1. MBCIS*WISEWOMAN Home Page
Contents
1. Cet aed teat Nous Eug 50 comm cei Total Cholesterol ist 180061 LIPID PANEL TC HDL TRIGLYCERIDES os ama i1 Tm ritcerite cose pio PO aonana hemoglobin Ate E E BL 30 s an pec Diagnostic ce Vs din Evluatn patent Type COC 3 2 3 Medical Evaluation Diagnostic Office Visit On the Referrals tab when the Service Visit Type selected is Medical Evaluation the selection of CPT Codes for the office visit depends on whether the patient is a New or Established patient as shown below Medical Evaluation CPT Code selection when patient New 199212 OFF MISIT ESTABLISHED PATIENT PARTI 8213 OFF CE VSIT ESTABUSUED PATIENT FULL 2214 OFFCE MISIT ESTASLSHED PATIENT FULL 96096 OFFCE VSIT ESTABLISHED PATIENT FULL Specify Diagnostic Otfice Visit Medical Evaluation Patient Type Noa CFT Cos y n vist oos FESTOS UST NEN PATENT PARTAL BIAN E tmi ore VIST NEW PATENT PARTAL 5109 OFF VISIT NEW PATENT Full EXAM marked wi re TEE NEW PATENT FUL aM VT NEW PATENT FULL EXAM 5007 OFFEE VISIT NEW PATIENT FULL DAM Medical Evaluation CPT Code selection when patient Established Specify Diagnostic Visit Medical Evaluation Patient Type Soest CFT Coce g er Visit nores Al folds marked aro roqui2. AI teise martea Cama Lemma 4 Outcome Management The new MBCIS WISEWOMAN is organized so that goals contacts navigation and evaluation items all fall under Outcome Management When you select the Outcome Management tab you will see its 5 sub tabs 1 Participant Agreement Captures information from the form of the same name 31 2 Contact this tab stores information from Lifestyle Program contacts and Health Coaching Sessions 3 Medic Adherence Corresponds directly to the questionnaire 4 Self Efficacy Corresponds directly to the questionnaire 5 Outcome Evaluation Captures information from Follow up cycles only 4 1 Participant Agreement When a client is ready to make healthy lifestyle changes as indicated by the Readiness Ruler her goals and plans are recorded on the Participant Agreement The form identifies related activities and the expectations for the client as part of the WISEWOMAN Program and what she can expect from the Program In MBCIS WISEWOMAN the Participant Agreement tab looks like this WISEWOMAN Participant Agreement Enrollments Health intake Screening Raforrats Nav Services case mam Contact Other contact medication Adherence Jf Self eficacy ff Outcome Eval Type Baseline Hei Home Conc io M gt
3. Clentperteipatedin et health coaching session or LSP encounter b n Clentconplees health coaching or LSP suc Ouicome Evaluation contact suse Gent exhibits positive changes on Outcome gt Evaluation contact i A A Visit Notes felis marked with are required Submit p Delete 30 3 4 Case Management Case Management will only be entered by a user with Administrative privileges to the MBCIS WISEWOMAN application but that information is viewable by any user with the WISEWOMAN role in the MBCIS WISEWOMAN application WISEWOMAN Case Management Screening Reterals Wav Servies alent Wea Reason for Case Management I Alert Blood Prossure lt Glucose Elevated Blood Pressure Participant Status Pending Case Management Results C for Medical Eval Atended Medical Eval Pantepating Complete Atented Medica Eva Relused rera Oprea but C Relused rolera Lost to Follow up No mediation prescribed deren 1 Not Applicable Not Applicabile Not Applicable Resolution de renmentPrescribet an aue ACIE UC MEET Contact ine Coll t Dae nnani Phone Cal 2 Date time Phone Can 3 Date L L Sont Dato Explanation tor Retused or not meeting 7 day edine tor diagnosi Cove Manager Sree arse CPT Code and Servico Deseription
4. Al fields marked wih are required 14 However if the client already has cycle information in MBCIS WISEWOMAN the WISEWOMAN Client Enrollments tab might look something like this WISEWOMAN Client Enrollments cient 1 1 mas Heath inter Referrats Cas Managemen Outcome Management Fotows Enrollment Type Relerred to HMP Medicaid Ne Enrolment Date Marketplace referral Participant Status BCCCP Status wisewoman Agency RNC CLEO Screening Facility Ce 08080 00 iw Readiness to Change as K chock this participant ls in WISEWOMAN Client Enrollments Client Age Print Helo Home Health Intake Screening Referrals case Management Outcome Management ls USER PURONGO D BAD RE N 2 5 1 Enrollment Cycle Data Entry The WISEWOMAN Client Enrollments tab contains basic enrollment information for each enrollment type UsoaA h AAEAEMA KLU L EE Enter the Required Fields Enrollment Type Select appropriate value from the dropdown list Enrollment Date Enter the date in MM DD YYYY format Participant Status Select choice from dropdown list Participant Status In Progreas InFollow up WISEWOMAN Agency Screening Facility Annu
5. The WISEWOMAN portion of the Michigan Breast and Cervical Cancer Control Navigation Program BCCCNP originated in 2008 and is herein referred to as MBCIS WISEWOMAN This manual has been updated to capture critical changes required by CDC for the FY2015 16 implementation of the WISEWOMAN Program The WISEWOMAN Program associated with MDE Version 9 0 was in some ways a total departure from things done earlier Although a few sections of this manual remain mostly unchanged from the 2012 version the remainder of the manual reflects the many changes made to the program Women participating in a Baseline or Returning cycle in WISEWOMAN will first complete Health Intake questions They will receive screening tests for elevated blood pressure or alert values associated with cholesterol or blood sugar Based on the screening results women may be sent for diagnostic follow up medical evaluation In rarer cases the results of follow up tests qualify the woman for case management services In WISEWOMAN all women will participate in Risk Reduction Counseling and complete a Readiness Confidence Ruler Those who are ready to make healthy changes will create lifestyle goals may participate in health coaching HC and may participate in lifestyle intervention programs LSP Navigating a client through the program is emphasized and client contacts for health coaching lifestyle intervention programs and other various contacts will be tracked in
