1.1. Care Navigator User Manual For Administrator Role. Community Care Partners MassHealth Program Last revised: 07/01/18. Version

Transcription

1 Care Navigator TM User Manual for Administrative Role Version 1.1 Care Navigator User Manual For Administrator Role Community Care Partners MassHealth Program Last revised: 07/01/18

2 Revision History Date Version Author Revision Summary 06/13/ Trish Ambrosio Original 07/01/ Trish Ambrosio Updated to reflect updates in Production Environment w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 2

3 Table of Contents Introduction... 6 Supported Browsers/Operating Systems... 7 Logging In... 7 Resetting your password... 8 If the user cannot log into your account... 8 To change a password:... 8 Options (Settings)... 9 Timeout Settings (Idle Timeout) Security Roles Updating an Existing Security Role Access Level Definitions Privilege Definitions Predefined Security Roles User Management Viewing Users Adding a New User Confirmation of New User Disabling an Existing User Activating a Deactivated User Business Units Create a New Business Unit Organizations Care Providers Admin Dashboards Enrollee Assignments (Capacity Tracker) Other Dashboards Create a Dashboard My Tasks Chart and Table My Appointments My Active Enrollees What s New w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 3

4 Creating a New Enrollee Record Enrollee List Viewing enrollees Search for a Specific Enrollee Search Examples using Wild Cards Bulk Reassign Enrollees to Another Business Unit Bulk Assign Enrollees to Another Care Coordinator Enrollee Chart: Outreach Form Enrollee Information: Header Enrollee Information: General Care Coordination / Engagement Status Widget Contact Information ACO/MCO/MassHealth Referral Outreach Workflow Summary Diagram Outreach Workflow Inactive Care Coordination Statuses Enrollee Chart: Enrollee Details General Information General Contact Information ACO/MCO Information/MassHealth Referral Information Medical History/Family Medical History Care Team Assigning enrollees to another Care Team Member Care Coordination Activities Encounters and Qualifying Activities Referrals Resources/Services General All Tasks Appointments Care Coordination Status Notes w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 4

5 Documents Uploading a Document Viewing Uploaded Documents Care Planning Activities About Me Challenges Goals Adding a Goal Assessments (not CHA**) Assessments Master List Create a New Assessment New Assessment Master Create Questions Within the Assessment Response Types: Creating Responses Child Questions - Create Child Questions Map to Parent Multiple Choice Multiple Response Section Title Publishing an Assessment Editing an Assessment Reports Running First Level Reports Advanced Find Feature Saving Queries as Reports Sharing Queries/Reports with Other Users Auditing Records Summary Audit Trail Enrollee Chart Detailed Audit Report- Entities within Forms Common Error Messages Dynamics Generated Error/Warning Message Clearing Cache and Cookies Internet Explorer 9, 10, and 11 (Windows) Logging Out w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 5

6 Introduction Care Navigator (CN ) is secure, HIPAA compliant, web-based software built on Microsoft Dynamics CRM that is being deployed for supporting effective care coordination to support the MassHealth Behavioral Health Initiative. The CN tool works to streamline communication among care team members, enrollees, and their support systems. This document will serve as a resource for configuring and supporting the Care Navigator system in the role of the Administrator user role. For functionality specific to day-to-day care coordination activities within the Care Navigator system, please refer to the Care Navigator User Manual for Care Coordinator/Supervisor Roles. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 6

7 Supported Browsers/Operating Systems While any browser can be used for day-to-day Care Navigator activities (i.e. non-administrator role functions), the following are recommended minimum supported browsers and operating systems for Care Navigator: For everyday care coordination tasks, i.e. non-administrator role functions: Google Chrome - Version (Official Build) (64-bit) For administrator role functions: Internet Explorer - Version Processor: Intel (R) Core (TM) i GHz, 3401 MHz, 4 Core(s), 8 Logical Processor(s) Installed Physical Memory (RAM) 8.00 GB This site can also be used as a reference: Logging In From any supported Internet browser: 1. Type in the URL for your organization 2. Enter username and password 3. Press Sign In w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 7

8 Resetting your password If the user cannot log into your account 1. Click Can t access your account? 2. A pop-up window will display to take the user through the steps to receive an to begin the reset process. To change a password: 1. Click on the cogwheel on the upper right-hand side of the screen next to the user profile photo/avatar. 2. Select Change Password. 3. Follow the steps on the pop-up screen to change the password. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 8

9 4. Click Submit when done to set the new password. Options (Settings) A user can set personal options such as time zone and default views. To set options: 1. Click on the cogwheel on the upper right-hand side of the screen next to the user profile photo/avatar. 2. Select Options 3. Set personal options and click ok to save them. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 9

10 Timeout Settings (Idle Timeout) By default, environments are configured (set) to timeout after 20 minutes of idle activity. If an administrator wants to change these settings, do the following: From the top menu, click on the chevron to the right of the Care Navigator icon and choose CN Settings from the menu options below Click on the chevron to the right next to CN Settings and select Client Settings Double click on the active user environment under Active Client Settings w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 10

11 Change the timeout accordingly (there may be a max setting per organization). Click the save icon at the bottom corner of the screen to save the changes The system will not idle timeout if the computer keystroke activities are checked under timeout activities. Definitions are included below: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 11

12 Security Roles In Care Navigator the fundamental concept in role-based security is that a role contains privileges that define a set of actions that can be performed within the organization. For example, the care coordinator role is assigned a set of privileges that are relevant to the performance of the tasks defined for that role. All users must be assigned to one or more predefined roles. In Care Navigator, roles can also be assigned to teams. When a user or team is assigned to one of these roles, the person or team members are assigned the set of privileges associated with that role. A user must be assigned to at least one role. A privilege authorizes the user to perform a specific action on a specific entity type. Privileges apply to an entire class of objects, rather than individual instances of objects. For example, if a user does not have the privilege to read patient records, any attempt by that user to read a patient record will fail. To view the current security roles for your organization: Click on CN Settings Click on Security Administration : w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 12

13 Click on Security Roles : A list of all existing security roles will be displayed. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 13

