CHADIS Office Set Up
Contents
1. care and support strengths Respondent Person completing questionnaires in CHADIS May be parent teenage patient or teacher CHADIS User s Manual V Visit type Reason for visit to the Clinician These categories can be selected by a practice to match services commonly provided and auto assignments set up for each visit type Homepage The first page seen by practices when first entering CHADIS CHADIS User s Manual Table of Contents Office Setup Overview Using the Demo Site The 5 Step Process CHADIS Tools Clinical Scenarios Well child Visit Default Questionnaires Developmental Behavioral Visit Default Questionnaires Clinical Recommendations for Tool Usage Billing Code 96110 amp Higher Levels of Service Billing under Code 96110 Monitoring Quality Assurance Submitting your resources to CHADIS CHADIS Implementation Guide Overview Step 1 Notifying Your Parents Registration Letter Registration Email About the Website Link Step 2 Remind Front Office Phone Reminders Answering Machines Automated Telephone Reminder Systems On 2 Hold Message CHADIS Automated Email Reminders CHADIS Reminder Posters Example of an Office Poster 11 x17 Step 3 View View CHADIS Reports Online Print a CHADIS Report Summary Page Using CHADIS with an Electronic Medical Record EMR Recommended Office Roles for CHADIS Use Waiting Room Solutions CHADIS Completed at Home A Practice Staff Roles CHADIS Completed at Home Role2. of MD Clinician CHADIS Not Completed at Home Waiting Room Solution CHADIS Not Completed at Home No Waiting Room Solution Instructions for Assisting Parents Registration Letter En Espa ol Registration Email En Espa ol Ages and Stages Questionnaires Age Administration Chart LL II lI lI l2 CHADIS How to Handbook Error Bookmark not defined CHADIS Office Set Up 1 Office Setup Overview This section guides you through setting up your office to use CHADIS There are three essential steps in this process 1 Watch the Video Prior to using CHADIS watch the brief demonstration movie located online at www CHADIS com in the For Clinicians tab 2 Use the Demo Site After watching the video follow The 5 Step Process outlined on the next page to review all the CHADIS functionality The CHADIS Demo Site is accessed by logging in on the CHADIS website under the For Clinicians tab To gain a complete knowledge and understanding of all of CHADIS functionality we recommend simulating the use of CHADIS as each of the following Clinician Office Staff member and Parent The How to Handbook is a good tool to assist you in these simulations 3 Review Default settings Once familiarized with CHADIS through using the Demo Site the Clinician should review the CHADIS Default Automatic Assignments which delineate the questionnaires assigned to all patients based on age and visit type The current default se
3. the previous pages as Routine would be collected before every well child visit for children in the age groups noted This will result in data on Parent priorities perceptions and best and hardest parts of parenting Anticipatory guidance and EPSDT data collection Developmental and autism screening for 0 5 Behavior screening of 4 and over Self report on mental health and substance use for children 13 and over Family well being depression social support and partner violence at selected visits Behavior or Development Concern Visits Tools listed on the previous pages as for mental health or behavior would be collected before behavior or development concern visits in primary care or mental health visits to a specialist for the age groups noted The tools for Routine visits will also be beneficial for these visits This will result in Comprehensive mental health assessment and provisional diagnoses CHADIS DSM for children 4 and over Comprehensive family assessment Use the McMaster plus the tools listed as Routine to assess family interaction social support parental depression life stresses and partner violence Use ACE for parental history of adverse events in a specialty setting Teacher and Parent assessment of ADHD symptoms Adolescent Specific Visits Some primary care clinicians and all adolescent mental health professionals will want to use tools to further assess risk behaviors in addition to those ma
