MobileWyse 2The Visit

Objectives:

•Facesheet: View and Navigate- ever enter specialcharacters, suffixes or prefixes in the demo raphicinformation in a chart.•Check Medications in Med tab‘Check Diagnoses — Codes! Onset! Exac dates‘Starting a visit in PW- Visit type!selection of forms•Ending a Visit‘Signing a Visit‘Visit Memos‘Patient! Mine List and Today Tabs•NHNF Visits

Homework:Either in Training Mode or with a Preceptor:‘Complete Visit & Note•Add a Medication to the record

V

11

7StepstoavisittoaSuccessful Visit

1. Locate the patient chart- the patient must have a visit scheduled. Thepatient will be located on the My patients list on the MobileWysedesktop, and in the Schedule for today’s date.

2. Review -the Overview, Memos, Medications and 485. You mustreview the goals, clinical orders and medication list prior to every visit.A green arrow indicates that there is a new medication or order sinceyour last chart access. Read memos from the desktop (Notes button)or in the Schedule screen (show Info button for patient with a 1.preceding their name).

3. Start visit- when face to face contact is made with the patient.a) Choose the visit reasonb) Choose the forms required- ex. Visit Note & Narrative

4. DAR tab- Enter Mileage and’travel time or verify NaviWyseprepopulated values. Enter Pre-Post time for each patient. Pre-Posttime is time spent on the patient, outside of the visit that day.Mileage, Travel time, and Pre-Post time can be updated in the DAR atany time.

5. Document the visit — while in the home with the patient. Alwaysassess pain in the Pain form and always complete a Narrative note forMedicare patients. Update any Clinical orders or Medications.

6. End the Visit- as per company Policy, when leaving the patient’s home.7. Sign — any updated orders first, and then the visit. Once the visit is

signed, it cannot be altered. Any addendums to the note must bemade through the Call Log.

Note: All appointments should be confirmed prior to making a visit. A phonecall with no answer does not constitute a Not Home Not Found visit.The Note Home not Found visit is reserved for actual visits to theHome. See process for documenting Not Home Not Found visits.

Find the Patient Chart on theMobileWyse Clinical Desktop.

I— —

- 1. Select the patient from thelist on the Desktop by:

Double clicking on the patientname, or click the name oncethen click the Chart button.

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2. Reviewz’~. i-; .-.i- k .4.

LI lit Overview- containsTrakrq, Owt NOT R&

SN Attributes—Mew Precautions, DNR and

ProfileV~sds care team found here.Forms425 Profile-contains patient DxCalls .

Mtgs medications, allergies,make demographics and

contacts.485- contains clinical

orders, goals,interventions and DCplan.

* Patient Chart

Start the Visit

485cab

ClickSta itVisit

he Visit Tab

Hit Start Visit to bag n a new V sit

C——0~ can run

New Visit

The current visit order will auto populate.

OrderQ2. O~R

Type

1-2xIWkx lOWks (8121/14)Routine Visit

C412 1114

1035A 1. Choose Type=VisitReason

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Pre-Post Time in the DAR tab.I

Forms2. Select Forms- Visit Note,Narrative. Additional formsmay be added at anytime

during a visit.

Enter/Verify Mileage, Travel and

OK

End the VisitComplete Visit

Type Routine Visit -

Date 08i21 14

Verify Visit Type, Date, time In/Outstop and Billable StatusThin Default. ~

At a? W2t12014

Neil.ei0812112014Ass~nedbMwseHeal.RN

Vet ToDa1 ~bdat~einCe.l

Ther~iy b~at1e m CellI SN ~ .‘Ceil

Remove - Added by Accident

Sign Visit

0

t Remove - Added by Accident

1.May change Chart Thinning from Default ifdesired.