6. MBCIS WISEWOMAN Data User s Manual 08 03 2015 Updated for MDE Version 9 2 BCCCN P Breast and Cervical Cancer Control Navigation Program WISEWOMAN DHHS Systems Use Notification The Michigan Department of Health and Human Services MDHHS computer information systems are the property of the State Of Michigan and subject to state and federal laws rules and regulations The systems are intended for use only by authorized persons and only for official state business Systems users are prohibited from using any assigned or entrusted access control mechanisms for any purposes other than those required to perform authorized data exchange with MDHHS Logon IDs and passwords are never to be shared Systems users must not disclose any confidential restricted or sensitive data to unauthorized persons Systems users will only access information on the systems for which they have authorization Systems users will not use MDHHS systems for commercial or partisan political purposes Following industry standards systems users must securely maintain any protected health information PHI downloaded printed or removed in any format from the systems When no longer needed this information must be destroyed in an appropriate manner specific to the format type By accessing information provided by the Michigan Department of Health and Human Services computer information systems 1 acknowledge and agree to abide by all gover
7. My goat ConTROL DET My Plan is CUT GLUTEN AND CONTINUE WITH WEIGHT WATCHERS lagreement Dote 0 s Fema Participant goal is related Medication Adherence Diabetes Prevention Quitting Smoking Weight Management ZNutrion Programming Physical Activity Loher specify Lifestyle Programs referred to Health Coaching HC CTake OF Pounds Sensibly TOPS Diabetes Prevention Program OPP Other please specify hoes wih are eure masa _ 4 1 1 Participant Agreement Data Entry Most fields on the Participant Agreement tab directly correspond to the items on the WISEWOMAN Participant Agreement form My Health Coach is Select the name from the dropdown list in MBCIS WISEWOMAN My goal is Enter the corresponding text from the Participant Agreement form My Plan is Enter the corresponding text from the Participant Agreement form Agreement Date Enter the date at the bottom of the Participant Agreement form by the signatures in MM DD YYYY format Participant goal is related to Check all boxes as indicated on the corresponding form If an activity has been entered for Other on the form enter it in MBCIS WISEWOMAN with descriptive text For the Lifestyle Programs referred to section of the tab in MBCIS WISEWOMAN derive information from the Participant Agreement form as shown WISEWOMAN Pa
8. 2nd BP Enter second BP measurement taken BMI Not entered automatically calculated by system Average BP Not entered automatically calculated by system Has Client fasted for at least 9 hours Select value from dropdown list Total Cholesterol mg dL Enter measurement value HDL mg dL Enter measurement value LDL mg dL Enter measurement value Glucose mg dL See Section 3 1 1 Hemoglobin Alc See Section 3 1 1 Venipuncture Make sure to check the Pay box when you add this Patient Type Choose the appropriate values based on the client s paperwork Visit Notes Optional text field for recording notes 3 2 2 Data Entry by Service Visit Type The table below shows the allowable field entry for the Referrals tab by the Service Visit Type selected as well as the CPT Codes associated with each service Service CPTCode Screening Medical Lab Other Alc Evaluation Work Unknown 1 BP No Yes Yes Yes 2 gp No Yes Yes Yes Fasting status No Yes Yes Yes Total 80061 No Yes Yes Yes Cholesterol 80061QW HDL 80061 No Yes Yes Yes 80061QW LDL 80061 No Yes Yes Yes 80061QW 80061 No Yes Yes Yes 80061QW 82947 No Yes Yes Yes 82947QW Hemoglobin Alc 83036 Yes Yes Yes Yes 83036QW Venipuncture 36415 No Yes Yes Yes Patient Type 99201 04 No Yes No Yes 99211 14 99386 87 99396 97 Eee The CPT code for the other related services need not be entered
9. ae 1 3 2 Referrals Tab The WISEWOMAN Referrals tab corresponds to clinical service data collected on the WISEWOMAN Screening form This tab is used for Baseline or Rescreening cycles The layout of the WISEWOMAN Referrals tab captures the Service Visit Type values of measures taken at the visit and associated CPT codes and approval for service payment When the Referrals tab is opened by default an A lc Afinion visit type will be present The system is set up this way because an Afinion Alc measure is collected during screening and needs to be associated with the screening tab when present In addition to Ale Afinior there are 4 other visit types that can be selected Medical b Work used to record data from a lab referral Non Integrated OV used to record an office visit for WISEWOMAN screening that does not take place at the same time as the BCCCNP office visit Other Unknown used to record data from any WISEWOMAN service that does not fit into any of the other categories Once a Service Visit Type is selected fields irrelevant for that service type will be grayed out to make data entry easier Unlike the Screening tab the Referrals tab displays billable services Relevant CPT Codes for a service are shown by drop down menu Beside each CPT code is a Pay box i e approval to pay and authorization date When the pay box is checked an authorization is submitted internally via the MBCIS WISEWOMAN sys
10. draw N Y ub Fasting blood Y Referrals tab Enter glucose value glucose from lab work results using Lab Work visit type N Lab Return to lab for fasting blood draw Y Office Alc obtained N Referrals tab Use default ATc using Afinion Afinion visit type to enter machine Hemoglobin Ale value Nor Lab Ale Y Referrals tab Enter Alc value from lab work results using Lab Work visit type NorY No glucose No Glucose N Enter reason missing from Select measure value and no Reason Missing below Glucose obtained Hemoglobin Screening tab Ale The Referrals tab is covered below in Section 3 2 3 1 2 Data Entry Validation Many data values associated with physical measurements or medical tests have built in ranges to detect possible errors For instance if you enter a woman s height as 79 inches or more gt 6 7 you will get a data validation message like this too tigh are you sre Ce If the value you are entering is in fact correct you can override the validation message by clicking OK and the information you entered will remain On the other hand if the value for a particular item is outside the range acceptable to CDC for submission in the WISEWOMAN Minimum Data Elements MDEs you will get an out of range message and the data value will not save Here is an example system message you will see if an entered Alc value is too high