4. CHADIS User s Manual 11 CHADIS Checklist Please review this CHADIS Users Packet in its entirety and complete the following tasks to start using CHADIS in your daily practice For the best implementation we recommend strongly that each practice establish one Lead person who is responsible for implementing all aspects of CHADIS throughout the practice Additionally we suggest the no den member of the Administrative staff taking this role Copy the CHADIS How to Handbook and distribute it to all Staff members Review the Default Automatic Assignments Pages 10 12 which delineate the questionnaires assigned to all patients based on age and visit type Enter your practice s phone number on the CHADIS Registration Letter Page 18 in the space provided this number will act as the Invitation Code for your practice When completed make copies and distribute to families Create a link to CHADIS on your website if your practice has a website see instructions on Page 20 Collect parents email addresses to facilitate their registration if you do not do so already Implement as many applicable notification procedures as possible Page 16 Establish reminders for parents to complete CHADIS on posters your automated telephone reminder system messages on hold messages and appointment cards CHADIS User s Manual 111 O Arrange to bill 96110 screens by reviewing the list of reimbursable validated to
5. X Family Medical History 0 years 21 years 3 Modified Checklist for Autism in Toddlers M CHAT 0 years 3 years 3 months 9 p Pediatric Symptom Checklist Youth Report Y PSC 13 years 21 years 11 99 months X 3 EPSDT Health Risk 0 years 5 years 3 months X 9 DSM PC 4 years 12 years 11 99 months X t 3 Partner Violence Screen PVS 0 years 21 years 11 99 months X p Pediatric Health Questionnaire for Adolescents PHQ A 13 years 21 years 11 99 months X 3 Ages amp Stages Questionnaires 4 months 3 months 4 99 months X y Ages amp Stages Questionnaires 6 months 5 months 6 99 months 9 F Ages amp Stages Questionnaires 8 months 7 months 8 99 months X y Ages amp Stages Questionnaires 10 months 9 months 10 99 months X y Ages amp Stages Questionnaires 12 months 11 months 12 5 months 9 y Ages amp Stages Questionnaires 14 months 13 1 months 14 99 months 9 p Ages amp Stages Questionnaires 16 months 15 months 16 99 months X J Ages amp Stages Questionnaires 18 months 17 months 18 99 months 9 y Ages amp Stages Questionnaires 20 months 19 months 20 99 months 9 y Ages amp Stages Questionnaires 22 months 21 months 22 99 months X y Ages amp Stages Questionnaires 24 months 23 months 2 years 1 5 months X y Ages amp Stages Questionnaires 27 months 2 years 1 53 months 2 years 4 5 months 9 y Ages amp Stages Questionnaires 30 months 2 year
6. do invitationCode Insert Office Invitation Code Here Once you enter the site you will be asked to create a username and password Your email address is the best username Write down your
7. ert your telephone number at the end of the address in the link in the space marked Insert Office Invitation Code Here When sending out email notifications remember to place all parent emails in the BCC Blind Carbon Copy box This makes the email list invisible to other recipients Also place your own email address in the to box so that any inadvertent reply messages are not sent to other parents Many practices have found it beneficial to add Do Not Reply to the subject line of the email Prior to sending out emails to your parents you may want to send a test message to your office assuring the link to CHADIS is operational Registration Email Dear Parent As you may be aware there is increased recognition within the Pediatric community that early diagnosis and treatment of health developmental and behavioral issues in children and adolescents is extremely beneficial in successfully dealing with them Many organizations including the American Academy of Pediatrics now recommend using pre visit screening tools to assist with early identification Starting immediately we will be using CHADIS an Internet based system through which you complete questionnaires prior to each visit in order to track your child s development as well as inform us of the topics you want to discuss Please click the link below to register to use CHADIS https secure childhealthcare org diagnosis respondent wel come
8. he requisite questionnaires prior to the visit If you have a system for regularly sending appointment reminders or bills to parents attaching the Registration Letter to the bill is extremely helpful CHADIS How To Handbook Handbook Page 19 CHADIS How To Handbook Handbook Page 20 Registration Letter Dear Parent As you may be aware there is increased recognition within the Pediatric community that early diagnosis and treatment of health developmental and behavioral issues in children and adolescents is extremely beneficial in successfully dealing with them Many organizations including the American Academy of Pediatrics now recommend using pre visit screening tools to assist with early identification Starting immediately we will be using CHADIS an Internet based system through which you complete questionnaires prior to each visit in order to track your child s development as well as inform us of the topics you want to discuss To use CHADIS please register online now at www CHADIS com Under the For Families tab click on New Users Register Here in the CHADIS Login box Please enter the Invitation Code below which is our office telephone number Office Phone Number Invitation Code Once you enter CHADIS you will be asked to create a username and password Your email address is the best username Write your new username and password below and please keep this letter If you have an appoin