14 Updating an Existing Security Role Follow the steps to view a security role above. Click on any of the Security Role you want to update. A window will open that displays the permissions matrices for the selected security roles divided in multiple tabs. Adjust the permissions as needed within each tab. See the section Access Definitions for reference. Click Save and Close when finished. Access Level Definitions The access level or privilege depth for a privilege determines, for a given entity type, at which levels within the organization hierarchy a user can act on that type of entity. The following table lists the levels of access in Care Navigator, starting with the most access. The icon is shown in the security role editor. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 14

15 Organization. This access level gives a user access to all records within the organization, regardless of the business unit hierarchical level to which the instance or the user belongs. Users who have Global access automatically have Parent: Child Business Units, Business Units, and User access, also. Because this access level gives access to information throughout the organization, it should be restricted to match the organization's data security plan. This level of access is usually reserved for managers with authority over the organization. Parent: Child Business Units. This access level gives a user access to records in the user's business unit and all business units subordinate to the user's business unit. Users who have Parent: Child Business Units access automatically have Business Unit and User access, also. Because this access level gives access to information throughout the business unit and subordinate business units, it should be restricted to match the organization's data security plan. This level of access is usually reserved for managers with authority over the business units. Business Unit. This access level gives a user access to records in the user's business unit. Users who have Local access automatically have User access, also. Because this access level gives access to information throughout the business unit, it should be restricted to match the organization's data security plan. This level of access is usually reserved for managers with authority over the business unit. User. This access level gives a user access to records he or she owns, objects that are shared with the user, and objects that are shared with a team of which the user is a member. This is the typical level of access for care coordinators, social workers, and community health workers. None. No access is allowed. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 15

16 Care Navigator TM User Manual for Administrative Role Privilege Definitions Each role is associated with a set of privileges that determines the user's access to information within the company. These privileges determine what actions a user with that security role can perform on entities. Privilege Create Read Write Delete Append Append To Assign Share Definition Create a record. View a record. Make changes to a record. Delete a record. Associate a record to another record. Associate entity records to this record. Transfer record ownership to another user. Give access to a record to another user while keeping your own access.

17 Predefined Security Roles Although each Community Partner (CP) has established and configured specific roles, a few roles have been predefined as common across all organizations: Role Care Coordinator Care Coordinator Supervisor System Admin Description The care coordinator works directly with a panel of enrollees using a collaborative approach with multiple entities on behalf of the enrollee. The care coordinator will be granted access to the Care Navigator Hub by the CP. They will have access to their enrollees and potentially other enrollees of other care coordinators within a care team depending on the care coordination model of the organization. The care coordinator supervisor is the manager or supervisor of the care coordination team. Managing the care coordination team includes assigning enrollees to team members, managing patient onboarding activities, generating operational reports on care coordinators and team performance and generating care navigation reports for enrollee and enrollee cohorts. The care coordinator supervisor will typically be given access to all patients being coordinated within the business unit of the supervisor. The system administrator is the user who is responsible for the management and maintenance of the application for the sponsoring organization. This person is typically responsible for the following: - User management - Permissions management - Entities list management (patients, providers, programs, organizations, etc.) - Managing workflows - Managing screen fields and layout - Managing outreach templates - Managing onboarding processes - Configuring views and reports - Run audit reports The system admin will have access to all patient records across the organization. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 17

18 User Management Viewing Users To view all users who have access to the Care Navigator platform: Click on CN Settings Click on Users A list of active users is presented. Double click on any user to view their information. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 18

19 Adding a New User Follow the steps to Viewing Users. Click on +New to open the form to add a new user. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 19

20 First Name Last Name Username Domain Title The user s first name. The user s last name. The Username will default to <First Name Initial><Last Name>. *The system will check for duplicate user names and prompt the user to change the Username to a unique username. This will default to cn and is not editable. The address of the user. An must be defined for the user to receive an invitation to access Care Navigator and subsequent notifications. The title of the user, e.g. Mr., Mrs., Ms. Security Role 1,2,3 A user can be associated to up to three security roles. At least one security role must be defined. This will define their level of access in Care Navigator. The user will default to the least restrictive security role when there is a conflicting level of access between assigned security roles (i.e. the roles work such that a user does NOT have permission to something unless granted permission to it). See the Security Roles section for definitions of security roles. System User Business Unit This is an in-built functionality of Care Navigator and is not editable. Indicate the user s business unit. The Business Unit limits the user s ability to view only records within their business unit. Phone Numbers Main and Mobile Phone Numbers can be specified here. To save the information for the new user, click SAVE or SAVE & CLOSE. The default password is Carenav@123 for any user. It s strongly encouraged to the change the password when the user logs in for the first time. Confirmation of New User To confirm whether a user received an upon creating them in Care Navigator, you may use the Advanced Find feature to query messages that include login details. From the main screen, select the Advanced Find button. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 20

21 In the Look for: box, select Messages from the drop down list. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 21

22 Click on Select and choose Subject from the drop-down list. Change the query criteria to Contains and enter Login Details in the free text box. Click the Results button to view s provided. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 22

23 Disabling an Existing User Follow the steps to Viewing Users. Select the user to be disabled by clicking once to the left of the user name which will put a checkmark on that row. Click on Deactivate. NOTE: Once a user record is deactivated, no changes can be made to the account anymore until it has been activated again. The user no longer has access to Care Navigator. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 23

24 Activating a Deactivated User Follow the steps to Viewing Users. Change the View from Active Users to Inactive Users by clicking on the down arrow next to Active Users. Select the user you want to activate by clicking on the checkmark on the row. Click Activate. The user should be able to access Care Navigator TM again. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 24

25 Business Units Business units are set up from the SETTINGS section of CARE NAVIGATOR. Click on the chevron to next to the Care Navigator logo to display the next set of menus, then click on the SETTINGS tile. Click on the chevron next to Settings to display the next set of menus, then click on the ADMINISTRATION tile. Click on Business Units. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 25

26 A list of all currently created business units will appear. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 26

27 Create a New Business Unit To create a new Business Unit, click New above the list of Business Units. A pop-up window will appear. Fill in the information below to create a new business unit. The fields marked with red asterisk are mandatory to create a new business unit. Press Save and Close to create a new business unit. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 27

