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PalmIT Clinic Flow at Magnet
PalmIT computers are distributed by the Concierge and volunteer assistants to customers as they check in for their appointments. Concierge staff give each customer a brief introduction to the computerized survey that can go something like:
“This is your self assessment for your HIV test. Please be as accurate as possible in your answers, and remember that your answers will not be shared with anyone today. Let me know if you have questions or problems and a Magnet staff will be happy to assist you. When you are done with the survey, return the device to me.”
After the customer finishes his self-assessment, the Concierge will enter the Magnet ID and scan the customer barcode (test ID) from the purple lab slip.
The device and the lab slip stickers will be routed to the counselor to begin the test session.
During the test session, counselors use the device for all HIV data collection, including running the test. After the test client has received his HIV test result, the counselor will complete the Counselor survey. Before returning the computer to the Concierge to be used again, the counselor checks that the survey is completed and saved and that the QDS program shows the blue wavy main screen.
In the event of a positive HIV result, the counselor will prepare a confirmatory lab slip and fill out the Positive survey with the customer.
PalmIT / Clinic Roles at Magnet
- Responsible for opening the client QDS survey on each PalmIT pda computer after confirming that the previous survey has been completed and saved.
- As testing customers are registered for their appointment, the Concierge hands out a pda to each customer, and writes down the number of each device on the paper routing slip
- Gives a quick introduction to each customer on how the device works and the nature of the survey
- Answers questions customers may have while they are filling out the survey
- After the customer has finished the survey and returned the device, the Concierge enters the Magnet ID and barcode scans the HIV ID
- Routes correct device to counselor
Concierge and volunteer staff training:
- Review of protocols and procedures outlined above
- Familiarity with the machine and the customer survey
- Practice barcode scanning
- Familiarity with the lab slip/purple sticker
- Know the difference between HIV ID number and Magnet ID number
- Responsible for entering Lab Slip, Counselor Interview, and any Positive forms
- Reporting any errors, problems that occur with the devices to the HIV coordinator or the PalmIT data manager during or immediately after the session, before continuing to a new client
Counselor training for PalmIT:
- The HIV Coordinator and the PalmIT Data Manager will be responsible for providing counselors with PalmIT training, as well as working with the Magnet Volunteer Coordinator to create a policy for volunteers who may need refreshing if they are not frequent volunteers at Magnet
- Training must include how to operate the PalmIT devices: turning the device on and off, launching and saving surveys, safety and security of the device
- Review of paper scripts of all the surveys: Customer/client survey, Lab slip survey, Counselor survey, Positive survey
- Input methods: different types of answer choices: yes/no, yes/no/refused, date, text, choose one, choose all, (…and more)
- How to use the barcode scanner, followed by some practice
- Several practice walk-throughs of all surveys
PalmIT Data Manager:
General tasks of the data manager:
- PalmIT daily maintenance of 6 pdas to ensure they are in working order and charged nightly
- Troubleshooting for PalmIT for both computer and survey related questions that the Concierge, counselors, or customers might have
- Daily data management of the electronic data
Start of shift duties:
- Remove all the machines from the cradles
- Turn them on and check that the batteries are fully charged
- Check that the time and date are correct. If not, fix the date immediately
- Match each machine with its case, making sure of course that the numbers on both match
- Check that the barcode scanner is working
- Make sure stylus is on machine
- Deliver to the Concierge desk 20 minutes before registration begins
End of shift duties:
- Determine which PalmIT devices were used by collecting the routing slips; collect all the devices that were used during the shift
- Check in with the counselors and concierge to find out if there were any issues or problems with devices
- Check the devices to see if they are all properly saved and closed
- Sync and upload the data using ActiveSync™ and Tumbleweed™
- Clean off the machines, delete data once it has been archived on the desktop.
- Turn off the machines and put them on the cradles to charge (When not in use during testing shifts, PalmIT devices are stored in the Phlebotomy Room in a locked cabinet under the counter.)
Reporting testing data to AIDS Office SFDPH
General tasks – summary:
- Email daily testing activity report to PalmIT Program Coordinator
- Synchronize the PalmIT pda’s and archive the HIV test data from the day
- Package and upload the daily HIV data on Tumbleweed™
- Once the data has been sent, respond promptly to any issues raised by the PalmIT Program Coordinator
General tesks – step-by-step:
- Check the clinic testing log for the total number of HIV tests run, the number of positives, false positives. Second, check with counselors and staff who were testing to see if there were any other problems related to the machines or the surveys during the shift.
All of these pieces of data go into an email formatted as in the example below, and emailed to the AO PalmIT Coordinator.
1. TOTAL NUMBER OF TESTS:
2. NUMBER OF POSITIVE TESTS:
3. NUMBER OF RNA TESTS:
3. LIST POSITIVE TEST IDS:
4. ANY DUMMIES? YES/NO
5. ANY PROBLEMS? YES/NO
6. DESCRIBE PROBLEM:
- Next, after you have collected all the devices, remove them from their metal cases, and sync them all with the Data Computer. Sync, then delete data from each device
(Guide to ActiveSync). Next, zip all the .QAD files (Guide to Zip File). Finally, upload zipped files on Tumbleweed ftp site (Guide to Tumbleweed).
- Troubleshooting and Quality Assurance:
The PalmIT Data manager is responsible for keeping track of errors and or problems when they occur with the PalmIT system. If, for example, data is missing for a particular client due to the client refusing to answer, or if data is missing because a counselor failed to fill a survey out, it is crucial this be communicated to the OA PalmIT Coordinator promptly.
Troubleshooting also includes doing the follow up necessary with the OA PalmIT Coordinator to find the best solutions to whatever the problem may be. In order to prevent a backlog of data it is important that the solution be implemented before the next testing shift (Guide to PalmIT QA and Troubleshooting).
- Other duties:
Installing survey updates when the OA PalmIT Coordinator makes changes to the surveys. (Guide for Updating Surveys)
Fixing barcode scanner problems (Guide for Barcode Scanners)
Guide to Zipping Files
The AIDS Office TA (Noah) periodically updates questionnaires (.qpp files) with both necessary and requested changes. When updated questionnaires arrive (usually via e-mail), they must be loaded onto one device and tested before they are used:
- With the device cradled, open the QDSv2 folder and remove the old .qpp file
- Copy the new file into the same folder and manually synchronize the device
- Un-cradle the device and start QDS
- When the QDS menu loads, select Cancel
- At the bottom of the screen, select Tools > Add Passwords
- Select the name of the new survey and enter the password then tap OK
- Open the new survey (Interview > Begin > [file name])
- When prompted, the Test ID should be all 9s
- Walk through the survey with as many scenarios possible
- Communicate problems/concerns to the HIV Coordinator (or designee) for feedback to the AO
- If immediate corrections are necessary, notify the HIV Coordinator and/or another staff member
- Once the survey is tested and approved by the HIV Coordinator, surveys should be replaced on all devices as outlined above
If scanners do not work at the beginning of the shift:
- Soft re-boot and this should resolve the problem. If not, contact a staff member who will assist you.
- Sometimes, stopping other running programs in the Programs / Memory settings then re-powering the device may resolve this issue
- Also, try removing then re-inserting the scanner.