Edition. MONTEREY COUNTY BEHAVIORAL HEALTH MD User Guide

Transcription

1 Edition 1 MONTEREY COUNTY BEHAVIORAL HEALTH MD User Guide i

2 Table of Content OderConnect/InfoScriber Registration CH1 Pg.2 Sign In to MyAvatar CH2..Pg.10 Sync OrderConnect Password CH3.Pg.14 Client Look up in MyAvatar CH4.Pg.16 Medication Consent CH5.Pg.18 Prescribing Event from MyAvatar CH6 Pg.25 Medication Progress Note CH7.Pg.43 Lab Order CH8 Pg.54 MEDS Only MD Annual Plan CH9.. Pg.68 Prescribing Even from the Internet CH10...Pg.83 Onset of Services CH11...Pg.102 Other Useful Informations Pg.114. i

3 Chapter 1 Order connect registration LOCATION PURPOSE Web address: The registration creates an account for Order Connect. This system is the primary means for medication and laboratory orders. This registration will require a Social Security number, NPI number, Physician s licenses and DEA number. Steps Action Click on the link to start the registration process, or type the address in, or you can copy and paste link into the internet address bar 2

4 1) Click on the New User 3

5 2) Enter Facility code: js639k and click Submit 4

6 3) Fill in all required fields. The clinic Addresses for the location you will be working *required fields 5

7 4) Input specialty and least one license. Enter MD license and DEA number if known 6

8 5) 840 will precede user name. Use your County Network user ID if one is already issued, otherwise use last name and first letter of first name 7

9 6) Acknowledge user agreement. Enter a password, this password is to Order Connect system only 8

10 7) You are done. You will be notified by when your account is active 9

11 Chapter 2 SIGN IN TO MYAVATAR LOCATION PURPOSE STEPS Work Station desktop Over view on how to launch MyAvatar application and sign in 1. Locate MyAvatar icon on your workstation desktop, double click on icon, to launch application If MyAvatar icon is not on your desktop, call the help line at Click on Start Avatar and wait until all new java scripts updates are loaded, this might take a little longer depending on the updates 3. When the prompted to sign in appears, the System Code is LIVE all caps, your Username in all caps, and password. Please note that the password is case sensitive. If you encounter any problems during this process, please call for assistance 10

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15 Chapter 3 Sync OrderConnect password in avatar LOCATION PURPOSE Avatar CWS > OrderConnect > OrderConnect User Password Update Allows the user to launch OrderConnect from within MyAvatar application Steps 1) Click on Avatar CWS (Clinical Work Station) Action 2) Click on OrderConnect 3) Select, OrderConnect User Password Update 14

16 4) Delete whatever is in this field and enter your OrderConnect password in both fields. This is not your Avatar password, this is the password for OrderConnect 5) Click Submit to complete the sync Once you click Submit you are done with the sync 15

17 Chapter 4 Look up a client LOCATION PURPOSE Search Clients field To locate the client and open the client s chart Steps 1) Enter client number or client last,first name and click on search button Action 16

18 2) Choose the client by highlighting the client name and 3) Click on Select 4) Click Select & View Chart to view the client chart overview You are in the client chart overview 17

19 Chapter 5 Medication consent form LOCATION PURPOSE Avatar CWS > MD Menu > Medication Consent Form California Code of Regulations, Title (b)(6) provides that a patient has a right to "participate actively in decisions regarding medical care. To the extent permitted by law, this includes the right to refuse treatment." Behavioral Health has the obligation to inform clients of the risks and benefits of medications. We must ensure that clients understand the content and has the capacity to consent before signing these forms. We do not need to have the clients re-sign the consent when they transfer from program-to-program, but it is important we inform them of the specific risks and benefits of each medication. A new consent has to be done for each medication. 18

20 Steps 1) Click on Avatar CWS, move your cursor to MD Menu and click on Medication Consent Form Action 19

21 2) Enter client number or client name 3) Click on client name to highlight it 4) And click on Select, to pick the client you want 20