9. hs Boy s and Girl s Club Boy Scouts of America and Girl Scouts of the USA Karate centers e Kindermusic CHADIS Office Set Up 16 e Gymboree Society for Prevention of Cruelty to Animals United Way Volunteer services CHADIS How To Handbook Handbook Page 17 CHADIS Implementation Guide Overview Implementing CHADIS involves a three step process which is summarized here The next several pages look more in depth into each aspect of the Implementation process Again it is beneficial that one Lead person manage the implementation to ensure optimal use and compliance throughout the practice Notify Remind View Step 1 Step 2 Step 3 Step 1 Notify An essential aspect of successful CHADIS implementation is notifying all your parents and other respondents about the use of CHADIS and their role in the process There are multiple ways to notify Parents such as office handouts traditional mail and e mail Step 2 Remind Reminding Respondents to complete their CHADIS questionnaires prior to the office visit is critical and needs to be done at all points of contact with the patient families Step 3 View To maximize the benefits of using CHADIS Clinicians must view and analyze the available CHADIS reports about the patient prior to the office visit These reports are based on the questionnaires completed by parents prior to the visit CHADIS How To Handbook Handbook Page 18 Step 1 No
10. link on the Search for Patient screen CHADIS Office Set Up 3 CHADIS Tools Development and Mental Health Tools Name Description Ages amp Stages Questionnaires ASQ Ages Routine developm ental screening Use Screening tool for the assessment of developmental delay Infant Development Inventory IDI Alternativ e tool to ASQ Superior for 0 9 months Screening tool for the assessment of developmental delays in infants Modified Checklist for Autism Toddler M CHAT Toddler Social Development M CHAT Follow Up Pediatric Symptom Checklist 17 item parent version PSC Pediatric Symptom Checklist Youth PSC Y CHADIS Diagnostic and Statistical Manual Primary Care CHADIS DSM PC Parent Concerns About Child Behavior Emotions Develop ment Patient Health Questionnaire for Adolescents PHQ A Questions about your feelings and behavior Kutcher Adolescent Depression Scale KADS Questions about sadness Routine autism screener Use if MCHAT is positive Routine school age screener Routine school age screener Diagnosti c tool for beh dev visits Routine adolescen t screen Alternativ e depressio n monitorin g Screening tool for the assessment of autism spectrum disorders Prompted interview by clinician refining positive M CHAT items and rescoring to reduce over referral Screening of internalizing externalizing and inattention s
11. list below Additionally one or more 96110 codes may be added to a Well child or Consultation visit without a 25 extender In some states the use of more than one 96110 code per visit will be reimbursed Please note reimbursement varies by insurance and state Be aware that you are required to bill the patient if the insurer declines to pay so set your office fee accordingly The following are the current validated tools in CHADIS for 96110 billing Development Ages and Stages Questionnaire all ages Infant Development Inventory Modified Checklist for Autism Toddler M CHAT M CHAT Follow Up Behavior Diagnostic and Statistic Manual Primary Care DSM PC Kutcher Adolescent Depression Scale KADS Pediatric Symptom Checklist 17 item Parent Version PSC Pediatric Symptom Checklist Youth PSC Y Patient Health Questionnaire for Adolescents PHQ A Vanderbilt Parent Revised or Follow Up Vanderbilt Teacher Revised or Follow Up NOTE You will be notified via email when other validated tools are added CHADIS Office Set Up 14 Monitoring Quality Assurance Your practice can view reports of questionnaire usage and results for quality assurance documentation This is important for administrative and billing purposes and for the Quality Improvement documentation that is required for Maintenance of Certification by the American Board of Pediatrics CHADIS Office Set Up 15 Submitting your resource
