TechCare Manual - Arizona Customizations

ADCRR Workflow Health Needs Request for Clinician Guide

ADCRR HNR Clinicians

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Mental Health Score Program

ADCRR is at the forefront of proactive Mental Health Care identification, tracking, follow-up and treatment. The Mental Health Score (MH Score) Program has been fully incorporated into TechCare®. Together with the EHR’s unique ability to meaningfully report on patient health outcomes, the State’s users will continue to have innovative tools and technology to support their patients’ evolving Mental Health needs.

The Mental Health Score form in TechCare® is key to viewing, adding and adjusting the patient’s current MH Score. You can access this form from the Main Patient Screen through the Forms button, but is also launched from the first checkbox on every Behavioral Health focused encounter document in TechCare®:

 

Following a few procedural questions, selecting the score itself then completing this form triggers all the necessary logic to ensure compliance and best practices are adhered to:

  • MH Score flag is set (e.g. MH-3E)

*Note* – Despite relying on the system’s flag module for identification and tracking, MH Score step ups or downs should only be managed within the forms and dashboards.

  • Previous MH Score flag (if applicable) is discontinued
  • Patient is automatically enrolled into the MH Score Program dashboard under the Program Administration option.

*Note* – This does not include MH-1 and MH-2 per policy

Using MH-3E as an example, the patient is added to the MH Score Program, which you can access from the Global Menu on the Main Patient Screen along the left:

While the Mental Health Score form is integral in maintaining the Score itself in TechCare®, the MH Score Program Dashboard is the only area of the EHR where the required encounters can and should be launched for consistency, visibility compliance tracking.

*Note* – The presentation, processes and usages of the MH Score dashboard functions the same regardless of the score. What varies is the recurrence and type of encounters required for each score. The table below defines each. MH-3E is used in the example.

Clicking the Score tab displays the following information columns:

  • First Name
  • Last Name
  • ADCRR Number
  • Mental Health Score – Displays the recently completed Mental Health Score forms during the patient’s time in the MH Score program.
  • Mental Health Progress Note – Displays the Mental Health Progress Note that has been recently completed during the patient’s time in this MH Score program.
  • Psychiatric Progress Note – Displays the Psychiatric Progress Note that has recently been completed during the patient’s time in this MH Score program.
  • Face-To-Face (Mental Health) – Each score has an associated Mental Health Face-To-Face timer that shows how quickly a Face-to-Face appointment must be completed per ADCRR requirements. To satisfy the timer, you must complete a Mental Health Progress Note form. Once you completed this form, the system resets the timer. If this Progress Note is not completed before the timer runs out, the system highlights the patient’s name in red to indicate it is overdue.
  • Face-To-Face (Psychiatric) – The majority of scores have an associated Psychiatry Face-To-Face timer that shows how quickly a Face-to-Face appointment must be completed per ADCRR requirements. To satisfy the timer the user must complete a Psychiatric Progress Note. If this Progress Note is not completed before the timer runs out, the system highlights the patient’s name in red to indicate it is overdue.

Use the toggle next to the patient’s name to open an Action dropdown menu with the following options:

  • Mental Health Score – Used to set the appropriate MH Score Flag and move patients throughout the MH Score Workflow Queues
  • Mental Health Progress Note – Used to satisfy Face-to-Face (Mental Health) Timer
  • Psychiatric Progress Note – Used to satisfy Face-to-Face (Psychiatric) Timer

Select the action you want to take for the patient, then click the Perform Action button to complete the action.


Moving a patient from one queue to another:

If a new Mental Health Score form is completed with a new MH Score checked at the bottom of the form, then the patient will move to the new MH Score Workflow Queue with the appropriate MH Score flag set on their chart.