28 Organizations This is a list of organizations that can be affiliated with an enrollee, a care provider, or a care team member. You can get to this list from the top ribbon of Care Navigator. When you click on Organizations you will see a list of active organizations in the system. To enter a new organization, click on the +NEW in the upper left-hand side of the page to pull up the new form. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 28

29 Enter the pertinent information specific to the organization. When selecting an Organization Type the options are related to the Transitions of Care Referral options and include: Behavioral / Mental Health Treatment, Medical Care, Nutrition Services, Pharmacy Review, Social Services, Substance Abuse Treatment, Tobacco Cessation, Transportation, ACO, and MCO. An organization may be assigned none, one or more of the Organization Type options. A URL can be entered for an organization to allow the user to take them directly to the website specific to the organization (example: to an ACO login page). Click save and close when done. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 29

30 Care Providers New care team members associated with an enrollee or an organization can be created in several ways. A new care team member can be created directly in the Care Team widget (see Care Team section for more information about adding a care team member in this way). A new care team member can be created for the general organization for assignment to one or more enrollees by choosing the CARE PROVIDERS widget from the navigation bar under the CARE NAVIGATOR bar: The care provider information can be entered (with some fields required). Certain providers may have an NPI number, and you can do a name search under NPI search to select the correct provider. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 30

31 When the NPI search is used and a provider selected, the full name will populate under NPI Full Name. The First Name, Last Name and Phone Number will also auto-populate. Click SAVE or SAVE & CLOSE to create the new record. 5. Admin Dashboards The administrator has dashboards that will enable them to oversee the entire enrollee population in a variety of ways to enable them to manage the referrals from MassHealth and the ACO/MCOs. The desired dashboard can be selected as the default dashboard view. In this case, if one wants to use the capacity tracker, choose the Enrollee Assignments Dashboard from the list of dashboards under My Work. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 31

32 Enrollee Assignments (Capacity Tracker) Each organization will have the ability to see the number of active enrollees assigned to each of the following: Business Unit, Child Business Unit (where applicable) and Team (where applicable). When Enrollee Assignments is selected from the list of system dashboards available on the homepage, the dashboard will display to show a tracker of enrollees sorted by each stage of the enrollment process and among the different units and teams. This dashboard will update in near-real time. As enrollees move through distinct phases of the enrollment process, this dashboard will also update accordingly. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 32

33 Other dashboards are available to admins such as enrollment trackers that will allow admins to able to track qualifying activities per enrollee over a specified period. Any of these dashboards can be set as default dashboards, or other dashboards can be created. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 33

34 Other Dashboards Dashboards are a way of viewing specific data types in a table and/or chart format. They can be viewed by Care Coordinators or Care Coordinator Supervisors (depending on permissions set by the organization) specifically created for the organization. Click on the filter where My Work is to see current dashboards created. Current standard dashboards are encompassed under Qualifying Activities Monthly Tracker and include: Active Care Coordination Status Current Month (Enrollee, Level of Care Coordination Status) Enrollees with Qualifying Activities Current Month Enrollees with Qualifying Activities Past Month Enrollees with Qualifying Activities Past Two Months Enrollees who do not have a Qualifying Activity in the past month Eligibility Enrollees and their eligibility status w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 34

35 Create a Dashboard A user can also create their own personal dashboard that can be saved for future viewing or shared with other members of the care team. These dashboards can be refreshed and will change in near-real time as data gets populated and changed in Care Navigator. To create a basic dashboard of charts and lists using the data from an organization: 1. From the homepage, click NEW. 2. Choose the desired layout for the Dashboard. Up to six sections can be fit on the dashboard depending on the chosen layout. 3. Click Create once the layout has been selected. 6. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 35

36 Name the dashboard. 5. Hover over the chart or list icon and click on the appropriate icon to begin. 6. Add the desired fields to be displayed in chart or list format on the dashboard. 7. Click Add to place the chart/list on the dashboard. 8. Click Save to save the dashboard. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 36

37 This dashboard will become available to choose among the list of dashboards under Personal View. My Tasks Chart and Table This is a display of different view of the tasks that are assigned to the user or others one has access to in the organization. The chart will show tasks that are coming due in the next seven days, that are due today, or that are overdue. New tasks can be created from this section, or from the top navigation bar by clicking +Create on the right side and then choosing the red box with a checkmark in it. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 37

38 My Appointments This section shows appointments that have been entered for the group of enrollees the user s care team is assigned to, or those enrollees the user has access to. New appointments can be created from this section or the top navigation bar by clicking +Create on the right side and then choosing the red box with a calendar in it. My Active Enrollees This section shows all enrollees that are assigned to the user, or enrollees to a care team the user has access to, or all enrollees that the user has permission to view. You can search for a specific enrollee by typing in a partial search and clicking on the spyglass icon to perform the search. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 38

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40 What s New This section is a like a secure Twitter feed, where activities related to enrollees the user is following or is assigned to are listed. One can choose to see both user-specific posts and automatically generated posts (due to a creation of a record, for example), or filter them accordingly. Clicking on a post that has been automatically generated will take the user to the form that generated that post. Notifications that have been sent will also show up in this section. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 40

41 Creating a New Enrollee Record There are a couple of ways to manually enter a new enrollee. To manually enter information for a new enrollee, click on the + sign in the My Active Enrollees widget on the My Work dashboard, which will take the user directly to a blank new enrollee form. Enter any mandatory information plus additional known enrollee information, then click on save and close to create a new enrollee record. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 41

42 A Care Navigator Enrollee ID will be automatically generated which will be a unique user ID for the enrollee. One can also select Enrollees from the main navigation bar after clicking on the chevron to the right of Care Navigator from anywhere in the system. A list of enrollees will display (or whatever preferred saved filter to be displayed will show). Click on +New to display a blank enrollee form as shown in the prior screenshots above. Follow the same instructions to add a new enrollee. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 42

43 Clicking on Enrollees from the main navigation bar when you click on the chevron to the right of Care Navigator from anywhere in the system will show a list of Enrollees in various stages of the onboarding process. The user can sort by clicking on the various column headers, or filter by clicking on the filter icon on the right, and then choosing the desired fields to filter the data accordingly. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 43

