Occupational Health Configuration

Article author
Sam Wood
  • Updated

Please Note - There is newer content available in separate articles under the Occupational Health section of the Help Centre.


 

Case Management Workflow

Overview

The case management workflow can be easily digested when broken down into phases. These are:

  • Referral Creation
    • A referral comes in to Meddbase from the referrer. This could be either sent electronically via the portal, or created on behalf of the referrer by a Meddbase user.
  • Referral Processing
    • Once the referral has been received a work item is generated for a Meddbase user to process. The referral goes through stages of collaboration, acceptance/rejection, and booking.
  • Clinical Appointment
    • A successful referral will result in an appointment being booked. This appointment becomes the home for all clinical findings during the patient encounter.
  • Report Writing
    • Completion of any appointment created from an occupational health referral results in a report being written. The report process has many optional routes, but will eventually result in the report being sent to the employee and referrer (if authorised).
  • Report Authorisation
    • Completed reports may go through an authorisation phase whereby the employee reviews the document and either accepts or refuses the content.
  • Follow Up (Optional)
    • Assuming this is not the last planned encounter with this employee, a follow up referral is created. This action leaves the case ‘open’ and begins the cycle again from the ‘Referral Processing’ phase.

Initial Setup

In order to begin using the Occupational Health system, it must first be enabled under ‘Admin’ > ‘Configuration’ > ‘Chargeable Features’ where it is listed as ‘Online Referral Portal’. Once enabled, new options will become available throughout the system.

Appointment Type Configuration

Any appointment type can be used for a referral, however, the appointment type must have at least one associated specialism to be referred.

The specialism of an appointment type can be configured under ‘Admin’ > ‘Appointment admin’. With the correct appointment type selected, clicking ‘Edit’ will bring up the appointment type properties. From here, clicking on the ‘Referral’ tab will bring up the required options.

The ‘Specialism’ option can be set to any suggestion available in the catalogue and is visible in reporting as well as the incoming referral task.

This same dialogue also allows you to select the ‘Referral Questionnaire’ to be completed by the referrer at the time of referring. If blank, no form will be required to refer and this stage will be skipped when referring.

 

Billing Rules (Referral Options and SLA Configuration)

The Billing Rules configuration respects all the usual rules within Meddbase, however, an additional rule will be present if the Online Referral Portal is enabled. The new ‘Portal Referral Rule’ must be added to the chargeband to allow referrals to be created. It is important to note that the rules that apply are the ones on the employer chargeband of the employee, not of the referrer.

This GIF demonstrates how to add a portal referral rule to a new client's default charge band:

addreferralrule.gif

The ‘Portal Referral Rule’ includes a number of options as described below:

  • Allow booking through the portal
    • Controls whether the services can be booked by the referrer.
  • Allow referring through the portal
    • Controls whether the services can be referred by the referrer.
  • Referral Contact Protocol
    • Controls the suggested contact process for the recipient of the referral when any of the services are referred.
  • Days to make a contact
    • Number of days from receiving the referral to making a booking before an SLA is failed for the listed services.
  • Days to place an appointment
    • Number of days from making a booking to the appointment before an SLA is failed for the listed services.
  • Days to finish the report
    • Number of days from the completion of the appointment to the sending of a report before an SLA is failed for the services.
  • Days to review the report by patient online
    • Number of days available for the patient to review the report. Time is measured from the report being available to automatic release, less any non-working days or bank holidays.
  • Days to review the report by patient manually
    • Number of days available for the patient to review the report when sent via a manual method. Time is measured from the report being available to automatic release, less any non-working days or bank holidays. Can be overridden at the time of report completion.   
  • Provided Services
    • The list of services for which the above SLA and configuration options apply.

 

Troubleshooting

I cannot find the ‘Portal Referral Rule’ in the billing rules.

The Portal Referral Rule is visible only in systems with the Online Referral Portal enabled. To do this, visit ‘Admin’ > ‘Configuration’ > ‘Chargeable Features‘ and check the option for ‘Online Referral Portal’.

 

Pre-Placement Questionnaire System

Overview

The Pre-Placement Questionnaire (PPQ System) is designed for employers looking to send questionnaires to employees. Each questionnaire can be configured with certain triggers that when hit, will feed back a status to the employer. The PPQ system specifically hides all the employees responses for confidentiality reasons and only exposes the ‘status’ to the employer.

To send a questionnaire to an employee, the manager would need to:

  • Log in to the referral portal.
  • Navigate to the employee’s profile by clicking Employee Overview > the name of the employee.
  • Click ‘Send Questionnaires’.
  • Choose a questionnaire to send.
  • Click ‘Send’.

Questionnaires can also be bundled into modules and sent as a group.

To create a new module:

  • Flag the questionnaires you want to be part of the module.
  • Click ‘Save as new module’.

To send the module, simply select it and click ‘Send’.

Once sent, the questionnaire will appear on the employee’s profile as incomplete. Once completed, the manager will be shown the status of the questionnaire and, if the employee’s answers indicated that a referral is required, be given the option to refer them.