For example, if the patient is currently MH-3E, and a new Mental Health Score form is completed updating them to MH-4, the following will occur:

  • MH-3E flag is deactivated and an MH-4 flag is activated on the patient’s chart.
  • The patient is automatically moved from the MH-3E workflow queue to the MH-4 workflow queue

NOTE: Selecting More Information > Expanded View displays additional fields on the patient ribbon, including the patient’s current MH Score.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Barcode Medication - Check In and Administration

Receiving and Checking in Medications for Administration

You can check in medications for patients using the Receivables screen. To access this screen, click the Pharmacy option from the Global Menu, then click Receivables.

Using the filters across the top of the screen, you can search for a specific RX Order number or by the Location Received (this is the location that received the medication from the pharmacy). You can also filter your list by drug category. To scan in a single medication, scan the barcode on the medication, select the housing unit for the patient, then click the Check In button. The scanned results appear below.

For multiple medication check in, scan in each medication packet and they will appear in the Scanned Results section of the Receivables screen. Click the Check In button to add the medications into TechCare®.


Administration Medications by Housing

You can manage and administer medications on a typical medication pass for a selected list of patients grouped by housing, as opposed to one.

Click the EMAR button on the Main Screen of TechCare®. If you have selected a patient from the Main Screen, the system displays their EMAR. You are still able to proceed in the same manner even if you do not select a patient.

The system opens the Medication Administration Record screen. From this module, you can select a filter from the row across the top of the screen. For a medication pass, narrow down the patients by specific housing units and times. Let’s start by applying filters.


Medication Administration by Barcode

Note – Not all facilities or all patients will have Wrist bands, but when available, the following instructions apply.

Wrist bands

  1. With the provided Scanner, scan the patient’s Wrist band/Badge to pull up the patient’s chart automatically. This allows you to quickly find the patient’s medications.

2. Once you have selected all medications and given them to the patient, click the Administer Selected button below.


Patient Specific Meds
  1. Scan the patient’s medication to pull up the patient’s account. This is the “ladder” bar code to the right of the medication label.
  2. Scan the medication a second time, which activates the “Administration” toggle (5.0) or checkbox (4.5) for every individual medication scanned.
  3. Once you have selected all medications and given them to the patient, click the Administer Selected button.


Stock Supply
  1. To administer medications from stock supply, the patient must have an ACTIVE ORDER for the stock medication you want to administer in TechCare®.
  2.  Using the Scanner that is provided, scan the medication bottle or blister pack.
  3.  Scan each medication order separately. By scanning the medication barcode, this activates the “Administration” toggle (5.0) or checkbox (4.5) for every individual medication scanned if there is an active order for the medication. If there is not an active order for the medication, you will simply hear a beep, but the switch will not be activated.
  4. Prior to completing the administration on any given patient, you can select different Administration Types from the dropdown list, as shown below. For example, if the patient did not come for med pass, you can select 9 – No Show for Medication Pass and enter a brief free text note for documentation purposes. TechCare® displays NS in red in the grid. You can also click the Add Note hyperlink at the bottom of the medication to enter any additional information.

Once you have appropriately documented a medication, the system displays a value in the medication grid, as shown below. In the example below, the system displays an S showing that the medication was administered from Floor Stock. You can also see who administered the medication and the date it was administered. You can view a five-day administration record in the medication grid so you can quickly see past medication compliance and if a medication is expired.

You can also click on the Administration hyperlink to display the Administration History for the medication. If errors occur, you can cancel the administration of the medication within 24 hours. Simply click the Cancel Administration hyperlink, enter a cancellation reason in the textbox, then click Save.

You can hover over any entry in the data grid for any administered medication and view the administration information.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Pharmacy - Drug Refill Request

The Drug Refill Request allows you to search for those medications that may be expiring so you can refill them quickly and conveniently. To access this screen, click on Pharmacy on the Global Menu, then click the Drug Refill Request option.