44 Enrollee List From the main enrollee chart, the user can see all enrollees assigned or available to them depending on their role by hovering over the chevron to the right of the Care Navigator menu, then clicking on the Enrollees tile. Viewing enrollees A list of all enrollees accessible to the user will be displayed. Click on the filter on the right-hand side to place arrows to the right of the column names to allow for further sorting or filtering of the enrollees. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 44

45 As an example, one can click on the Last Name column to sort by last name. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 45

46 Or, if a user wants to focus on all enrollees in a specific phase of outreach, they can click on the chevron to open the filter and select the desired criteria. Click on ok to implement the filter and see the results of the search. Search for a Specific Enrollee w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 46

47 A user can search for a specific enrollee using the following fields: First Name, Last Name, Full Name, MassHealth ID Search Examples using Wild Cards Searches by default always include a trailing wild-card Example: Adam Westerfall Searching with: "987", "987*", "Adam", "West", "West*", "Westerfall" will all find this enrollee. Example 2: Adam Westerfall Brook West Searching with " ", "098", "West", and "West*" will return both enrollees. However, searching with " ", "987", and "Wester" will only return the first enrollee. Example 3: Full name column includes middle initial when available, can make searching on full name not user friendly. Example: Adam West Adam K West Searching for: Adam West will only return the first enrollee Searching for : Adam K West will only return the second enrollee Searching for : Adam * West will return both enrollees Due to this, if users are searching for enrollees by full name, they should always include the wildcard in the place of the middle initial. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 47

48 Bulk Reassign Enrollees to Another Business Unit The user can reassign one or more enrollees at a time to another business unit from this screen. Select the enrollee(s) to be reassigned by clicking the space to the left of the enrollee to place a check box next to the enrollee name. The menu options at the top of the screen will change. Click Assign Business Unit. A new tab will open. Select the Business Unit to transfer the enrollee to and click Submit. Close the tab and return to the main screen. Refresh the page. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 48

49 Use the filters to verify enrollees have transferred to the new Business Unit. Bulk Assign Enrollees to Another Care Coordinator The user can reassign one or more enrollees at a time to another care coordinator from this screen. Select the enrollee(s) to be reassigned by clicking the space to the left of the enrollee to place a check box next to the enrollee name. The menu options at the top of the screen will change, click Assign Care Provider. A new window will open. One can select the new role from a dropdown list. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 49

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51 Once the role is selected, click Select to return a list of folks in this role to transfer the enrollees to. Click Add of the User to reassign the enrollees to. Select the role the User will be on the Care Team. Click Add and a confirmation message will be seen. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 51

52 Click on the enrollee and look at the Care Team widget to see the new care team member. Alternatively, one may search for the name of the user to transfer the enrollees to and click Search. Follow the steps above, beginning with Click Add of the User to reassign the enrollees to reassign the user to the enrollees. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 52

53 * NOTE: There are three possible search criteria a user can search by in the bulk assignment (Care Provider Type, First Name, Last Name) There may be challenges with searching for a care provider using more than two search criteria The user can still search without all three criteria, using the following options: - Care Provider Type Only - First Name Only - First Name and Last Name only - Care Provider Type and First Name only w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 53

54 Enrollee Chart: Outreach Form There are two main components of an Enrollee Chart: The Outreach component and the main enrollee chart. From just above the enrollee name, there is a dropdown list with two choices. Outreach will take the user to the Outreach section of the enrollee chart. Enrollee Details is the main enrollee chart. If there are common fields in one form, they will populate in the other form, so no duplicate entry is required. To get to the Outreach form, click on the chevron above the Enrollee s name and select Outreach. Enrollee Information: Header This section highlights each of the phases of the outreach process. A flag will appear over the phase of the process the enrollee is actively in. The enrollee will progress automatically through each of the phases of outreach as specific criteria are met per the MassHealth contract requirements (see the Outreach Workflow section for details). w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 54

55 Enrollee Information: General This information contains general demographic information that includes the Care Navigatorgenerated unique ID field (Enrollee ID), MassHealth ID, and the main organizational information the enrollee is assigned to. This section is also repeated in the main enrollee chart. Care Coordination / Engagement Status Widget The enrollee s care coordination status history is in this widget. This widget is also located in the main enrollee chart. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 55

56 Contact Information The enrollee s contact information and preferences will be located here. This section is also repeated in the main enrollee chart. ACO/MCO/MassHealth Referral The enrollee s insurance information will be located here. This section is also repeated in the main enrollee chart. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 5 6

57 Outreach Workflow Summary Diagram The steps to progress through the outreach phases are summarized in this diagram below. The next sections will outline each of the phases in detail. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 57

58 Outreach Workflow The Outreach form has an automatic workflow process in the header that will take users through all the requirements needed to progress an enrollee through the phases the MassHealth defined Care Coordination Statuses (Referred, Assigned, In Outreach, In Process, Engaged). The enrollee will be in any one of these phases of care coordination/enrollment. Specific criteria need to be met to progress to the next phase. ** Note: The user should not manually change any fields within the orange header; otherwise this may cause errors in the automated Outreach workflow process (This will be locked down once go-live/enrollment files have been finalized). To get to the Outreach form, click on the chevron above the Enrollee s name and select OUTREACH. Referred: First Phase (When file received from Mass Health or ACO/MCO - MassHealth Definition) Enrollee receives a referral date based the on when assignment file is received and referral source (MassHealth, ACO/MCO) This triggers a 30-day task set to be automatically assigned to the enrollee: "30-day onboarding activities" (due date T-30 from auto-assign date) - priority = MEDIUM o Tasks include: Visit locations enrollee is known to reside w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 58

59 Conduct face-to-face visit Call enrollee Use e-communication to contact enrollee o If CC completes at least one activity, task set can be considered "complete" If task set is marked complete all tasks will subsequently be marked as complete Enrollee is also assigned to a Service Area. 9. This triggers a 90-day task set to be automatically assigned to the enrollee (BH or LTSS depending on what is chosen) 10. "90-day onboarding activities" (due date T-90 from auto-assign date) - priority = LOW o Tasks include: Attempt a face-to-face visit Complete PCTP (or LTSS Care Plan) Complete Comprehensive Assessment If task set is marked complete all tasks will subsequently be marked as complete Operational Start Date will default to the 1 st date of the month after the referral date. To pass the Referred phase: Assign a Care Coordinator to the Enrollee Assigned: Second Status (MassHealth Definition) Enrollee has been assigned to a specific AP or business unit and a Care Coordinator has been assigned. To pass the Assigned phase: Complete an Outreach QA (No opt-in status has to be chosen) w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 59

