Monday, August 7, 2017

Bali retreat - it is a go!


Bali retreat is all set up, with enough attendees to ensure that it will go ahead. I'm still to finalise the list of talks and seminars, but this is slowly taking shape as well.

The retreat is in Candidasa, on 8-14 of October. For more information, head to http://www.deep-impact-retreats.com/.

I'm looking forward to a great mix of professional development and holidays!



Cheers,

Izabela


Sunday, August 6, 2017

The top 100 neuroscience blogs

If you want to have a look at the feedspot's top best 100 neuroscience blogs, here is the link:

http://blog.feedspot.com/neuroscience_blogs/

The blogs range from neuroscience news, through open access journals, to educational journals for professionals and/or general public.

I found this bloggy goodness in a very nice way - I got a congratulation email saying that Neuropsych Geek got selected into the list. Admittedly, it is in the 100th place, but the neighborhood is very impressive!

Cheers,

Izabela


Thursday, May 18, 2017

Practice software management seminar

In case some of you missed it in the APS email, there is a webinar on practice management software solutions on 22 of May at 7:30pm. Details here: https://register.gotowebinar.com/register/3931281117175958017

It looks like a good thing to attend.

Cheers,

Izabela

Friday, February 24, 2017

Rest, relaxation and PD points - Bali retreat follow up

I have a follow up on the Bali PD retreat idea. As you remember from two posts ago, I have contacted the organisers to suggest that it would be nice if they set up a retreat that would be useful for neuropsychologists. I had a terrific response. They have an option of running a neuropsychology/testing retreat between the 8th and 14th of October this year if there was enough interest.

I was most impressed and promised to find out if people would be interested in the idea. So I’d appreciate an email (IzaWalters at gmail.com) if anybody would like to go. The information about a general psychology retreat is on http://www.deep-impact-retreats.com.

I am not yet sure about the details and how we would source the content. Maybe through some people offering to give a talk or seminar in their area of interest? Any ideas appreciated, as the organisers seem to be willing to work out a retreat to our liking.

No commercial interest in this for me, but I could do with a nice Bali holiday. 

Cheers,

Izabela

Thursday, February 23, 2017

Patient data management

With Debbie Anderson's permission, I re-post her in-depth discussion of patient data management issues that was originally posted on npinoz in January this year. Here is Debbie:


It all starts with the patient booking system, and gets complicated from there. Bridget did a nice introductory summary of booking systems on the neuropsych geek blog in September last year, if you are interested in more on that.
 

Snail mail
Just a word on snail mail – I have a friend who tracked deliveries through Australia Post (yes I attract obsessive number-crunchers like myself) and found that an incredible percentage (20% if memory serves correctly, and I have also heard a similar number presented in the media) of mail is just not delivered – presumably lost (… imagine where it could be…). Our experience is that mail is incorrectly delivered frequently, so that also does not re-assure me very much.


Current situation:
With regards to cloud based information storage, despite using Q-interactive to administer and score the Wechslers (I believe it uses the Canadian cloud) I am concerned about exposing my more detailed clinical information (ie the report, rather than just patient details beyond name, dob & uninterpreted scores that QI stores) to the outside world. So we have all that stored on a computer that does not access the internet (with two backups), and bookings are made the old fashioned way, via phone with secretary putting an appointment into Outlook. But we are expanding and need a booking & records system that can cope with more than one clinician, and that’s where it gets tricky – because most of the patient management systems are in the cloud.


Patient data management/diary:

With regards to patient data management systems (ie bookings, data collection, notes) I have investigated MANY different options both here and overseas. The majority of them are in the cloud – over months of research I could only find two that were not cloud based. One is from the UK which was very clunky and upset my computer network, and another that was very expensive and the vendors were unresponsive to my questions (that’s the APS recommended one) – so I have given up hope of finding a non-cloud option. I have in the past had one custom-made and am considering it again, but that has significant costs attached.
 