11. PREVENTATIVE MEDICINE COUNSELING NOIVIEUAL 15 Ores ema CREVENIAIVE MEDICINE COUNSELING me am Bawesc OFFICE VIST ESTABUSHED PATENT PART masia er PANEL HDL TROLYGERDES suas sme Sow 0728203 DENSITY CHOLESTEROL DL cenas um TOC m PREVENTATIVE MEDICINE COUNSELING NONIDUALGO gy gots IUE PACE TO FACE OR TELEPHONE 6 2 Claims Tab Use the Claims tab in MBCIS WISEWOMAN to view detailed claim information including claim number procedure date provider ID and the date the claim was received Currently there is no difference between the Claims tab and the Final Claims tab WISEWOMAN Client Claims ms Aw Punt Hep Home Gents ER Fat came Au Services Procedure Date 07 00 Provideri Show Recent Claims Only show WISEWONAN Claims Oniy Search Prevous 362 V Next Search Resuts r Dea oeann t anas ER 7 Deleting Information from the system Because MBCIS WISEWOMAN is a client driven application the top unit for storing data is at the client level For each client there can be multiple cycles and for each cycle there will be multiple services and other tabs containing client information Deleting clients is done through MBCIS not MBCIS WISEWOMAN The topic of deleting information from MBCIS is explained in pages 101 108 of the current MBCIS User s Manual
12. ANTING TO BE HEALTHY 3 How confident are you at maintaining change 0 not confident v 9 What else would you lie to tell us about your experience 1d 10 really confident Al fields marked with required Submit Conc Delete 6 Viewing Claim Information With your WISEWOMAN privileges in MBCIS WISEWOMAN you will be able to view claim and CPT code information for WISEWOMAN clients Starting from the WISEWOMAN Client screen refer to section 2 1 1 you will have access to the Claims Final Claims and Auth Services tabs WISEWOMAN Client Status ACTIVE Hein Home Clients Claims Final Claims 6 1 Authorized Services Tab With regard to data entry for WISEWOMAN clients the first tab that will be of use is the WISEWOMAN Auth Services tab After data for a WISEWOMAN client has been entered you can use this screen to view all of the services that have been authorized for payment The Screen will look similar to the one shown in the graphic below Note that all column headings on this screen are sortable simply by clicking on the column name If needed you can use the search fields Procedure Code Procedure Date to reduce the number of services displayed WISEWOMAN Auth Services d bu Print Help Procedure Code Procedure Owe E show A Records sen Fe ce Previous 1255928 T Next Search Resuts
13. ISEWOMAN TOPS Contact requires 6 Baseline Rescreen Participation Incentive meetings over 3 months 12 How Ready are You Enroliments Follow up 13 WISEWOMAN Follow Up Questions Health Intake Follow up 14 WISEWOMAN Outcome Evaluation Outcome Evaluation Follow up Contact Form Minimum req for Bascline Rescreen cycle Minimum req for Follow up cycle 1 MBCIS WISEWOMAN Home Page Overview of the Home Page Once a user has signed on and selected the MICHIGAN BREAST AND CERVICAL CANCER CONTROL INFORMATION SYSTEM APPLICATION the MBCIS home page will display The roles that have been assigned to a user will determine the look of this screen for each user A user that only has access to the WISEWOMAN role will see a screen that looks similar to this Cancer Control Information System Eum Em Emuoliment Information Lagin user information Exit application WISEWOMAN Section ient Informatic i this link takes you to the WISEWOMAN Client page for a client based search information you enter ollment Information this link takes you to the WISEWOMAN Client Enrollments page for a client based on search information you enter Other Section Go to New Agency Allows users to switch between agencies not applicable for most users Login User Information Allows a user to view their user privileges Exit Application Exits MBCIS WISEWOMAN and returns user to the applications l
14. Statewide Search MBCISID ux E T Client ID T wa f Lastame FirstName mi r Maiden Binh Doe A Previous TTET E Next Search Results p Eind Client To pull up information for an existing client you enter information into one fields in the Find Client area to search Typically you will be searching by client name or MBCIS ID but many other possibilities are available More information on the client search features of MBCIS are described in the Clients Window section of the MBCIS manual under MBCIS Find Client Screen For instance entering the MBCIS ID matches to the search information 2 2 Using the Client Information Link If you selected Client Information prior to searching you will be taken to the WISEWOMAN Client screen which will look like this 23456 and clicking the Search button brings up all nas cisims Final aims Auth Services a E um ae EE m Street 107NGARFIELO IN City Port austin INE RE N S eum ne ES Er poma o esses medicare Ref Staus Family Cancer Seas cpm dE Ron ras roe nus _ RUN E RES marked win wre read suma Find Glee The WISEWOMAN Client screen contains enrollment information from the Michiga
15. ack 20 How much fuit do you eatin an average day IERI ANN 21 How many vogotablos do you estin an avorago day v 22 Do you oat two sorvings or moro of fish wookly Be vl 23 Do you eat 3 ounces or more of whole grains daily Ber v 24 Do you drink less than 36 ounces 450 calories of beverages with added vy Sugars weekly gnus And Health Intake3 will look like this WISEWOMAN Health Intake3 cien nk I Home Enrollment Screening Referrals Nav Servicos case Outcome mgmt Health Health take 1 25 Are you currently watching or reducing your sodium or intake How much moderate physical activity do you getin week v 21 much vigorous physical activity you getin a week howe vs SD mato 28 Do you emoks Includes Tom 28 1 you smoke How many cigarettes 30 Do you use e eigarettas 31 Do you want to smoking 32 About how many hours day on average are you in the same room or vehicle with another porson who is smoking Thinking about your physical health which includes physical ness and injury on how many days during the pest 30 days was your physical health not goad 234 Thinking about your mental health which includes stress depression and None probleme with emotions on how many days during the past 30 days was our mental healt