12. ocial Support X 3 Multidimensional Scale of Perceived Social Support X 3 Potential Stressors 4r p Potential Stressors 3 y Potential Stressors 3 months 17 months 23 months Max Age 3 years 6 months 12 years 6 months 5 years 6 months 5 years 6 months 5 years 6 months 0 3 months 10 months 2 years 2 months 18 years 11 99 months 20 months 2 years 2 months 2 years 7 months 3 years 2 months 18 years 11 99 months 18 years 11 99 months 5 years 6 months 14 months 3 months 7 months 2 years 2 months 18 years 11 99 months 18 years 11 99 months 4 99 months 18 99 months 2 years 1 5 months 2 years 4 53 months 2 years 7 5 months 2 years 10 53 months 3 years 2 99 months 3 years 9 months 5 months 8 months 3 months 16 months 3 years 10 months 5 years 6 months 10 months 22 months 2 years 10 months 4 years 2 99 months 7 months 10 months 5 months 20 months 4 years 6 months 12 years 6 months 14 months 2 years 2 months 18 years 11 99 months CHADIS Office Set Up 11 Developmental Behavioral Visit Default Questionnaires Developmental Behavioral Visit Questionnaire Min Age Max Age 3 4r 0 3 Overall Appraisal of Functioning 0 years 3 years 6 months 9 J Questions and Concerns 0 years 12 years 6 months X 4 Best Parts of Parenting 0 years 5 years 6 months X t 4 Challenging Parts of Parenting 0 years 5 years 6 months X Adjectives to Describe Your Child 0 years 5 years 6 months
13. ols setting up the code on billing sheets and determining your charge rate Page 14 O Decide how resources printed out from CHADIS will be handed to patients O Send your preferred Clinical Care resources and handouts to CHADIS for inclusion in the CHADIS Resource database CHADIS User s Manual IV Glossary of Terms Used in this Manual Parent Used throughout this Manual refers to any person completing CHADIS questionnaires Automatic Assignments Any questionnaires that are selected by a practice to appear automatically after login to be completed for children of a given age and type of visit CHADIS Report Comprehensive summary of completed parent questionnaires and their scored results for one visit Clinician Professional providing direct patient care Clinicians have permission to view all data for the practice in CHADIS that is not designated Private Clinician Worksheet Interactive web pages containing CHADIS report and any data entered during the visit Also gives links to electronic textbook and resources Diagnostic and Treatment Worksheet DTW Electronic chapter for the Clinician Exclusive Function in CHADIS that allows searching for patients assigned to one Clinician Invitation Code Unique identifier that allows parents to enter data in the practice files This is usually the ten digit office phone number Resources Listing of handouts providers books agencies etc to assist in patient
14. ressors Partner Violence Screen PVS Partner Interactions Family Medical History Patient Health Questionnaire for Adolescents PHQ A Questions about your feelings and behavior iniu Kutcher Adolescent 13 Depression Scale KADS 20 Questions about sadness years 13 18 Ages Behavioral Visits Routine Screen in 1st Year Used in Specialty Behavioral Clinics Only Routine Screen Routine Annual Screen Routine Screen Routine Annual Visits Routine adolescen t screen Alternativ e depressio Use Questionnaire assessing quality of family interaction family members support for one another conflict management etc Postpartum depression in parents Parent adverse experiences growing up Screening tool for the assessment of an adult s social support from family friends and significant other Checklist of potential stressors and risk factors financial problems marital problems etc derived from the environmental situations list of the DSM PC 3 item screener for domestic violence Checklist of medical conditions allergies diabetes depression etc for which a family history exists Covers depression anxiety eating disorders and substance abuse Teen self report measure specific to depression CHADIS Office Set Up 6 Tool name seen by Parents Respondents CHADIS Office Set Up 7 Clinical Scenarios Well Child Visits Tools listed on
15. rked for Routine use This will result in data on Depression symptoms for initial screening or for monitoring patients with known symptoms from the KADS CHADIS Office Set Up 8 Default Auto Assignments CHADIS automatically assigns questionnaires based on a child s age and the type of visit Well child or Developmental Behavior The current default Auto Assignment settings in CHADIS include all of the Developmental and Mental Health screens recommended by the American Academy of Pediatrics However the defaults can be tailored specifically to your practice s preferences Also Clinicians can assign additional questionnaires for an individual patient on a case by case basis The list on the following pages shows the default questionnaires already established in CHADIS Please see the How to Hanabook for instructions on how to change the default Auto Assignments To set up additional Type of Visit options please contact our Customer Service representatives CHADIS Office Set Up 9 Well child Visit Default Questionnaires CHADIS Office Set Up 10 Well child visit Questionnaire X 3 0 3 Overall Appraisal of Functioning 3 3 Questions and Concerns X 3 Best Parts of Parenting X 3 Challenging Parts of Parenting X 3 Adjectives to Describe Your Child 3 amp p Family Medical History X 3 Family Medical History X 3 Family Medical History X 3 Family Medical History X y Modified Checkli
