CORE-AT System Online Training - The Athletic Training Practice
Contents
1. 22 CORE AT PROJECT This will direct you to the Injury Demographic form oe f En fe ee ee ee ee rad U The injury demographic is a simple form to capture information for a patient s injury It is not meant to be a complete evaluation Within this form you will complete the necessaty fields according to your evaluation findings 23 Some fields within the patient demographic are dependent upon others For example the preliminary diagnosis cannot be selected until after the body part injured is selected CORE AT PROJECT Fields include Height Body Part Injured Weight Side of Body Date of Injury Initial Pain Description Date of evaluation Numeric Pain Scale Sport Current Participation Status Position Previous History of Injury Level Other Health Conditions Injured During Preliminary Diagnosis Simple Mechanism of injury Severity of Injury Time of injury Initial Plan of Action CLINICAL OUTCOMES INSTRUMENTS Clinical Outcome instruments are utilized within the CORE AT system as part of the overall patient documentation For each patient 2 outcomes instruments will be generated automatically Patients who are 18 years old and younger will complete the PEDS QL sutvey Patients who are older than 18 years old will complete the SF I2 In addition to the general instruments a body part or region specific instrument will be generated This will be dependent upon the body part injured I2. This will limit the ability for a person other than the athletic trainer to access the computer and view personal health information that has been entered into the system
3. or upcoming patient forms in the Form Table see 11 below 11 Form Table lists all forms associated with the AT page 11 or Patient page 12 view 47 CORE AT Registration Form For your convenience we have included a registration form to facilitate the patient registration process within the CORE AT system The CORE AT registration form is intended for athletic trainers to use as a tool possibly something to include in pre participation examination packets to help streamline the patient registration process 48 CORE AT For Parents Registering Your Student Athlete The athletic trainer at your child s high school utilizes an electronic medical record to document healthcare services provided to your child In order to assist your athletic trainer in the proper documentation of services provided to your child including injury evaluations and treatment wound care and preventative care we ask that you please register your child s information within the EMR system This process requires internet access and will only take a few minutes 1 To access the system please logon to http www core at com From this screen select the orange Patient tab and then click the link for Patient Self Registration This website will direct you to the patient registration form PATIENT 2 On the patient registration form select your child s high school from the center list You can scroll through the l
4. 100 38 CORE AT Generated Outcomes Instruments Generic Instruments Pediatric Quality of Life Inventory PedsQL The PedsQL is a 23 item generic measure of health related quality of life HRQOL designed for the pediatric population and has established reliability validity and feasibility The PedsQL has four subscales including physical functioning 8 items emotional functioning 5 items social functioning 5 items and school functioning 5 items as well as two summary scores psychosocial health summary and physical health summary and one total score Each question is scored on a 5 point response scale and total scores range from 0 100 with higher scores indicating better HRQOL The PedsQL is generated automatically for those patients between the ages of 12 18 Short Form 12 SF 12 The SF 12 is a well validated measure of general health status consisting of twelve items measuring eight concepts of both physical and mental health The SF 12 version 2 contains 12 items from the SF 36 Health Survey It includes one or two items that measure each of the eight domains of health included in the SF 36 physical functioning role limitations due to physical health bodily pain general health perceptions vitality social functioning role limitations due to emotional problems and mental health The SF 12 and SF 36 have been used in a variety of different patient populations including the cognitive
5. For each patient s injury a generic and if appropriate region specific outcomes instrument will be generated for the patient to complete Generic outcomes instruments are generated based on the patient s age while region specific outcomes instruments are generated based on the body part selected in the Injury Demographic form All multi question outcomes instruments are administered on a specific timeline with initial completion at the time of injury first follow up 10 days post injury and final follow up 30 days post injury and at discharge The EMR system is designed to notify both the athletic trainer and the patient when outcomes instruments need to be completed Athletic trainers receive notification at the completion of the injury evaluation and can also monitor the status of outcomes forms from the Injury Menu Patient View and on the Daily Treatment form Patients will receive email notification when outcomes forms are due and an additional email notification 2 days after forms become overdue To view completed patient outcomes instruments select the injury from the Injury Menu Click on the Patient button to enter Patient View Highlight the selected outcomes instrument and click on the View Form button below the window Status DASH 19 100 SPORT 6 100 Tue Aug 18 2009 DASH Survey Overcue Tue Aug 18 2009 PEDS QL Survey Overdue i aiid Wed Sep 9 12 01 54 GMT 0700 2009 PEDS QL Survey 53
6. Injured Knee a E3 Treatment WE Taping EE Wound Care Sport Volleyball sv Side of Body Right v W3 Evaluation W Ice Pack Hot Pack WE Other EE Is Locked Update Delete 19 CORE AT PROJECT 6 After reviewing the patient s login and making any necessary changes login record check the box labeled confirmed and click Update to officially submit the information to the system nhai 04 27 2011 Pom tame 04 27 2011 bod Patient Create Date Is Locked a i a TO tina mae View Totals New Injury v Body Part Injured head Fj Treatment WE Taping Wound Care Sport GOD Side of Body OTT 4 Evaluation WE Ice Pack Hot Pack WE Other ith ie aaa SRT Is Locked 7 Once the patients login information is locked you will notice that the right hand column now reads true You will no longer be able to make future changes to the information Another feature of the daily login page is the ability for the clinician to track the number of patient visits treatments new injuries evaluations etc This feature can be accessed by clicking the View Totals box at the bottom center of the screen Additionally if you would like to track patient visits over a specific period of time you can adjust the start and end dates at the top of the page This tool can be used to quickly track daily weekly monthly or yearly services rendered by an athletic trainer Patient es an eal BM m View Total
