CareManager User Training version 3.5_113009

2. CareManager User Trainingversion 3.5_113009 Asthma Module

3. Class Agenda • Overview of Asthma Module • Control Panel & Dashboard in EHR • Identification Tab • Treatment & Services Due Tab • Performance Tab • Resources and Help

4. CareManager Asthma Module (Registry) • Identification and documentation of patients with a diagnosis of asthma and most recent assessment of their asthma control. • Status of guideline-recommended use of medications and implementation of asthma Action Plan. • Identification of patients for whom a diagnosis of asthma may be considered. • Displays tables to highlight patients who are due for treatment and monitoring. • Performance feedback reports of a clinician's performance compared to peer benchmarking. • Resources for clinicians, staff, and patients.

5. Asthma Dashboard (Point of Care)

6. CareManager Control Panel – access by starting Chart Update in EHR • Care management summary for the patient, showing key treatment indicators for each module • Color Coded for triage • Detailed Dashboards available for all modules • Screening module dashboards available as well

7. How to Access the Control Panel form within an office note using the HPI Launcher • CareManager Control Panel form within your HPI-CCC form. • To insert the form, click the check box to the left of the CareManager Control Panel entry.

8. How to Access the Control Panel form within an office note using My Folders Users have the ability to add the CareManager Control Panel to their MyFolder. Please follow the MyFolder workflow to add this form to your MyFolder. http://www.emr.msu.edu/TrainingResources/

9. How to Access the Control Panel form within an office note using Favorites If your clinic does not use the HPI-CCC form, the form can be easily added to the favorites pane. Please follow the instructions provided to users during the 2005 Centricity EMR upgrade http://www.emr.msu.edu/TrainingResources/2005/2005Instructions1.pdf

10. CareManager Control Panel

11. What do the colors mean? Green = in compliance with recommended care ( i.e. test is not overdue or the test result is within target) Yellow = test due shortly or test result is slightly above target Red = overdue or a result significantly above target White = guideline or evidence does not apply, or insufficient information available

12. Using a Dashboard - Asthma • Start at Control Panel then select Dashboard • Opens to first of four tabsFirst tab is summary area used to: • Assess • Review • Record Action

13. Navigating the Asthma Dashboard Other Tabs are used on a PRN basis • Steps Tab shows managing asthma steps • Action Plan used to setup green, yellow & red plans • Intervention Tracking for recording interventions

14. Asthma Dashboard –First Tab: Assess Section • Use ? for Help • Use boxes for entering assessments

15. Asthma Dashboard – First Tab: Review Section • Review current information and interventions

16. Asthma Dashboard – First Tab: Record Action Section • Update Medications PRN • Record Flu or Tobacco Use PRN • Add another Allergy PRN OR Go to Steps Tab to Review steps for managing asthma

17. Asthma Dashboard – Steps Tab • Choices: • Review the Steps • Go to Classifications • Print Asthma Handout • When ready, select Assessment Tab to return to Main Assessment Page • Then select

18. Asthma Dashboard – Action Plan Tab: Green Zone • Complete Green Plan • Then select Go to Yellow Zone so that you can complete that plan

19. Asthma Dashboard – Action Plan Tab: Yellow Zone • Complete Yellow Plan • Then select Go to Red Zone so that you can complete that plan

20. Asthma Dashboard – Action Plan Tab: Red Zone • Complete Red Plan • Select Print & Record • Select Intervention Tab if needed

21. Asthma Dashboard – Intervention Tracking Tab • Update as needed • Close, end update and sign

22. CareManager Application (Web)

23. CareManager Application (Web) • Modules purchased • Can view by provider, one or more Locations of Care or entire organization depending on setup Staff users can be associated with specific clinicians if desired

24. Accessing Care Manager Web Application http://team-caremanweb/CareManager/MainMenu.aspx • PC Logins - Users must log PCs and Tablet PCs using their HealthTeam username and password (e.g. Username: krumsa and password: XXXXX). Users will not be able to access the CareManager Web application if they log into the network using generic log ins and passwords. • Accessing CareManager Web Page – The CareManager website address is http://team-caremanweb/CareManager/MainMenu.aspx. This website address can be added to your internet favorites or it can be sent to desktop as shortcut. • CareManager MainMenu – By logging into the PC or Tablet PC using your Network and login, the system will direct you to the CareManager Main Page. When using a clinic PC or Tablet PC, and you are not direct to this page, please verify your log in credentials and make sure you logged in under your HealthTeam username and password. Note, when accessing the EMR, you will need to login into your Clinic’s PCs and Tablets using the appropriate generic accounts (such as intemer####) like you are doing at this time. Therefore, you will want to block time when working in the EMR so you will not have to log in and log off the clinic PCs and/or Tablet PCs multiple times.