Anyway, talking to lots of clinical psychs who run fairly large group practices, they all seem to use the cloud-based patient management systems such as PowerDiary & HealthKit (Coreplus is also an option but not popular in Qld). Those systems are both for managing a diary, storing patient information and making notes. Now if you want to have a nightmare, just think about how much information a hacker could get if they had access to all those therapy notes …. The vendors say that they offer a good level of security, and not being an expert I have to assume that they are being honest/accurate (they are all marketed at medicine/psychology/allied health, so must meet a reasonable standard). However, I remain reluctant to move over fully to the cloud (although my accountant has insisted that I do for the financials … that is another example of how we just can’t get away from it). When I sought independent expert IT advice last year, they were flabbergasted at my reluctance to move to the cloud – and essentially said that everything is going that way, there is no getting away from it, and remember that your office might not be all that secure (ie someone could break in and steal your files (or computer).

Some of the patient management systems have inbuilt access to secure messaging (see communications below) so the potential exists for an all in one solution. But…

 
Communications – sending & receiving referrals and reports:
With regards to receiving referrals and sending reports: currently my preference for reports is hard copy via snail mail. Most doctors seems to use fax, some use email.
 
As was pointed out in a previous email, a secure communication system exists for the medical profession, but my reading of it is that there are at least three different sorts (Argus, Healthlink& Medical Objects) and they don’t talk to each other. They are also quite expensive, Coreplus (using Argus & Healthlink) charges per message received (plus the ongoing cost of their system) and Medical Objects has an annual fee. (ie some of these are attached to the patient record management systems [above], some are independent – eg Medical Objects).
 
The problem is that if you sign up for one, but your referral source uses another … you are back to the same problem! I have been reluctant to make a choice for this reason, but am going to collect data for the next few months to see if there is one that is more common amongst our referrers. I understand that for the medical practices (and psychs) that have one of these systems, they prefer to send referrals and receive reports via it. The problem for neuropsych is that we (well in my case) tend to get referrals from a range of doctors, and thus they use different systems (or none at all). Argh!!! So, unfortunately it isn’t the straightforward solution it would seem.
 
Lawyers, who on the one hand seem to be very concerned about security, regularly send us records and request that we send them reports via email – without any password protection (ie full medical records, possibly more dangerous than a simple referral letter). Only one of my many legal referrers password protects it. Obviously, its not ok to say just because they don’t keep to the standard we prefer its ok to act like them (but we have been emailing reports :(), so this year I have been considering the idea of adding at least password protection to the pdf reports in email.
 
I have also been investigating having a secure page for exchange of information through my website, and whilst I know its possible, I’m not up to speed technically. It also may not be any more secure than a document with a password.
 
I am also trialing an American (HIPPA compliant) medical records system/diary/document exchange system, which says it has secure messaging – and lets you create a patient portal for them to send & receive documents & messages – so that could be good. I think it assumes communication with referrers is within the system, but I’m still to establish that (because that won’t solve the report communication problem).
 
So the result of all this long winded research is that there is no single standard solution for electronic communications – it looks like we are all still fending for ourselves individually.
 
Alex, I will look into sync as a stand alone solution, but I was hoping for an integrated solution.

It might be a good thing for the CCN to have a committee/discussion group to come up with some recommendations for our members, so we are not all wasting time on the same research??


Computer security
Obviously it is our job to protect our information as best we can, and a good start is high quality security for our computer system, and yes (in my view) you really need to pay for it. I have one that often tells me that it has detected a ransomware attempt, so I feel that I’m making a reasonable effort there. I think all we can do is demonstrably take reasonable precautions, but we do live in a world that communicates electronically, and that has associated flaws.
 
I hope that helps, and I’d like to hear how others have resolved this.



Thank you, Debbie.  
Feel free to comment or I'd be happy to upload other people's thoughts on the topic in separate posts - just email me (IzaWalters at gmail.com).

Izabela

Tuesday, January 31, 2017

Getting your PD points the easy and pleasant way

I have came across this information about a PD retreat for psychologists in Bali:

http://www.deep-impact-retreats.com/

It promises to allow participants to collect all their PD points for the year during one relaxing week in Bali. This includes peer supervision ones. And a free massage.

