POC Therapy Manual

Listed here are the features on the Barnestorm login screen.

Icon

Your desktop may have one of the three icons on your desktop. Double-click on the icon to open the Login Screen. The login screen will either pull up your Windows username or show a blank User ID field so that you can enter your Barnestorm User ID.  Note: your Barnestorm User ID may not be the same as your Windows username.

Switch Users

There’s a global setting that can be set to allow any user to switch users on the login screen. This saves time so that one user does not have to log out of Windows to allow another user to login.  

Incorrect Password

There is a security feature in the Barnestorm Point of Care software that is activated when a user attempts to log in three times incorrectly - Does Not Apply to Office. 

If this happens the software will remove identifying patient information from the local database.  All of the information collected on the tablet will be retained, but the vital patient data needing to be secured will be removed.  

An office staff will need to unlock your profile from Barnestorm Office. You may want to check with your office to verify you have the correct password.  Note that Barnestorm support staff will not supply password information. Once the laptop is connected to your network, the user will be able to log into POC.  Most likely, the user will need to start a chat to have Barnestorm support complete a rebuild of the database. 

Version and Updates

The login window might have a link available that shows the most recent updates related to the version you are using. 

With an internet connection, select the link to open a web page with recent updates. If the link does not show up then there are no related updates to view. 

POC Video: Select a Patient - YouTube

From the Main Menu in Barnestorm you can search for a patient by entering their last name, first name, or chart number. When you start to enter the data a list of patients with that data will appear. The more you type in the fewer the patients will show up. 

Barnestorm Office Select Patient


At the bottom of the screen, select the viewing option: 

• Patients by Name will search both first and last name.
• Patients by FirstName and LastName to narrow down which data type to search.
• Chart number will search for both active and discharged patients. 
• When searching for a discharged patient by name select the discharge bullet. 
• Use the Program dropdown field to refine data by program. 
• The Show field will restrict the number of rows to return (ie. 10 will only show top 10). 
• The icon with the three lines will allow you to Auto Run Searches. This will save your last search and run it each time you enter the Select Patient screen. 

Barnestorm Point-of-Care Select Patient

• If the patient is active leave the Active bullet selected; or
• Select the Discharged bullet
• Pull up a patient by entering their six digit chart number; or
• Select Last Name or First Name and start to type in their name
• This Program# Only will help refine your search to a specific program code

Click on the patient you want to select. You’ll notice the patient’s information will appear at the top of the page. This is your way of knowing which patient is currently selected.

When Barnestorm is maximized the patient data search criteria will look slightly different and will also include the patient's last visit date and Hospice benefit period. 

From the Main Menu in Barnestorm Point-of-Care click on My Patients. This shows all patients that are assigned to you (in Barnestorm Office > Referrals > Employees tab). They will appear in alphabetical order by patient last name.  When you select a patient the bottom panel will list the most recent visits, 485’s, and OASIS for that patient. You will have the choice to Edit or Print from here.

From the Main Menu in Barnestorm Point-of-Care click on My Recent Visits. When you click on this button a list of your most recent visits will appear in date and time order. By default the visits will go back 14 days. Visits in the Incomplete or Completed status will show up regardless of the number of days.  You can change the number of days to look back by changing that number. You can go back up to 120 days. This is a great way to see which visits are not locked.  Run this daily to see which visits need completed.  

From the Main Menu in Barnestorm Point-of-Care click on My Recent CCNs. This will list your care coordination notes by date. 

Patient Info button is used to view patient information, but not change it. This is the quickest way to find information concerning a specific patient. You may print any tab under Patient Info by clicking the Print button. Some screens will show an itemized list where you are able to select an item to view the full content. To return back to the itemized list click on the text anywhere. 

Use the Get Map/Directions button to view a map from your agency to the patient’s home.

Copy Feature:  This allows you to copy a selected tab from Patient Info and paste it somewhere else. 

Most of the tabs work in the same fashion, it will list an itemized list and then you click on it to view additional information. 

OASIS-PPS: This will show each OASIS entered. Click on an OASIS and it will show you which OASIS questions where used to create the HIPPS code. The first section shows you the first 6 ICD codes used for billing. To the left of each code will show the value of the code. The next section shows the rest of the ICD codes used for the patient. Next to each code shows the potential value of the code. The third section shows a mixture of MO questions and the value of each.

Office Notes:  This information comes from POC > Assessment > Care Goals > Status Improvements section.

Care Conference:   This information comes from POC > Assessment > Care Goals > Summary of Progress. 