60 In Outreach: Third Status To progress from the In Outreach to In Process the care coordinator must: 11. Complete an Outreach QA with Opt In/Opt Out Status = Opt In 1. Upload a document type = Consent Form Once the enrollee (G9011) Outreach form indicates 'Opt In' and the consent form has been returned, the enrollee is considered to have passed In Outreach and proceeds to the In Process Phase. In Process: Fourth Status This is the status the enrollee stays in during the initial onboarding phase until initial outreach activities are completed. To progress from the In Progress to Engaged the care coordinator must: 1. Complete the Comprehensive Assessment and document the appropriate QA (Comprehensive Assessment G0506) 2. Complete the PCTP (or LTSS Care Plan for LTSS Enrollees) and document the appropriate QA (T2024-U4 BH (or LTSS) Treatment Plan Complete) w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 60

61 Engaged: Final Status This is the status the enrollee remains in throughout their time participating in the MassHealth program until they become disengaged for any reason. To stay at an engaged status at least one Qualifying Activity (QA) must be completed every month. **If the enrollee declines and the Opt In/Opt Out Status = Opt Out, the Care Coordination Status will change to Declined and the Enrollee Record will become Inactive and in Read- Only Mode. This can only be changed by a System Admin. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 61

62 Inactive Care Coordination Statuses Care Coordination Statuses of Inactive include: 1. Declined When the field: Consent QA = Opt Out, enrollee status changes to Inactive Declined 2. Unreachable When the field: Consent QA = Neither Opt in or Opt Out, enrollee status changes to Inactive Unreachable This happens once 30 days have passed since the Operational Start Date. 3. Disengaged Applied to any previously Active Engaged enrollee who becomes inactive for any reason Any disengaged enrollee can have an option populated via the dropdown menu to define reason for status: o Options: Completed, Discharged, Refusing Supports, Changing CP, Other Inactive Enrollees (Care Coordination Status: Declined, Unreachable, Disengaged) will be found by looking up Inactive Enrollee s from the Enrollee Chart section. Finally, if any enrollee has not had a Qualifying Activity documented in 6 months (from the date the enrollee status = Engaged) then the Care Coordination status will automatically change that enrollee to Inactive Disengaged. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 62

63 Enrollee Chart: Enrollee Details The second, or main component, of the enrollee chart is the Enrollee Details form. A user can click on the dropdown above enrollee s name in and select Enrollee Details to take the user from the Outreach form to the main enrollee chart. General Information This contains all the basic demographic data of the enrollee. Some key aspects of this section will also display in the header, which stays in place even when the user scrolls to other sections of the chart. Also, some fields and sections, when populated, will also populate accordingly in the Person- Centered Treatment Plan (PCTP) and Comprehensive Assessment (CHA). The sections in the General Information section include: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 63

64 General This is the same information from the Outreach section. This contains general demographic information about the enrollee. Contact Information This is the same information from the Outreach section. Both the general and contact information may come in via referral file or automatically generated (such as the Enrollee ID), and the rest can be manually filled in as information becomes known. ACO/MCO Information/MassHealth Referral Information This is the same information from the Outreach section. The insurance information above usually comes in from the imported referral file or via another automated workflow. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 64

65 Medical History/Family Medical History Click on the + sign at the top of either widget to enter a new diagnosis associated either with the enrollee directly (Medical History) or the enrollee s family (Family Medical History). This will open a new form that will allow the user to look up a diagnosis by name (type * in front of the search term to widen the search), and the ICD-10 will automatically populate once the desired name is populated. Click on SAVE & CLOSE to populate the information in the widget. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 65

66 Care Team This is the same information from the Outreach section. This section contains all the members of the enrollee s care team. The primary care coordinator and PCP are displayed on top of the care team section. To add a new Care Team Member to an enrollee record, click on the grid in the upper righthand corner of the widget and fill in the appropriate information. If a PCP or Care Coordinator needs to be designated as the primary provider respectively to display in the appropriate fields in the enrollee chart, mark the is primary checkbox. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 66

67 Assigning enrollees to another Care Team Member A user can assign an enrollee to another care team member by clicking on the Assign button at the top of the enrollee chart, or can assign another care team member s enrollee to themselves. A box will pop up where the user can choose the appropriate radio button below. If assigning to someone else, click on the grid to bring up a list of care team members to assign the enrollee to, or type in the care team member to populate in the appropriate field. Click OK to complete the action, or cancel to cancel the action and return to the main enrollee page. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 67

68 Care Coordination Activities This is the main area which the user will perform the main activities pertaining to the day-today aspects of care coordination. The following sections are found in this area: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 68

69 Encounters and Qualifying Activities This section is for the user to document all encounters and qualifying activities for the enrollee. Some are populated with billing codes and will be extracted for billing purposes. Other forms are contained in this section that need to be tracked as part of the care coordination process for the enrollee. The list of all possible selections is: (G9011) Outreach (G0506) Comprehensive Assessment (T2024) BH CP Treatment Planning (T2024) LTSS Care Planning (T2024-U4) BH Treatment Plan Complete (T2024-U4) LTSS Care Plan Complete (G9011) Outreach (G9007) Care Transitions (G9007-U5) Follow Up After Discharge (G8427) Medication Reconciliation (G9006) Health and Wellness Coaching (G9004) Connection and Community Social Services (T1023) Social Services Screening Tool Completed (T1023-U6) Referral to ACO for Flexible Services Comprehensive Assessment Reviewed Grievance Report Critical Incident Report w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 69

70 Each form has different fields depending on which one is selected. Once the QA Documentation Complete box is checked, this form becomes read-only (i.e. finalized and considered ready for submission for claims/billing) to Care Coordinators and Care Coordinator Supervisors. System Admins are the only users that can amend forms once these have been made read-only. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 70

71 Referrals Referrals contain all services the user has identified as being necessary for the enrollee to have as part of the care coordination process. Information entered here indicates authorization has been sought and/or recorded for the service. Resources/Services w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 71