16. al Cycle Complete Unable a Contact Refused Furor Readiness to Change Em Confidence to Change Reasons ready for healthy change 54 System WISEWOMAN Agency Select agency from dropdown list Screening Facility Select facility from dropdown list Readiness to Change Select corresponding value from Readine nearest 0 5 on the dropdown list sto Change Ruler to the Confidence to Change Select corresponding value from Readiness to Change Ruler to the nearest 0 5 on the dropdown list Note All dates in MBCIS are in the MM DD YYYY format Optional Fields The first 2 fields are not needed for a Baseline Cycle Reasons ready for healthy change Enter text from the Readiness to Change Ruler that is appropriate for this field 16 Reasons Not ready for healthy change Enter text from the Readiness to Change Ruler that is appropriate for this field Next Contact Date Enter the date the next contact is expected for this client in MM DD YYYY format Imported Fields values from BCCCNP data that cannot be edited in MBCIS WISEWOMAN Participant Status WISEWOMAN Agency Screening Facility Click the Submit button at the bottom of the page to save your data Only click submit after all required data elements have been entered or you will receive an error message to id iN 2 6 Health Intake Tab Alter completing d
17. ata entry for the Enrollment Cycle page you will enter data from the WISEWOMAN Health Intake Questions in the 3 sub tabs on the Health Intake tab When you click on the Health Intake tab tabs for Health Intake 1 Health Intake 2 and Health Intake 3 will be visible The layout of the tabs has the same question order and the same page breaks as the forms The fastest way to enter data on this screen is to use a combination of the tab key and the up and down arrows or the tab key and the first letter of the desired response AIL responses for the WISEWOMAN Health Intake Questions will be entered from dropdown lists in MBCIS WISEWOMAN Health Intake will look like this WISEWOMAN Health Intakel cre ype i Hela Hore Enrollments Screening Referrals Nav Services Case outcome Mam _Health Intake Health Intake a your highest level of education the primary language spoken in your home Have you ever been told you have high cholesterol Do you take medication lower your cholostarol During the past 7 days on how many days did you take prescribed medication lower your cholesterol Have you ever been told that you have hypertension high blood pressure Do you take medication to lower your blood pressure B During the past 7 days on how many days did you take prescribed medication including diuretics to lower your blood pressure 3 you
18. cation sdherence C Education materiais Reterrta lother Participant referred these community based resources Community Navigator marked eene Sumit Gama Em 31 4 3 Hypertension Control When a WISEWOMAN client has hypertension and indicates a readiness to work on hypertension control she will complete the Medication Adherence Questionnaire for Hypertension and the Sel data entry screens for these forms are shown in the following sections 4 3 1 Medication Adherence The Medication Adherence tab in MBCIS WISEWOMAN matches the form Use the radio buttons checkboxes and text fields to match corresponding responses from the form WISEWOMAN Medication Citem Pini Hei Home Adherence mecs i Lal 4 Do you sometimes ferget to take your high blood pressure pills Over da yes how often Rarely Ones white C Sometimes Usually All the Time db explain why 2 Do you ever cut back or stop taking your BP medicine Yes Ono 2a Feel better 26 E Feel worse when you take 2c 02 Are having trouble paying ferit 4 17 Are having trouble getting to the pharmacy 2e Are not sure why tis important 21 18 Are you having any side effects from your medication you use more than one pharmacy te get your medications Oves ON 4 Taking medication every day be inconvenient for s
19. e VENCOZR First Name IESSE KW T COLORECTAL Maiden Binh Dawe ne age E Enroll Sho ISTHICT FIOREALTH DEPT_WHITECIOUD __ If you try to enter data for a woman who is not active in MBCIS you will see the following message NCIS Cent status te Inactive Wisewoman senices can not be ent WISEWOMAN Enrollments Client JESSE MENDOZA Status s ACTIVE Hen Home MBCIS1D 88728 LCA DSTRCT 10 HEALTH DEPT WMITE CLOUD Thetolewing the list of enrollments added for dient JESSE MENDOZA Please cick ad button to stari new enrollment You must dose previous enrolment cyl to stari new one 2 5 Adding an Enrollment Cycle If a client does not yet have WISEWOMAN data in MBCIS the WISEWOMAN Client Enrollments tab will look like this WISEWOMAN Client Enrollments Print Hep Home Keath tntake screening Raterrats Cave Management Outcome Management Enrollment Baseine Referred to HIPI Medicaid No Enrotinent Date CH ACA Marketplace referral Paricipant Status inPrgiess inFoiowsp BCCCP Status WISEWOMAN Agency HURON COUNTY HEALTH DEPT ai Sereening Facility Senet Serenng Sr E Readiness to Change penes Reasons ready for healthy change Reasons Not ready for heathy change Next Contact Date Household Income Members Povery Level
20. ect Other and enter program name in text box HC Health Coaching Contact Select program from dropdown list MSU Extension Other Contact Select Other and enter program name in text box 35 QUITLINE Other Contact Select Other and enter ere cy program name in text box ORE Gees Om Fonds pm nep Sena opaca 4 2 2 Additional Data Entry for the Contact Tabs There is a lot of overlap in data entry for contacts and other contacts however this may not be evident when first looking at the two tabs On the Contact tab there are Content and Other Topics Covered sections that are not found on the Other Contact tab Refer to 4 2 3 below for information on when to use those sections of the Contact tab The remaining parts of the two tabs are similar In general the Other Contact tab requires less data Contact tab LSP HC Session Date LSPI HC Program ES REDE ET Contact Ty Setting a of Pounds Sense TOPS Length Seesiont V Completed Programt Ne Spike a aat n meee VT Notes CLIENT IS ATTENDING WEIGHT WATCHERS tact tab ot LSP HC Session Date Contact Date LSP HC Program Program Other Contact Type Contact Type Setting Set