60 Day Summary: This will show vital signs for each 485 episodes. When you click on an episode it shows any of the following information: temperature, respiration, pulse, weight, and blood pressure. It also shows wounds and the measurements, type, and location. This will also show pulse-ox readings.  Comments from the Start screen of assessment if the "Add to 60 day summary" box is checked.  Comments from Care Coordination Notes if the "Add to 60 day summary" box is checked. Assessment > Care Goals > Status Improvements section.

Scheduled Visits: Shows planned visits by employee, date, type of visit, program/payer code and comments.  It will also show if an actual visit was completed for that date or not.  The scheduled visit will be compared to the assessments employee and time in.  If the employee matches and the time is close then a "OK" will show up next to the scheduled visits. 

Clinical Notes:  This is a great way to quickly see everything that’s going on with the patient.  It pulls a collection of information together to view on one report: Care Coordination Note discussion text, assessment Start screen comments, assessment Misc Notes > 60 Day Summary text.  

Messaging Log: Pulls up Messages used in the Barnestorm system tagged with the patient's chart. 

Pt Progress:  Allows you to select specific information to pull into a graph based on a date range. 

While in various screens in Barnestorm you have a chance to insert pre-entered text called [T]Text Items. 
This screen will allow you to enter one code or multiple codes at once. By clicking once on the text you want, it will go directly to the document you are working on.

Text Item Icon =       

Multi-Select Allows you to select more than one T code and will insert the codes in the order you selected them. Once you checkmark the Multi-Select box and click on your codes, click on the Insert Selected Items button. You will be directed back to the document you were working on along with the text you selected.

You also have the choice to Add No Extra Spaces, Add 2 Spaces, or Go to the Next Line after each code you have selected.

Show Mulit-line Having this checked will show you all the text that was typed in on the code. Unchecked will only show the first line of the text.

Search Filter allows you to sort through the codes and only show what you want.

Video: Patient Information Screen Video - YouTube

Search for Patients

• Select the Patients bullet. This screen will allow you to search for patients using specific text in the 485, verbal orders, care coordination notes, or patient information screen. 
• If you leave the From and Thru dates as today’s date, it will bring up all active patients as of today. Otherwise, you will receive the report for all patients that were active on and between the two dates. 
• Type in the text you want to search for in the Text to search for box. 
• Oldest to Newest will order by patient last name, then by date. 
• Check the box 1 Page per Pt if needed. 
• You can select which sections of Barnestorm to search for the patient information: 485’s, Verbal Orders, Care Coord Notes, and Patient Info. Uncheck the boxes for any areas you wish to exclude from the search. 
• Enter the Program, Team, Employee codes if needed. Any items left blank will cause the search to include all codes. 
• Click on View. This will generate a list of patients with the criteria you selected. 
• To print the list, click the Print button. Click on the Print button from the Print Preview screen. 

Soc. Sec. No.: Search for a patient by social; enter at least the first five digits of the social security number into the text field.  Then click on the Soc. Sec. No. button. 

You should synchronize your Barnestorm Point of Care as often as possible. The longer between sync's, the longer it will take to complete. It is ideal to sync twice (before and after) or more each day you work. Synchronizing will 1) send all of your data to the main server, and 2) retrieve data from the main server to load onto your local database. 

How to Sync

1. From the Main Menu, select the Synchronize button. 
2. A pop-up box will appear showing a connection or not. 
3. Click the Synchronize button. The pop-up will hide and you will see a percentage (progress) of the synchronize process. If you have a lot of information to sync then this may take a while. You can continue to work in Barnestorm while this process takes place. 

If you do not have a connected status, check your internet connection or try rebooting your machine. 

Keywords and details about the sync

Database = A collection of patient data. 

Entries/Log = Each time a piece of information is saved, it gets recorded in a single log, or an entry. For an example, when documenting an assessment, each screen documented will save an entry. If you return to the same screen several times to edit, it will save one entry per edit. This allows for a historical picture of documentation that occurred. 

Local = Each machine that uses Point of Care has its own local database. This means when you are documenting patient data, it gets saved on your machine only until you complete a synchronization. 

You will see two numbers separated by a dash. The first number represents the last log/entry number that has been sync'd to the server. The second number is the most recent log/entry that has not been sync'd yet.  This means the sync process will send all the log/entries starting with that first number, to send to the server. 

Network/Server = The main place where all of the patient data is stored. Each machine that completes a sync will move their data to the server.

The two numbers work the same as the local, it will return any data since the last time you synchronized. 

How much data is saved on the local?

