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manual:organisation_administration_careplansadministration

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Organisation Administration - Care Plan Management

Care Plan Management allows administrators to set up care plans templates for users in MMEx.
There will be two types of templates that an administrator see:

  • Global Templates and
  • Organisation Templates.

The visibility of the care plans for assigning are controlled on this administration screen

Global Templates

These are templates that are available to every organisation in MMEx. They are maintained by MMEx Administrators.

Actions that can be performed by an MMEx Administrator only on a Global Template include:

  • Edit the content and characteristics of the care plan
  • Control the active status of a template.

Other actions that can be performed on global template (both by MMEx Administrator and Organisation Administrator)

  • Clone: This allows the user to clone a public template which create a copy of that template as a self-managed private template for that organisation. If that organisation has children under it, it will automatically assign the cloned template to those orgs.


The user has the option to migrate the cloned template to all patients within the organisation and also to external organisations within the customer.

NB: if you are cloning the Lifetime Surveillance Careplan, please insert your org initials in brackets after the title. eg “Lifetime Surveillance Careplan Female(ISAHCS). Also advise MMEx helpdesk so that the system can be configured to apply this care plan to all of your patients automatically.

  • Subscribe/Unsubscribe: This functionality allows the user either to subscribe or unsubscribe to a template. Subscribe = care plan will show in the patient care plan selection list, Unsubscribe = care plan will not show in the patient care plan screen.

Organisation Templates

These are self-managed templates that have been created by and are available to your organisation. Actions that can be performed on an Organisational Template are as follows:

  • Create, edit and control the active status of a template
  • Share templates with an organisation.



Organisation Administrators can only share with active organisations within their customer group whereas MMEx Administrators can share a careplan (on your behalf) with any active organisation in the system.

  • An organisation's template can be promoted to being a global template only by an MMEx Administrator.

Creating a New Care Plan

Organisational care plans can only be created by users with permission to manage care plans in the Organisation Centre.

On the Care Plan Management tab, in the Organisational Templates section click on the Add new care plan button. Give your template a name and complete the remaining fields.

  • Name - users will search for this term - ensure that the name given is logical for users searching for a management plan
  • Type:
    • Options: Chronic Conditions, Disease, Ears and Hearing, Health Checks, Immunisation, Management, Men's and Women's Health, Renal, Respiratory, RHD, Sexual Health
  • Description:
    • This information can assist the user to select the correct care plan
  • Mutually Exclusive Care Plans
    • Select care plans that should NOT be applied to a patient if this care plan is already applied, or care plans that, if already applied, should prevent this one being applied
  • Upper Age Boundary Criterion:
    • This is the age at which the care plan stops being relevant to patients and no longer displays in the selection list.
    • The care plan will not appear as an option in the selection list for patients older than this age.
  • Lower Age Boundary Criterion:
    • This is the age at which the care plan starts being relevant to patients and should display in the selection list.
    • The care plan will not appear in the selection list for patients younger than this age.
  • Sex Criterion:
    • This is the gender that the care plan is relevant to.
    • The care plan will not appear in the selection list for patients without this gender recorded
  • Ethnicity Criterion:
    • This is the ethnicity that the care plan is relevant to.
    • The care plan will not appear in the selection list for patients without this ethnicity recorded
  • Owner user:
    • Select your organisation's name here.
  • Privacy Level
    • Select a privacy level if relevant
    • Only users with this privacy level set in their user profile will be able to select the care plan and see the care plan and its contents after it is applied.
  • Automatically Archive Care Plan when all Activities Complete
    • Check the box if you want this to occur.

Click Add. The care plan will be created and additional options will display.

Observation Based Criteria

You may then add observation based criteria

Select the relevant data type (observation/pathology result) complete the rule parameters and click Add

The care plan will now also only display as an option for selection for patients that meet the observation criteria.

Care Plan Tags

You may also add a tag to the care plan.
Tags link careplans to specific parts of MMEx.
For Example:

  • Cancer - links the care plan to the Cancer module
  • Ear Health - links the care plan to the Ear Health and Hearing module
  • OCHRESTREAMS tags - link the care plans for nKPI reporting purposes

Click Update to save the care plan.

Cloning Care Plans

In the Organisation Centre, on the Care Plan Management page, you will see a list of Public (global) care plans. These care plans are visible to all subscribed orgs.