16. s 4 53 months 2 years 7 5 months 9 Ages amp Stages Questionnaires 33 months 2 years 7 53 months 2 years 10 5 months X y Ages amp Stages Questionnaires amp 36 months 2 years 10 53 months 3 years 2 99 months 9 4r y Multidimensional Scale of Perceived Social Support 0 years 18 years 11 months 9 t McMaster Family Assessment Device General Functioning Subscale 0 years 18 years 11 months 9 Potential Stressors 0 years 21 years 11 99 months 9 Adverse Childhood Experiences ACE 0 years 21 years 11 99 months 9 Vanderbilt Parent Revised 4 years 12 years 11 99 months X Vanderbilt Teacher Revised 4 years 12 years 11 99 months CHADIS Office Set Up Clinical Recommendations for Tool Usage WWW CHADIS Office Set Up 13 Billing Code 96110 amp Higher Levels of Service When visits are more complex or take more time appropriate additional fees are charged by using higher level codes These codes are based on face to face time during the visit as well as decision making complexity and the severity of the problem CHADIS questionnaire results provide documentation of complexity without taking Clinician time and are always available online if charges are challenged Billing under Code 96110 In order to bill under Code 96110 there must be at least one validated tool assessing the child s development or emotions it must be scored and an interpretation must be recorded in the medical record see
17. s to CHADIS The CHADIS Resources Database is a comprehensive catalog of information materials and resources organized by Clinical topic and searchable by zip code and provider name The database is accessed automatically based on needs identified by questionnaire results or can be searched by the Clinician in the following categories e Health Providers e Clinical Programs e Equipment e Software CDs e Books and Videos e Patient Handouts gt 600 As part of your subscription we will add resources that you supply to our database These include your practice handouts local resources you commonly recommend and national resources Adding your resources allows them to be searched and printed as part of individualized handouts Below are the types of resources you may consider for inclusion Resources should be sent via email attachment They may also be mailed in either CD or paper format to Total Child Health Inc 6017 Altamont Place Baltimore MD 21210 Child services Women Infants and Children WIC Child Protective Services Visiting Nurse Association Early intervention program Child Find program Community Mental Health Center Department of Education Director of Special Education Family Services Family Support Center Parents Anonymous Homeless shelter House of Ruth Disability Determination Administration Alcoholics Anonymous Drug treatment services Unemployment office Legal Aid Services to promote strengt
18. st for Autism in Toddlers M CHAT X y Modified Checklist for Autism in Toddlers M CHAT X y Modified Checklist for Autism in Toddlers M CHAT X y Modified Checklist for Autism in Toddlers M CHAT X p Pediatric Symptom Checklist 17 item Parent Version X p Pediatric Symptom Checklist Youth Report Y PSC X t EPSDT Health Risk X 3 Parents Emotions Edinburgh X 3 Partner Violence Screen PVS X 4r Partner Violence Screen PVS X 3 Partner Violence Screen PVS X 3 Partner Violence Screen PVS Min Age 0 years 0 years 0 years 0 years 0 years 0 years 8 months 22 months 2 years 10 months 16 months 22 months 2 years 3 months 2 years 10 months 3 years 10 months 13 years 0 years 1 month 1 month 5 months 22 months 2 years 10 months X y Pediatric Health Questionnaire for Adolescents PHQ A 13 years X y Ages amp Stages Questionnaires 4 months X y Ages amp Stages Questionnaires amp 18 months X y Ages amp Stages Questionnaires amp 24 months X t y Ages amp Stages Questionnaires amp 30 months X t y Ages amp Stages Questionnaires amp 36 months X t y Ages amp Stages Questionnaires amp 48 months X 3 Infant Development Inventory All Domains X 3 Infant Development Inventory All Domains X Multidimensional Scale of Perceived Social Support X 3 Multidimensional Scale of Perceived Social Support X 3 Multidimensional Scale of Perceived S
19. tifying Your Paren Using multiple methods to inform families about your use of CHADIS will increase substantially the proportion of parents who complete pre visit questionnaires and is a key factor for successful implementation Whenever possible please reinforce the value of CHADIS by reminding parents about your use of CHADIS and thanking them for their time and effort in completing the questionnaires Listed below are the suggested notification methods 1 Distributing the Registration Letter 2 Notifying by Email 3 Creating a Website Link 1 Distributing the Registration Letter On the following page is a copy of the standard Registration Letter Print this letter on your office letterhead inserting your Invitation Code which is your main office phone number with no spaces slashes parentheses or dashes Distribute this letter to a parents who come into the practice for sick and well visits Additionally the practice should also send this letter through traditional mail to your parents based on the next block of scheduled visits e g every 2 weeks Completing both steps simultaneously will generate the greatest number of registered parents which will increase the proportion of parents with pre visit data We recommend mailing out the letter on a regular basis Respondents tend to remember to fill out their questionnaires soon after they receive a mailing and frequent mailing better assures parents will have completed t