During the sync process, data that is older than 120 days will be removed from the machine. This does not mean the data is deleted, it just clears it from the local machine so that it does not bog the machine down with data that may not be needed. The data is preserved on the server database. Patients that have been discharged 120 days ago will be removed from the local database. 

If you need to recover data that has been removed

• From the Select Patient in Point of Care, click the Recover Chart button.
• Enter the patient's six digit chart number.
• Enter the number of days you need to go back to pull the patient's assessments.
• Select the Search button, the patient's name and number of assessments available will appear.
• Select the Recover button.
• You will receive a message when the process is complete - select the Close button. 

From Barnestorm Point of Care, you can start an assessment a couple of different ways. 

Starting the Visits/Assessments Video: Starting the Visit/Assessment - YouTube

Edit Visits/Assessments Video: Edit Visit Assessment - YouTube

You can edit the assessment the same way you started the assessment.  Instead of using the New button you will use the Edit button. 

If the visit is locked then you will need to unlock it first from the Visits/Assessment screen.

You will need to have an appropriate member of an office staff unlock the visit, if you do not have permission.  You will need to complete a sync to get the update.

From Barnestorm POC

When creating a 485 from an assessment, you can pull over other discipline’s Orders/Goals from their assessment. To follow this method, only one clinician can create the Start of Care or Recertification assessment type. The other clinician will document their orders and goals under the Orders/Goals section on their visit note. 

Instructions for clinicians who are NOT creating the 485

The assessment type you select cannot be the Start of Care or Recertification assessment type - only one user can use this type and it will need to be the user who creates the 485.  

• Select the Orders/Goals screen from either the Required or Optional list of your Visits/Assessments. 

• You will use the Box21: Orders and Box 22: Goals tab to document your plan of care. 

Box 21 should include your frequency. Be sure to use a format your agency has approved. Ex. PT: 2 WK 7. This will allow the frequency to show up in different areas of the software. 

Use the Text Item feature to insert predefined text.

Use any of the onscreen buttons to pull additional information from past visits. 

Freehand type additional information that is not covered from the Text Item or onscreen buttons. 

• Continue to document the rest of the note as you normally would.  As needed, you can select the Menu Style > Required/Optional Screens. 

Instructions for the clinician who is creating the 485 from their SOC or Recertification assessment type

Before pulling over the information, you’ll want to make sure the other clinician is finished with their documentation and has synchronized Point of Care.  This feature will look for the most recent Orders/Goals going back 10 days to 20 days after the current assessment.

• From Point of Care start or edit the patient’s Start of Care or Recertification assessment type.

• The person creating the 485 can enter their Orders and Goals into the Orders/Goals screen.

• From the Box 21 and 22 tabs, click on the Build from Disciplines button.  (This step can be repeated if corrections were made to the other disciplines Orders/Goals at a later time).

• The most recent orders and goals from other discipline’s assessments will pull over for that patient.

• The information pulled over will be added to the bottom of the page.

• Build the 485 as you normally would from the Finish screen of the assessment. 

 *Note: Each time you click on the Build from Disciplines button, it will add another copy of the other disciplines orders and goals at the bottom of the page.  If the other disciplines made a correction to their Orders/Goals text and you Build from Disciplines again, you will need to delete the previous text before or after you pull over the new information.  Be careful not to delete your own information. 

*Troubleshooting:  If the correct information is not pulling over, then check to see if there were multiple Orders/Goals documented recently.  Ie. if there were two different assessments that have had Orders/Goals documented, only the most recent will get pulled. 

Vital Signs Video: Vital Signs - YouTube 

Pain Assessment Video (Start at 11:56 and end at 17:56): Pain Assessment in Visits/Assessments

Point of Care > Visits/Assessments > Pain screen. This screen has several tabs that run across the top of the screen. Some questions may differ depending on the payer type. 

Main

This screen in the assessment allows you to measure the patient’s range of motion and balance as well as set goals for physical therapy.  This screen appears in the assessment for physical therapy discipline under the Optional tab, but can be moved to Required by an office staff.

The Balance, ROM L, ROM R, Strength, Transfer, and Treatments tabs have options to select a goal and current status score for different range of motions and treatments.  After you start a new visit, you will see the previous value given for each item.

Original = This field shows the original value entered in the “Current” field (from the initial Goal Progress assessment).  It will appear with the value and then the date of the assessment.  Ex. 2 – 01/24

Goal = Enter the goals for the patient.  This number will copy over from the previous note.  It can be changed, as needed.    

Previous = Shows the most recent value answered in that field (from previous physical therapy note).  Ex. 3 – 01/29

Current = Allows you to enter a value based on the current assessment for that date. 