If you want to keep using one of the careplans, but want to modify the activities to better suit your organisation's unique requirements, the clone feature allows you to create a clone of the a public template. This creates a copy of that template as a self-managed private template for your organisation.

If your organisation has children orgs under it, the cloned care plan will automatically replace the public one for those orgs. Cloning should ALWAYS be done at the parent organisation.

Identify the care plan you wish to clone. On the action menu select Clone.

A pop up will open.

You have the option to rename the care plan. If you are cloning the Lifetime Surveillance Careplan, please insert your org initials in brackets after the title. eg “Lifetime Surveillance Careplan Female(ISAHCS)

By default, the clone operation will copy the new template and replace it for all patients, within the organisation, who are linked to the old template.

  • Selecting Yes will migrate the cloned template to all patients within your organisation and at the end of the operation will appear in MY Templates. The global template will be unsubscribed.
  • Selecting No will create the clone of the global template and it will appear in My Templates. No Migration will occur in this case. The global template will not be unsubscribed.

If your organisation is one of several linked to a single customer, you will see this field, followed by a list of all orgs connected to the customer.

Checking this box allows migration of the care plan to the other organisations within the customer, and will copy it to those as well. (When you click ok.)

Note: Cloning and migrating can be a long-running operation. Please do not close or cancel the operation once you begin.


If you manage cloned care plans, any changes to them MUST ONLY be made in organisation centre of the owner organisation. Deviation from this will create duplicate care plans that cannot be removed.
If you manage multiple sites, you should consider turning off Care Plan Management permission on all user profiles except the one linked to the owner organisation so that changes are not inadvertently made at the wrong organisation.

Care Plan Activity Template Management

In the Organisation Centre you will find a tab named Care Plan Management.
At the bottom of this tab you will see a section for Care Plan Activity Templates that displays activities that have been created by your organisation.

Activities display in a table with sort-able columns:

  • Name
  • Category
  • Privacy Level
  • Edited By and
  • Edited Date

The list can be searched using a keyword search and filtered by current and archived activities.

Create New Activity Template

To create a new care plan activity template click on Add new activity template button. Complete the following fields:

  • Name - the display name of the activity.
    • Check spelling is the same as other activities of the same name that you want to display as a single activity
  • Category - the group name under which the activity will display in the care plan schedule view
    • Check that category spelling is correct so that only one version of that group displays
    • Previously used categories will display for selection
  • Description - a brief description of the activity can be recorded (optional). This will display in the care plan activity window
  • Priority - assign a display order ranking for the activity
    • Determines the order of display of activities within a group
    • If no priority is assigned, the activities will display alphabetically.
  • Show - select modals to display in the activity event completion window
    • Progress Note editor - displays the full progress notes entry field in the activity
    • Medication - displays the Medications table in the activity
    • Medical History - displays the Medical History table in the activity
  • Privacy Level - assign a privacy level restriction to the care plan activity
    • Only users with the selected privacy permission will be able to view the activity
  • Items - select additional display fields for care plan activities as well as items that, when recorded in the patient record, will trigger auto-completion of the care plan activity event.
    • Items display in a table that allows their display order to be configured.

Care Plan Activity Template Items

Click on Add New Item.

Select and item from the Item type list, complete the configuration and then click Save.
Items you can configure include:

Control

A control is a pre-configured assessment module.

From the drop down list select a control to include in the activity event window. These controls allow you to complete a specific assessment from the activity window. You may choose from the following:

  • Smoking
  • Alcohol
  • Diet/Nutrition
  • Physical Activity
  • Oral Health
  • Sexual and Reproductive Health

You can also mark the control as Mandatory - this means a user will not be able to mark the activity as complete unless the assessment has been done.

Form

A form is an existing hard-coded form, used to capture specific sets of information that is already developed in MMEx. Available options can be seen on the Forms page.

In the search, field type the name of a form that you would like to link to directly from the activity. The form will be linked by a Launch Form button and a hyperlink to the completed form will be created after the form is completed.

You can also mark the form as Mandatory - this means a user will not be able to mark the care plan activity as complete unless the form has been completed. For forms where a draft option is available, the form needs to be marked as complete.

Observation

An observation is a patient data type that is usually recorded on the Observations tab in the patient record. These can be pathology items, general observations or other data-recording fields.

Select a patient data type by typing the name into the search field.