If a referral is made, the employee’s responses will be attached along with the referral letter to the referral.

 

Split Medical Record

Overview

This feature ensures that data recorded about patients in a primary care context is hidden from the practitioner carrying out an occupational health appointment.

 

Certificate Rights

Appointments, documents and consultation notes are tied to a medical certificate. Your permissions on that certificate dictate whether those appointments, documents and notes are visible to you, the user.

If you are using Meddbase to record both primary care data and occupational health data, you will need two medical certificates - one for each context. Your primary care appointment types will be tied to a primary care certificate, and your OH appointment types will be tied to an OH certificate.

Users whose role involves viewing occupational health data will have permissions on the OH certificate, whilst users whose role involves viewing primary care data will have permissions on the primary care certificate. Users whose role involves viewing both types of data, such as System Administrators, may have permissions on both certificates.

The following GIF demonstrates how to add a role group to the OH certificate and set permissions:

addrolegrouptomedcert.gif

Each certificate has the following rights:

  • View Patient Demographic
    • If granted, demographic data in this context can be viewed.
  • View Patient Medical Record
    • If granted, medical data in this context can be viewed.
  • Modify Patient Medical Record
    • If granted, medical data in this context can be changed.

These rights can be granted or denied to individuals or role groups.

If you have permissions on just one certificate, you will only see appointments, documents and consultation notes relating to appointments tied to that certificate. You will also only be able to participate in appointments that are tied to that certificate.

If you have permissions on both certificates, you will be given the option to select a policy to filter by the first time you view a patient’s medical record. This decision remains active until you choose a different policy to filter by, which you can do by going to the patient record, clicking ‘choose policy’ and selecting a policy. Whilst you are filtering by a medical policy, certain appointments, consultation notes and documents may not be visible.

 

Appointment Type Configuration

To apply a medical policy to an appointment type, go to ‘Admin’ > ‘Appointment admin’, choose the appointment type to edit, then change the ‘medical policy applied’.

 

Troubleshooting

Can’t see relevant appointments, documents or medical history.

If you can’t find the appointment, document or data you’re looking for on a patient’s record, you may not have the correct policy set for that patient. To change policies, navigate to the patient’s record, click ‘choose policy’, then select the policy that matches the context of what you’re looking for.

Error: The medical policy you have applied for this patient does not permit you to participate in this appointment.

If you are receiving this error message, it means that the policy you have set for the patient you are seeing does not match the medical policy applied to that appointment type. For example, if you are a doctor that can see both OH and primary care data, and you last viewed primary care data on that patient’s record, then you will need to switch policies to OH before you can act as an attendee for their OH appointment.

To change policies, navigate to the patient’s record, click ‘choose policy’, then select the policy that matches the appointment type you are trying to book.

 

Health Surveillance Workflow

Overview

The Health Surveillance workflow within Meddbase is quite simple, and can be broken down into the following steps;

  • Recall Creation
    • The system is made aware of the need for a recall, either by manual creation or bulk upload.
  • Appointment Booking
    • The recall prompts the need for an appointment to be booked. This can either be completed by a Meddbase user or a Manager on the Referral Portal.
  • Clinical Appointment
    • The appointment goes ahead, and all relevant clinical notes are taken within Meddbase.
  • Documentation Creation
    • At the end of the appointment, some form of documentation (usually a Fitness Certificate or similar) is created, and shared with the employee and employer.
  • Follow up/recall creation
    • If the Employee should continue to be on the Health Surveillance program, a follow up recall can be created to ensure the Employee is seen again for their next recall

 

Recall Creation

When Recalls are created, they can be assigned an Admin Reminder duration. This is the amount of time before the recall is due when it will appear on the Recall Admin user group’s task list as a work item.

Recalls are visible as soon as they are created on the Referral Portal, and no specific time delay needs to be set to make them visible.

Recalls cannot be created by Managers, but if a recall list or similar is provided, this can be imported to the system using the Data Imports tool.

Billing Rules

To allow managers to book appointments to satisfy these recalls, a specific type of Portal Referral Rule should be created. If the recalls should be Bookable rather than Referable, then the option Allow booking through the portal should be checked, and every appointment type and module that should be bookable should be added to this rule.

 

The ‘Portal Referral Rule’ includes a number of options as described below:

  • Allow booking through the portal
    • Controls whether the services can be booked by the referrer.
  • Allow referring through the portal
    • Controls whether the services can be referred by the referrer.
  • Referral Contact Protocol
    • Controls the suggested contact process for the recipient of the referral when any of the services are referred. Note that if appointments are booked directly on the portal, the Contact Protocol will not be used.
  • Days to make a contact
    • Number of days from receiving the referral to making a booking before an SLA is failed for the listed services. Note that if appointments are booked directly on the portal, the SLA will not be used.
  • Days to place an appointment
    • Number of days from making a booking to the appointment before an SLA is failed for the listed services. Note that if appointments are booked directly on the portal, the SLA will not be used.
  • Days to finish the report
    • Number of days from the completion of the appointment to the sending of a report before an SLA is failed for the services. Note that if appointments are booked directly on the portal, the SLA will not be used.
  • Days to review the report by patient online
    • Number of days available for the patient to review the report. Time is measured from the report being available to automatic release, less any non-working days or bank holidays. Note that if appointments are booked directly on the portal, the SLA will not be used.
  • Days to review the report by patient manually
    • Number of days available for the patient to review the report when sent via a manual method. Time is measured from the report being available to automatic release, less any non-working days or bank holidays. Can be overridden at the time of report completion. Note that if appointments are booked directly on the portal, the SLA will not be used.
  • Provided Services
    • The list of services for which the above SLA and configuration options apply.

