ACHSA IBHIS SEMINAR SERIES Electronic Health Record System Demonstrations with sample scripting and scoring Facilitated by Sahara Management Solutions, Inc.
DEMO INSTRUCTIONS Thank you for participating in the EHR-S product demonstration days for the ACHSA members. The demo days are part of a series of Seminars which ACHSA is sponsoring for the agencies who have contracts with the LA Department of Mental Health and must implement EDI transactions and are interested in a full Electronic Health Record System. These agencies have been participating in a series of seminars to assist them in strategic planning for DMH compliance and a structured process for selecting an EHR-S that best fits their needs. These demos have two purposes, the first is to introduce the ACHSA members to a recommended product demonstration process as part of a complete selection process, the second is to introduce them to your product and company. It is not the intention of these demonstrations to provide the agencies with sufficient product knowledge to make their EHR-S selection, but only to introduce them to several product options and a process. We will not be distributing the attendee list, but we are happy to provide a sign-up sheet for the agency participants to request a follow-up from your company. The demonstrations are scheduled to last only 2 hours. The first 30 minutes of the schedule will be given to you to introduce your company and product and to use as you see fit or to begin the Front Desk portion right away. We recommend you avoid lengthy PowerPoint presentations during this time, as the agencies are most interested in the product itself and Los Angeles compliant functionality. The remaining 90 minutes will include time for attendees to ask questions, so the first 70 minutes will be used to demonstrate your product following the scripted outlines provided and the last 20 minutes will be used for a Q&A session. Typically the questions require demonstration to respond. It would be very helpful for the audience if you could conduct the demo in the sequence outlined here, so that they can follow along easily with each vendor they see. However, we will not insist that you follow the items in sequence in each worksheet. We do ask, however, that you follow the workflow from one worksheet to the other, beginning with Front Desk and ending with Billing. Within each worksheet, do what makes most sense within your product, but please refer to the outline scripts to keep the audience on track with you. If you need to skip a section due to time contraints, please do so while verbalizing your products ability to meet the requirements stated. Keely McGeehan will be the facilitator throughout. She will work to keep everyone to the schedule and outlines. Thank you again for your participation and we hope this opportunity is helpful to you in Los Angeles. All Rights Reserved 2 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Instructions
SCORING INSTRUCTIONS Scale: 1-3, 1 = does not meet your needs, 2 = meets your need, 3 = exceeds your needs Vendor/Product Needs EXAMPLE: demonstrate how a receptionist can schedule a client appt., then later the provider reschedules the same appt. 1 2 Product did not allow another user access to the providers calendar, so the receptionist could not schedule the appt. Scheduling an appt. was quite easy, with only 2 clicks. Q: Can we move an appt. after the day of the appt. has taken place? (should not be able to I think)
1.00 EHR-S Demonstration, Front Desk Needs Please demonstrate how your product meets the needs of typical Front Desk staff. We would like to see each of these key tasks demonstrated if possible. 1.01 1.02 1.03 1.04 1.05 1.06 The Front Desk staff role at one of the Agency sites may include: welcoming clients, checking them in for their appointment, assuring clients complete required paperwork, scanning in client signature documents and attaching them to the chart, notifying providers of their clients' arrival. Some agencies have internal policies fro no shows and cancels and need to track both by client. Some may be charged for at the discretion of the agency. Check today's patient schedule for the site, seeing all site provider's and clients for the day. See a warning for one client coming in, "has violent episodes in the lobby". For a client that has just arrived, search for them in system and identify them from others with the same name, using DOB, address, etc. Show how the Front Desk only sees the client summary data, having no access to the rest of the clinical chart. Look them up on today's schedule to verify they have an appt. and who their clinician is, they don't remember what time or who with. Check them in as arrived/attended. Locate and print the paperwork that the client must complete/sign while they are there. Demonstrate how a client might sign the paperwork at the front desk and how this gets attached to the chart for a later audit. Look up client's payments due, see old balances due, collect partial payment and record it. Print receipt. All Rights Reserved 4 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Front Desk