The system displays the Drug Refill Request screen, where you can filter the results by the following options:

  • Days – You can search for a list of drugs that have not be refilled in a certain number of days. Enter the number of days in this field to narrow your search.
  • Housing Location – Use this dropdown menu to narrow your search by patients in a certain housing location.
  • Category – You can use this dropdown menu to search for patients who have been ordered a medication from a specific drug category.
  • Drug Options – Use this dropdown menu to narrow your search by drug options selected when the medication was ordered. Options include:
    • ATE – Allowed to Expire
    • Court Monitored Medication
    • DOT – Directly Observed Treatment
    • KOP – Keep on Person
    • Medical Medication
    • PMRB
    • PRN
    • Profile Only
    • Psych Medication
    • Release Medication
    • TORB – Telephone Order With Readback
    • VORB – Verbal Order With Readback
  • Search button – Once you have selected your filters, click this button to view your updated list.
  • Toggle Switches – You can use the toggle switch at the top of the list to select all patients in the list, or you can select each patient by using the one next to their information. Once you turn on a toggle switch, there are two buttons that appear so you can Print or Refill the medication for the patient(s) you have selected.


Action menu

You can use the Action dropdown menu beside the Patient Name to do one of the following options:

  • Print – Click this option to print the drug order.
  • Refill – Click this option to refill this request.
  • View – Click this option to view the drug order.
  • View Chart – Select this option if you want to open the patient’s chart.
  • View Vital Signs – Click this option if you want to view the patient’s last recorded vital signs.
  • View Flags – Select this option to view the patient’s flag history.
  • View Allergies – Click this option to view all of the patient’s allergies.
  • View Drugs – Select this option to view the patient’s drug order history.
  • View Progress Notes – Click this option to view any progress notes added for the patient.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Medical Dropdown Menu - Visual Acuity

Using this screen, you can document when a patient is being seen for a Visual Acuity exam. To access this screen, select the Medical Dropdown Menu from the patient’s chart, then select the Visual Acuity option.

The system displays the Visual Acuity screen, where you view any prior screenings for the patient. To add a new screening, click the Add Visual Acuity button.

The system displays the Add New Visual Acuity screen, where you can use the dropdown fields to document the screening.

Use the dropdown menus to enter information in the following fields:

  1. Use this dropdown to select which eye you are documenting. Options include Right Eye (OD) or Left Eye (OS).
  2. Use this dropdown menu to select whether you are performing the screening With correction (glasses on) – CC, or Without correction (glasses off) – SC.
  3. Use this dropdown menu to document the results of the exam. Options include:
    • Unset value
    • 20/20
    • 20/25
    • 20/30
    • 20/40
    • 20/50
    • 20/60
    • 20/70
    • 20/80
    • 20/100
    • 20/200
    • 20/400
    • Count Fingers – CF
    • Hand Motion – HM
    • Light Perception – LP
    • No Light Perception – NLP
  4. Once you have entered information in the above fields, click the Set button to save the data into the chart below (shown in the red rectangle above). Repeat the process for the other eye. Once you have entered all information, click the Save (6) button.
  5. If for some reason the patient cannot complete the visual acuity screening, click the Yes button and select an option from the Unable to Complete Reason field, then click the Save button. Options included in this list are shown below.

 

The system opens a new window where you must add a Quick Note. You can change the Note Type field from Administrative to whatever type of note it should be. The reason you selected for the patient being unable to complete the screening appears in the box below. You may enter additional notes or information in the text box, if desired. Click the Save button.

The system returns you to the Visual Acuity screen, where you can view the results of the screening. The system displays the name of the person who completed the screening and the date and time it was completed.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Primary Practitioner and Primary Therapist

ADCRR recognizes the importance and great benefit to patients’ overall health by having a dedicated Primary Practitioner and Primary Therapist assigned to each unit within the DOC. This proactive system approach helps prevent any gaps and ensures consistent care for all patients.

When needed, you can edit or reassign the Primary Practitioner and/or Primary Therapist within TechCare®. NOTE: Only those individuals with the correct administrative role can edit the assigned Primary Practitioner and/or the Primary Therapist within the Admin dashboard.

