy of a Care Plan: Actions Triggers + Actions = Care Plan Action!

10. Objectives Create a New Action and add to an Existing Care Plan Action! Hands On #1 We would like to add the TB Risk Assessment Survey to our Bright Futures Care Plan. The recall for this will be annually.

11. Objectives Acon! Hands On #1 Define the Triggers_________ Define the Action__________ Define the Recall Schedule______ Action! Same as Bright Futures TB Survey Every 12 months

12. 2015 Office Practicum User Conference 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 ▪Click on ▪Enter: ▪Item Name = TB Survey ▪Item Type = Survey ▪Check “Is Action” ▪Default Interval = 12 ▪Action SQL= like’%Tub%’

13. 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

14. 2015 Office Practicum User Conference Hands On #1: Add a Survey to BF

15. 2015 Office Practicum User Conference Hands On #1: Add a Survey to BF Open a Chart go to the Care Plan Tab and look for your TB Survey. Is it there? Does it say Due? Check it out...

16. 2015 Office Practicum User Conference Cloning Cloning is a powerful tool: ▪You can clone: ▪Care Plan Items ▪Care Plans ▪Create new items without worrying about the format.

17. Objectives 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. Hands On #2

18. Objectives Acon! Define the Triggers_________ Define the Action__________ Define the Recall Schedule______ Action! Lead Level between 5 AND 10 OR Problem List SNOMED = '407151008' Lead level Every 3 months Hands On #2

19. 2015 Office Practicum User Conference 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:

20. 2015 Office Practicum User Conference 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

21. 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: ▪ Purpose ▪ Auto Enroll = Yes ▪ Active as of = Today ▪ Contrary days = 30 ▪ View Privacy = Any Staff Member ▪ Source Information ▪ Save with Green Checkmark

22. 2015 Office Practicum User Conference Hands On #2 Completed Definition Section:

23. 2015 Office Practicum User Conference Hands On #2 Step 4: Add Triggers:

24. 2015 Office Practicum User Conference Hands On #2 Step 5: Add Action: ▪Add Lead q 3 months ▪Suppress Routine Lead Screening Action!

25. 2015 Office Practicum User Conference Hands On #2: Open a Chart for a child who has an elevated lead. Does it show the Lead q 3 months? Check it out...

26. Objectives 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. Hands On #3

27. Objectives Acon! Define the Triggers_________ Define the Action__________ Define the Recall Schedule______ Action! Medicaid Insurance Fluoride Varnish Begin Age = 6 months Interval = 6 months Recurrence Rule = As per Interval Begin Age = 36 months Recurrence Rule = Suppress Display Hands On #3

28. 2015 Office Practicum User Conference 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%'

29. 2015 Office Practicum User Conference Hands On #3: Step 2: Add Recall Schedule for Fluoride Varnish ▪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

30. 2015 Office Practicum User Conference 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

31. 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: ▪ 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

32. 2015 Office Practicum User Conference Hands On #3 Step 5: Add Medicaid as Trigger: ▪Click Green ▪Grouping Rules = And ▪Item Name = Primary Payer ▪Condition = Contains ▪Value = like’%MCD%’ ▪Green Checkmark to Save

33. 2015 Office Practicum User Conference Hands On #3 Step 6: Add Trigger: ▪Add Fluoride Varnish Action!

34. 2015 Office Practicum User Conference Demo: Importing Care Plans

35. 2015 Office Practicum User Conference Next Steps: ▪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

36. 2015 Office Practicum User Conference Will be available on Conference Website: ▪Diabetes ▪ADHD Visits ▪Primary Language Please refer to Instruction provided along with Care Plans. Reference: Care Plans to Import

37. 2015 Office Practicum User Conference

38. Reference: Trigger Conditions ▪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

39. 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.

40. 2015 Office Practicum User Conference Reference: Recurrence Rules Definitions ▪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

41. 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

42. 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