72 Resources and services contain all the programs the user has been approved for. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 72

73 General This section contains all general care coordination tasks that do not fall under a Goal, Referral, or Resource/Service. This can include tasks to complete monthly outreach (via phone, in person, or other means) to the enrollee; documentation; or other general activities specific to care coordination of the enrollee. All Tasks This section contains all tasks and task sets regardless of category that are associated with the user. A user can use the task set/task feature and choose the appropriate Activity Category above (General, Goal, Referral, Resources/Services) to populate the record in the correct widget. All task sets and tasks will collectively show in the All tasks section regardless of Activity Category. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 73

74 Activity Level: Options (Task Set, Task) Default to Task Set (Locked from further additions) Activity Category: Goal, Referral, Resources & Services, General (Default to Referral) (Locked from further additions) o Allow user to refine Category type search based on 'Activity Category Type' when looking up Task or Task Sets o Create a new task or task set, it should store to the Task/Task Set library to be o available for assignment to any enrollee Once a Task or Task set is assigned to an enrollee, it may be modified for only that enrollee it is assigned to Activity Type: Medical Service, LTSS Service, Social Service, Flexible Service, Social Service, Other Category Type: List of 45 groups o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o Alcohol/Substance Use Benefits & programs Care Coordination Compliance Dental Disease Management Education Employment End of Life Support Family Planning Financial Stability Food & Nutrition Health & Wellness Housing Legal Assistance Medical Equipment Medications Mental Health Nicotine Use Other Addictions Pain Management Parenting Physical Activity Pregnancy Provider Relationship Recreation Safety Social Supports Stress Management Transportation w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 74

75 o Volunteer Activity: The user will need to add new activities to this field if they do not exist previously in the system. The user can look up to all created Task Sets in the organization Activity Name: Defaults to the name of the Task Set selected in Activity field The task can be assigned to any user in the enrollee s care team, including the enrollee themselves. Status Drop down options Not Started, In Progress, Waiting for Authorization, Deferred, Refused (default to none) Priority Options (Low, Medium, High) default to None Click save on the task or task set to start the record. The user can add a series of further tasks under the Tasks section in the form that will be associated with the task set (like a checklist) to define a series of steps that will need to be completed to finish off the overarching task. A task can be reassigned to another user in the enrollee s care team by clicking on the Assigned to field and changing to another person on the care team and then saving your changes. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 75

76 Appointments This section contains all appointments set regarding the enrollee. They can be a record of the upcoming appointments the enrollee has with external providers, or a user can create reminders to contact enrollee at specific times during the month regarding specific qualifying activities. Clicking on the + sign on the right of the appointments widget will open a new window to allow the user to enter information for a new appointment for the enrollee. The appointments widget is also located in the My Work section of Care Navigator. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 76

77 One can also create a new or recurring appointment by clicking on +Create on the top right and then the red calendar icon, or by clicking on the + sign on the right of the appointments widget. Creating an appointment this way will open a generic form, and the user will also need to enter the name of the enrollee. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 77

78 Care Coordination Status This is what shows in the Outreach section, indicating the enrollee s Care Coordination status. Notes This is a list of all notes contained in the enrollee chart documented from various places in the system (marked as an activities/notes widget within the form) that allow the user to document notes over the past 30 days. When the user clicks on a specific line item, it will take the user to the form in the enrollee chart where the original documentation occurred. This will allow the user to add to the note specific to that activity. Any notes older than 30 days can be found in the main ribbon of Care Navigator under Enrollee Note Mapping. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 78

79 Documents This section serves as the enrollees e-folder where it contains the electronic version of any part of the enrollee chart that can be viewed and printed. Uploading a Document *Note: Currently, only members of a Care Team for an enrollee will have the option available to upload a document visible to them. To upload a document into this section, click on Upload Document in the upper left side of the enrollee form. Populate the appropriate fields in the pop-up menu, select the proper file, and then click on Upload File. The list of uploaded Documents will show in this section. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 79

80 Viewing Uploaded Documents To view uploaded documents, double-click on the document you want to view. The document will show in a separate window. Care Planning Activities This section contains aspects that will be extracted into either the Comprehensive Assessment and/or the Person-Centered Treatment Plan (or LTSS Care Plan for LTSS enrollees). About Me Users can fill in each area either as a text field or drop-down section as appropriate. The list of questions are as follows: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 80

81 The fields that have dropdown choices are: o How I Learn Dropdown Choices: Auditory, Visual, Tactile o Does the Member have the ability to communicate Check Boxes for: Concerns, Symptoms, Care Goals o Physical Mobility Dropdown Choices: Independent, Independent w/ Adaptive Device, 1 Person Assist, 2 Person Assist, Dependent Challenges Any challenges and action plan associated with the enrollee are populated in this section. To enter a new challenge, click on the + side to pull up the form and enter the following information: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 81

82 Goals Challenge Type Look up table: Income, Education, Job Security, Early Childhood Development, Food Insecurity, Housing, Social Exclusion/Inclusion, Social Safety Network, Health Services, Gender, Race, Disability, Language Care Team Member: Default to the user entering in the Challenge Look up for Care Team members associated with the Enrollee Enrollee: defaults to the record the user is in Action Plan: Enter the action plan for this specific challenge Click Save which will then allow the user to enter any notes associated with addressing this challenge. This is the section that allows the user to enter any goals to be set for the enrollee. This complete list of goals will populate into the Person-Centered Treatment Plan. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 82

83 Adding a Goal Click on the + sign to open the form to enter the information needed to enter a new Goal. Click on the Include in PCTP to include a goal in the Person-Centered Treatment Plan. Assessments (not CHA**) The assessment module allows the organizations to create and manage assessments. Navigation: To access the Assessment Module and view questions for specific assessments in Care Navigator already, from the main menu click on the chevron to the right of the Care Navigator icon and select ASSESSMENTS. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 83

84 By default, a list of all Active Questions will be seen in the main page from each assessment that exists in Care Navigator. Click on the filter icon on the far right to filter and select questions by specific assessment. Then, select Assessments Master from the chevron to the right of CN Settings. Assessments Master List The Assessments Master provides a view of all active and inactive Assessments for your organization. The list will display the following attributes: Title, Date Created, Publish Status, Date of Publish, and the identified version. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 84