7. following patient care information will be captured 1 The reason for visit New Injury Current Injury Prevention 2 Current Sport 3 Body Part 4 Side of Body 5 Services being provided ie treatment evaluation taping ice pack hot pack wound care other 16 CORE AT PROJECT SE me we n baad kasa Once complete the patient can then Submit his her information For security purposes once a patient completes and submits his her daily login information the system is redirected back to the Daily Login Homepage for the next patient to login To log out of the Daily Login Homepage simply close the window of your internet browser and return back to the CORE AT EMR webpage at core at com Daily Login Athletic Trainer View In order to ensure that all information entered by patients is accurate the athletic trainer will need to log into Athletic Trainer View and confirm all entries To review edit and confirm the daily login entries 1 Click on the button labeled View Daily Logins from the Main Menu 17 CORE AT PROJECT am Type a name into the search box to find an existing patient Patient Last Visit v Delta Patient Delta Has not yet logged i Beta Patient Beta Tue Jun 7 2011 Alpha Patient Alpha Tue May 10 2011 Patient Profile Patent Injuries 2 On the View Daily Login page you will see a list of all patients who logged into the Daily Login The defau
8. for Practice Exposures Game Exposures Practice Injuries and Game Injuries 09 09 2005 F HE EE HE o f BERR RRR J is Zi o jo oe HEHH o L fad al al dd dd li oO TT TTT cu guenncdeeerene o o a i el el Ree Surveillance is completed on a weekly basis with the week running from Sunday through Saturday To complete your weekly surveillance use the calendar button to select the appropriate week you want to record 06 26 2009 2009 gt rf S 4 5 6 11 i2 13 18 19 20 43 CORE AT Check the boxes next to the sports that are in season You will notice that once checked the exposure and injury fields will become active Surveillance data Snor iocked once Enter the total number of exposures for each sport separated by practices and games submitted so you Then enter the total number of injuries that occurred during both practices and games can easily return for each sport to change information for any Click on the Submit button to save your entries week EXPOSURE AND INJURY DEFINITIONS An exposure is defined as an athlete participating in 1 practice or competition that exposes the individual to the chance of athletic injury It is possible to have multiple exposures for one athlete on the same day Injury is defined as any injury that 1 results from participation in interscholastic practices or competitions and 2 requires medical attention b
9. patient documentation and overall care with a more efficient intuitive and effective documentation and injury surveillance component in addition to contributing valuable information to the efforts of the CORE AT Project CORE AT PROJECT Electronic Medical Record EMR The CORE AT EMR system is comprised of two types of pages Menus and Forms Throughout this manual we will refer to pages where patient information is accessed as a Menu and pages where patient information is entered as a Form Menus within the system include the Main Menu which provides access to all registered patients and the Injury Menu which provides access to all injuries documented for a specific patient Forms within the system include the patient registration form injury demographic form evaluation form daily treatment form discharge summary form and the various patient oriented outcome forms SF 12 PEDS QL FAAM etc Forms are completed by either the clinician or the patient and once submitted cannot be edited You can view all completed forms from the Injury Menu NAVIGATION TIPS Because the CORE AT system uses Flash Technology clicking the Back button on your browser will cause you to exit the system For this reason make sure you always click on one of the buttons within the system Now let s look at the individual Menus and Forms within the CORE AT EMR system Global Admin is the login tab for the CORE AT Proj
10. records The ISC is designed to integrate seamlessly with the EMR system and to eliminate the need for double data entry All that is required of the athletic trainer is to record the number of participants for each team s practices and games throughout the week All incidences of injury time loss severity etc are automatically calculated via the documentation system within the EMR system CORE AT PROJECT One unique feature of the CORE AT EMR is the built in patient oriented outcomes instruments For each injury that is recorded into the system a series of general and region specific outcomes instruments are generated for the patient to complete These instruments provide valuable information to the athletic trainer regarding how the patient is progressing with his her injury and the overall effectiveness of the care being provided The patient can complete outcomes instruments in the athletic training room at the time of evaluation or log onto the system from home to complete the instruments Integration of patient oriented outcome instruments will help to improve clinical practice not only with individual patients but also within the profession as a whole as we work to characterize athletic training practice through the development of the CORE AT Project Each component of the CORE AT system is explained in detail within this manual It is our hope that you will be able to utilize this system to effectively improve your
11. standardization to the rehabilitation exercises Codes are provided for the most common procedures utilized by athletic trainers Standard coding considers one unit to be 8 15 minutes of activity For the exercises in the above image it is be estimated that it would take the patient 15 minutes to perform all three activities so the CPT code of 97110 Therapeutic Exercise would be selected along with 1 unit Once you have completed the Daily Treatment form 1 Lock and Submit submit completed daily treatment form and return to Injury Menu NOTE once the daily treatment form is submitted it cannot be edited 2 Save for Later save the current daily treatment form for completion at a later time 3 Cancel discard the current daily treatment form and return to the Injury Menu NOTE no information will be saved 34 CORE AT PROJECT Discharge Summary Form To complete the Discharge Summary form select an injury from the Injury Menu Click on the Complete Discharge Summary button above the center window Number of Overdue Forms Type of Visit Wed Sep 9 2009 Daily Treatment Completed Wed Aug 12 2009 Injury Demographic Created The Discharge Summary provides an complete re evaluation of the patient s injury and includes all of the information from the Injury Evaluation form such as weight bearing status range of motion general inspection palpation strength testing flexibility neurological testing functio