22 The pre-display will show consents already in the client s chart, you may 5) Add to create new consent form 6) Edit to edit an existing consent form 7) Delete to delete an existing consent form 8) Cancel to get out of consent form 21

23 9) When adding a consent, you may choose an existing consent and this information will default into a consent you are currently working on and click OK 22

24 10) Drop down menu to pick client language 11) Date consent was signed, T today, Y Yesterday or input date 12) Medication the client is consenting for, nature of mental condition, minimum dosage and maximum dosage, if applicable 13) Client signature, click on Get Signature to activate signature pad 14) Date of signature 15) Drop down menu to get who sign consent, Parent, Guardian or Patient 16) Get witness signature, click on Get Signature to activate signature pad 17) Drop down menu to get relationship to client 23

25 18) Notes if any 19) Doctor s signature, click Get Signature to activate signature pad 20) Date consent signed 21) If client unable to sign consent, drop down menu for reason 22) Drop down menu if copy was printed for client 23) Click on submit when you are done You have complete a consent for medication 24

26 Chapter 6 Order prescription LOCATION PURPOSE Avatar CWS > OrderConnect > Launch OrderConnect Allows the user to prescribe medication and send laboratory orders for patients Steps 1) Click on Avatar CWS (Clinical Work Station) Action 2) Click on OrderConnect 3) Select, Launch OrderConnect 25

27 4) Enter client number or client name 5) Select the client, by clicking on client name and hit Select or double click on client you want 26

28 6) Select an episode. The selected episode must have no End date 7) Click on Ok 27

29 8) Click on Launch OrderConnect 28

30 9) Current Medication Profile screen. The Action buttons allows prescriber to d/c, reorder, or change active medication orders -Discontinue - Reorder - Change order 29

31 10) Click on the Action button to highlight it 11) Hit GO to initiate the prescribing event 30

32 12) To order a new medication, check the box next to the Add New Prescription 13) And click on GO 31

33 14) Rx Libraries screen. Type in the medication name. To broaden your search, just type in the first few letters of the drug name 15) Click on Search 16) A list of medications will populate here. To select the drug you want, just roll your cursor over the drug name and click 32

34 17) The selected drug will appear here, if you want to remove this selection, click on the trash can 18) Click on the Next to continue with ordering event 33

35 19) Custom Orders screen. Confirm Order Date and Start Date. DAW- Dispensed As Written, check the box to activate command 20) Drop down menu to select Strength/Form/Route 34

36 21) Input #/Dose 22) Drop down menu to select Schedule 35

37 23) If you wish to type in your own directions or edit the ones that automatically display, click Custom Sig. Whatever is displayed is what will be shown on the prescriptions as directions for taking the medication 24) You can either indicate how much medication you would like to dispense by the pharmacy or you can click on the Calc button to have the correct amount automatically calculated, based on the number per dose and days supply indicated. You can also choose the form of the medication you like dispensed, by dropping down the menu 36

38 25) Drop down the menu to select a condition you are prescribing the medication for 26) If you want to include any information or instructions for the Pharmacist, enter it here 37

39 27) Click on check mark to view drug to drug, drug to food interactions and drug alerts for prescribed medication 38

40 28) Order Confirmation screen. The preferred pharmacy according to the patient is displayed. 39

41 29) To change pharmacy, click Change 30) Type in the first few letters of the pharmacy, example; cvs, Walmart, Walgreen, and click on Search 31) To pick the pharmacy from the list, click on select 40

42 32) Print a Leaflet to provider drug information for client. Patient Consent is done in MyAvatar; nothing needs to be done here. 33) Output; Print print order for client to hand carry to lab or pharmacy Fax the order will go to the OrderConnect server, and they fax to pharmacy. You don t need to fax anything *erx this is the preferred method, the order will be sent electronically to the pharmacy None no output 41

43 34) Reports: you don t have to do anything with these options 35) Accept your order will be finalized and sent using the Output method you selected Edit will take you back to Custom Orders screen Cancel will take you back to Current Medication Profile Cancel & Close will take you back to Prescriber s Desktop You have completed a medication prescribing event 42