You can also mark this as Mandatory - this means a user will not be able to mark the activity as complete unless the specified observation is recorded in the patient record.

Question

A question is a customisable feature where specific and targeted questions can be asked and responses recorded. This provides users the ability to fully customise careplan activities to suit a range of new functionality. The information captured will be reportable using ISA Insights.

In the Display Text space, type the question/text you want to display in the care plan activity. Select the answer type and add the values (response options) you want to display. You can reorder the responses by using click / drag / drop.

Billing Item

Select a billing item by typing the code (for MBS items) or the name (for custom billing items) into the Search field. Billing of that billing item will mark the activity as complete You can also mark this as Mandatory - this means a user will not be able to mark the activity as complete unless the medication event has been recorded in the patient record.

Medication Event

Select a medication (type name into the field) and mark whether prescribing, dispensing, supply or administration of that medication is the trigger for activity completion. You can also mark this as Mandatory - this means a user will not be able to mark the activity as complete unless the medication event has been recorded in the patient record.

Pathology

Select a diagnostic test or test template from the RCPA list (the same list used in Pathology requests). Requesting a test of this type will mark the activity as complete.

You can also mark this as Mandatory - this means a user will not be able to mark the activity as complete unless the specified test has been requested. If you are wanting to ensure results are received BEFORE a pathology activity is marked as complete, either:

  • add both Pathology and Observation items to the same activity - the activity will be marked In Progress when the tests are requested and Compelete when the results are received; or
  • add only observations for the results that will be requested.

Immunisation Event

Select a group of immunisations that will trigger completion of this activity.

The selection list contains all generic immunisation groups. These groups are managed by MMEx with current immunisations added as they are released, added to schedules or become available in MIMS. Recording an immunisation of that type will trigger the activity to be completed.

Managing item display

Added event items will display in a table in the activity details screen. The items can be re-ordered, grouped by a category and arranged so as to facilitate optimal workflow for users.

To add a new item category, type the category name into the field and click +.

The category will be added to the bottom of the table. Click anywhere in the category cell and drag it to re-position.
To edit the category name click on the pencil icon adjacent to the category name, make the required change and click the tick icon.

If a category has no items/events listed in it, the category will be removed when the activity is saved.

Edit an existing Activity Template


REMEMBER, when you update an activity or care plan you are updating existing activities and care plans. The time it takes to update/add the item is directly proportional to the number of patients with that care plan applied.
ONLY CLICK THE SAVE BUTTON ONCE.
Clicking more than once will result in multiples being added to your plans.

Editing existing activity attributes is a restricted activity.

Activities can either be managed at a Global and Organisation level,

On the Care Plan Management tab, in the Care plan Activity Templates section you will see a list of activities already created Click on the Action menu and select Edit.
The activity properties will display and be available for editing.

You will see an advisement that notifies the care plans that will be impacted by the change you are about to make.

Changes will only affect overdue and or incomplete activities. The changes will be made instantly.

Care Plan Activity scheduling

Whereas activity creation is restricted, any user with care plan access can add activities to a care plan and define the schedule.
To configure the schedule for a care plan activity, firstly select the activity you will be adding to the care plan template or individual patient care plan.
The Select Activity screen shows care plan name, category and Privacy Level, use the search field to filter the list by activity name or category.
The Information icon displays the items configured for this activity and the mandatory status of them if relevant to assist you to select the activity you wish to add. Select your required activity and click on it. The schedule configuration screen will display.

Here you can configure the schedule to your requirements or select from a list of previously configured schedules for this activity.

Three fields are used to determine when an event starts, how often it occurs and when it finishes. They can be used in combination to schedule the activity to your requirements.

Starting Field

This field determines when the activity will start.There are three options for defining when a care plan activity should start.

Begin when the schedule is added to patient

  • the activity scheduling commences from the date that the care plan or activity is applied to the patient record
  • this works best for events:
    • that need to be completed at the time of diagnosis of a chronic condition, or at the beginning of a treatment plan
    • that occur at intervals that are measured from the date of diagnosis (eg 3 months after start)

Begin at a specified interval after adding the activity to the patient

  • activity scheduling starts at a specific time after the application of a care plan or care plan activity
  • works best for events that need to be completed at specific intervals after diagnosis, or at specific intervals during a treatment plan
  • enter the number of periods into the Start field and select the period (days,weeks,months or years)

Begin when patient is at a specified age

  • this is most suited to age related activities such as immunisation schedules
  • enter relevant age into the Start field and select the qualifier (days,weeks,months or years)

Frequency Field

This determines how often the activity will occur.There are three options for defining when a care plan activity should start.