25. CareManager - Identification Tab

26. Identification Tab This tab is used to identify patients of any age who do not have a diagnosis of Asthma or COPD but are on: • A short-acting β2-agonist (such as albuterol HFA) • A long-acting β2-agonist (such as fluticasone/salmeterol DPI) • An inhaled corticosteroid (such as fluticasone HFA/MDI) • A leukotriene receptor antagonist (such as montelukast) • Theophylline or inhaled cromolyn

27. To ADD Diagnosis of Asthma or COPD using EHR • Start Chart Update – use CareManager Encounter Type. • From the CareManagerControl Panel, select the De-Identify tab. • Select Patient HAS a diagnosis of Asthma or COPD and add DX. • Close, end and sign update.

28. If Patient’s status is inactive, deceased or in hospice • Begin a chart update. • Open the CareManager Control Panel. • Click Gen DeID. • Complete the form by selecting the Patient is not mine or Patient in Hospice reason and close and sign update. • For inactive or deceased patients, you also must ensure patient is inactivated or deceased or assigned to another clinician in EMR so CareManager will update overnight. ONLY hospice patients are moved to the de-identified table.

29. Treatment & Services Due Tab – CareManager

30. Color Review Green = in compliance with recommended care (i.e. test is not overdue or the test result is within target). Yellow = test due shortly or test result is slightly above target. Red = overdue or a result significantly above target. White = guideline or evidence does not apply, or insufficient information available.

31. What do the symbols mean? Active Stop = Do not pursue treatment at this time. Expired Stop = Expiration date for stop is over.Pursue. Active Wait = Waiting for patient action, result or treatment. Expired Wait = Expiration date for wait is over. Pursue. Multiple Provider Support = Multiple Providers involved.

32. Using the Treatment & Services Due Tab • Colored coded except for Severity Column. • No label indicates that the patient has no measure of control and there is no controller on the medication list. • The label Int (for intermittent) indicates that the patient's last measure of control was "Well," and there is no controller on the medication list. • The label Pers (for persistent) indicates that the patient's last measure of control was "Not Well" or "Very Poor," or that there is a controller on the medication list.

33. Performance Feedback Tab

34. Performance Feedback Tab - CareManager • Control level assessment • Patients with a current assessment • Persistent asthma patients on a controller • Patients with Asthma Action Plans • Patients treated with a long-acting β2-agonist without an inhaled corticosteroid • Asthma patients who are tobacco users

35. Using the Performance Tab • This tab is used by providers to track performance monthly • Updated monthly only • Open CareManager • From main menu, click and select provider being reviewed • Click the Asthma button • Ensure you are on Performance Feedback tab • Review Information and print if desired • Print by using Press CTRL + P.

36. Resources and Help - CareManager

37. Resources & Help are actually helpful! Problem #1: You are in the Treatment tab and cannot figure out why a patient’s Controller Med is YELLOW Solution: Click on the at the top right of the page and the Table of Contents for HELP will open for you..

38. Resources & Help are actually helpful! • Select Treatment & Services Tab from the Contents • Click theword Yellow • You will be taken to a table with details about the Yellow status and discover that your patient’s treatment type is ALTCONTROLLER and there is no LABA and no ICS and no ICSLABA. The label "Alt Only" is displayed.

39. Resources & Help are actually helpful! Problem #2: You are in the Asthma module and want to know what ICD codes are used to place a patient in this module Solution: Click on the at the top right of the page and the Asthma Table of Contents will open for you

40. Resources & Help are actually helpful! • Click on ICD & CPT codes • You will be taken to a list of all the ICD and CPT codes that are used in the this module

41. Resources & Help are actually helpful! Problem #3: You are in the Asthma module and would like to check the latest guidelines Solution: Select the Resources Tab 1. You will see a list of the latest guidelines 2. Click on the area you would like to review

42. CareManager Introduction & Asthma Module Questions? Thanks for attending! Please contact the EMR Department if you have questions using the Point of Care Tool