44 Chapter 7 Medication progress note LOCATION PURPOSE Avatar CWS > MD Menu > Medication Progress Notes The MD progress note is used to record the service that result in claims and provide the treatment team with the most accurate information on treatment progress. MD notes must accurately reflect the services/interventions provided and must be a medically necessary service. Steps 1) In Search Forms field, type in note, or progress and hit search. Or go to Avatar CWS > MD Menu > Medication Progress Notes Action 2) Select the form you want by double clicking on the Medication Progress Notes selection 43

45 3) Enter client number or name 4) Click search 5) Select the client by highlighting the client name, and click on Select 44

46 6) Select an episode or program. Ensure the episode does not have an End date 7) Click OK 45

47 8) Click on Add button to add a new medication note 9) Click New Service 10) Enter date of service 11) Type in service code and click on search, select service code by double clicking on 361 code 46

48 12) Enter Service Duration in minutes 13) Drop down menu to select service Location 14) Drop down Note Type menu to select MD Note 47

49 15) Select Client Treatment Plan (non- Episode based) 16) Select T.P. Item Note Addresses 48

50 17) Select intervention from the Treatment Plan addressed in this MD note 49

51 18) Click to clear Note Addresses Which Treatment Plan Problem field 50

52 19) In the Notes Field, right click the mouse, select 361 Notes, to get the note template 51

53 20) Using the template as a guide, start writing your progress note 52

54 21) Click on MD Additional Information to get to 2 nd page 22) Enter Dx, this is not a required field, leave it blank if you prefer 23) Click on Monterey County Psychiatrist to sign your note 24) Click on Ambulatory Progress Note to go back to 1 st page 25) Select Draft if you are coming back to finish your note, otherwise click on Final 26) Click Submit to complete the process 53

55 Chapter 8 Lab order LOCATION PURPOSE Avatar CWS > OrderConnect > Launch OrderConnect To order laboratory tests and view lab results Steps 1) Click on Avatar CWS (Clinical Work Station) Action 2) Click on OrderConnect 3) Select, Launch OrderConnect 54

56 4) Enter client number or client name 5) Select the client, by clicking on client name and hit Select or double click on client you want 55

57 6) Select an episode. The selected episode must have no End date 7) Click on Ok 56

58 8) Click on Launch OrderConnect 57

59 9) Current Medication Profile screen. Click on Orders tab 58

60 10) Current Order Profile screen. You can reorder current standing order from here -Discontinue - Reorder For example, to reorder CBC, check the box under reorder column and click on GO 59

61 11) Click on Results Queue and it will take you to all lab results queue 60

62 12) When lab results are present in the Current Order Profile it will appear like this. To view the results simply click on the lab name 61

63 Lab results will display in a separate window 62

64 13) To order new lab test, click on Add order 63

65 14) Enter Information screen. *Drop down menu, ensure to pick your name 15) *Drop down menu to select a laboratory 16) *Select order type 17) *Payor is Unknown and click Next *Required fields 64

66 18) Enter description of lab you want to order her, and click Search 19) List of labs will populate here 65

67 20) Highlight the lab you want and click Add Selected, this will add the labs to your order list 66

68 21) This is the lab you ordering 22) Dx is required for lab orders, drop down the menu to pick dx 23) Confirm Oder Date and Start Date, type in Special Instructions, Order Guidelines if needed 24) Check Output method Print if you wish to give the order to patient Fax the order will be faxed from the Order Connect servers to the lab elab do not user this method 25) Accept Order to complete the lab order process 67