21. h not good 25 During the past 30 days on about how many days did poor physicaler None mental health keep you from doing your usual activites such as self care or recreation pipes or cigars smoked tobacco in any Gu More hen 17 gs wi day do you smoke 19 2 6 1 How to Handle Omitted Responses Ideally you will have someone reviewing Health Intake forms for completeness before the client s screening visit is over However at some point you will likely encounter a missing response that is not clearly a refusal When this happens consult the chart below for the response you should enter Essentially we need to treat skipped omitted items as refused responses for data entry into MBCIS WISEWOMAN Refused Don t want to answer 2 Don twant to answer 20 Don t want to answer 3 Don t want to answer 21 Don t want to answer 4 Don t want to answer 22 Don t want to answer 5 1 then Not Applicable If 4 is 23 Don t want to answer yes then Don t know If 4 was not answered then Don t want to answer 6 Don t want to answer 24 Don t want to answer 7 Don t want to answer 25 Don t want to answer 8 If7is no then Not Applicable If 7 is 26 Enter minutes or None yes then Don t know If 7 was not answered then Don t want to answer 9 Don t want to answer 27 Enter O minutes or None 10 Don t wan
22. hanges your medicines o o 44 I you are not sure how or what it does for you o o 48 How confident are you that you willbe able to afford your medicines o o How conientare you that you wil be able ro getto he pharmacy to Submit 39 5 Outcome Evaluation In the WISEWOMAN Program an outcome evaluation contact person or by phone is required for participants who were ready to make change at enrollment to assess progress and reinforce goals The outcome evaluation contact will take place 6 to 8 months after screening for participants who participated in health coaching or medication adherence For participants who participated in an evidence based or community based lifestyle program the outcome evaluation contact will take place upon completion of the program OOOO The follow up cycle can be entered in MBCIS WISEWOMAN after the outcome evaluation contact has taken place Follow up enrollment cycle only p Outcome Evaluation Data entry tor Confidence Ruler is on this tab Information needed for the follow up cycle in MBCIS WISEWOMAN is the following 1 Completed WISEWOMAN Follow Up Questions 2 Completed WISEWOMAN Outcome Evaluation Contact Form To enter a follow up cycle in MBCIS WISEWOMAN 1 Adda follow up visit type on the Client Enrollments tab cf Enrollment Cycle Data Entry section 2 3 1 p 15 9 Within the foll
23. have diabetes either Type 1 or Type 2 10 Are you taking medication to lower your blood sugar for diabetes m 11 During the past 7 days on how many days did you take prescribed medication to lower blood sugar for diabetes 12 Have you ever been told you had gestational diabetes diabetes while dlc pregnant mme 18 Health Intake2 will look like this WISEWOMAN Health Intake we Pint I Hei ione Enrollment Screening Referrals Wav Services Case Mam Outcome Mart Health Intake Health Intakes EEUU ofthese condions coronary heart IEEE v Pain heart attack heart failure stokelransient ischemic attack vascular disease or congenital hoart defects 14 Has your father brother or son had a stroke or heart attack before age 55 v 15 Has your mother sister or daughter had a stroke or heart attack before age Yer v 16 ether of your parents your brother or sister or your child ever been told Ns vi hat he or she has diabetes Hr Do you measure your blood pressure at home or using other calibrated v sources ike machine at a pharmacy 18 How often do you measure your blood pressure at home or using other Matis wo por day v calibrated sources 19 Do you regulary share blood pressure readings with a health care provider for v feedb
24. hoose the appropriate value from the dropdown list Yes No Unknown Risk Reduction Counseling completed Choose the appropriate value from the dropdown list Yes No Unknown Nes marea win af rearea Click the Submit button at the bottom of the page to save your data Only click submit after all required data elements have been entered or you will receive an error message 3 1 1 Special Case Glucose Data Entry How the WISEWOMAN Program tracks blood sugar screening has evolved over time Instead of interpreting glucose values based on whether the screening was fasting or non fasting the focus If a non fasting value is collected at screening the measure should be supplemented i e replaced with a fasting blood glucose measure from lab work or a hemoglobin Alc measure These new procedures result in added complexity in the database There are now multiple pathways for measuring blood glucose that depend on the following factors 1 Is the participant already diabetic 2 Is the participant fasting 3 Where was the blood glucose measure obtained R Already Fasting Where Expected Billfor MBCIS WISEWOMAN Data Diabetic measure Blood Sugar Glucose Entry obtained Measure Measure and or Venipuncture N Y Office Fasting blood N Screening tab Enter Glucose glucose value from screening form N Office Send to lab for NIA fasting blood
25. ist within the SSO application BCCCNP staff with WISEWOMAN privileges will see a home page that looks similar to this Client Information View Client Info Go to New Agency Enrollment Information View Enrollment Info ogin User Information Primary Care Providers View Enrollment sites View Providers View Enrollment sites View Facilities WISEWOMAN Client Information Client Information Enrollment Information Enrollment Information Please refer to the MBCIS Manual for information about the Clinical Clinical View and Colorectal roles for MBCIS users Version The current system information is shown at the bottom of the MBCIS Home Page When this manual was updated the current version of MBCIS was MBCIS Version 5 1 9 Last Updated July 08 2015 9 00 AM 2 WW Client Enrollment Information 2 1 Find Client a Gent misaia a Clicking either Client Information or Enrollment Information in the WISEWOMAN section of the home page will take you to the WISEWOMAN Find Client screen see below The only difference between the two links is where you end up after your client information has been retrieved by the system This difference will be described shortly WISEWOMAN Find Client Hail ome Please ener one or more pieces of formation on ne screen below Then cick the earch button to rebevethe matching otentintermston Please awaya esten or cent new dent F
