CMTS FAQ. Frequently Asked Questions about CMTS. Technical:

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1 CMTS FAQ Frequently Asked Questions about CMTS Technical: Question: CMTS is displaying strangely on my computer and not working. What s going on? Answer: You may be using an incompatible browser version. We suggest using Google Chrome (version 4 or higher) or Firefox (version 4 or higher) rather than Internet Explorer. Question: I can t log into my account after various attempts. How do I get back into my account? Answer: If you are unable to sign in, your account has probably been disabled due to too many incorrect login attempts. CMTS will lock you out of your account after 5 incorrect login attempts. Your account administrator will have to log in and reset your password and then re-enable the user and/or provider account (see pages 2-3 of the Account Administrator User Guide on Understanding User/Provider Roles ). Question: Is there a way that I can see each PHQ-9 assessment in CMTS? We can only see the first and latest assessment. Answer: When looking at the caseload in CMTS for your site, you will only see the first and last PHQ-9 scores. However, you can look at the PHQ-9 history on the patient level. To do this you select a patient ID, and under Patient on the top bar go to Treatment History. There you will find the dates each PHQ- 9 was administered, the scores, and also a graph that shows you the trend in each clinical measure. You can also view their PHQ-9 history in the Clinical Dashboard. Question: CMTS will not let me add a new follow-up note for a patient and it is giving me a message about uncommitted changes. How do I add my follow-up note? Answer: CMTS will only let one person create a note at a time, therefore it is likely that another Care Manager or someone else has a drafted note open. Communicate with others working with that patient to see if they have a drafted note open. The note will show up on the reminders page. Once this person has either deleted or completed the note, you will be allowed to create a note. Question: Is there a way to turn off auto-save for adding notes? Answer: Unfortunately CMTS does not have the function to turn off auto-save unless it was specifically programmed for a project or account. Question: Is there a way to convert a follow-up note to a contact attempt? Answer: There is really no way to convert a follow-up note into a contact attempt. However, if the Care Managers want to go back and enter the contact attempts, then the CMTS account administrator could delete the inadvertent follow-up notes. The Care Manager would need to send a list of the CMTS ID number and dates of the notes to be deleted to their local CMTS administrator. Instructions for deleting notes are available in the CMTS account admin user guide: Account Administrator User Guide.

2 Administrative: Question: I am having some challenges removing a previous Care Manager from CMTS. I have attempted to remove them, but their account displays 5 active patients and it will not allow me to disable their account. Answer: CMTS will not allow you to deactivate a provider s account unless all active patients have been moved to another provider. You can deactivate their user account (the account which allows them to access CMTS), but to deactivate their provider account (the account which allows you to select their name and assign patients) you need to remove the active patients from their caseload. In order to deactivate the account, you will need to remove them as a provider for all of the patients they re assigned to. To do this, you ll need to sign into your care manager or site manager account (since you cannot manage provider assignments from your admin account) and view the list of active patients assigned to them, which you can do from the Caseload Statistics. Then you ll go into each patient s Provider & Clinic List and remove them as a provider. See pages 7-8 of the Account Administrator User Guide on Managing CMTS Accounts and pages of the Care Manager User Guide on Managing Provider and Clinic Assignments. Question: How do I calculate total patients enrolled to-date and engagement with the Care Partner? Answer: Go to Caseload > Caseload Lists > Custom Search; select Advanced Search on the right side of the screen. From the drop down, select Site and then your site. You will see a screen with your patients, with various statuses. To look at Phase 2 enrollment on or past 8/1/2017, select Date and enter in this date. Use the #CBO and #w/ Family columns to count to your sites specific enrollment guidelines. Of note, the El Sol site is following a slightly different guideline and tracking 6 or more sessions with the CHWs. Documentation: Contact Type Overview Follow-up Contact: After an initial assessment has been completed with a patient, subsequent encounters with the patient should be marked as follow-up contacts, whether in clinic or by phone. The follow-up note is similar to the initial assessment note but does not include questions about patient history specific to the first encounter. Any unsuccessful follow-ups should be entered into the registry as contact attempts. In contrast to contact attempts, a follow-up note is used when something therapeutic occurred during the call or visit. Contact Attempt: A contact attempt is different than the follow-up contact and should not be used in place of the follow-up contact note, nor does it count as a follow-up appointment. The contact attempt note is intended to document when a care manager or case manager has attempted to contact the patient and has been unable to reach them. Nothing therapeutic has