69 Chapter 9 Meds only md annual plan LOCATION PURPOSE Avatar CWS >MD Menu > Meds Only MD Annual Plan Client-Centered treatment planning has been recognized as best practice in mental health services. The Treatment Plan is the primary way we empower clients to develop a plan to achieve their recovery and resiliency goals. It means putting the client in the driver s seat of their care; clinicians, client, and treatment team work together to determine the best course of treatment by providing client with information on what to expect, what is offered, and other options related to their treatment. This process is done by joining with the client within the context of dignity, diversity, strengths, motivations, disabilities, and individual s unique needs. Doctors must have a finalized annual treatment plan for Medication Only clients. To get a list of clients on your caseload, run the caseload report in Search Forms. Client_Centered_Care_and_Treatment_Planning.pdf RULES Build on client s strengths Written in client-friendly language Stage of change used to help client identify goals Goals are written in client s words Objectives are attainable and measureable Interventions are clearly written and measurable Identifies and utilizes natural supports May be updated as needed, but at least, annually 68

70 1) Go to Avatar CWS, move the cursor to MD Menu and to Meds Only MD Annual Plan 69

71 2) Enter client number or name and click search button 3) Highlight client by click on the name and 4) Click Select 70

72 5) The form will open with all the required forms needed for MD treatment plan listed in the tabs Click on the tabs to take you to the specific form 6) Fields titled in red are required fields, and needs to be filled in 7) Click on the light bulbs to get hints on how to complete these fields 8) Update client demographic information, to include address, phone number etc. And click on Submit to go to next tab 71

73 9) Mental Status tab will open in pre-display on if prior mental status was done a) Add to add new assessment b) Edit - to edit existing assessment c) Cancel to move to next tab 72

74 10) When adding or editing an assessment, click on the these heading to move to different categories of the mental status assessment 11) Submit when done with the assessment to move to the next tab 73

75 12) Treatment plan tab will open in pre-display window, the prior plans will display a) Add to add new plan b) Edit to edit an existing plan c) Cancel to close form and move to the next tab For more information about treatment plans, follow the link below: nd_4-client_centered_care_and_treatment_planning.pdf 74

76 13) When adding a new plan, it will prompt you if you want default information from previous treatment plan entered, if no previous treatment plan, you will go right into treatment plan 14) Click on headings to move to different pages of treatment plan a) Click on light bulb to get hints on Plan Name b) click Submit when done 75

77 15) Diagnosis tab a) Ok to go into form b) Cancel to move to the next form 76

78 c) Click on different categories to change page d) Check radial button for type of diagnosis e) Date of diagnosis f) Time of diagnosis g) Input diagnosis code or brief description of diagnosis and click Submit when done 77

79 16) Medical Necessity CWS open in pre-display if there are prior entries a) Add add new medical necessity b) Edit edit existing assessment c) Cancel to move to next tab 78

80 17) Consent for Behavioral Health Services form This form is being replaced by the Onset of Services Form, please look at Onset for Services Form. 79

81 18) AIMS form will open in pre-display if there are existing entries. 80

82 19) Medication consents form will open in pre-display if there are existing entries: Refer to Medication Consents 81

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84 Chapter 10 Prescribing event from internet OrderConnect LOCATION Click on link to launch OrderConnect PURPOSE Allows the user to launch OrderConnect from the internet. This is another option to log into OrderConnect with launching the application from within MyAvatar. Steps 1) Click on link or type this link in web address Action 83

85 2) Log in using OrderConnect user name and password Username: 840 Click Login 3) Drop down menu to select clinic 84

86 4) Click Continue 85

87 5) Prescriber s Desktop screen. 86

88 6) Search for client by name: A. Type the first few letters of client last name, and few letters of first name B. Click on GO C. Client search list will appear here. Pick the client by clicking on client name or number 87

89 7) Current Medication Profile screen. The Action buttons allows prescriber to d/c, reorder, or change active medication orders -Discontinue - Reorder - Change order 88

90 8) Click on the Action button to highlight it 9) Hit GO to initiate the prescribing event 89

91 10) To order a new medication, check the box next to the Add New Prescription 11) And click on GO 90

92 12) Rx Libraries screen. Type in the medication name. To broaden your search, just type in the first few letters of the drug name 13) Click on Search 14) A list of medications will populate here. To select the drug you want, just roll your cursor over the drug name and click 91