26. n BCCCN Program You can review client identification and contact details as well as information about race and ethnicity At the bottom of the page are dates for most recent activity in the WISEWOMAN program as well the next anniversary for WISEWOMAN The Anniversary Date for WISEWOMAN is the program enrollment date plus 1 year eS cu m pM cn c ON Cervical Pap Eligibility He D ae reget To proceed to data entry for WISEWOMAN clients from this screen you will need to click the Enrollments button near the bottom of the screen Hitting the Enrollments button from the WISEWOMAN Client screen takes you to the WISEWOMAN Client Enrollments screen The WISEWOMAN Client Enrollments screen is shown on the next page under section 2 3 2 2 1 Editing Client Information Much of the information you will see on the WISEWOMAN Client screen cannot be edited However there are some items you may update All elements of the client s physical address Street Apt City PO Box State Zip Code County Addl Address Email Address Client Phone Denotes required field 2 3 Using the Enrollment Information Link If you click Enrollment Information from the home page instead of Client Information you will be taken directly to the WISEWOMAN Client Enrollments screen after you find and select a specific client Here i
27. neyt michigan gov 0 Before Entering Data Before entering client data into MBCIS WISEWOMAN it will help to have your client s WISEWOMAN data forms in order 1 WISEWOMAN Screening Form Screening Baseline Rescreen 2 How Ready are You Enrollments Baseline Rescreen 3 WISEWOMAN Health Intake Questions Health Intake Baseline Rescreen 4 work results from provider not a Referrals Baseline Rescreen WISEWOMAN form 5 WISEWOMAN Referral for Medical Referrals Baseline Rescreen Evaluation 5a Health Information Referrals Indicates RRC Baseline Rescreen took place 6 Other related diagnostic services nota Referrals Baseline Resereen WISEWOMAN form 7 WISEWOMAN Case Management Form Case Management Baseline Rescreen 8 WISEWOMAN Participant Agreement Participant Agreement Baseline Rescreen 9 Medication Adherence Questionnaire for Medication Adherence Baseline Rescreen Hypertension 10 Self Efficacy For Appropriate Medication Self Efficacy Baseline Rescreen Use Scale 11 WISEWOMAN Contact Form s Contact Baseline Rescreen Tia WISEWOMAN Diabetes Prevention Contact Baseline Rescreen Program Agreement lib WISEWOMAN TOPS Membership Contact Date and Baseline Rescreen Agreement location of 1 TOPS meeting lie Optional WISEWOMAN TOPS Contact Dates of Baseline Rescreen Program Quarterly Attendance Record meetings attended lid Optional W
28. ning privacy and security terms conditions policies and restrictions for each authorized application Table of Contents Introduction to MBCIS WISEWOMAN System Overview and Logging On 0 Before Entering Data MBCIS WISEWOMAN Home Page WW Client Enrollment Information 2 1 Find Client 2 2 Using the Client Information Link Editing Client Information 3 Using the Enrollment Information Link 2 4 Inactive Clients in MBCIS 2 5 Adding an Enrollment Cycle 2 5 1 Enrollment Cycle Data Entry 2 6 Health Intake Tab 2 6 1 How to Handle Omitted Responses WW Clinical Service Data 3 1 Screening Tab Data Entry 3 1 1 Special Case Glucose Data Entry 3 1 2 Data Entry Validation 3 2 Referrals Tab 3 2 1 Referrals Tab Data Entry Data Entry by Service Visit Type 3 2 3 Medical Evaluation Diagnostic Office Visit 4 Other Unknown Service Data 3 3 Navigation Services Case Management Outcome Management 4 1 Participant Agreement 4 1 1 Participant Agreement Data Entry 4 2 Contact and Other Contact Tab 4 2 1 Data Entry Details for Contact Tabs 4 2 2 Additional Data Entry for the Contact Tabs 4 2 3 Contact Health Coaching Hypertension Control 1 Medication Adherence Self Efficacy 5 Outcome Evaluation 6 Viewing Claim Information 6 1 Authorized Services Tab 6 2 Claims Tab 7 Deleting Information from the system Lal Data User Information Usage Agreement Introduction to MBCIS WISEWOMAN
29. ntact tab looks like this WISEWOMAN Client Contact Other ce Tg tee Enrollments Hest Intake Screening ev Services Cese Mant Partiapant agreement Contact cay Contact type 0 Medication Sei cay Outcome Eval Choices are Other or Not Ready When using Other a description must be entered Contact Program SNAP ED 1 Communi Navigator modii ars Jj queni 4 2 1 Data Entry Details for Contact Tabs Before entering a contact in the Contact tab or the Other Contact tab you need to know where to enter it Only CDC recognized contacts go on the Contact tab We currently have 3 CDC recognized contacts DPP Diabetes Prevention Program HC Health Coaching and TOPS Taking Off Pounds Sensibly Any other contact will require the Other Contact tab Use the table below as a guide to the using the Contact tab versus the Other Contact tab Entering Contacts in MBCIS WISEWOMAN Lifestyle Program Name Name of tab to use Note CRC Program Other Contact Select Other and enter program name in text Curves Other Contact Select Other and enter program name in text box DPP Diabetes Prevention Contact Select program from Program dropdown list Gardening Other Contact Sel
30. ome people Do you ever feel hassled about sticking to your blood pressure treatment plan Oves C No Followup Pian PAYASSIST Efficacy For Appropriate Medication Use Scale The corresponding Enrolments esi Ita Screening terae Cue Management greener cono seremcac F Outcome vata 38 4 3 2 Self Efficacy The Self Efficacy tab in MBCIS WISEWOMAN matches the form Use the radio buttons to match corresponding client responses from the form WISEWOMAN Self Efficacy eed e Print eio Hone MBOSIDS Enrolimonts Health Tatale Screening Referrals Case Management Partkdpant agreement Contact Mediation adherence emm Selt Etcacy For Appropriate Medication Use Sal you take several different medicines each day 2 you take medicines more than once day o o e 3 you are away from home o o 4 Myou have busy day planned o o they cause some side effects o amp ino one reminds you to take the medicine o o 7 the schedule to take the medicine is not convenient o o your normal routine gets messed up 8 you are not sure how to take the medicine o e o 410 you are not sure what time of the day to take your medicine o o Ifyou are feeling sick you know e having a cold or the fiu o 12 you geta ret your ola medicinas and some ofthe ok erent o o 3 doctor c
31. on on tracking client contacts It is possible that sessions of an LSP may extend beyond one year from the client s enrollment date If there are questions over where contact information should be entered please contact Mike Carr 517 335 9954 In MBCIS WISEWOMAN the Contact tab looks like this ILSPIHC Session Dow 1 LSPIHC Program Sesa Prasen Tree E Contact Typo v Seti Length of Session v Completed rogram No LSE Ce sas sages V Content Ask oper ended questions use rfecve stein rol wi resistance express empathy Progross mado goal changes Listen and reflect met goat T did not moot goat T goal L other Barriers sten and refezt Develop discrepancy spouse andior family caregiving responsibilities C other Support systems Listan and tet L spouso andor family pooploat work C C community program Navigator Cohw Identity solutions Listen and ask permission to make suggestions redefined goal attend community programming other 1 Other Topics Covered L medication adherence L Education materials Referrals Loter Notes Participant referred to these community based resources Community Navigator Sess Canmunty v Al fes marked with are required Submit 34 In MBCIS WISEWOMAN the Other Co
