NAVIGATE Training
COMPASS VISIT SEQUENCE AND OVERVIEW
Benji Kurian, MD, MPHRonny Pipes, MA, LPC
UT Southwestern Medical Center at Dallas
COMPASS OVERVIEW
COMPASS is a web-based decision support system that promotes:
MBC,
Evidence-based practice, and
Shared decision-making
COMPASS OVERVIEW
COMPASS provides feedback to providers at the point of care.
The concept of MBC for COMPASS is to use validated ratings at defined intervals to systematically assess:
symptoms,
side effects, and
treatment adherence.
PATIENT VISIT FLOW DIAGRAM
Patient checks inFront desk
receptionist notifies RA
RA enters:New patient info
Medical History FormLabs & Vitals
Opens Patient SR Form
Once Patient SR form is entered in
computer, patient is ready to see doctor
Doctor assesses patient & completes the Clinician Rating
Form online
Doctor & Patient discuss priorities for treatment and
exercise shared decision making
Doctor reviews messages from decision support and
selects treatment
Doctor finalizes visit on the Finishing Up screen & completes the visit
RA Visit Flow
Prescriber Visit Flow
The First Section of the Patient Visit is Led by the Site Research AssistantLogin Using Your Unique User Profile
User IDPassword
RA Visit Flow
Logging In
User ID = 1st initial of your first name + your last name• No spaces• Example: John Doe = jdoe
Password = Trainingpassword1
COMPASS WELCOME SCREEN
Click on your clinic name:AMHC
Is the center we’ll use for training
PATIENTS SCREEN
Click on:Add new patient
NEW PATIENT ENTRY SCREEN
Enter patient information, then
click “Initial History” to open the next form.
Remember to assign the
prescriber & the RA
INITIAL HISTORY FORM
Complete the form by clicking
through each item
INITIAL HISTORY FORM (CONTINUED)
+ and – signs add & remove
lines for medications
WHEN FORM IS COMPLETE CLICK SUBMIT
CLICK ON “ADD NEW LABS”
LABS SCREEN: ENTER LAB VALUES AND CLICK “SUBMIT”
RETURN TO THE REPORT CENTER PAGE & CLICK ON “NEW VISIT”
ENTER VITAL SIGNS & CLICK TO PATIENT SELF EVALUATION
Little red boxes indicate items
not yet addressed
WHEN FORM IS COMPLETE, CLICK “SAVE”
- END OF RA/PATIENT ENCOUNTER - PATIENT READY TO SEE PRESCRIBER
PRESCRIBER VISIT FLOW
Login with Your Unique User ProfileUser NamePassword
Logging In
User ID = 1st initial of your first name + your last name• No spaces• Example: John Doe = jdoe
Password = Trainingpassword1
COMPASS WELCOME SCREEN
Click on your clinic name:AMHC
Is the center we’ll use for training
NOW PATIENT IS READY TO BE SEEN BY THE PRESCRIBER
CLICK ON “STATUS”
PATIENT STATUS SCREENMood & anxiety
symptoms graphs
Pull-down menu allows you to select which symptoms to
graph
PATIENT STATUS SCREEN
Medication dose, Side effects, weight, etc also w/ pull-down
CLICK “PATIENT ASSESSMENT” TO GO TO CLINICIAN RATED QUESTIONS
DOCTOR ASSESSES PATIENT & COMPLETES THE CLINICIAN RATED QUESTIONS FORM
This section reports information from Patient Self-Report that does not have
a corresponding question on the Clinician Rated Form
CLINICIAN RATED FORM INCLUDES INFORMATION FROM PATIENT SELF-RATED FORM ON CORRESPONDING ITEMS AND ADJUSTS THE PROMPT QUESTIONS ACCORDINGLY.
This item includes prompt question for a patient who
did not endorse depressed mood on the
Self-Report Form
Prompt question for patient who did endorse anxious
mood
AFTER COMPLETING THE CLINICIAN RATING FORM, CLICK “NEXT: PRIORITIZE TREATMENT”
SHARED DECISION MAKING: DISCUSS WITH PATIENT WHICH TREATMENT ISSUES ARE MOST IMPORTANT TO ADDRESS AT THIS VISIT.
Highlight the symptom or side effect in the list on the left then click the arrow next to the priority number on the right
SHARED DECISION MAKING: PRIORITIZING TREATMENT ISSUES
Here you can type as much free text into the progress note as you
like
It’s easy to re-prioritizeAny number up to 5 is acceptable
When you’re finished prioritizing, click here to go to the decision
support/treatment selection screen
DECISION SUPPORT & TREATMENT SELECTION SCREEN
Here you will get your list of issues to address in order of priority.
Under each issue there will be a recommendation for treatment
from the decision support messenger
More room for free text for the progress note here
Step 1: From this drop-down you
select from a list of clinical issues
to treat
Step 2: From this drop down you will
choose from a list of recommended
treatments for the selected clinical issue
TREATMENT SELECTION − PRINCIPLESMeasurement Based Care
Evidence based principles to guide treatment selection based on
regular assessments of symptoms, SE and adherence
Shared Decision Making
Suggested treatment guidelines are based on 5 priorities that
prescriber and patient decided on prior page
Suggested Sequence/Dose of Medications
Generally, emphasizes medications having recent studies with
efficacy data in FEP and/or adolescents with schizophrenia
spectrum disorders
TREATMENT SELECTION − MEDICATIONS (CONT’D)
Suggested Sequence/Dose of Medications (cont’d)
Efficacy studies provide the base for efficacy, dosing and SE
Antipsychotic and SE medications without studies in FEP patient
groups are not supported by COMPASS.
While unsupported meds may be effective, dosing and SE profiles for these
meds in FEP patients are unknown
COMPASS does provide support for antidepressants and mood
stabilizers
These recommendations are based on studies in patients with primary mood
disorders, as data from FEP patient studies is unavailable
LIST OF COMPASS SUPPORTED MEDICATIONS (ALPHABETICAL ORDER)Antipsychotics:
AripiprazoleChlorpromazineClozapineHaloperidolOlanzapinePaliperidoneQuetiapineRisperidoneZiprasidoneAntidepressants:
BupropionCitalopramDuloxetineEscitalopramFluoxetineMirtazapineParoxetineSertralineVenlafaxineMood Stabilizers:Divalproex
Lithium
Side Effect Medications:BenztropineLorazepamPropranolol
POSITIVE SYMPTOMS TREATMENT
Aripiprazole is started at 5mg for 7 days, then
titrated up to 10mg until next visit
POSITIVE SYMPTOMS TREATMENT
Click on the blue text with the drug information to
navigate to pricing screen
Drug Information Link
Click on the name of the drug to get information
Pricing Information
Drug pricing is listed here
When you’re finished, close
the window
WHEN YOU’VE FINISHED WITH TREATMENT SELECTION, PROCEED TO THE FINISHING UP SCREEN
Click Next: Status
to advance to the final screen
FINISHING UP SCREEN
Address Suicidality
Address Homicidality
Explain Risks & Benefits of Medications
Check Finalize When
finished
COMPLETE THE VISIT
Free Text Notes have Full
Function Text Editing Toolbar
Click Submit to Finish Visit and Return to Home
Screen
LOGGING OUT
LOGGING OUT
OTHER ASPECTS OF COMPASS
Other Providers with Access
Designated Psychosocial Treatment Team Members
Access and Security
Site Secure website
User specific login/passwords (DO NOT SHARE)
User requirements
Stable Internet Connection
Works best on Internet Explorer 6 or later
CONTACTING YOU
Brief Primer in the next few weeks
If you have questions please contact us:
