EHR for Behavioral Health. Alerts Patient Record Flags and Postings

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1 EHR for Behavioral Health Alerts Patient Record Flags and

2 Developed by: Teresa Chasteen, RHIT Bemidji Area Office Clinical Applications Coordinator Amy Rubin, PharmD, MMI Oklahoma City Area Office Clinical Applications Coordinator 2

3 Learning Objectives Compare and Contrast Policies and Guidelines for Patient Record Flags and Note Title Alerts as they relate to a BH program. Identify HIMS and BH Roles and Responsibilities for Management of Patient Record Flags and Note Title Alerts. Create a Patient Record Flag. Generate a Patient Record Flag Due Report. Compare and Contrast CWAD versus Treatment Contract in Personal Health. 3

Identify HIMS and BH Roles and Responsibilities for Management of Patient Record Flags and Note

4 What are Flags? Patient record flags is a mechanism in which an alert can be assigned to patients who have certain high risk clinical needs or behavior problems. This alert can be configured to pop up during the patient look-up process. Alerts Patient Record Flag and 4

5 Why use Patient Record Flags? Informing clinical staff of patient s clinical needs can improve the quality of patient care and safety. Identify behavior and characteristics that may pose a threat. Alerts Patient Record Flag and 5

6 Types of Flags Patient flags are divided in two Categories: Category I (National): These can not be locally edited Behavior Flags Category II (Local): Locally established by facilities and can not be shared Alerts Patient Record Flag and 6

Behavior Flags Category II (Local): Locally established by

7 Caution Limit use to high risk clinical situations and unusual clinical risks that threaten health care safety and quality. Limit to information essential for the delivery of safe and appropriate health care. Alerts Patient Record Flag and 7

8 Note Title Alerts Uses note titles and associated business rules to place a warning in CWADF area of EHR to alert providers of essential issues for patients Alerts Patient Record Flag and 8

9 (CWADF) Button Code A C D F W Meaning There is an Allergy(s) present. There is a Crisis Note(s) present. There is a Directive Note(s) present. There is a Patient Record Flag(s) present. There is a Clinical Warning(s) present. Alerts Patient Record Flag and 9

10 Types of Note Title Alerts Warning Notes: Note Title = Clinical Warning Crisis Notes: Note Title = Crisis Note Advance Directives: Note Title = Advance Directives 10

11 Implementation of Patient Flags Sites need an implementation plan: How a request for flagging a patient s record will be processed? Who is going to approve the flag? Who will be responsible for reviewing, updating and creating new flags? Who will be placing, removing and training staff on how to use flags? 11

12 RPMS Keys DGPF LOCAL FLAG EDIT: This key is used to control access to the Record Flag Management option. A holder of this key can add new local flags and edit local flags. DGPF PRF ACCESS: This key controls the Patient Record Flag menu. A holder of this key can display record flag detail and patient assignment detail, and can generate reports. 12

DGPF PRF ACCESS: This key controls the Patient Record Flag menu.

13 RPMS Keys DGPF PRF CONFIG: This key controls access to the PRF System Configuration. DGPF RECORD FLAG ASSIGNMENT: This key controls access to the list manager and record flag assignment menu. A holder of this key can assign, edit, and change ownership local flags. 13

DGPF RECORD FLAG ASSIGNMENT: This key controls access to the list

14 RPMS Menu Site manager should add this menu to the IHS core: DGPF RECORD FLAGS MAIN MENU 14

15 Patient Record Flag Main Menu RM Record Flag Reports Menu... FA Record Flag Assignment FM Record Flag Management TM Record Flag Transmission Mgmt... ED Record Flag Enable Divisions Select Patient Record Flags Main Menu Option: 15

16 Creating Local Record Flags Follow Site policy for creating local flags. Coordinate flag creation with a multidisciplinary group: Medical Staff CAC HIM Recommend HIM be the owner of Patient Flag package. 16

17 New Flag Creation Process 1. AF Add New Record Flag Only add Cat II Flag - may have to change category CC 2. Enter the Record Flag Name: TEST 3. Enter the Status of the Flag: ACTIVE// ACTIVE 4. Enter the Type of the Flag:?? Choose from: BEHAVIORAL CLINICAL OTHER RESEARCH 17

18 New Flag Creation Process 1. Enter the Review Frequency Days: Per facility policy 2. Enter the Notification Days: Per facility policy 3. Enter the Review Mail Group: DGPF BEHAVIORAL FLAG REVIEW Mail group created locally per need Last prompt you can save the new flag 18

19 Flag Assignment Process 1. SP: Select Patient. 2. AF: Assign Flag. 3. Assignment Narrative: optional - shows up to the system user when accessing the patient record. 4. Approved By: select from system users. 19

20 Flag Assignment Process RECORD FLAG ASSIGNMENT Jan 18, :05:17 Page: 1 of 1 Patient: PATIENT,Demo A ( ) DOB: 05/17/83 ---Flag Assigned--Review Date--Active--Local--Owner Site PAIN AGREEMENT 10/29/12 10/30/12 YES YES CLINTON TEST DAT Enter?? For more actions SP Select Patient EF Edit Flag Assignment DA Display Assignment Details CO Change Assignment Ownership AF Assign Flag Select Actions:Quit// 20

10/30/12 YES YES CLINTON TEST DAT ----------Enter?

21 Patient Flag Review Patient Flags should be reviewed to ensure that they are still appropriate and still valid. Mailman group assigned to the flag will get a mailman message that a flag is due for review. You can also run a report to get a list of flags needing review. 21

22 Running Reports FAR Flag assignment report: Display or print all of the patient assignments for Category I and/or Category II Flags. Information includes patient name, chart number, date assigned, review date and any notifications. 22

23 Assignments Due for Review Report Display or print all Category I or Category II Flag Assignments due for review. Information provided includes patient name, chart number, when it was assigned, review date and if a notification was sent. 23

24 Sample Report PATIENT RECORD FLAGS ASSIGNMENTS DUE FOR REVIEW REPORT Page: Printed: Jan 18, 2013@12:08 CATEGORY: Category II (Local) DATE RANGE: 10/20/12 TO 01/18/13 FLAG NAME: MINOR CONSENT PATIENT NAME CHART# ASSIGNED REVIEW DT NOTIFICATION SENT PATIENT,DEMO A /21/12 11/22/12 NO Total Review Assignments for Flag: 1 Note: * indicates that review date is past due Enter RETURN to continue or ^ to exit: 24

25 BH Flag Examples A history of physical violence against patients or staff at a medical center or clinic. Documented acts of repeated violence against others. Credible verbal threats of harm against specific individuals, patients, staff, or clinic property. Possession of weapons or objects used as weapons in a health care facility. 25

26 BH Flag Examples (cont.) A history of suicidal or parasuicidal behavior within health care facilities. A history of repeated nuisance and disruptive or larcenous behavior that disrupts the environment of care. A history of sexual harassment toward patients or staff. Patients with documented drug-seeking behavior. 26

27 CWADF vs. Treatment Contract Functionality Availability Language 27

28 Treatment Contract Under Personal Health and selecting Treatment Contract. 28

29 Hands-on Exercises 1. Review Sample Policy and Procedures. 2. Create a Patient Record Flag. 3. Assign a Patient Record Flag to a patient. 4. Generate a Patient Flag Due Report. 5. Add a Crisis Note. 29

30 Questions? 30

EHR Behavioral Health for CACs

RESOURCE AND PATIENT MANAGEMENT SYSTEM EHR Behavioral Health for CACs Office of Information Technology (OIT) Albuquerque, New Mexico Table of Contents 1.0 General Information...3 1.1 Purpose of Training...3