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Santa Cruz County Behavioral Health CWS Go-Live Preparation / End-User Training Competency Assessment

Process & Instructions: Santa Cruz trainers should use this script to prepare for the Go-Live Preparation event.

In addition to practicing and preparing to demonstrate the skills listed in the script, all trainers should complete the following tasks in Avatar

BEFORE the Go-Live Preparation event and be prepared to demonstrate the completed items:

o Admitted at least one client to Avatar and completed the following for at least this one client: Entered a Diagnosis (Use form: Diagnosis) Entered at least three problems in the Problem List (Use form: Problem List) Added the client to their caseload (Use form: Caseload Assignment) Scheduled an initial assessment appointment (Use form: Scheduling Calendar) Submitted a Psychosocial Assessment (Use form: Psychosocial Assessment SC) Submitted a progress note, based on the appointment, documenting the appointment/service and completion of the

assessment (Use form: SC General Purpose Progress Note) Completed a Treatment Plan (either MH or ADP) (Use form: SC MH Treatment Plan or SC ADP Treatment Plan)

o Registered a group in Avatar Use form: Group Registration) o Scheduled an appointment for the group Use form: Scheduling Calendar) o Submitted group progress notes for the scheduled group Use form: SC Group Progress Note)

Note: The forms for the listed tasks above are identical for ADP and MH with the only distinction being that MH and ADP use different Tx

Plan forms, as noted. The client’s EPISODE is what distinguishes whether the documentation on the form applies to MH or ADP. The

exception to this rule is that certain forms, like the Problem List, for example, will apply to all episodes.

The Go-Live Preparation event will be conducted via teleconference.

While sharing their computer screen with a Netsmart trainer one-on-one, Santa Cruz trainer(s) will follow the script to describe and demonstrate their knowledge of the system.

The Netsmart trainer will score the presentation for each trainer, answer questions, and provide constructive feedback.

The goal is to support Santa Cruz trainers and to assure that those responsible for testing and end-user training are comfortable and prepared.

Any identified issues should have a defined action plan to address.

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Scoring Grid: Indicator Status

Minor to no coaching required. Clearly understands and can articulate system workflow and concepts.

Improvements needed but not major. Nothing that would require an action plan, simply noted as constructive feedback.

Requires action plan to address. Include action plan as a part of constructive feedback.

[Clinician’s Name] [Optional: summary statement of trainer’s preparedness in lieu of specific comments on individual items.]

Basic Navigation

Task Score Constructive Feedback Demonstrate the ability to log into Avatar OK

Explain concept of widgets and consoles OK

Demonstrate use of Lock / Unlock and reasons for Lock vs. Sign Out

OK Is the Lockout function time limited? Yes, it has not yet been determined how long the lockout time will be.

Demonstrate configuration of Spell Checking and Widgets from the Preferences menu

? Clarify. Found the preferences area but it does not appear that anything but default dictionary can be selected successfully.

1. Preferences / Spell Checking Tab: Demo how to add new words to the default dictionary. Demo how to add a new word to use as a shortcut (e.g. add the new word “SCPT” then use in a progress note as a shortcut for “Schizophrenia, Chronic Paranoid Type”).

2. Preferences / Widgets Tab: Demo how to arrange and add widgets to view. Demo how to reload Home View from server.

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Demonstrate ability to add or remove widgets from Home View

OK

Demonstrate restoring the Home View / Chart View to the original/saved configuration

OK

Demonstrate how to minimize, toggle (on/off), and restore; undock, maximize, and re-dock widgets

OK How do you Toggle on and off? Toggling is referring to moving from one open form or chart to another and back to the home view.

Home View and Admissions Process

Task Score Constructive Feedback Explain use of the My Clients widget OK

Demonstrate knowledge of Search Clients OK

Demonstrate use “Advanced” link to confirm whether a new client is already in the system, and/or distinguish among multiple clients with the same name

OK See “advanced” link to the right of “Search Clients” field.

Show the client you admitted in preparation ? Clarify. Is this the client you would like us to use in our End-User Training Competency Assessment?

Yes, please use the client you admitted in preparation as the demo client during the assessment.

Explain Episodes (Program of Admission) vs. Programs of Service as used by Santa Cruz county, and demonstrate use of Client Episode widget

? Remains one of the most frequently asked questions. The concept is hard to sink in. Can you take a stab at your simplest explanation with examples for our different users?