12. the patient s previous numeric pain rating This imported information is taken from the most recent patient visit either the injury evaluation or last daily treatment Also included in the Daily Treatment form is the status of the clinical outcomes instruments The Outcomes Scores window gives the clinician information on which outcomes instruments the patient has completed or needs to complete The Login as Patient provides quick access to the outcomes instruments Fields Include Current Numeric Pain Rating Procedure Summary Overall Condition of Injury Recommendations Notes Global Rating of Function Exercises Global Rating of Disability 33 Ms Alison Snyder Mr Bart Anderson more units CORE AT PROJECT When entering exercises into the daily treatment record provide a description of the exercise and then enter the duration frequency weight etc You can use the Tab button on your keyboard to move through the boxes Once you enter a duration frequency an additional set of fields will be generated allowing you to enter as much information as needed single leg balance 5 sets of 30 seconds body weight squats 3 sets of 10 walking lunges 2 sets of 10 right and left sides 10Ibs The procedure summary fields allow for coding of the specific activities performed during the visit Utilizing standard Common Procedural Terminology CPT codes you can characterize your treatment activities and provide
13. 29 2011 false EE View Totals Body Part Injured Knee yw P72 Treatment M Taping EE Wound Care H Volleyball ew LO Right uw W7 Evaluation Ice Pack Hot Pack WE Other EE Is Locked Ups i _ Delete NAVIGATION TIPS On the View Daily Login page if the patient enters new injury for the reason of the visit an Injury Demographic button will be provided for the athletic trainer so that he or she can begin documenting the new injury If the patient enters current injury the system will attempt to match the injury based on the body part entered If the system can match the injury then it will provide a button to a Daily Treatment form which allows the clinician to complete the necessary documentation for the injury 5 To link information entered into the Daily Login to existing documentation records you must complete the patient s injury demographic form or daily treatment form If these forms are not completed before submitting or locking the patient s login information the program will not be able to link the patient s login with the injury demographic or treatment forms lata 07 29 2011 FAGE 07 29 2011 f Patient Sport Injury Services Create Date Is Locked Patient Beta Beta Cheerleading Injury Not Found Treatment Evaluation Taping Fri Jul 29 2011 false Patient Delta Delta Football New Injury Evaluation Fri Jul 29 2011 false EE View Totals New Injury Body Part
14. CLINICAL OUTCOMES RESEARCH EDUCATION FOR ATHLETIC TRAINERS A T Still University Athletic Training Program CORE AT PROJECT Table of Contents The CORE AT System System Overview Electronic Medical Record EMR Menus Login Page Logging In Main Menu Injury Menu Athletic Trainer View Patient View Forms Registering a New Patient Daily Login ee Injury Demographic Form Region Specific Injury Evaluation Form Concussion Specific Evaluation Form Digital File Upload amp Notes Feature Daily Treatment Form Discharge Summary Form Printing Forms Outcomes Instruments Generated Outcomes Instruments Generic Instruments Pediatric Quality of Life Inventory PedsQL Short Form 12 SF 12 Region Specific Instruments Headache Impact Test HIT 6 Disabilities of the Arm Shoulder and Hand DASH Lower Extremity Functional Scale LEFS International Knee Documentation Committee Knee Form IKDC Functional Ankle Ability Measure FAAM Modified Oswestry Low Back Disability Questionnaire MOSW Patient Specific Functional Scale PSFS Injury Surveillance Component ISC Quick Reference Guides Patient Self Registration Instructions Best Practice Guidelines HIPAA and Registration Forms CORE AT PROJECT The CORE AT System The Clinical Outcomes Research Education for Athletic Trainers CORE AT system is a web based electronic medical record and injury surveillance component for athletic trainers The CORE AT sy
15. In Treatment Right Knee 717 9 Internal Derangement Wed Aug 5 2009 gt Discharged Once an injury is selected several new options will be available Date Type of Visit Wed Aug 12 2009 Injury Demographic Created Below the injury list you will find buttons to complete an injury evaluation add a daily treatment or complete a 8 Athletic Trainer Forms Buttons create an injury evaluation report daily discharge treatment note or discharge summary using these respective buttons summary These buttons are only 9 AT Tab lists all forms completed by the athletic trainer in the Form Table available for use see 11 below when a specific injury has been 10 Patient Tabs lists all completed overdue or upcoming patient forms in the selected Form Table see 11 below 11 Form Table lists all forms associated with the AT page 11 or Patient page 12 view 10 CORE AT PROJECT Athletic Trainer View The AT view shown below provides a list of all of the documentation forms for the specific injury selected This includes the Injury Demographic Injury Evaluation all Daily Treatments and the Discharge Summary forms Also included are the dates that the forms were completed and the clinician that completed the forms Number of Overdwe Forms Daily Treatment Completed Ms Alison Snyder Injury Demographic Created Mr Bart Anderson To view a completed form simply highlight the form in the wi
16. New Patient button in the top left of the Main Menu shown below This will direct you to the patient registration form On the patient registration form complete the fields with the patient s personal demographic information 13 CORE AT PROJECT PATIENT USERNAME AND PASSWORD The patient username is the personal patient id that your patient will use to access the system from home It should be something simple to remember and unique to each patient We recommend using a standard system for all patients such as first initial last name or first name last initial John Doe jdoe or johnd Please note that you cannot register two patients with the same username If a username is already in use the form will submit but the patient will not be available within the patient list window Primary Care Physician Guardian 1 and Guardian 2 information is not required for patient registration but is recommended for complete documentation Once all of the required forms are completed click on the Submit button to register the patient You will be returned to the Main Menu and your newly registered patient will be available in the Patient List window Patient Self Registration The patient self registration feature allows a parent or student athlete to access the CORE AT EMR from home for registration This tool allows student athletes to enter their demographic information into the system before the beginning of a