Regular event

  • for events that occur at regular intervals from the time specified in the start field. eg every 3 months, yearly
  • enter the interval length into the empty field and select the period (days,weeks,months or years)

At specific times after the start time

  • for events that occur at specific intervals after the start date
  • enter the interval length into the empty field and select the period (days,weeks,months or years)
    • you can specify the interval using a comma separated list e.g. 1,3,6,12,20 weeks
  • Check the box Retain Period Between Events if events need to always occur at the specified interval. this become important when events are completed late.
    • Example: HBA1c should be completed every 3 months, this time I complete the task 1 month late:
      • if I don't have this box checked, the care plan activity will remain scheduled for 2 months time.
      • if I do have this box checked, the schedule will automatically readjust to move the next task to 3 months from today. (All subsequent tasks will be spaced 3-monthly from today as well)

A single event - for events that occur once only

  • for one-off care plan activities.
  • As this is a one-off event, the Care Plan Ending field will not display if this option is selected.

Care Plan Ending Field

The Ending field determines how long the care plan activity recurrence (as defined in the frequency field) will continue. It is important to select the correct ending period for your activity, otherwise your care plan will display activities that are no longer relevant and clinicians will be prompted to undertake activities that are not required (over-servicing).

Event is continuous and doesn't end

  • use this option for activities that are ongoing and continue for the duration of the care plan. The activity will only end when the careplan is archived.

End at a specified interval after the start date

  • use this option for activities that run for a specific period of time eg. weekly for 3 months

End when patient is at a specific age

  • this option sets activities to end when when the patient reaches a specific age.
  • it can also be used where the frequency of an activity changes when a patient reaches a specific age.
    • Cease this activity at that age and start a new similar one, with a different frequency at the same age.

Activity Relevance

Activity relevance is important for ensuring that the care plan schedule is not overcrowded or displaying apparently empty activity lines.

If an activity is only relevant to patients of a certain age, specifying this here means the activity will only display when the patient is within that age range. Example:

  • an activity that is relevant for a patient who is 13+, set the older than field to 12.
    • when the patient's age changes from 12 to 13 the activity will start to display
  • an activity that is relevant for a patients up to the age of 65, set the younger than field to 66
    • when the patient's age changes from 65 to 66 the activity will disappear.

Scheduling Scenarios

Below are some scenarios for schedules to assist you with determining how the settings should be applied for best functionality.

Activity should start as soon as the care plan is added and I want it to happen every 5 years until the patient is 70
Start:Begin when the activity is added to the patientFrequency:Regular event; 5 Years Ending: End when patient is at specified age; 70 years
Activity should occur when the patient is 2,4 and 6 months old. The frequency spacing is important for clinical reasons.
Start:Begin when the patient is at a specified age; 0 Days OldFrequency:At specific times after the start time 2,4,6 Months. Check Retain period between events Ending:End at a specified interval after the start date: 1 Year
Activity should occur every month until the patient is 2, then every 6 months until they are 10, then one follow up when they are 13
Start:Begin when patient is at a specified age; 0 Days Old. Frequency:Regular Event; 1 Month Ending:When patient is at a specified age; 2 Years Old
Age Relevance: when patient is younger than 3 years old
Start:Begin when patient is at a specified age; 2 Years Old Frequency:Regular Event; 6 Months Ending:When patient is at a specified age; 10 Years Old
Age Relevance: when patient is older than 2 years old & when patient is younger than 11 years old
Start:Begin when patient is at a specified age; 13 Years Old Frequency:Single Event
Age Relevance: when patient is older than 12 years old & when patient is younger than 14 years old
Activity should occur only once, 6 months after I add the care plan
Start:Begin at a specified interval after adding the activity to the patient; 6 months Frequency:Single Event

Changes made to existing care plans will automatically update the care plans of patient with that care plan applied.


It is recommended that you apply the careplan to a test patient to ensure you are happy with the scheduling and display of activities as the final step in creating a new plan.

manual/organisation_administration_careplansadministration.txt · Last modified: 2019/11/28 04:09 by sarahb