1. Excel ® Registry Tool Diane Powers Manager, AIMS Center University of Washington Psychiatry & Behavioral Sciences http://uwaims.org

2. Why Track Outcomes Facilitate treatment planning and adjustment (know when it’s time to change) –Avoid Patients staying on ineffective treatments for too long Know when to get consultation / help –Example: Blood Pressure

3. http://uwaims.org Remember: Most Patients Will Need Treatment Adjustments Only 30 – 50% of patients will have a complete response to initial treatment Remaining 50 – 70% will require at least one change in treatment to get better

4. http://uwaims.org Tracking Systems Tracking is an essential function of all effective integrated care programs –Can be accomplished in many different ways –Find the best option for your setting How many users? How many sites? How many patients? Existing registry and/or EMR systems

5. http://uwaims.org How Can a Registry Help? Keep track of all clients so no one “falls through the cracks” Identify who needs additional attention –Clients who are not following up –Clients who are not improving Facilitate communication, consultation, and care coordination

6. http://uwaims.org Using the Excel ® Registry 2 versions of Excel file -Blank -Example Instructions (Word file)

7. http://uwaims.org Blank Version

8. http://uwaims.org Example Version

9. http://uwaims.orgInstructions

10. Using the Excel ® Registry Spreadsheet defaults -75 patients total -6 rows per patient -PHQ-9 only -Reminder tickler based on date of first contact -Tickler messages can be customized / added

11. http://uwaims.org Using the Excel ® Registry Customize it to suit your needs -More patients -More rows per patient -More measures -Change timing of contact reminders -Add reminders to tickler -Create linked aggregate report to see snapshot of entire caseload -Add brief note/summary area for each patient and/or each contact

12. http://uwaims.org Using the Excel ® Registry Enter information into the white cells ONLY - VERY IMPORTANT -Colored cells already have information in them (or will display after information entered into white cell); typing into these cells will remove formulas that help the spreadsheet function correctly -Shaded cells neither display information or have information entered into them

13. http://uwaims.org First Visit Enter Name, ID, Phone Number Enter Start Date –Date for follow-up will automatically populate Enter baseline PHQ-9 Score –Percent change in depression symptoms from baseline will automatically calculate –If no depression score is entered at a follow-up visit, the percent change will be reflected as -100% –As depression scores are entered at follow-up visits, you will automatically see the reduction in depression symptoms from baseline, or from the first visit

14. http://uwaims.org First Visit Enter Medications (if any) Enter description of Treatment Plan –Summarize briefly Enter Referrals (if any) Enter Process information (if using)

15. http://uwaims.org Follow-up Visits Enter Contact Date Enter PHQ-9 Score –Change from baseline will calculate Enter Medications (if any) Enter brief description of Treatment Plan Enter Referrals (if any) Enter Process information (if using)

16. http://uwaims.org Tickler To View Only Records with “Prepare to Contact” or “Past Due” –Click on the little arrow in cell B1 (labeled “Tickler”) –By default, all possible data entries in column B are checked, meaning they are all displayed NOTE: Until the action of Prepare to Contact or Past Due is triggered by dates of contact entered, they will not be displayed or show up as options in the Tickler pull-down menu –Un-check the box next to “(Select All)” This will de-select all data –Check the box next to the data you want to see e.g., “Past Due” will display all patients with an Action tickler of Past Due –To return to the default option of viewing all data, check the box next to “(Select All)”

17. http://uwaims.org Turning Off the Tickler If a Follow-Up is Not Needed –Go to the “Contact Date” (Column I) for that Patient –Type “Not Needed” into the field, or any other note that you might find helpful to indicate that no contact is needed This will automatically turn off the Action tickler; in other words, “Prepare to Contact” or “Past Due” will not appear –It is important that you do not type over the formulas in the columns for “Date Follow-up Due” and “Action”

18. http://uwaims.org Important Note Columns F and I (“.”) in each of the white cells before data are entered –If you want to delete information you have previously entered into one of these cells, it is important to replace the period (“.”) –If you do not replace the period (“.”) in these cells the formulas will not function properly

19. http://uwaims.org PrintingDefaults -All columns -Landscape view -First 2 patientsCustomize -Select print area, paper size, etc.