32. ow up visit type data enter the responses to the follow up version of the WISEWOMAN Health Intake Questions 3 Enter responses from the WISEWOMAN Outcome Evaluation Contact Form on the Outcome Evaluation tab In MBCIS WISEWOMAN the Outcome Evaluation tab looks like this WISEWOMAN Outcome pm Boios nce Enrollments Health rene Screening Referrals Nav Services Cose Mant Rareement Contact Other Contact Mediation adherence Outcome Evaluation S l ans 1 How successful t mooting your goal pe 2 What helped you be successful or not DETERMINATION D Which Programs did you participate Y Health Coaching 1 jcomacts A ore coro sessions attondod rors 0 mootings participatod ed reste AIO Sita jot at all successful and 10 successful SNAPE Farmer s Markot B Domen What helped you or kept you trom completing your program FOR HER Own PHYSICAL WELL BENG 6 Whar changes havo you mado or nodced None Lost weight pounds C Lower blood sugar Eating beter Increased confidonco Physicaly active mimwesweek CI Made new supportive fiends L Less stresstanxiety Taking Meds as prescribed Feel better V Blood pressure is lower Mood is better Omn f What do you think helped you make that change W
33. rage BP Not entered automatically calculated by system Middle of Screening Tab Has Client fasted for at least 9 hours Select value from dropdown list Has Client fasted tor at least9 hours 7 No v 2 or le not curent be Baten igh 200 239 maa arr Fastng gd Pre curry 2 or HDL Desirable 4059 No refera fo Medical Eaton or 100 mg dL Fasting OR 70 140 mo Casual No referral for Followup Medical Baton Glucose mg dL Hemoglobin Ate Ate must be entre om the Reena tab Total Cholesterol mg dL Enter value from screening form if missing you will need to indicate a reason missing from the adjacent dropdown box HDL mg dL Enter value from screening form if missing you will need to indicate a reason missing from the adjacent dropdown box Glucose mg dL See next section Hemoglobin Alc See next section Bottom of Screening Tab Referral Medical Evaluation Choose the appropriate value from the dropdown list Yes No Unknown Refused Referral Labwork Choose the appropriate value from the dropdown list Yes No Unknown Referral Medical Evaluation No Referral Labwork Yes Referral Case Management No Hypertension Case Management No Risk Reduction Counseling completed Referral Case Management Choose the appropriate value from the dropdown list Yes No Unknown Hypertension Case Management C
34. rod iu 5621 OFF EE VEIT ESTABLISHED PATENT PARTI 3 2 4 Other Unknown Service Data The last Service Visit Type that can be chosen for data entry is Other Unknown All fields are open on this screen however the system user must have Administrative privileges to select CPT codes and approve them for payment This service type will only be used under exceptional cumstances However if this type of service data has been entered for a WISEWOMAN client you will be able to view it 3 3 Navigation Services Navigation Services represent services associated with the management of clients through lifestyle programming activities As shown in the graphic below each code is associated with billing conditions that should be met before agencies attempt to get reimbursed for the service The payment process for MBCIS WISEWOMAN has not changed other than the addition the new codes and service When the billing condition button is checked the corresponding code in at the bottom of the screen Multiple or all buttons can be checked simultaneously WISEWOMAN Navigation Print Home Reimbursement Enrolments esi Tatake Screening Raferrat Case Outcome Mame 7 New WISEWOMAN recruited new since 2008 ricis Clentisnotready to change Make Callin 1 gents ET Clentiniiotes Medication Adherence soss
35. rticipant Agreement The WISEWOMAN Program will Work on my healthybehaviorgoal C Support me by providing resources to heip me reach my goal Wien yp tpr and complere DP Jim EES Part Agreement tabin eate program tfe Fromm WISEWOMAN S pue REA RN ean Caching Hc Take Of Pounds Seni TOPS Diabetea Prevention Program OPP times a month E Other phase specty Follow throug with recommenda heal care provider T Pay for my eligible medical ofce visit and necessary lab work U Takemy medicine as 4 9 Help me find affordable medicine and me fnd a way to remember to take it a Lifestyle Programs referred to Check none one or multiple boxes as indicated on the corresponding form If an activity has been entered for Other on the form enter it in MBCIS WISEWOMAN with descriptive text 4 2 Contact and Other Contact Tabs There are two tabs in MBCIS WISEWOMAN used to collect information on contacts The Contact tab collects information from each Lifestyle Program LSP contact or Health Coaching HC contact that a WISEWOMAN client makes in one annual cycle The Other Contact tab is used to collect other contacts that will not be evaluated by CDC The latter tab is also used to collect information on women who are not ready to make changes yet Please refer to the most recent version of the WISEWOMAN Community Navigation Protocols for detailed informati
36. s what that tab will show you WISEWOMAN Client Enrollments cient Ap Print Help Home mis e screen Referrals Case management Oxtcome Paragane just ren onasan MWMCHA GAVLORD as Besee 0217204 mucha GAYLORD as Enrollment Type Referred to HMP Medicaid No Enrollment Date ACA Marketplace referral Participant Status erus Cre Contae Z BCCCP Status wisewoman agency Screening Facil Readiness to Change 95 wj check this If participant is in maintenance Confidence to Change sl Reasons ready for healthy change GETTING CHOLESTEROL DOWN AND SEE DR U Reasons Not ready for healthy change Next Contact Date Household Income Members Poverty Level All fields marked with are required Open ient _ Delete 2 4 Inactive Clients in MBCIS At the top of the WISEWOMAN Client screen you can determine the status of the client in MBCIS i e the woman s status for the BCCCNP If you do not have MBCIS BCCCNP Clinical privileges you will need to contact someone from the parent Local Coordinating Agency and ask that the client s active status be restored WISEWOMAN Client Client JESSE MENDOZA Home MEC 6725 LCA DISTRICT FIO HEALTH DEPT WHITE CLOUD Clients Claims Final Claims MBCISID 3526 Client 10 Last Mam