** Answer will be updated soon. **

Demonstrate adding a client to caseload ? Clarify. Use Caseload assignment form?

Yes, use the Caseload Assignment form.

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The Avatar-only definition of “caseload” is the list of clients you have added to your MyClient’s Widget. This can be any client. You can use this list of clients in a quick way to open their charts and to open forms for the clients from the home page. This is what “caseload” means in Avatar.

Demonstrate removing a client from caseload ? Clarify. Also, use Caseload assignment form?

Yes, use the Caseload Assignment form.

Explain difference between Recent Clients & My Clients (i.e. difference between session state and permanent state)

? Clarify. Is Session State is only active during current login? When you logout and login again is the permanent state all you will see (those clients actually assigned to the user’s caseload”.

Yes, you have described session and permanent state correctly.

Demonstrate methods for adding forms to the My Forms widget

OK

Demonstrate organizing forms in folders in the My Forms widget

OK

Demonstrate use of Search Forms vs. Browse Forms and explain priority order for ease of access (1. Widget, 2. Search, 3. Browse).

? Clarify. Are they quickest in numerical order? Widgets immediately available. Search if you don’t have form in your my forms widget. Browse if you need a full list.

Yes, you have explained the form access priority correctly.

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Chart View

Task Score Constructive Feedback Demonstrate access to Chart View, and how to navigate between Home View and Chart View

OK

Demonstrate ability to print the Psychosocial Assessment (or other completed form) from the Chart View

OK

Demonstrate using the Chart View’s “Inquiry Views” to display existing form data

? Clarify “Inquiry View” – no label or title in Avatar. We could not find an area in the Chart View actually labeled “Inquiry View”. We think it is the series of green links to forms listed under the chart “Overview” section.

SHORT ANSWER: Yes, these green links are where you access the “Inquiry View” of data previously entered in a form. LONG ANSWER: These views are the quickest and easiest way to see data that has been entered in a given form. They are also really useful because of the filtering tools they provide and the ability to print and open a new form for data entry. At the same time, they are a challenge for trainers because of the nomenclature issue you are pointing out. “Inquiry View” is the most logical terminology I could come up with (I can explain why if you’re interested in an even longer answer). I realize that “Inquiry” is not a meaningful term for most users, so your trainers will have to use the term consistently so users will eventually know what you’re talking about when anyone uses the term. At least “Inquiry” has the advantage of being unique. It is important for trainers and users to be able to master the terminology necessary to distinguish the Inquiry View from other ways of viewing data after it has been entered:

1. Widgets (e.g. Progress Notes widget) 2. Crystal Reports (where available) 3. TIFF image (available in the Chart View or via the Clinical

Document Viewer for users with permission to access them – this decision is pending)

4. Scanned documents

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Note that #3 and #4 above also appear as green links in this left-hand Chart View column, yet they are not “Inquiry” views. In your screenshot, where you see the heading “Documents” at the bottom, those links will take you to TIFF images (the product of Document Routing) and/or scanned images. You won’t see any scanned images at the moment (because nothing has been scanned yet), and depending on the decision noted in #3 above, you may not see any TIFF images by the time we Go Live. So for now, training should focus on the Inquiry Views that users can add to their chart by clicking the “filing cards” icon (next to the red X in your screenshot), then adding Form Groups and then adding forms to the Form Groups you create.

Demonstrate how to add forms to the Chart View’s Inquiry View list (to enable viewing data that has already been entered in an unlisted form)

OK

Order Connect

Task Score Constructive Feedback Demonstrate knowledge of the purpose of Order Connect (MD use for meds, labs, allergies, all will come back to Avatar)

NONE OF THE TRAINERS REPORT THAT THEY WILL BE USING ORDER CONNECT

I do understand that the trainers will not be using Order Connect. But I’m sure that all practitioners will want to be able to see a client’s current medications, labs, allergies, and vital signs. There is no expectation that trainers would know how to use OC or to be prepared to train on OC. However, they do need to be able to describe the role of OC within Avatar and how clinicians can view OC-sourced data (i.e. meds, labs, allergies) within Avatar. All we’re looking for here is for the trainers to be able to tell us that:

a. OC is a module of Avatar that will be used by prescribers to manage clients’ medications and labs.