17. S NOTE Once you have uploaded a file it cannot be removed from the patient s File menu To comment or modify an already existing document you must create a new document ie using Microsoft Word To open and view a file that has been uploaded you can either 1 double click on the file or 2 highlight the file by clicking on it once and a Download button will appear at the bottom of the screen You can then click Download to open the file 30 CORE AT PROJECT Filename Size KB Clinician Fri May 27 2011 Baker_MRI_5 10 11 docx Accounti Demoldemol To exit the file menu once you have finished viewing uploaded files click Cancel at the bottom of the window and you will be redirected back to the patient Injury Menu Notes Feature The notes feature can be accessed in the same location of the EMR system as the digital file upload The notes feature was created to allow clinicians to write a simple sentence or two pertaining to the patient s medical care These notes may consist of comments related to recently uploaded patient files patient cancelation of an expected treatment session or dates of future follow up appointments with physicians 31 CORE AT PROJECT Filename Size KB Clinician Fri May 27 2011 Baker_PT_ProgressNotes 5 27 11 doc 13 Account1 Demofdemo1 Fri May 27 2011 Baker MRI_5 10 11 docx 13 Accountl1 Demofdemol To create a new patient note simple write in th
18. atient s status over time To complete the PSFS patients identify 3 5 functional tasks that are difficult to complete as a result of their injury and these items are evaluated at the beginning and end of care The PSFS is an optional scale that must be added on the Injury Demographic form Items indicated by the patient on the PSFS are automatically entered into the Injury Evaluation as patient specific goals We highly recommend utilizing this patient centered outcomes instrument with all of your patients 41 CORE AT Injury Surveillance Component ISC The Injury Surveillance Component ISC of CORE AT is primarily driven by the EMR and the data collected through injury documentation The only information that must be entered into the system manually is the number of exposures and injuries To access the ISC click on the Injury Surveillance button in the top left corner of the Main Menu Type a name into the search box to find an existing patient Patient Last Visit patient test testpatient Has not yet logged Registration2 Self sregistration2 Has not yet logged tim jon timj Mon Jul 25 2011 Anderson Owen oanderson Mon Jul 25 2011 Hinkle Lisa Ihinkle Has not yet logged v Atkins Angie Angie Mon Jul 25 2011 Patient Profite Patient Injuries 42 CORE AT Once in the Injury Surveillance form you will see fields for all available sports along with fields
19. be saved Information from the Injury Demographic Form is automatically imported into the evaluation form which reduces the need for double entry saving time for the clinician 26 CORE AT PROJECT Compared to the Injury Demographic form the Injury Evaluation form is much more comprehensive and provides a complete evaluation template to document all types of injuries For instance the screenshot below illustrates the Passive Range of Motion options that are automatically generated after the clinician designates UCL sprain of the elbow as the diagnosis 27 CORE AT PROJECT Concussion Specific Evaluation Form Additionally there is a unique form generated after a clinician designates a concussion diagnosis on the injury demographic form The concussion evaluation form automatically generates evaluation fields unique to head injury evaluation For instance the form includes drop down menus for loss of consciousness amnesia pupillary sions coordination cranial nerve assessment cervical spine range of motion upper quarter neurological assessment and functional testing 28 CORE AT PROJECT Digital File Upload amp Notes Feature Digital File Upload The Digital File Upload feature provides the athletic trainer with the ability to upload documents associated with a patient s care For instance the athletic trainer can upload documents referred from other health care professionals treating his her patient
20. bility and lower HRQOL The DASH consists of questions that relate to symptoms e g presence of pain and stiffness in your arm shoulder or hand and disability e g ability to place an object on a shelf above your head write and make your bed The 4 question sport module measures functional status which includes questions that relate to disability e g ability to play your musical instrument ot sport as well as you would like and ability to spend your usual amount of time practicing or playing your instrument or sport The DASH is generated for patients who suffer from an injury to the upper extremity Lower Extremity Functional Scale LEFS The LEFS is a 20 item instrument that evaluates function in people with a variety of lower extremity orthopedic conditions and is useful as both a clinical and research tool Scores on the LEFS range from 0 80 with higher scores indicative of better functional status The LEFS is generated for patients with injury to the hip or thigh It can also be manually added on the Injury Demographic form 40 CORE AT International Knee Documentation Committee Knee Form IKDC The IKDC is a reliable and valid 18 item outcomes instrument used for evaluating the symptoms function and sports activity in people with a variety of knee conditions or injuries including ligament meniscal and cartilage injuries and osteoarthritis and patellofemoral pain Scores on the IKDC range from 0 100 with higher sco
21. complete injury evaluation form It can also be used to track the number of new evaluations treatments and other daily practice activities on a weekly monthly or yearly basis When entering the athletic training room for care the athlete will log into the system and select the reasons for their visit The daily login portion of the EMR functions independently from the Athletic Trainer View of the system so both can be open simultaneously on separate computers For instance the AT may have a patient station at the entrance of the athletic training room or clinic in order for the patient to sign in in addition to having the EMR open on the AT s personal computer at a desk To activate the Daily Login feature click the Daily Login Page button in the upper right hand corner of the Main Menu screen This action will log you out of the Athletic Trainer View within the system and open the Daily Login Homepage a Type a name into the search box to find an existing patient Patient Last Visit v Delta Patient Delta Has not yet logged i Beta Patient Beta Tue Jun 7 2011 Alpha Patient Alpha Tue May 10 2011 Patient Profile Patient Injuries 15 CORE AT PROJECT Daily Login Patient View From the Daily Login Homepage the patient will be asked to type in his or her first name middle initial and last name OR patient username This will lead the patient to the Main Daily Login page where the