2. View Visit Stats on the left.3. Add Memo to next visit if needed.

4. Update info in the DAR tab.

Click OK to Sign the VisitYou MUST address the Red Items before you can sign the visit Yellow Items can be overriden at your d scretlon

Document Errors

Overdue Orders

Uni~wd Ordn

1. Address any yellow Chart Compliancewarnings.

2. Go to the DAR and Visit tabs to Verify VisitReason, date, time in/out and Pre-Post time

as needed

Populating travel time and Mileage t the DARwith NaviWyse

When Starting a visit, NaviWyse adds the travel time andmileage estimates to the DAR when the AR tab then

are clicked.lielt: You musi top ~i the OAR tob and lof, OK rot the deiaII~ to flow to the OAR for subniis&on

New Visit

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htih~~ 1~’.,ii 000 I.t0iInn —

ftschedule IhWo

>Miles and travel timeV.~4 i~i.h.Mn ~th.. ft

estimates will populate19. 034

to the right of theUse the Map Button to accessdirections from the pervious patient. patient in the Schedule

Screen.4/

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>Highlight a patient on the list and use the arrow up/downto change the visit sequence.>Mileage and travel time will update as the visit order ischange.>NaviWyse cannot provide travel estimates to the firstpatient, to patients visited after a meeting or lab drop.

Documenting Not Home Visits

All patient appointments should be confirmed prior to the visit. If a patient is not home for a confirmedvisit, a Not Home/Not found visit should be entered in MobileWyse.

1. Start a visit using the Not Home/Not Found visitReason (Type).

New Visit2. Uncheck Last visit docs. l~McxlOW1cs(7/2l/l4)

3. Narrative Note will remain highlighted. NomelNotFound

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.p-o

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4. Click on DAR Tab5. Enter Time spent looking for patient in the Pre/Post Visit field.6. Enter Travel Time and Mileage if not already populated.

New visit

1* Patient Chart

Resdia~uIe

7. Answer Yes or No to the Pop up Question Do you want toreschedule the Appoinment?

8. Choose No if:a. You want to attempt the visit again same day.b. You want to give the visit to another Clinician for another day (you MUST call

scheduling to reassign the visit to another clinician on another day).c. You plan to DC that visit appointment -proceed to the scheduling screen and DC the

appointment for that day. Never DC an appointment from your schedule if you are goingto call scheduling to give the appointment to another clinician. The appointment willcome off your schedule when the scheduler moves it. (Do not Unassign the visit appt!)

9. Choose Yes if you want to move the appointment to another day on your own schedule.10. In the Narrative document your attempt to make a visit and the reason patient was not home if

known.11. Sign the Narrative Visit Note.12. The visit will default to “0” time and Nonbillable.

Adding, reviewing, and adjusting Medications

The visiting clinician is responsible for creating and maintainingthe current medication profile or “Current Med List’~ which isaccessed through the patient chart in the Profile.Note-at Soc and recert the Med list may be accessed via the485/POT creation Wizard.

Adding a medication to the current Meds Profile1. Navigate to the patient’s chart.2. click on the patient Profile.3. Double click on Medications to display the med list

ft Patient ChartSN . Facesheet

InsuranceOverviewProfilevisits Medieahon~Fomis Document Tr4fl5 CalendarCalls Mverse EventsIntake Patient AttrthutesSN 41 0 Cl n cal Alert Thresflclds Current

Note the type of meds list displayed:

> soc N/TD>RocIf the current Meds list is not already displayed, click thedrop down arrow beside the list type box and select current.

Medications- Continued

Note the type of meds list displayed:Current

>SOC>ROCIf the Current Meds list is not already displayed, click the dropdown arrow beside the list type box and select Current.

Review the medications listed in the top portion of the screenby highlighting each medication and reviewing thedescription in the Details area that appears at the bottom ofthe screen.

* Patient Chart I Medi ationsCizrei~ Advair Disicus (tRflicasone-samlelerol) 501250 ~lcrOgram lraiaIallOo Did

Nigeienun Cm dan-dan~nale) 500 nijigram oral Bid

M.’lt

~ch.duI.d

PRF‘vim

peiidmn V polassiLmi 250 niiligra,s oral BidTØenoI (acetaninophen) QCIiOXYGEN 21 CONT

Oxygen 2

(oea~2~ii&pr E..ry Day)en

Sratn~ 520013arinday ba.A Sflmbea PT(51V201

Note- There are separate tabs for meds that are:a) Scheduledb) PRNc) IVd) Hx/Meds (DC’d meds)

Current -}

ScheduledFRNV/TO

Hx

To ADD a new MedicationClick the ADD button on the lower right of the screen.

To search for a med, start to type the name of the med in the searchbox on the bottom of the screen. Click the med as it appears above,then click ADD on the lower right.