20. tment within the next two weeks please log back into CHADIS using the user name and password you just created Your doctor has assigned questionnaires for that visit Otherwise before each visit please log onto CHADIS and complete the prescribed questionnaires You will receive reminders from CHADIS to fill them out These questionnaires are recommended by the American Academy of Pediatrics and we are glad to be a leader in providing them to you Please note that CHADIS is a secure website and that your information will never be made available to outside organizations As a partner in your child s healthcare your input is essential in helping us provide the best care possible We are dedicated to this goal and we believe CHADIS is a great new tool for achieving this objective CHADIS How To Handbook Handbook Page 21 See you soon Practice Name CHADIS How To Handbook Handbook Page 22 2 Notifying Parents by Email In order to use this method having your parents emails is necessary If your practice does not already collect email addresses please begin to do so immediately Thereafter send the Registration Email shown below to all clients coming in for a Well visit within the next two weeks Emails should be sent every two weeks until all families have registered About the Registration Email n the Registration email you can set up a link so that your practice s Invitation Code is entered automatically You must ins
21. ttings in CHADIS include all of the Developmental and Mental Health screens recommended by the American Academy of Pediatrics A detailed listing of the current defaults for both Developmental Behavioral and Well Child visits are listed on Page 9 and 10 CHADIS Office Set Up 2 Using the Demo Site The 5 Step Process Step One Invitation Code Go to www CHADIS com under the For Clinicians tab and find the Demo Login box on the right of the page Click on I Have an Invitation Code and you will be transferred to the Welcome to CHADIS page Enter 5551234567 in the Invitation Code box under New Users Follow the prompts to complete demographic information for a pretend parent and patient Step Two Complete Questionnaires Complete the questionnaires that were automatically assigned based on the child s age as a pretend parent then log out Step Three Clinician View Now re enter through the Demo Login as a Clinician using the following username and password Username doctor Password 1secret2 Step Four Create a Report Search for your pretend patient then scroll down and click on Create Report to see the results You may click on the printer icon to see a summary page of the patient s results and any information you entered as the Clinician Lak Step Five Select Resources Search and select appropriate Resources for pretend patient from the Electronic Worksheet the Resources tab or the Resources
22. ymptoms Self report screening of internalizing externalizing and inattention symptoms Comprehensive diagnostic questionnaire based on the DSM PC Covers depression anxiety eating disorders and substance abuse Teen self report measure specific to depression Tool name seen by Parents Respondents CHADIS Office Set Up 4 Teacher Tools Name Ages Use Description Vanderbilt Follow Up Parent 6 18 Behavioral Tracking of ADHD us and Teacher years Visits symptoms over time Health Supervision Tools Name Ages Use Description Parent s rating of child s functioning across 5 major domains 0 3 Overall Appraisal of 0 3 Routine Functioning years visits Checklist for parent to endorse best parts of parenting this child 0 5 Routine Best Parts of Parenting years cits Routine Health risks including visits exposure to HIV TB lead 0 5 Required low fluoride smoker years for substance abuser and Medicaid contact person with low visits 0 5 immunity EPSDT Health Risk Tool name seen by Parents Respondents CHADIS Office Set Up 5 Family Environment Tools Name Description General Functioning Subscale of the McMaster Family Assessment Device McMaster Family Interactions Edinburgh Parents Emotions Adverse Childhood Events ACE Parent of a child 4 month s 18 years Multidimensional Scale of Perceived Social Support MSPSS Social Support Potential St
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