3 occurred during the time of the contact attempt. Contact attempt notes can guide discussion of alternative methods of reaching the patient or know when a patient may need to be discharged (i.e., a high number of contact attempts without follow-up notes may indicate that a patient should be moved to Inactive status). Collateral Contact: A collateral contact is intended to document communication with an outside source about the patient s care when the patient is not present. Such communication typically would occur with a professional outside the clinic + CBO partnership (e.g., a social worker at a nearby food bank or Adult Protective Services). A collateral contact could also document contact with a family care partner if the patient is not present. We anticipate these types of contacts with family will be infrequent, but should be documented if they occur. Question: If only the family is present during a contact and not the patient, does this count as a follow-up contact? Answer: Family contacts that occur without directly involving the patient should not be documented as follow-up contacts. The exception to this is if you first speak with the family and then the patient which should be considered a patient contact with the family. Instead, these contacts that involve the family without the patient should be documented as collateral contacts (the option directly underneath New Contact ). We anticipate these types of contacts will be infrequent but should be documented when they occur. Question: How does CMTS differ from an EMR? Answer: Electronic Medical Records (EMRs) keep track of clinical information about a specific patient s care for clinical, billing and legal purposes. Most EMRs are not designed to track or manage caseloads of patients or to facilitate the delivery of evidence-based care for specific medical or behavioral health conditions. Some EMRs have query or filter functions that are called a registry. These functions allow you to identify all of the patients being treated for a specific condition. However, these filter functions do not typically have clinical logic and algorithms that facilitate the delivery of evidence-based clinical care. In some cases, this functionality can be built into the EMR but this usually takes a significant investment of both time and money Question: If a patient is on a relapse prevention plan, and then becomes unstable during that period of time, do they become re-enrolled in a new episode of care or is the visit considered a follow-up? In that case, they are left on the relapse prevention plan. Answer: You would go back to the patient s RPP note (a patient can only have one at a time), and enter an End Date. This bumps them off of RPP status and brings them back into active treatment status within the same episode of care. Then continue entering follow-up notes. See page 20 of the Care Manager User Guide on Relapse Prevention Plan

4 Question: Is there a way I can document an encounter after the fact? I saw a patient and did not enter the info in a timely manner. Another Care Manager then entered info on an encounter she had after the one I did. The system won t let me enter the info without indicating that everything entered after that date will be hidden or lost. How do I do this? Answer: This pop-up just means is that you cannot fill out the sections for Care Plan and Appointments because there are more recent follow-up contact notes entered that would contain this information if it was relevant. This warning just means you won t have the option to fill out these sections on this specific follow-up contact note (and you shouldn t necessarily need to), but everything else can be filled out without a problem. Question: Is there another way to deactivate a patient in CMTS other than discharge? We cannot get a hold of a patient who was entered into CMTS but never given an initial assessment. Answer: If your contact attempts with someone have been unsuccessful, you should discharge them anyway. If they are contacting you again, you can pull up their record and open a new episode of care for them by entering an initial assessment note. Question: Do we only need to enter psychotropic medications into CMTS versus all medications? Answer: Yes, however, if you are conducting a case review with CMTS open, and the Care Manager and Psychiatric Consultant are finding that they have to constantly go back and search through the patient s medical record in the EMR to look at medications other than psych medications, then it may be helpful to put all medications into CMTS. Question: I have a question about the field # on meds. The amount and percentage of patients on meds seems like a lot. How does CMTS calculate this? Is it based on antidepressant medication or something else? Answer: The medications column is meant to reflect how regularly Care Managers are reviewing patient medications during their appointments, not necessarily what percentage of patients are taking medication. The medication list confirmation is required at each appointment and is meant to ensure that the Psychiatric Consultant can see an accurate and complete med list.

5 Question: How are treatment adjustments captured in CMTS? Answer: Please see this page on our website about documenting treatment changes in CMTS. Question: How do you document a PHQ-9 in the CMTS registry that was done in clinic but without an accompanying session with a Care Manager or Psychotherapist? Answer: Care Managers can enter a note into CMTS dated with the date the PHQ-9 was actually collected, then enter "no session" in the location field at the bottom of the note. Notes marked as "no session" will not count in the contact totals, but the PHQ-9 score will be included on the patient's treatment history.