22. d a new injury for the patient 2 Patient Demographic Information view a patient s demographic information 3 Number of Overdue Forms indicates how many pending outcome instruments a patient needs to complete 4 Injury Drop Down Menu view all recorded injuries as well as the diagnosis date of injury and status of each injury see page 10 for more information NOTE this drop down menu will be empty for new patients 5 Main Menu return to Main Menu 6 Login as Patient log into Patient View see page 12 where the patient can complete pending forms associated with his her injury This feature can be utilized for patients who need to complete their outcomes instruments in the athletic training room during a treatment visit 7 Logout log out of the CORE AT system CORE AT PROJECT In the center of the screen is a drop down menu see 4 above to view patient injuries This drop down menu will show all injuries that were previously recorded within the system as well as that injury s current status For new patients this drop down menu will be empty Number of Overdue Forms 14 Back 724 2 Pain low back Mon Aug 31 2009 gt In Treatment Head 850 9 Concussion Tue Aug 11 2009 gt In Treatment Left Ankle 924 21 Contusion Mon Aug 10 2009 gt In Treatment Back 846 10 Sprain Strain Sacroiliac Sun Aug 9 2009 gt In Treatment Left Shoulder 726 2 Impingement Syndrome Sat Aug 8 2009 gt
23. e empty text box provided Once you create a note a new text box will be created for you to enter subsequent notes Once you have created and saved a note you cannot delete the documentation created by Mr Demo Account on Fri May 27 2011 Pt s parents were contacted regarding rehabilitation progress in the athletic training room created by Mr Demo Account on Fri May 27 2011 Pt s next physician follow up in on 6 12 11 32 Outcomes Instruments are completed at multiple time points e g at initial injury 10 days post injury 30 days post injury and at discharge The Outcomes Scores window will display the current timeline for completing outcomes instruments CORE AT PROJECT Daily Treatment Form To complete a Daily Treatment form select an injury from the Injury Menu Click on the Add Daily Treatment button above the center window Number of Overdue Forms 14 Date Type of Visit Status Clinician Wed Sep 9 2009 Daily Treatment Completed Draft Wed Aug 12 2009 Injury Demographic Created Complete View Form Edit Draft The Daily Treatment form provides the athletic trainer with the ability to document daily rehabilitation activities and subjective information for the patient Basic information on the status of the injury is imported into the form automatically including the diagnosis current participation status time since injury treatment time and
24. ect Personnel Athletic Trainer is the login tab for athletic trainers Patient is the login tab for registered patients CORE AT PROJECT Menus Login Page To access the CORE AT system open your Internet browser to the following URL http www core at com On this page you will find orange tabs for Global Admin Athletic Trainer and Patient CLINICAL OUTCOMES RESEARCH EDUCATION Funding for the CORE AT project was provided through a grant from the National Athletic Trainer s Association Research and Education Foundation FOR ATHLETIC TRAINERS Select the appropriate tab above to begin Your use of this service means that you agree to the This service was developed in conjuction with Click on the Athletic Trainer tab to open the login fields CORE AT PROJECT Logging In Because the CORE AT system is used by athletic trainers across the country it requires you to specify your clinic high school your personal username and your personal password To sign into the CORE AT THLET system enter your Clinic ID IC TRAINER Clinic demo In the next field enter your personal Username Username demo1 Password seed Account Information is case sensitive Finally enter your personal Password Now click on Login CORE AT PROJECT Main Menu After logging into the system you will be directed to the Main Menu shown below i Pr TIE WT Te OB ST FF ORY DLT Th
25. etailed Mechanism of Injury Neurological Testing Weight Bearing Status Functional Tests Active Range of Motion Gait Analysis Passtve Range of Motion Special Tests Palpation Recommended Treatment Plan Effusion Home Exercises Instructions Edema Procedure Summary Ecchymosis Goals Streneth Tests Included in the Injury Evaluation form are several stock goals related to objective measurements of function i e pain rating range of motion strength and balance Also included are goals for the region specific outcomes instruments This goal is generated based on the patient s initial score on the outcomes scale and then adding the minimum change in score to indicate clinical relevancy If you chose to have your patient complete the Patient Specific Functional Scale as part of your outcomes measutes the specific activities that the patient enters will be included in the goals section of the Injury Evaluation form This provides an effective way to adequately address patient specific problems related to his her injury Once you have completed the Injury Evaluation form 1 Lock and Submit submit completed injury evaluation form and return to Injury Menu NOTE once the injury evaluation form is submitted it cannot be edited Save for Later save the current injury evaluation form for completion at a later time Cancel discard the current injury demographic form and return to the Injury Menu NOTE no information will
26. f you would like to add additional outcomes instruments to your patient documentation you can select these in the Injury Demographic form Once the injury demographic is completed there are several options for proceeding 1 Save for Later save the current injury demographic form for completion at a later time Lock and Submit submit completed demographic form and return to Injury Menu NOTE once the injury demographic form is submitted it cannot be edited Lock and Submit and Continue to Outcomes submit completed injury demographic form and proceed to outcomes instruments related to the injury for immediate patient completion Cancel discard the current injury demographic form and return to the Injury Menu NOTE no information will be saved 24 You must first complete an Injury Demographic for the patient s injury before you can complete an Injury Evaluation CORE AT PROJECT Region Specific Injury Evaluation Form Once the Injury Demographic Form has been completed a Region Specific Injury Evaluation Form will be auto populated in relation to the body part indicated by the clinician Region specific forms will include drop down menu items for range of motion special tests manual muscle tests and neurological screening associated with the injured body region These region specific forms were developed to improve efficiency and ease of documentation for clinicians This form will also provide summary info
27. including electronic diagnostic imaging physician notes and physical therapy progress reports This feature also allows an athletic trainer the flexibility to upload additional patient information which cannot be appropriately included in the other available forms For instance the athletic trainer can upload a file documenting contact with a patient s parents regarding medical recommendations for the treatment of an injury To manage a patient s files click the Files button on the right above the center window Number of Overdue Forms 4 Injury Evaluation Type of Visit i Status Clinician Wed Mar 9 2011 Injury Evaluation Created Complete Mr Demo Accountl Wed Mar 9 2011 Injury Demographic Created Complete Mr Demo Accountl Once you have selected the Files button you will be redirected to a window where uploaded files will be displayed The column titles of this window display the date the file was downloaded the filename the size of the file and the clinician who downloaded the file To upload a new file click the Upload button at the bottom of the window 29 CORE AT PROJECT A pop up window will allow you to determine the location from which your file will be uploaded Once you have located your file click Open in the pop up window and your document will be uploaded to the EMR system If your document has uploaded properly it will now be visible on the file list NAVIGATION TIP