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b. OC is not accessible to non-prescribers, but its data can be viewed by non-prescribers via widgets (displaying, for example, Current Medications, Labs, and Vital Signs) if they are enabled in your Home View/console or Chart View. (Decisions are pending about which widgets will be available in the Home and Chart views.)

c. Allergies are displayed in the upper right-hand corner of the Chart View.

d. Also, all practitioners should know (trainers should train them) that the Med Service Progress Note form will be used by all prescribers to record medication services. This is important because if you are looking for progress notes written by prescribers, you can use the Inquiry View of the Med Service Progress Note form to view only the notes submitted using that form (i.e., submitted by prescribers).

Demonstrate use of console and/or Chart View to view meds, allergies and labs

OK

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Assessments / Data Entry

Task Score Constructive Feedback Demonstrate launching a form from the Home View without first selecting a client from My Clients widget

OK

Demonstrate launching a form from the Home View by first selecting a client from My Clients widget

? If Client is selected why doesn’t a PROGRESS NOTE open for them?

Progress notes, unfortunately, don’t work the same way as other forms in this regard. If you’re opening a progress note form from the Forms & Data widget on the Home View, you will have to manually select a client after you open the form.

a. There is good news for folks who use the Scheduling Calendar… Users/User Roles can be configured to make it possible for you to right-click an appointment (in the Scheduling Calendar or the My Calendar widget), then select the Progress Note form. When the form is opened this way it is pre-populated, not only with the client’s name but with all the info from the appointment.

b. Another way to open the progress note form with the client’s name pre-populated is by clicking “Add” from the Inquiry View, as shown in my screenshot below.

c. The other way to open the progress note form from the Chart View is by clicking the green “plus” icon (upper left, just to the right of the tab that says “Chart”). But this opens the Forms & Data widget (the same one that’s on the Home View), so you’re back to #1 above – the form will open, but it won’t be populated.

d. Editorial comment – I know this is inconsistent, but Netsmart has made a lot of progress on making it better very recently (among other improvements, the functionality described in a. and b. above is brand new), so I’m confident there are more improvements in our future.

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Demonstrate two ways to launch a form from the Chart View

OK From “Inquiry View” and from Browse forms tab “+”

Explain Episode Selection and Pre-Display ? Please clarify

Episode Selection and Pre-Display – when you open an episodic form in Avatar (Diagnosis in the example shown in screenshots below), the first thing you see is an Episode Selection screen (first screenshot) and the second thing you see is a Pre-Display showing all instances of the form previously filed for that client/episode (second screenshot). These two screens are fundamental to opening forms in Avatar. They are displayed when opening most – but not all -- client forms in Avatar. These screens look a lot alike, and they show up sometimes but not always, so I’m looking for trainers to know the difference between these two screens, what they are called, when/why they are displayed (and when/why not), and what to do when they are displayed.

a. Episodic forms are those that are specific to an episode. When you enter data in an episodic form, it is for the specific client in the specific episode. When opening an episodic form, the Episode Selection screen is displayed first.

i. Progress notes, again, are unique in this. Progress notes are episodic, but they do not display Episode Selection or Pre-Display when you open them. Instead, in progress notes you select the client and episode within the form itself (or they are pre-populated as described above).

b. The Episode Selection Screen displays even if the client has only one episode.

c. The Pre-Display is skipped when there are no previous entries. So for episodic forms, if there are no previous

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records, the form opens directly after the Episode Selection screen.

i. The buttons at the bottom of the Pre-Display will allow you to Add a new record and Cancel. In addition, they MAY allow you to Edit or Delete an existing record.

d. Most client-based forms are episodic, but not all. For example, Diagnosis is episodic, but Client Contacts is not episodic. Non-episodic forms do not display the Episode Selection screen when you open them. For example, when you open Client Contacts, you will see a Pre-Display showing previous entries, if any exist. If no previous entries exist, the form opens directly.

A good compare and contrast for practice: ADP Treatment Plan is episodic. MH Treatment Plan is not episodic

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Demonstrate the difference between Closing and Submitting a Form & why some forms have Submit button greyed out

? Can’t submit if required data is missing or form has already been submitted – VERIFY?

Closing vs. Submitting – here I’m looking for trainers to know a couple of things:

a. If you simply close a form (by clicking the red “X” in the left-hand panel), data is not saved. Data is only saved when the form is submitted.

i. One exception is the “Plan Builder” page of the Treatment Plan. Here, if you click “Exit To Home Screen,” all data is saved (assuming you have entered data in the Plan Builder).