Document Sharing

When Health Surveillance Documents are created, they are shared directly to the portal, rather than following a release protocol as Case Management documents do. To share a document with the Manager, after the document is created, the Meddbase user should check the Share with Employer checkbox on the Document overview screen.

Troubleshooting

I cannot find the ‘Portal Referral Rule’ in the billing rules.

The Portal Referral Rule is visible only in systems with the Online Referral Portal enabled. To do this, visit ‘Admin’ > ‘Configuration’ > ‘Chargeable Features‘ and check the option for ‘Online Referral Portal’.

The Referral Portal:

Features

Case Management

The Case Management section allows clients to view open cases and closed cases, along with the ability to create a new referral. The case view allows managers to view the current status of all cases including:

  • The state of the most recent appointment (unbooked, booked or arrived)
  • The state of the report (complete of incomplete)
  • SLA information (pass or failed for each of the three SLA markers)
  • The status of each case

Furthermore, clicking on a case allows the manager to dive deeper into the information held against a case including viewing any documents or appointments for the case. When in the individual case view, the single case can be reassigned to another manager by clicking ‘Allocate Case’ and typing the employee number of the manager to be assigned.

Additional documents can also be attached to the case by clicking on the ‘Attach new Document’ button on the menu bar.

 

Employee Management

The employee management section allows clients to view their employees and register new employees on the system.

The ‘Employee Overview’ page allows managers to view the most recent activity for each employee. Clicking on an employee’s name will take them to their profile, where they can find a list of that employee’s appointments, questionnaires, recalls and any documents shared back to the employer.

Clients can create new employees by clicking ‘create new employee’ and completing the required fields. Once created, a patient record for that employee will appear on Meddbase.

 

Health Surveillance

Managers who have the Statistics/Charts permission can view a report which details all upcoming recalls, for user specified departments, which are due in a user specified date range. They can also view statistics on variables such as Compliance, broken down by Department.

Once a recall is due, the manager can either refer for this recall, or book the appointment directly, from the Employee Overview section. After searching for the correct patient record, and opening that record, a section called Recalls will become visible. Each recall will have a Book button next to it, which will start the booking/referral process.

 

User Management

The user management section allows clients to view/edit portal users and create new portal users on the system.

The ‘User Overview’ page allows managers to view portal users and edit their details. Clicking on a user’s name will allow them to edit that user’s details, set their accessible departments and set their portal access permissions.

Clients can create new users by clicking ‘create new user’ and completing the required fields. Once created, a patient record for that user will appear on Meddbase.

 

Reporting and MI

The Referral Portal has access to a set of prebuilt reports, detailed below. In all cases, the manager logged in to the Portal can see data only for Department(s) which they have access to.

Report Name

Definition

Assessment Outcomes

An overview of outcomes from all assessment types

Case Outcomes

An overview of outcomes from Case Management

Compliance

An overview of compliance for all assessment types

Disease Codes

An overview of disease codes that have been recorded in employee departments

Recalls

A list of employee Recalls

Referral Reasons

An overview of reasons why employees have been referred

 

All reports can be filtered by dates, and can be drilled through by Employee Department, and in some cases by Appointment Type (where relevant).

The reports have some configurability; each of the outcome based reports can have a concept ID linked to them which specifies what clinical form element to report on, and each of the reports can also be limited to only report on a specified list of Clinical forms and/or services.

 

Information Library

The information library contains a series of documents which Client Managers can access and download. These are uploaded to a specific folder in the Meddbase FileShare. If additional documents need to be uploaded, please submit a support request to Meddbase including the documents.

These documents are visible to all companies with access to the portal, and cannot be changed based on the employer of a user.

 

Manager Experience

Portal account settings

Each manager using the portal will have a corresponding patient record in Meddbase. What is and is not visible to them on the portal will depend on their portal account settings.

To view and change their portal account settings:

  1. Navigate to their patient record in Meddbase;
  2. Click Referral Portal > Portal Account Settings.

From there, you can grant access to the following portal features:

  • Case management: The user can refer patients and manage the referrals.
  • Recall management: The user can view and manage the recalls.
  • User management: The user can create/edit and remove users.
  • Bulk case reallocation: The user can reallocate all referrals from one user to another.
  • Statistics/Charts: The user can view portal statistics and charts.
  • Questionnaire management: The user can share and delete questionnaire modules.