28. is page provides navigation for the entire system 1 Injury Surveillance complete weekly injury surveillance reports 2 Register New Patient add a new patient into the system 3 Search Patients locate a patient s record by entering his her name into the seatch box 4 Patient List Table a list of your registered patients 5 Patient Profile record view or update a patient s demographic and contact information 6 Patient Injuries enter a patient s Injury Menu record view or update the patient s injuries and the forms associated with these injuries 7 Logout log out of the CORE AT system CORE AT PROJECT Injury Menu The Injury Menu provides access to all of the documentation for a specific patient and is where you will enter new injuries document daily treatments and complete discharge notes To reach a patient s Injury Menu from the Main Menu Rae it F ethan te Tpere nera forte ihe came th boe tee Tred Ge Ge eng pe Deri 1 double click on his her name in the Patient List Table OR 2 highlight the patient s name in the Patient List Table and click on the Patient Injuries button CORE AT PROJECT Once in the Injury Menu shown below you will find the following screen m 1 Nurnber of Overdue Forms 12 3 a ee ii eT Name fest Patient Add Daily Treatrwat Connieta Discharge Username testpatent Email msatcO3 yahoo co School Year Freshman 1 Add New Injury ad
29. ist in the center window or simply type the name of the high school in the seatch box Once found click on the name of the high school to highlight it Please select your school tech eo School Allen D Nease High School Apache Junction High School Arizona State University Athletes Performance Bedford High School Bellow Falls Union High School 49 CORE AT 3 You will be asked to create a patient username which is the personal ID that your child will use to access the system from home PATIENT USERNAME AND PASSWORD The username and password should be something simple but unique We recommend using your child s first initial last name or first name last initial For instance John Doe jdoe or johnd Please note that the system cannot register two patients with the same username If a username is already in use the form will not allow you to submit it If this is the case please choose a different username 4 Next complete the fields with your child s information Primary Care Physician Guardian 1 and Guardian 2 information is not required for patient registration but is recommended for complete documentation Once all of the required entries are completed click on the Submit button to complete your registration The system will provide you with a Success message This message indicates that the information has been submitted to your child s athletic trainer If you have trouble with you
30. ivacy Act FERPA release form All information entered into the CORE AT system is uploaded and transmitted to secure redundant servers in real time and never stored on local computers While this process provides added security to the storage of the entered information the transmission of this information is regulated under FERPA Just as the athletic trainer would be required to have the patient parent legal guardian to sign a FERPA release form to transmit information eg fax email to a team family physician it is recommended that the athletic trainer obtain formal approval from the patient parent legal guardian prior to registering the patient into the EMR system To facilitate this process we have included a generic FERPA release form that the athletic trainer may use for his her practice To expedite this process it is recommended that the athletic trainer include a similar form in pre participation examination packets 2 Computer access and security While the CORE AT system is designed to provide a high level of security it is recommended that the athletic trainer take additional steps to limit computer access to non healthcare professionals and ensure the privacy of all medical records and information It is recommended that the athletic trainer change his her computer settings so that the computer hibernates sleeps switches to a screensaver within a minute of idling and then require a password in order to re access the computer
31. lt time range is for the current day Dui 07 29 2011 FGH 07 29 2011 E Patient Sport Injury Services Create Date Is Locked Patient Beta Beta Cheerleading Injury Not Found Treatment Evaluation Taping Fri Jul 29 2011 false Patient Alpha Alpha Volleyball New Injury Treatment Evaluation Fri Jul 29 2011 false Patient Delta Delta Football New Injury Evaluation Fri Jul 29 2011 false E View Totals Patient Injuries This View Daily Login page provides a quick summary of all patients who logged into the system during the selected time period From this list you can see patient names sports services selected and the date of login In addition the right hand column indicates whether the login record has been reviewed and confirmed by the athletic trainer ie false not confirmed true confirmed 3 To view the entered details for a specific patient click on the row containing the patient s entry 4 You will now see the detailed information that the patient entered into the system This includes the reason for visit body part side of the body sport and selected services Here you can modify the entered information as needed 18 CORE AT PROJECT esa 07 29 2011 07 29 2011 f Patient Sport Injury Services Create Date Is Locked Patient Beta Beta Cheerleading Injury Not Found Treatment Evaluation Taping Fri Jul 29 2011 false Patient Delta Delta Football New Injury Evaluation Fri Jul
32. ly impaired those with traumatic brain injury patients with low back pain and sufferers of achilles injuries The SF 12 is generated automatically for those patients over the age of 18 It can also be added manually on the Injury Demographic form 39 CORE AT Region Specific Instruments Headache Impact Test HIT 6 The HIT 6 is a 6 item instrument that was developed using items from previously validated headache disability instruments to measure a wide spectrum of the burden of headache on HRQOL The instrument addresses the effects of headache on pain social function role function vitality cognitive function and psychological distress The instrument is scored on a range from 36 to 78 with a higher score demonstrating a oreater impact of headache on daily life The scores are further grouped into little or no impact some impact substantial impact and severe impact Change of 5 or more points is considered a clinically meaningful change and a 3 point change is considered noteworthy The HIT 6 is generated for patients who suffer an injury to the head Disabilities of the Arm Shoulder and Hand DASH The DASH is a 30 item instrument which contains separate work and sports performing arts modules that measures upper extremity symptoms and disability and serves as a measure of HRQOL The general scale and the sport module are each scored on a separate 100 point scale with higher scores indicating greater symptoms and disa