85 Clicking on any existing Assessment will allow the ability to view and edit the questions, schedule and attributes. Create a New Assessment From the Assessment Master List, click + NEW in the upper left of the screen to open a New Assessment Master Document w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 85

86 New Assessment Master Enter the specific details regarding the new assessment. Field Name Type Description Title * Text - Title of the Assessment to be displayed to users Required Instruction Text Instructions to be displayed within the assessment to the end user Description Text Instructions about the assessment that will only be visible to anyone opening or editing the assessment in the master list Allow Notes Drop Down YES: Allows end user of assessment to add and submit free-text notes NO: Prevents end user of assessment to add and submit free-text notes Display Notes Drop Down When Allow Notes is set to YES: TOP: Free text box will display to end user at top of assessment BOTTOM: Free text box will display to end user a bottom of assessment Author Text Define the Author of the assessment Organization / Public Text / URL Define if the Assessment is attributed to a specific person or organization. A URL link can also be added Allow Resume/Draft Drop Down here for reference purposes. YES: Allows the end user to save a draft of their responses and resume later NO: Requires the end user to complete the entire assessment in one sitting Update Version Text Allows Assessment creators to define a versioning structure for future updates Publish Drop Down YES: Only published Assessments will be available for assignment NO: Will not be available for assignment Date Published Date Define the creation date of the Assessment Created On LOCKED Editable by Creator Dropdown YES: Only the creator of the assessment can edit it in the future NO: Other users will be able to edit the assessment Once the Assessment configurations have been set, click Save at the top left of the screen before starting to create the questions. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 86

87 Create Questions Within the Assessment From within an assessment, select the + from the Assessments section of the form. A New Assessment Master form will open to create the new question. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 87

88 Field Name Type Description Question * Text - Required Title of the Question to be listed in the assessment form Instruction Text Instructions to be displayed for the question within the assigned assessment Assessment * Populated The associated assessment the question is attributed to will populate Is Parent Drop Down This field should be NO by default. It will only change to YES in the event a child question is created in response to an answer in the question. If there will not be a branched question, the field will remain NO. NOTE: Children questions are only allowed for Multiple Choice One Response Response Type Drop Down Text Alpha-numeric responses (must define max character limit) Numeric Number responses (must define min and max values) Date Date selection Yes/No Present a check box for YES and NO in the response Multiple Choice One Response Can add multiple options to the end user, but only one choice may be selected. Multiple Choice Multiple Response Can add multiple options to the end user, and more than one choice may be selected. Section Title allows formatting of the Assessment and delineate between sections. Display Sequence Text Allows the assessment creator to assign numbers or letters to display in front of the questions to the end user of the Assessment. Sequence Numeric Defines the physical order in which the questions will be displayed on the assessment to the user. Allow Notes Drop Down YES: Allows the end user to type in text at the end of a question response. NO: Does not allow the end user to type in text at the end of a question response. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 88

89 Response Types: Text Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific assessment If created from the Assessment, then it will populate automatically If created outside of a specific assessment, use the look up to search for your desired assessment Is Parent: Should be NO for a text response Response Type: Text Max Characters: Indicate the maximum characters you want to allow the end user to respond with. This number will appear in parentheses for the end user to view. Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question Click SAVE to save this question to the associated assessment w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 89

90 Numeric Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific Assessment If created from the Assessment, then it will populate automatically If created outside of a specific Assessment, use the look up to search for your desired Assessment Is Parent: Should be NO for a numeric response Response Type: Numeric Range Max / Range Min: Define the limits of what numbers can be submitted to this question. The range will appear next to the question in the Assessment to the end user Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the Assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question Click SAVE to save this question to the associated Assessment Date Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific Assessment If created from the Assessment, then it will populate automatically If created outside of a specific Assessment, use the look up to search for your desired Assessment Is Parent: Should be NO for a date response Response Type: Date Format will be displayed to the end user in the Assessment Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the Assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question Click SAVE to save this question to the associated Assessment w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 90

91 Yes/No Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific Assessment If created from the Assessment, then it will populate automatically If created outside of a specific Assessment, use the look up to search for your desired Assessment Is Parent: Should be NO for a Yes/No response Response Type: Check boxes for YES and NO responses will appear to the end user in the Assessment Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the Assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question Click SAVE to save this question to the associated Assessment Multiple Choice One Response Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific Assessment If created from the Assessment, then it will populate automatically If created outside of a specific Assessment, use the look up to search for your desired Assessment Is Parent: Should be NO during the creation of the response type. It will change to YES in the event a child question is created for a response Response Type: Multiple Choice Single Response Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the Assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question Click SAVE to save this question to the associated Assessment. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 91

92 Creating Responses To create the responses to a Multiple Choice question, select the + sign next to Responses below the question configurations to open the Response Master form Response: Create the response as it should appear in the Assessment Question: This field associates your response to a specific question If created from within the question, then it will populate automatically If created outside of a specific question, use the look up to search for your desired question to associate Sequence: Defines the order in which the response choices should appear on the Assessment Score: Allows a numeric association to if a calculated result is desired Once the choices have been created, they will appear below the question in the Question Master form w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 92

93 Child Questions - Create Child questions are follow up questions based on a response to the main parent questions. Child questions can only be created within Multiple Choice Single Response parent questions. To create a child question, open the Multiple Choice Single Response question in the desired Assessment and change the Is Parent response to Yes then click Save The Child Questions section will display below the Responses section of the parent Click the + to the right of the screen next to the Child Questions section The Parent Question name should populate itself. However, if it does not, you can use the search tool to find the parent question. To create the child question, click on the spyglass in the Child Question field then click + New Create the question in the same manner as you have done previously, then click Save. Now that the child question has been created, it can be mapped to your parent question w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 93