93 15) The selected drug will appear here, if you want to remove this selection, click on the trash can 16) Click on the Next to continue with ordering event 92

94 17) Custom Orders screen. Confirm Order Date and Start Date. DAW- Dispensed As Written, check the box to activate command 18) Drop down menu to select Strength/Form/Route 93

95 19) Input #/Dose 20) Drop down menu to select Schedule 94

96 21) If you wish to type in your own directions or edit the ones that automatically display, click Custom Sig. Whatever is displayed is what will be shown on the prescriptions as directions for taking the medication 22) You can either indicate how much medication you would like to dispense by the pharmacy or you can click on the Calc button to have the correct amount automatically calculated, based on the number per dose and days supply indicated. You can also choose the form of the medication you like dispensed, by dropping down the menu 95

97 23) Drop down the menu to select a condition you are prescribing the medication for 24) If you want to include any information or instructions for the Pharmacist, enter it here 96

98 25) Click on check mark to view drug to drug, drug to food interactions and drug alerts for prescribed medication 97

99 26) Order Confirmation screen. The preferred pharmacy according to the patient is displayed. 98

100 27) To change pharmacy, click Change 28) Type in the first few letters of the pharmacy, example; cvs, Walmart, Walgreen, and click on Search 29) To pick the pharmacy from the list, click on select 99

101 30) Print a Leaflet to provider drug information for client. Patient Consent is done in MyAvatar; nothing needs to be done here. 31) Output; Print print order for client to hand carry to lab or pharmacy Fax the order will go to the OrderConnect server and faxed to pharmacy. You don t need to fax anything *erx this is the preferred method, the order will be sent electronically to pharmacy or laboratory None no output 100

102 32) Reports: you don t have to do anything with these options 33) Accept your order will be finalized and sent using the Output method you selected Edit will take you back to Custom Orders screen Cancel will take you back to Current Medication Profile Cancel & Close will take you back to Prescriber s Desktop 101

103 Chapter 11 Onset of Services LOCATION PURPOSE RULES Avatar CWS > Clinician Menu > Onset of Services This form replaced the Consent for Behavioral Health Services. Clients in need of behavioral health services must give voluntary general consent to treatment, demonstrated by the person s or legal guardian s signature on a general consent form, before receiving behavioral health services except in an emergency situation or pursuant to a court order. For persons under the age of 18, the parent, legal guardian, or a lawfully authorized custodial agency must give general consent to treatment, demonstrated by the parent, legal guardian, or a lawfully authorized custodial agency representative s signature on a general consent form prior to the delivery of behavioral health services, except in an emergency situation or pursuant to a court order. This form must be complete before initiation of any services. It only needs to be completed once as long as the client is open to Behavioral health programs. This form will have to be renewed if client has been closed for a period of 360 days or longer. 102

104 Steps 1) In the Search Forms field, type onset Action 103

105 2) Select client 104

106 3) Add new consent 105

107 4) These tabs take you to different sections of the form 5) Click on the to view consent in English and Spanish 6) Check radial button if consent was scanned into client s chart 7) Check radial button if language other than English 8) Input the client s preferred language 106

108 9) Click Get Signature to activate signature pad 10) Fill in this fields if any person other than the client signs the consent 107

109 11) Click these tabs to move to different sections of the form 12) Click on the to view consents in English and Spanish 108

110 13) Click these tabs to move to different sections of the form 14) Click on to view consent or print 15) Fields labeled in red are required 109

111 16) Notice of Privacy Practices, click on the to view the consent 110

112 17) Click on to view consent to release information 111

113 18) this is to revoke a consent 112

114 19) Problem resolution process is also explained in brochures in the front lobby 20) Click Submit to finish form 113

115 For a list of service codes and functions The Documentation Guide For more information on Behavioral Health Programs and services and other helpful information Look under MD Staff for information related to our MD Team If you need immediate assistance with MyAvatar or OrderConnect, please call