33. nal testing gait and special tests It also provides documentation for achievement of goals that were developed with the initial evaluation Fields Include Weight Bearing Status Neurological Testing Active Range of Motion Functional Tests Passive Range of Motion Gait Analysis Palpation Special Tests Effusion Goal Achievement Edema Plan of Action Ecchymosis Procedure Summary Streneth Tests Global Rating of Satisfaction Flexibility Tests Assessment 35 CORE AT PROJECT Once you have completed the Discharge Summary form 1 Lock and Submit submit completed discharge summary form and return to Injury Menu NOTE once the discharge summary form is submitted it cannot be edited 2 Save for Later save the current discharge summary form for completion at a later time 3 Cancel discard the current discharge summary form and return to the Injury Menu NOTE no information will be saved 36 CORE AT PROJECT Printing Forms All completed forms can be printed directly from the CORE AT system Simply double click on the desired completed form from the Form Table Number of Overdue Forms Next find and click on the Print button located at the bottom of the completed form window 824 3 Fracture Fibula Treatment 37 CORE AT PROJECT Outcomes Instruments The outcomes instruments utilized by the CORE AT EMR include both generic and region specific outcomes instruments
34. ndow and then either double click on it or click the View Form button below the window Number of Overdue Forms 14 You cannot edit EEIEIEE ee EEEN pen ee ane EO OPEET EEEE EEEE forms that have already been completed and Type of Visit Status Clinician locked Only drafts Daily Treatment Completed Draft Ms Alison Sriyder Tp P forms saved for later can be edited by using the Edit Draft button Fdit Orar AEP Wed Aug 12 09 21 12 GMT 0700 2009 Injury Demographic Created Com plete 11 CORE AT PROJECT Patient View The Patient View shown below provides a list of all outcomes instruments that the patient has completed as well as upcoming or overdue forms The date the instrument was completed the name of the instrument as well as the score is displayed in the The Patient View Form Table should be utilized by the athletic trainer to monitor Number of Overdue Forms 14 the athlete s Salt Straulder 726 2 Lensinsamant Sundrome Sat Aus 2008 gt In Trastment iw timely completion of the outcomes instruments Ar Date Type of Visit Status Wed Sep 9 2009 DASH Survey DASH 19 100 SPORT 6 100 Wed Sep 9 2009 PEDS QL Survey 53 100 Tue Aug 15 2009 DASH Survey Overdue Tue Aug 15 2009 PEDS QL Survey Overdue 12 Note that fields with an are required in order to submit the form CORE AT PROJECT Forms Registering a New Patient To register a new patient click on the Register
35. r registration please contact the certified athletic trainer at your high school The Clinical Outcomes Research Education for Athletic Trainers CORE AT system is a web based electronic medical record for athletic trainers The CORE AT system is compliant with the data acquisition storage and transmission standards set forth by the Health Insurance Portability and Accountability Act HIPAA The health information obtained using the CORE AT system is not stored locally on computers Instead data is uploaded in real time and transmitted to secure redundant servers 50 Best Practice Guidelines When considering medical record keeping within the athletic training room the clinician should be aware of various best practice guidelines For example in terms of paper form medical records it is best practice to store these records in a locked cabinet that is not easily accessible to the general public As with all methods of medical record keeping there are specific guidelines to consider when using a web based electronic medical record EMR system In the following pages best practice guidelines related to EMR use are identified and described It is recommended that the athletic trainer review and follow these guidelines and incorporate any additional standards set forth by his her school school district and or state that is related to the use of an EMR system within his her athletic training room 1 Family Educational Rights and Pr
36. res indicative of better function and sports activity A change of 13 IKDC scale points is indicative of both true changes in patient status and 1s likely to be perceived as meaningful by patients The IKDC is generated for patients suffering an injury to the ce Functional Ankle Ability Measure FAAM The FAAM is a modified version of the Foot and Ankle Disability Index FADI and was created as a comprehensive evaluation tool for people with a variety of lower leg foot and ankle musculoskeletal disorders Scoring for the FAAM is based on two subscales with one Activities of Daily Living ADL 21 questions and the other related to sports activities 8 questions The ADL subscale is scored from 0 84 and the Sports Module is scored from 0 32 with higher scores indicating higher ability level The FAAM is generated for patients suffering from a lower leg ankle foot or toe injury Modified Oswestry Low Back Disability Questionnaire MOSW The MOSW is a 10 item region specific self report instrument aimed at evaluating function in people with low back pain Scoring is based on a 0 5 Likert scale with higher scores indicative of greater disability The MOSW is generated for patients suffering an injury to the back or trunk Patient Specific Functional Scale PSFS In addition to the general and specific outcomes instruments the CORE AT EMR system includes the PSFS which is an instrument that allows for measuring change in a single p
37. rmation for end of season and year reports as well as further efforts to characterize athletic training practice Also included on the Injury Evaluation form are free entry text boxes to add additional information regarding the various clinical tests This allows the clinician to not only enter standardized data through the drop down menus but also document any additional findings or information To complete an Injury Evaluation form select an injury for the patient from the Injury Menu Click on the Complete Injury Evaluation button above the center window Number of Overdue Forms 14 Date Type of Visit Status Clinician Wed Aug 12 2009 Injury Demographic Created Edit Draft View Form Following the traditional documentation format the clinician can first enter a detailed mechanism of injury and other clinical findings including weight bearing status range of motion palpation strength testing flexibility neurological testing functional testing gait and special tests as well as the recommended plan for the management of the injury timelines for rehabilitation goals home exercises and instructions and coding for procedures performed 25 Wed Sep 9 2009 Daily Treatment Completed Draft Ms Alison Snyder Complete Mr Bart Anderson Fields highlighted in red must be completed in order to submit the form CORE AT PROJECT Fields Include Diagnosis Flexibility Tests Assessment D