Add Medication

Meds may be searched alphabetically by clicking the Alpha list.Order sets are also available-IV, 02, Flu vaccines, & hospice comfort kit.

Enter the med status in the

Add Plavix

Changes field

f~ STATUS

Q 2. Dosing 0 Existing MedEJ 3. Dispense

Q 4. Options 0 New Med ( < 30 days)Q5. Advanced 0 Change in Rx ( < 60 days)

U 6. Scheduled Time(s)

Q 7. Scheduled Day(s)

Complete the dosing Tab for all medsincluding Dose, Route & Frequency

~dd lisinopril~ I~fr.ooaig Standard Dosing

~:=~ 5mg,POJ 5 M..st.d Custom DosingJs S&.oMdrn4si Dose toJr &h.*MdOay(a

Units <Units>Route <Route>

Fr€q BidPRN

You may use Standard dosing if applicable. If not use the customdosing field. If a med is a PRN, always indicate the PRN reason (youmay free text or choose from the dropdown here).

•ln the Dispense Tab, you may enter a med start date, # of days, refills,pharmacy and prescriber.•Starting- Include dates that begin in the Future as meds will be listedas future meds in the meds in the med list in MobileWyse Start d teentered in thUs field does not flow to 485/POT orders•Prescriber field is required when the Prescriber is not the PCP (EX-Usethis field to enter an antibiotic start date and the # of days)

Edit lisinoprilI Ct.aiigs I

~2.Dosmg StartIng 05)29113

For 0 DaysQ4 OØaisQs Advanced With 0 . . RefiII(s

Q 6 SchedijledThsw()Q 7 scaieoii.~ Day(s) ~D Interchange Allowed

Pharmacy

Presc,Iber

<Ph a rmaçy~

<Clinician>

Options:1. Add notes specific to the medication.2 If a med starts in the future you, must indicate the future start date

here as well as in the Dispense tab. MD can only view the future medstart date when stated Th the Notes secton.

3. Add drug category-default is set by the last user and may be changed.4. Add drug administration details (Ex-check am & w/meal)

Note- Medications will view on their respective tabs> Scheduled> PRN

IV/TD * Patient Chart I MedicationsFuture Ic4a ~ OfCd OflJg

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Fine

Med Alerts> Appear when a med has expired or has been identified as an allergy

(**free texted allergies do not alert)> Yellow warning triangle indicates a high risk med.

Advanced tab in Medication screenAllows for designation of Med Financial, Pre-Pour

& Administration Status

Add tyelenol1. Changes Financial <Pavor>

Q 2. DosingQs. Dispense Pie-Pour <Pre-Pour>

4. Oplions

A4vanced Administer <Administer>6 scheduled Time(s)

Q 7 Scheduled Day(s)

Scheduled Times tab- Used to enter med schedule.Populates the Med Administration Record (MAR)at theHospice House.Schedule Days- Enables documentation for Non QDDosing

NOTE-Changes in med dosing should be completed byDC’ing the me” with the old dose, and adding the med withthe new dose If you enter the med dosing screen on anexisting med, and make no changes, always click CANCELw en done so you don’t create a duplicate order.

II med changes must be signed in the 485/POT.

Understanding the Medication List

IAdams, Abigail______ Risks 0

*Patient Chart I MedicationsOsisent

•J.pln

I&hJ~dPRN

t4ileds

Rspido Enteho Coiled (espido) 81 miLligram oral Every Day

gabapenirn 100 milligram oral Every Day

C Lasts (furosemlde) 40 millgram oral Every Day

lisinopril 10 mdligr.m ttl Every Day

N Pints (clopidogrel)

N Augmenim (amonicillip-ciavslapale) 5~ milligram oral lid lOd

d/s

I/s

OflOEN 21 CaNt

N • Osygen 2 Uers/min nasal cannula conirnuously

C= Change in treatment(red pencil) =unsigned med change(clock) = expired med

/ die =med discontinued in last 48 hours, DC unsigned

Alerts- Click to view. May indicate an expired med or anallergy.Note- Free texted allergies do not alert in the current system.

Current 6120/13 Expired~ Augrnentin

Open

IAIens

Able Joseph 27 Ple.nar(MLswrence, ISA 01~

Z~/l3

4)IWI$48 (%~~

N= New medication

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