2.00 EHR-S Demonstration, Screening / Referral Needs Please demonstrate how your product meets the needs of an Access /Referral /Call-in /Walk-in Center. We would like to see each of these key tasks demonstrated if possible. Typically Access / Referral / Call-in / Walk-in sites need to screen and collect data on every incoming caller/walk-in, even though they may not ultimately be admitted to one of the Agency's programs. Some programs / payors have specific forms and data elements that must be captured. This role may include: assuring the caller is not already a client or in the system, assuring that no duplicate records are created for previous callers, collecting data on a first-time caller or walk-in who is not yet a client (typically capturing Name, Address, Phone, Age, School & grade, Parents' Names & marital status, Guardian, Presenting Problem, Funding source, Language, SFPR, Social Worker, Court, Attorney), determine whether to refer them to an internal intake process, put them on an internal wait list, or refer the caller to an outside agency. The referral sources may be a regional database available on CD and in book format. The Agency needs to be able to track all outside referrals and intake referrals, and later report on the specifics. Also this role must be able to handle crisis calls/walk-ins quickly, with later follow-up. 2.01 Search for caller by name and other elements. 2.02 Open a new record or an existing one for a second time caller. Collect data elements, including mandatory elements. 2.03 Refer them out, or put them on an internal wait list, or refer them for intake to a program. All Rights Reserved 5 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Screening_Referral
3.00 EHR-S Demonstration, Enrollment/Opening/Intake Needs Please demonstrate how your product meets the needs of typical Intake staff. We would like to see each of these key tasks demonstrated if possible. Intake staff must be able to quickly and easily collect data and open clients in programs, setting-up all the necessary billing information, and in some cases establishing a preliminary or initial Diagnosis. We must be able to link related clients, for example siblings, that are also in treatment at the Agency. This can prevent scheduling multiple family sessions when only one is required for both clients, for example. During intake the paperwork due dates are also established, based on the Agency enrollment date, the program enrollment date, and/or the LA County Cycle Date. Clinical staff will also be assigned to each case, and in some cases a provider team is assigned. Some agencies need to search for clinicians by skill set, for example, language skills. Some clients may be enrolled in multiple programs and thus have different primary providers managing their cases. Client's financial information is gathered and their co-payment or liability is established using the UMDAP (Uniform Methods of Determining Ability to Pay) scale. 3.01 Open a client in the agency and into a program. 3.02 Indicate family relationships and link other clients to the case as required. 3.03 Establish the client's initial diagnosis. 3.04 Collect the client's financial information and establish their payments. 3.05 Assign the client to a Spanish speaking provider. 3.06 Establish the client's paperwork due dates, based on their outside DMH Cycle Date. All Rights Reserved 6 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Enrollment
4.00 EHR-S Demonstration, Treatment Planning (Client Care/Coordination Plan) Please demonstrate how your product meets the needs of typical Treatment Planning. We would like to see each of these key tasks demonstrated if possible. Needs Each program / payor may have a different Treatment Plan format. DMH requires the Client Care/Coordination Plan (CCCP) which must be updated annually based on the client's County Cycle Date. The CCCP must be linked to the Progress, as each PN must state the progress against the goals and interventions planned in the CCCP. Some Agencies would like to standardize their planning process by using an electronic library of goals, problems, and interventions or other required data elements which are mapped to the client's diagnosis or symptoms. Some agencies may choose to develop their own libraries and others may license them from a subject matter expert. For audits, the Tx Plan may need to be printed or viewed in the existing payor format. The Tx Plan typically must be signed by the provider and in the case of the CCCP, must be signed by several staff and the client. Managing diagnosis changes is always a challenge as multiple staff may be involved. Complete a Treatment Plan, showing options for different formats by program, and options for the use 4.01 of electronic Tx libraries, custom or licensed. Provider signs the Tx plan and saves it to the chart. Discuss/show your product's provider signature 4.02 method. 4.03 Pull up the completed Tx Plan from the chart, as for an audit, in the format we use now. All Rights Reserved 7 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Tx Planning
5.00 EHR-S Demonstration, Therapist Please demonstrate how your product meets the needs of typical Therapists. We would like to see each of these key tasks demonstrated if possible. Needs A Clinic Based Therapist has a large case load and their role may include: assuring clients complete required paperwork, scheduling/rescheduling client appointments, delivering billable and unbillable individual and group services, completing assessments, completing progress notes (PN), assuring Supervisor co-signs PN's/Assessments/Tx Plans, tracking all paperwork due by client to assure compliance, documenting outcome data, and updating paperwork on renewal dates. Some providers work in both programs Mental Health (MH) and Alcohol & Drug (ADPA) programs, and some clients are enrolled in both programs. ADPA has stricter guidelines on chart/record access and confidentiality (Title 22). The ability to restrict the MH provider from viewing the ADPA records of their client is required, unless a release has been signed and then access to both charts should be possible. Clinicians also flag certain clients' charts with alerts and notify other staff members as appropriate, for example 'do not schedule' or 'do not refill'. Community based providers