From the Main Screen, select the Admin option from the Global Menu, then click the Housing Primary Carers option. The system displays the Housing Primary Carers screen.

You are able to view all of the housing units within the DOC and you can also view which Primary Practitioner and/or Primary Therapist is assigned to the unit. If you have the ability to update or edit the information, click the name of the housing unit you want to update. The system displays the Edit Housing Primary Carers window, where you can use the dropdown menus to select the Primary Therapist or Primary Practitioner for the specified housing unit.

Once you have made the update, lick the Save button. You should see the changes reflected on the Housing Primary Carers screen. 

The system updates the Primary Therapist and Primary Practitioner information for all patients within that housing unit. You can view this information from the Main Patient Screen.

When you click the Primary Practitioner or Primary Therapist hyperlinks, you can view the history of practitioner or therapist changes, along with the date and time the changes occurred.

Click the Close button to return to the Main Patient Dashboard.


Assigning individual patients to a Primary Practitioner or Therapist

Due to the size and the number of patients in a housing unit within the DOC, many units may have multiple Primary Practitioners and Primary Therapists. It may become necessary for you to reassign a Primary Practitioner and/or Primary Therapist to an individual patient. To edit or update the information for a single patient, you click the More Information dropdown menu located above the Patient Number on the Main Patient Dashboard.

Click the Edit Patient option from the dropdown menu. The system displays the Edit Patient screen. At the bottom of the screen, select the appropriate Therapist and/or Practitioner from the dropdown list, then click Save.

You can view the updated patient information on the Main Patient Dashboard.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

Mental Health - Primary Therapist Queue

The Primary Therapist Queue displays a list of all patients who have either been moved to another housing unit based on a mental health score of MH-3xx or above, or if their Primary Therapist has been manually updated. To access this queue, click Queues from the Global Menu, then click Mental Health.

The system displays the active patients in the queue. You can filter your list by date range (1), housing location (2), or by Primary Therapist (3).  Once you have selected your filters, click the Filter button. You can also Export your patient results to Excel.

You can view information in the following fields:

  • Patient ID – This field displays the patient’s Identification Number. Click the hyperlink to view the patient’s chart in a new tab.
  • Name – This field displays the patient’s name in last name, first name format.
  • Previous Facility – This field displays the name of the previous housing facility and unit.
  • Previous Housing – This field displays the previous housing location code.
  • Previous MH Score – This field displays the Mental Health score that the patient had from the previous housing location.
  • Facility – This field displays the current housing facility and unit.
  • Housing – This field displays the patient’s current housing location code.
  • MH Score – This field displays the current Mental Health score of the patient.
  • Primary Therapist – This field displays the name of the provider if the user entered one.
  • Stamp – This field displays the date and time that the alert came into the queue.
  • Timer – This field displays the length of time the patient has been in the Primary Therapist Queue.
  • Comment – This field displays any comments about the patient.
  • Action – You can use this dropdown menu to do the following:
    • Edit Select this option to view the change that occurred, who made the change, the date and time the change occurred, and who it was changed to. You can enter a Comment in the field and click Save to save the information. These comments are not stored in the patient record, only in this queue.

    • View Patient – Select this option to open the patient’s chart in a new tab.
    • View Treatment Plan – Select this option to view the patient’s Mental Health Treatment Plan in a new tab.
    • Discharge– Select this option to discharge the patient from the queue. The system displays the Discharge From Queue window, where you must select a Discharge Type of either the Mental Health Transfer of Care Summary form or the MH Transfer Review form. Once you select the appropriate form to complete, click the Discharge button and the system will automatically open the form for you to complete. Once you have completed the form, the patient will be removed from the queue.

© 2024 TechCare® User Manual - Version 4.5 / Proprietary & Confidential

© 2024 TechCare EHR®. All rights reserved.