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b. Some forms have their own special button that does the same thing as the Submit button. Progress notes are a good example. The “submit” button is at the bottom of the form next to the Draft/Final field, and it says “File Note” rather than “Submit.” In this case and others like it, the usual Submit button (in the left-hand panel of the form) is greyed out.

c. P.S. – your comment (can only submit when required fields are completed) is not what I’m looking for here, but it is a True statement… when submitting as Final. When submitting as Draft, in most cases (not all) you can submit even though required fields are blank.

Using the Psychosocial Assessment form, demonstrate data entry (required fields, dates, check boxes, radio buttons, templates, text editor, spell check)

? No one could find a form with an embedded Template. Which form can we use as an example? Did not see it in the Psychosocial.

Templates – good point! There is one in the General Purpose Progress Note form, in the Client Presentation field. This would be a good opportunity to show knowledge of the “notepad” (icon) functionality too, since the template is too big to display fully in the text box provided. (There are a couple of templates in the Med Service Progress Note form too.) In this item, I’m really looking for trainers to show the basics of Avatar data entry. Psychosocial is a good form to use because it has so much variety, but you’re right, I don’t think it has any templates, so it’s OK to skip that part and show it when entering a progress note.

Demonstrate the ability to use the Online Documentation link from within a form

OK But, only for some forms. Found it for the “Problem List” form.

Santa Cruz Forms

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Task Score Constructive Feedback Demonstrate the ability to run and print a Crystal report (use Master Client Inquiry report for this task)

? WHO WILL NEED TO KNOW AND USE THIS FEATURE?

Crystal Reports – you will all definitely use them. As described above, along with widgets and Inquiry Views, Crystal Reports are a primary way of viewing data that has been entered in Avatar. Your management team is hard at work defining reports that will be useful to you. They are not all available yet, but the Master Client Inquiry report is always available. To run the Master Client Inquiry report, search for a form of that name, fill out the parameters, and click “Process.” What happens next is what happens with any Crystal Report you run in Avatar. Trainers need to be able to show how this works, what to do at the prompts, how to navigate in the report once it is displayed, and how to navigate from the report back to Avatar (or close the report) when done. Plus… you will love the Master Client Inquiry. It may need a bit of tweaking for your purposes, but it is a really good report that is very useful to practitioners.

Describe prerequisite for use of Staff Messaging form

? We practiced with this but don’t understand what the “prerequisites” are.

Staff Messaging – the prerequisite for all users who want to use the Staff Messaging form is that they need to have defined a list of users they can send messages to (“Notification Users”). Your Notification Users can include individual users, or pre-defined list(s) of users. Pre-defined lists are setup using the User List Management form, where you can add individual users or all users assigned to a specific user role to a pre-defined list. So for example, an easy way to get all social workers on your Notification Users list is to create a User List called “social workers” (User List Management form), add the “social worker” user role to that list, then add that list to your Notification Users list (Notification Users form). (This is a hypothetical example – I

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don’t know what your actual user roles are, and these won’t really be available in their final version until we are in the LIVE environment.)

a. You probably already have your Notification Users list because you set it up in training. But the people you are training will not have their list yet, so they will not be able to use Staff Messaging and they will be asking you to “fix” it.

b. In addition to User List Management, the forms you will use for this task are:

Demonstrate use of Staff Messaging form OK Practiced in room successfully between some participants.

Demonstrate use of Service Request form ? Clarify which form is the “Service Request Form”. Is this question referring to the “service request and disposition log”?

Service Request – sorry, my mistake. I’m referring to the Service Request and Disposition Log. This form is really Santa Cruz-specific more than Avatar-specific, so you will need to seek guidance about when it needs to be filled out. I’m looking forward to learning all about it from you!

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Problem List & Treatment Plan

Task Score Constructive Feedback Show the Problem List you previously created for the client.

OK

Demonstrate launching the SC MH Treatment Plan OK

Demonstrate creating a new SC MH Treatment Plan

OK

Demonstrate selecting a problem from the Problem List to include in the Treatment Plan

OK

Demonstrate entering a new Problem in the SC MH Treatment Plan

OK

Demonstrate entering goals into the SC MH Treatment Plan

OK

Demonstrate entering objectives into the SC MH Treatment Plan

OK

Demonstrate entering interventions into the SC MH Treatment Plan

OK

Demonstrate entering plan participants into the SC MH Treatment Plan

? Should the client always be included as a participant?