may deliver a large number of unscheduled service in a day and may need to be off the Agency network when completing paperwork and Progress. Residential and Day Tx providers may need to track services or activities delivered to each client, however, the billable time is not based on individual services but on a full day or half day rate and attendance. Go to the clinician's Homepage or most appropriate main screen to start the day. 5.01 Show access to paperwork and tasks coming due, case load, and appointments. Record a scheduled service, documenting the service time delivered by 2 providers in one session and the primary therapist's documentation time (both billable to Medi- Cal), and complete the Progress Note. Show how to link the Note to the Tx plan 5.02 goals. Complete the PN/service and send for billing. Receive a completed PN back from your Supervisor with their notes for edits. Make 5.03 the edits and send it back for final co-signature. Record a Group Service and complete the Note. Complete the individual PN's for 5.04 each client in the group session. 5.05 Record an unscheduled session and PN. 5.06 Document entering outcome data which is due for a client. 5.07 Document activities and attendance for a residential program client. Discuss how offline and/or remote access can be enabled for Community based 5.08 clinicians. All Rights Reserved 8 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Therapist
6.00 EHR-S Demonstration, Psychiatrist Needs Please demonstrate how your product meets the needs of typical Psychiatrist. We would like to see each of these key tasks demonstrated if possible. Psychiatrists typically work at multiple sites and in multiple programs, and their role may include: providing billable individual services, writing prescriptions from formulary lists and reviewing for medication contraindications and other potential issues, providing clients with medication information sheets, obtaining parent and client consents, changing/establishing diagnosis, completing assessments, completing progress notes (PN), tracking all paperwork due by client to assure compliance, updating paperwork on renewal dates, updating court authorizations for medication. 6.01 Go to the psychiatrist's Homepage or most appropriate main screen to start the day. Show access to paperwork and tasks coming due, case load, and appointments. 6.02 View a client's medication history and diagnosis history. 6.03 See that a client is out of authorizations. 6.04 Write a prescription. (if possilbe, while first looking-up the prescription from the correct payor formulary, and checking for contradictions, allergies, and side effects.) 6.05 Print prescription information sheet and consent form for the client. 6.06 Show/Discuss the ability to submit prescriptions to a pharmacy electronically. All Rights Reserved 9 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Psychiatrist
7.00 EHR-S Demonstration, Supervisor Needs Please demonstrate how your product meets the needs of typical Clinical Supervisor. We would like to see each of these key tasks demonstrated if possible. A Clinical Supervisor's role may include: providing client billable services, supervising therapists, assuring all required paperwork is complete and in compliance, conducting periodic internal chart audits, reviewing/commenting/signing PN's and other paperwork, assigning/re-assigning clients to therapists, assigning and monitoring on-call staff, and monitoring caseloads, wait lists, and outcome measures across all team's clients. Go to the Supervisor's Homepage or most appropriate main screen to start the day. Show access to your team of providers' paperwork, tasks overdue, case loads, and 7.01 appointments. 7.02 Review all your team's outstanding PN's for services provided. See that a therapist has completed a PN for your review and signature. Review it, provide 7.03 comments and return it without co-signing. All Rights Reserved 10 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Supervisor
8.00 EHR-S Demonstration, Biller & Eligibility Verification Needs Please demonstrate how your product meets the needs of typical Billing staff. We would like to see each of these key tasks demonstrated if possible. A Biller's role may include: checking eligibility for all clients monthly and updating in their chart, processing retroactive billing due to eligibility changes, processing all claims for a site or program, creating 837 EDI records and submitting them to LACDMH for payment, processing all 835's received from LACDMH, reviewing all denials in 835 transactions and correcting for re-submission, escalating claim errors to providers and their Supervisors, creating all required billing formats by payor, including HCFA, custom statements/reports, and reports for data entry into 3rd party systems. 8.01 Show/Discuss the monthly eligibility verification task and updates to charts. Preferably via a batch process directly with the state Medi-Cal system. Update all the client files, and bill retroactively as appropriate. 8.02 Process some claims. 8.03 Correct errors as possible in batch. Create EDI 837 batch for all claims without error. 8.04 Process a 835 batch. 8.05 Show billing a secondary payor in sequence, based on payments received. All Rights Reserved 11 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Biller, Eligib
9.00 EHR-S Demonstration, Reporting & Outcomes Needs Please demonstrate how your product meets the reporting needs of the agency. 9.01 Demonstrate your product's reporting capabilities, including the standard reports that are included with the system. Show/Discuss the ability to export data. All Rights Reserved 12 of 12 ACHSA Demo Outline 100707_handouts (2).xls - Reporting & Outcomes