Print = Check this box if you want the information to appear on the printed assessment. 

The ROM and Treatments tabs do not have a drop-down list; you will need to enter a number in the Goal and Current field.  Each tab has a comment box at the bottom of the screen that will appear on the preview of the note. 

The standard phrases and values can be changed per your agency by going to Barnestorm Office > Codes > POC Codes > Note Codes.  Use the Filter Page name PT/Assess and look through the several “Name” options.   Use this article to learn how to modify the value/phrases as needed.  Customizing Screens

The Fall History screen will show the documentation of fall entries/post falls for a selected patient.  Point of Care will allow the clinician to mark a fall as "Fall Precautions Retaught This Visit".   Please note that the screen within the assessment is named Post Fall and will have a main menu that shows the list of falls.

 

From Barnestorm Office pull up the patient and click the Patient Histories tab then select the Fall History tab. 

From Barnestorm Point of Care pull up the patient and click on Fall History from the Main Menu or within a visit assessment.

 

The main screen of the Fall History will show the date of the fall, observed by, location, and if the fall precautions was retaught it will show the name and date of the assessment.  

NOTE: If you are viewing this screen outside of a visit assessment you will see a button labeled "Pull Post Fall Assessments".  This will pull previous post fall entries into the Fall History screen. 

Fall History > Main Menu

Add Fall

• Click the Add Fall Button.
• Enter the Date of the fall.  Select the drop-down calendar to select a date, as needed.
• Check the box Alone at time of fall or Fall was observed.
• If Alone at time of fall was checked then Observed by will become grey and "Patient was alone" will show up.
• Otherwise, key in the name of the person who observed the fall.
• Enter the Location, Reason and Safety device they were using.
• Document the Surroundings by checking each box that applies to the scenario or type in the Other box a description.
• Document the Healthcare status by checking each box that applies to the patient or type in the Other box.
• If the patient and/or caregiver needs retaught the fall precautions, check Reteach Fall Precautions.
• Use the Interpretation to box to type notes regarding the fall. 
• Click on Save.

Edit Fall

• Select the fall from the main menu of the Fall History screen.
• Click the Edit Fall button.
• Modify the documentation needed and click on Save.

Delete a Fall

• Select the fall from the main menu of the Fall History screen.
• Click the Remove Fall button.
• A message will appear asking if you are sure you want to remove the fall.  Click on Yes to remove or No to cancel.

*This can also be done from within the Edit Fall screen.

Print Falls

• To print an individual fall, click the fall from the main screen.
• Click the Print Fall button.
• From the preview click the printer icon to send to the printer.
• Click on Close.
• You can also print the fall from the Edit Fall screen.
• To print a running list of falls, click the Print All Falls from the main menu.
• From the preview click the printer icon to send to the printer.
• Click on Close.

Document Re-teaching of the Fall

The following option can only be done from a visit assessment.  You will be able to "reteach"  fall precautions more than once per fall. The history of fall precautions is listed within the Edit Fall, which shows who retaught and when. 

• From Point of Care visit assessment, locate and select the Post Fall screen.  If a fall entry has been marked as needing retaught, then it should show up under the Required section of the note.
• Select the fall entry you need to re-educate the patient on.
• Click on Edit Fall.
• Check the box for Fall Precautions Retaught This Visit.
• Click on Save.
• The preview of the visit assessment will show the fall entry information, along with the phrase "Fall Precautions Retaught This Visit". 

Fall History Main Menu in Point of Care

Fall History > Edit Fall

You can create a reminder note in between visits that will copy over to the next visit assessment Start > Comments screen.  You can select which discipline should receive the reminder or select All if should be assigned to the next discipline to start an assessment.  This feature can be found in a few places; 1) the Visits / Assessments tab 2) From the Finish screen within a visit note 3) or in the Pause feature of a visit note. 

To add a reminder, pull up the Add Reminder screen for a selected patient. Select which discipline can capture the reminder (All will go to the next person who creates a note).  Enter the comment that will appear in the Start screen of the visit note.  Click on Ok.

If you need to add additional notes just click on the Add Reminder button again and it will add on your note to the previous one. 

If you click on Add Reminder and your note is no longer showing, then someone has already created a visit assessment and that reminder was added to their Comments section of the Start screen.

If someone creates a visit assessment and the reminder needs to be forwarded to the next employee, then cut and paste the text into a new reminder.  From the visit assessment you can click on the Pause button and go into the reminder screen to add text for the next assessment.  

Capture a patient's signature after a visit in Point of Care Video: Patient Signature on Visit Assessment - YouTube