94 Child Questions Map to Parent From the Child Question section of the parent question, click the + symbol The names of the Parent Question and the Child Question should populate in their respective positions. If they do not, use the spyglass icon in the field to search for the questions in the question library. Once the names are populated, click SAVE. Upon saving the Question Relationship, a + symbol will appear next to the Response Mapping section to open the Question Relationship Response Mapping form The Question Relationship will pre-populate for you. In the Response Master, click the spyglass to open the list of responses for the parent question. Select the response the child question should appear after and click SAVE. From the parent question screen, the responses and child questions will display. Multiple Choice Multiple Response Multiple Response multiple choice are created in the same manner as Single Response (above). The only differences are: Allows the end user to select more than one response in a question Cannot create Child Questions Section Title Question Name: Will appear in the Assessment and in the Question Master List record Instructions: Input directions for the end user which may pertain to the question Assessment: This field associates your question to a specific Assessment If created from the Assessment, then it will populate automatically If created outside of a specific Assessment, use the look up to search for your desired Assessment Is Parent: Should be NO Response Type: Section Title typically used as a separation between sections in an Assessment Display Sequence: Can be numbers or letters and is what the end user will see as they complete their Assessment Sequence: Is the defined order the Assessment will be delivering the questions in Allow Notes: select YES if you would like the end user to be able to submit a narrative associated with this question w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 94

95 Click SAVE to save this question to the associated Assessment Publishing an Assessment Once an assessment is completed with the questions and order desired, to make it available for assignment to the patient, the Publish status must be changed from NO to YES. Editing an Assessment Change the Publish status to NO and rev the version number so you know it is an updated version of the Assessment Make changes to the questions by opening each one and making the desired changes and Saving Once completed, select PUBLISH to make this available again for assignment existing assignments of this Assessment will receive the updated version the next time the Assessment is opened by the end user. Therefore, any Assessments completed prior to publishing a new version will render the previous version. NOTE: The Comprehensive Assessment (CHA) will be administered via a different workflow/web resource connected to Care Navigator TM. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 95

96 Reports The reports section provides Admins and Care Coordinator Supervisors the ability to obtain standard reports specifically created for the organization. The standard MassHealth required reports include the following: w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 96

97 Running First Level Reports Advanced Find Feature First level reports can be created using the Advanced Find feature and can fulfill many baseline reports that need to be run. More detailed and complex reports need an SQL writer such as Visual Studio and more advanced report writing training to be able to create such reports. Another manual is available, Advanced Report Writing, to be able to learn how to write more complex reports. To use Advanced Find: From the top menu, click on Advanced Find. A popup window will show. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 97

98 Look for the entity to do a search or a report on. For example, there might be a report that needs to be completed about all enrollees in the system who are part of the THP ACO. Under Look for Select the entities that you need to run a report on. In this case, select Enrollees, and then ACO/MCO. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 98

99 Since there is only one ACO/MCO being focused on, where the query says, Enter Value, click on that hyperlink and a pop-up window will display showing all the possible ACO/MCO choices. Choose the ACO/MCO to be included in the report by single clicking on the name to the left of the ACO/MCO to highlight the name. Click the >> to put the name of the ACO/MCO in the box to the right of the list to include the organization in the search. When multiple entities need to be chosen, hold down the Ctrl key and make multiple selections before clicking >>. If any choice needs to be removed, highlight a selected option and click <<. Click OK when done. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 99

100 If the query needs to be started over, click clear. Click Results to run the Report. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 100

101 The results of the query will be displayed. The results of the report can be exported into an excel file or pivot table. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 101

102 Saving Queries as Reports Queries can also be saved so they can be run again as needed or shared with other users. To save a query: Click on the advanced find subtab within the same window. Give a name to the query as a report and provide a description if needed. Click Save. This report/query will be accessible in the dropdown list under Use Saved View dropdown list in the main advanced find window. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 102

103 Sharing Queries/Reports with Other Users To share a query/report generated from advanced find: Click on Saved Views next to Advanced Find within the main pop-up window of the Advanced Find screen. Select the query/report to be shared by clicking to the left of the name of the report. A checkbox will appear to the left of the report. Click Share. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 103

104 Click Add User/Team to get a pop-up window of users to choose from. Select the user or users to share the report with by single clicking on the name to the left of the user, then click Select. Click Add when done. Specific permissions will then need to be selected in the next screen. By default, the user(s) will be able to read the query/report only. Select any other types of permissions to be given to the user specific to this query, then click Share when done. ` w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 104

105 The user will now be able to see this query in their Saved Views in Advanced Find. Auditing Records There are two types of audits in Care Navigator TM. Summary audit trails of the enrollee are available to all users, and one can also audit the different entities within each form. Summary Audit Trail Enrollee Chart This is a general audit view that is viewable at the Care Coordinator/Care Coordinator Supervisor level which can provide a general history of who viewed an enrollee record, or who made a change to an enrollee record (but not to any level of detail). The user can click on Patient Audits to see a general audit view of who either viewed an enrollee record and when, or who changed an enrollee record and when. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 105

106 Detailed Audit Report- Entities within Forms A second type of audit can be run at the administrator level that can look at specific forms within any entity of Care Navigator TM that provides a history of any change to any field within that form. As an example, if one wants to see what changes were made to a specific organization, navigate to that form within the Organizations section, click on Audit History, and then select a field to see any changes that were made, on what date those changes were made, and by whom. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 106

107 Common Error Messages During the use of the platform you may receive common Microsoft CRM error messages. These can be turned off by following the steps outlined below. Dynamics Generated Error/Warning Message You can edit your notification settings by first selecting the Change error notification settings link as shown below. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 107

108 Step 1: Select Automatically send an error report to Microsoft without asking me for permission Step 2: Click Ok and your error message notification changes will be updated. Clearing Cache and Cookies Internet Explorer 9, 10, and 11 (Windows) There may be certain situations where the support team may instruct you to clear your cache and cookies. Here is to clear to clear cache and cookies on Internet Explorer 9, 10, and 11 (Windows platform). 1. Select Tools (via the Gear Icon) > Safety > Delete browsing history NOTE: You can also access this menu by holding Ctrl + Shift + Delete. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 108

109 2. Be sure to uncheck Preserve Favorites Website Data and check both Temporary Internet Files and Cookies. Then click Delete w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 109

110 3.You will receive a confirmation at the bottom of the window once it has successfully cleared your cache and cookies. w ww.mycarenav.com 2018 Care Navigator Inc. For client use only. 110