38. s Injury Menu record view or update the patient s injuries and the forms associated with these injuries 7 Logout log out of the CORE AT system 45 CORE AT Injury Menu Main 5 4 5 6 7 Add New Injury add a new injury for the patient Patient Demographic Information view a patients demographic information Number of Overdue Forms indicates how many pending forms a patient needs to complete Injury Drop Down Menu view all recorded injuries as well as the diagnosis date of injury and status of each injury see page 10 for more information NOTE this drop down menu will be empty for new patients Main Menu return to Main Menu Login as Patient log into Patient View see page 13 where the patient can complete pending forms associated with his her injury This feature can be utilized for patients who need to complete their outcomes instruments in the athletic training room during a treatment visit Logout log out of the CORE AT system 46 CORE AT Injury Menu Submenu Number of Overdue Forms Date Type of Visit Wed Aug 12 2009 Injury Demographic Created Mr Bart Anderson 8 Athletic Trainer Forms Buttons create an injury evaluation report daily treatment note or discharge summary using these respective buttons 9 AT Tab will list all forms completed by the athletic trainer in the Form Table see 11 below 10 Patient Tabs will list all completed overdue
39. s i Patient Visits 1 Treatments 1 Tapings Wound Care O New Injuries 1 Evals Hot Cold Packs 0 Other O 20 CORE AT PROJECT 21 An injury demographic must be completed in order to access the other documentation forms within the system CORE AT PROJECT Injury Demographic Form The CORE AT EMR system s injury documentation format is broken down into two steps the injury demographic and the injury evaluation The injury demographic contains the minimal amount of documentation needed for a patient s injury The injury evaluation is a more detailed evaluation that allows for complete documentation of all evaluation findings NOTE We recommend utilizing both the injury demographic and the injury evaluation for the most complete documentation for your practice To add a new injury for the patient click on the Add New Injury button in the top left corner of the Injury Menu screen Number of Overdue Forms Name Test Patient Complete Injury Evaluation Add Daily Treatment Username testpatient Email msatcO3 yahoo com School Year Freshman Date Type of Visit Status DOB 12 12 1995 Wed Aug 19 2009 Injury Evaluation Created Complete A i Ma 13 Wed Aug 19 2009 Injury Discharge Created Complete Mon Aug 10 2009 Daily Treatment Completed Complete Sex Male Fri Aug 7 2009 Injury Demographic Created Complete PcpName unknown PcpPhone Edit Draft View Form
40. sports season Once this information has been entered it will be readily available for the clinician at the time of an evaluation or treatment This feature was developed to remove the inconvenience from the clinician of entering all student athlete information into the EMR Please refer to self registration directions that can be printed as a handout on page 48 Please note in order to access the patient demographic forms for patients who have self registered the clinician must first approve the registrations To approve registrations these steps must be followed 1 Log into clinician account 2 Click on Manage Public Registrations at the top of the page 3 You will be taken to a page with a list of patients who self registered You should then be able to click on the name of the athlete and approve that he she be added to your clinic 14 already have his her name and demographic information registered in the system to utilize the Daily Login feature CORE AT PROJECT Daily Login The Daily Login is designed to replace the traditional paper form Sign in sheet The athletic trainer should use this feature to document patients who receive athletic training services over the course of a day Particularly the athletic trainer should find this feature to be useful in capturing injuries eg non time loss injuries and services eg prevention exercises prophylactic taping that may not require a
41. stem was designed and developed by athletic trainers in partnership with Essentialtalk an international technology communication company The CORE AT system is compliant with the data acquisition storage and transmission standards set forth by the Health Insurance Portability and Accountability Act HIPAA Health information obtained using the CORE AT system is not stored locally on computers Instead data is uploaded in real time and transmitted to secure redundant servers This manual is designed to help orient the athletic trainer to the CORE AT system and to provide technical information and training System Overview The CORE AT system is comprised of an Electronic Medical Record EMR system as well as an Injury Surveillance Component ISC Within each of these two components are several primary pieces that create the complete system This EMR has the ability to register new patients record personal demographic information e g PCP guardian and contact information initial injury demographics complete injury evaluation daily treatment notes progress notes and discharge evaluations and summaties The system is organized by patient names with the ability to quickly search through registered patients in your clinic using the Main Menu as well as access patient injuries and files from a centralized Injury Menu In essence the CORE AT EMR system acts like a virtual filing cabinet for secure storage of all your patient
42. y a certified athletic trainer or physician and 3 results in restricted participation or performance for 1 or more days beyond the day of injury Example 15 baseball athletes participate in one practice and one injury occurs this would result in 15 practice exposures and one practice injury for baseball Injuries recorded in the EMR Injury Demographic will be automatically imported into the ISC These injury counts can be seen in the left side of the practice and game injury columns This provides a check and balance system for both documentation and injury surveillance for the athletic trainer Manual injury counts and automatically generated injury counts should match up 44 CORE AT Quick Reference Guides For your convenience we have included single page reference guides to the primary menus of the CORE AT system Please print and use them as quick references as you become more familiar with the system Main Menu PD TSE We TSS A ST OE ot Ay MA This page provides navigation for the entire system 1 Injury Surveillance complete weekly injury surveillance reports 2 Register New Patient add a new patient into the system 3 Search Patients locate a patient s record by entering his her name into the seatch box 4 Patient List Table a list of your registered patients 5 Patient Profile record view or update a patient s demographic and contact information 6 Patient Injuries enter a patient
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