Yes, good question. The client should always be included as a plan participant, because that’s the only way to get the client’s signature (using the signature pad).

a. Also, the practitioner should always be included as a plan participant. The practitioner DOES NOT sign with the signature pad (their signature is electronically added when they submit the Final Tx Plan), but they must be added in order to receive a “notification” (To Do) when the plan is due for renewal.

b. Anyone else who participates in creating the plan, or any other staff who need to get a “notification” should also be included here.

Demonstrate submitting and editing a draft SC MH Treatment Plan

OK

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Demonstrate deleting a problem, goal or objective from a draft SC MH Treatment Plan

OK

Demonstrate finalizing the SC MH Treatment Plan and routing it to yourself (as if you were the supervisor). What/where is the electronic signature?

? Is the electronic signature your password?

Yes, the electronic signature is authenticated when you enter your password. That’s the same as if you signed your name in ink to a paper form. The only way it could be forged is if someone knows your password (which is why you would never share it with anyone).

Demonstrate rejecting the SC MH Treatment Plan OK

Demonstrate reviewing the To Do for the SC MH Treatment Plan

OK

Demonstrate finalizing the SC MH Treatment Plan OK

Demonstrate approving the SC MH Treatment Plan OK

Demonstrate viewing the finalized SC MH Treatment Plan in chart

OK

Demonstrate creating a new SC MH Treatment Plan, pulling forward data from the previous plan

OK

Scheduling Calendar

Task Score Constructive Feedback Demonstrate launching the Scheduling Calendar OK

Demonstrate adding a new individual appointment OK

Demonstrate knowledge of calendar icons OK

Demonstrate knowledge of right-click menu OK

Demonstrate scheduling a group appointment ? Clarify. Must you first register a group, including yourself as a provider?

It is best practice to register your group (Group Registration form) before scheduling the appointment. You do not, however, include yourself as provider in the registered group. When you schedule

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the appointment, you specify the provider and the group (the one you registered).

Progress Notes

Task Score Constructive Feedback Demonstrate entering a SC General Purpose Progress Note based on the scheduled appointment

OK This issue was addressed and trainers were assigned to a site.

Discuss why it is important to fill out fields in order in the progress note form

? Clarify. Because logic is built into the form so that some choices populate depending on which others are filled out?

Exactly – this is especially important in progress note forms (though not only progress note forms). Going out of order MAY lead to data loss / need to re-enter data.

Demonstrate saving the progress note as draft. Do all required fields have to be filled out to save in draft? Is this different on progress note forms vs. other forms?

? Clarify. No, not all fields need to be filled out, but some do. We believe this is true of some other forms in the system but we’re not positive which ones. Can we ask which forms are exceptions?

At the moment progress notes are the only exception I’m aware of. Every form has at least one field (may be client/episode and/or a date field) that must be filled out in order to save in Draft, but generally speaking you can save forms in Draft without all required fields completed – except for progress notes.

Demonstrate retrieving the draft note and finalizing it

OK

Demonstrate viewing a finalized Progress Note in the chart view Progress Notes widget

OK

Demonstrate use of the Progress Notes widget, including filtering by number of days and Note Type

OK

Describe the difference between viewing progress notes in the widget vs. the “Inquiry Views”

? Clarify. Widget displays predetermined specific information but has less information than the inquiry view?

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What you said is not wrong, but the main difference is that the Inquiry view shows ONLY those progress notes created in the specific form whose view you select. So if you select the inquiry view for SC Med Service Progress Note, you are only going to see progress notes created using that form (MD access only). The widget shows all notes (with filter at top for date range) regardless of the form used. (Also important: the widget displays progress notes sorted by data entry date – not by service date).

Show your registered group and the group notes you submitted previously (in preparation)

? Clarification needed on Group notes, registering logic. Many folks having trouble with this. Some groups aren’t actionable for some clinicians?

** Answer will be updated soon. **

Explain the process of submitting a Group Default note and finalizing scratch notes

? Clarify Scratch Notes?

Scratch notes are the progress notes Avatar creates when you submit the Group Default Note (one identical scratch note for every client in the group). To finish your group notes, you must personalize/finalize each scratch note so it is unique to the individual client.

When does it make sense to save a group note in draft? If you did, how would you retrieve it?

? Clarify? Using the SC Group Progress Note form under “Select draft note to edit”?

Yes, that is how you could retrieve a draft group note once submitted. You can also open it directly by clicking the link in the draft note To Do item.