37. sterol p img Bis Deine 68 pl No fa Medien ri met e Drs lame cas ad Ned lations ae T Hemoglobin cmb ned om the ede tab efor Evaluation ves Referral Labwork feral case Management v Risk Reduction Counseling completed noue 3 aperension Case Management 3 1 Screening Tab Data Entry Screening services are entered on the WISEWOMAN SCREENING tab in MBCIS WISEWOMAN Top Part of Screening Tab Service Date Enter the date in MM DD YYYY format Provider The dropdown list that appears will be limited to those providers in MBCIS that connected to your agency Select choice from dropdown list Enrolimens neant take eres case management outcome wanaaenent Service Date eps Provider Height inches e emsa SS Weight pounds oo Norrat 1852430 co pr n s Average BP 105 175 i85 Jor 2nd BP Norrat 120 systolic and lt 80 aste No referal far Medical Evaluation Height inches Enter height in inches from screening form Weight pounds Enter weight in pounds from screening form BP Enter first BP measurement taken from screening form 2nd BP Not indicated as required but if missing you will need to indicate a reason missing from the adjacent dropdown box BMI Not entered automatically calculated by system Ave
38. t to answer 28 Don t want to answer 11 11015 no then Not Applicable If 10is 29 If 28 indicates the woman does not smoke yes then Don t know If 10 was not enter 0 otherwise if no client response answered then Don t want to answer leave blank 12 Dontknow 30 1 client response leave unselected 13 Don t want to answer 31 Ifno client response leave unselected 14 to answer 32 Don t want to answer 15 Don t want to answer 33 Don t know Not sure 16 Dontwantto answer 34 Don tknow Not sure 17 IfGis no thenNotApplicable otherwise 35 Don tknow Not sure Don t want to answer 18 IfGis no then Not Applicable otherwise Don t want to answer 3 WW Clinical Service Data The WISEWOMAN Screening tab corresponds to clinical service data collected on the WISEWOMAN Screening form This tab will always be used for Baseline or Rescreening cycles WISEWOMAN clinical service data may also be recorded on the Referrals and Case Management tabs as appropriate The WISEWOMAN Screening tab looks like this WISEWOMAN Screening Cen Prat usio Case Management Outcome Hoigm nores E wor Weight pounds s 105249 eral Mode Clun EX Average BP 15 js an acl o Eat Has Cent fasted oratieast Bhours T verre REDE am Jor dn 200239 Rr ar Faste Ug Pe fry Total Chole
39. tem This authorization is a required component of service payment on the BCCCNP end The WISEWOMAN Referrals tab looks like this WISEWOMAN Referral Services Enrolments nean intake Screening it Semel Servicervisit Type Are Funding Source WSEWONAN 13 average OP 105 775 Cholesterol mga Lot Trigtyceride Glucose lH Hemoglobin Ate Sele OPT Code oC VVenipuncture Specify Diagnostic Office Visi Medical Evaluation Patient Type tek reaired Subs Concor 3 2 1 Referrals Tab Data Entry This section goes over all fields on the Referrals tab but in practice the fields you enter will depend on the Service Visit Type chosen The system prevents entry of irrelevant services by graying out services not associated with the visit type you have selected Referrals Tab Service Visit Type Select the type of service for this visit Dropdown list choices are as shown Servicel Visit Service Provider Service Date Enter the date in MM DD YYYY format Provider The dropdown list that appears will be limited to those providers in MBCIS that are connected to your agency Select choice from dropdown list Funding Source Set by default to WISEWOMAN change only if necessary eee 1 BP Enter first BP measurement taken
40. the database Information collected in the follow up cycle when applicable will summarize progress toward achieving goals Women are encouraged to return to the program one year from their baseline or most recent enrollment date System Overview A high level summary of the WISEWOMAN program as it corresponds to data entry tabs in the MBCIS WISEWOMAN application is shown below The path any single woman will take through the program will vary depending on what visit types are needed in Referrals what contacts are present or added later and if case management is needed MBCIS WISEWOMAN screens as they correspond to data entry flow pected path Optional As needed Envotiments p gt Entar as lic aa coe Logging On In order to access MBCIS WISEWOMAN the user will log on through the State of Michigan Single Sign On SSO process htps sso state mi us A Single Sign On account is required to access MBCIS and an MBCIS account is required to use MBCIS WISEWOMAN Please see the Single Sign On Manual SSO located at the following address h p www michigan gov documents m ch 032008 sso registration instructions Final Copy 228984 7 pdf Please refer to the Michigan Breast and Cervical Cancer Control Information System Data User Information Usage Agreement Contact Tory Doney for more information about access to MBCIS do
41. ting Length of Session Completed Program Other Topics Covered Notes Notes Participant referred to these n a Community Navigator Community Navigator 36 Other Contact tab Contact Dates o _ o7 2015 Program Not Ready vi contact Soning ores Community Navigator A marked with are requred Submit Cancel 4 2 3 Contact tab Health Coaching WISEWOMAN Client Contacts cin me Purse one neant sean screening weterrats Wav services case mam Partiopant Agreement emer Contact Medication Adherence Self ciency Outcome vat CNET Tem cm FE L NEL It 5P HC Sesion Dore Contact rype Setting length of Completed Progranr v Content Ask open ended questions use refective listening oll with resistance express empathy Progress chee Es Z met goat LI not meet goat E adapwa gosi C other Barriere Liston and eet Develop diseropancy L spouse andlor family L caregiving responsibilities work eter Support systems sten ana renee S spouse and or family LI people at work miende Z community program Navigator Identify solutions Liston and ask permission to make suggestions D rodotinod goat I attand community programming L other enmar Topics Covered 1 Medi
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