Of course, the retreat is not aimed at neuropsychologists, with the main topic being Buddist mindfulness. Also, I doubt that we would get much relevant peer supervision considering that there would be few people doing work that is similar to ours. But I have sent an email to the guy who organises the retreats to suggest  an assessment-related retreat. Wouldn't it be nice?
Something to keep an eye on.

Cheers,

Izabela

Saturday, October 22, 2016

WMS-IV iPad administration – part 2

Part 3 of the series on Q-interactive by Debbie Anderson



Welcome back to the second half of the WMS-IV administration.  

Verbal Paired Associates I
The administration screen starts with the test instructions, then lists the pairs for you to read out.  A little trap is that you have to scroll the pairs up to find all fourteen (for the adult version, they are all in view for the older adult version) to read out.  Then the pairs are presented individually, and you simply have to indicate if the response is correct or not.  You have the option of writing down incorrect responses (or transcribing them later as it is also recorded – but that will take a lot of extra time, so I would encourage you to do it during administration).   It tallies them up, and keeps presenting them to you to read out, until they are all done.  Once again you know immediately how your client is going, with a total score and age scaled score in the screen at the end of the subtests.

Designs I
So to what I believe is probably the least popular test to administer – designs.  Luckily, it is much easier on Q-interactive.  Once again the stimuli are presented on the client’s ipad, and they respond using the grid and the design cards. 

Now the great part is that you don’t have to deal with the confusing grid on the form to record the answers, nor pull your hair out trying to score them – this little treasure does it for you.  So, after the stimuli are presented (it removes it from the client’s screen after the correct exposure time) their screen is blank.  The examiner’s screen has a grid in the same orientation as you are viewing it (i.e. looking down on it).  When the client puts a card in place, you touch that spot on your grid.  A set of cards comes onto the screen, and you just tap on the design that they have put down.  Continue this for the number of cards.  It won’t let you record more than the correct number of responses (i.e. you know immediately if there is a rule violation, in case you weren’t counting along…). If you really like lifting up the grid and recording the numbers (or checking if you are doing it correctly) the program has a button you can press to convert what you have recorded into numbers.  This is SOOOOO much easier!  I, personally, transcribe those numbers to input into the scoring program, but you aren’t obliged to, because at the end it gives you the age scaled score! No more headaches with scoring this!

Spatial Span
Administration is so much easier on the iPad, the clients see the symbols (it counts the time, so the exposure is exact) then the choices.  They just have to touch on their answers in order.

Here’s the beautiful part, it tells you, the examiner, what responses they have chosen, and in what order.  So much easier than trying to watch what the person does and remember the order to write it down etc.  You then need to check if it’s a 0,1 or 2 point answer, and press on the appropriate button.  It does the rest – again keeping score, and stopping at the correct discontinue point. 

Verbal Paired Associates II
To avoid getting boring, I’m pretty sure you are getting the idea now. 
The item comes on the screen for you to read, and you record the client’s response, and whether it was right or wrong.  Recognition is done in the same way.

Designs II
No surprises here, you record the recall responses in exactly the same manner as for Designs I.  And the recognition is nice and easy – clients just touch on their responses.

So there it is – the WMS-IV on Q-interactive.

The advantages as I see them are:
1)     Much easier to administer
2)     Exact timing on the exposure of the visual items, so no errors
3)     Exact administration i.e. verbatim instructions are integrated and easy to use
4)     Does record verbal answers so that you can check them later
5)     Much easier to record and score all of the visual items, the ones that have made my life easier are Designs, Spatial Addition and Symbol span.
6)     Immediate feedback as to how the patient is scoring
7)     Can administer either the adult or older adult version as appropriate (and it will prompt you if you make a mistake with that choice).
8)     Gives all the index scores at the end – so once you’ve fixed up the scoring on items that were missed you know the scores straight away
Disadvantages:
1)     It does cost quite a few administration credits
2)     It still takes a while to administer, and some clients still don’t like the challenging items!
3)     Whilst it does do some comparisons with the WAIS-IV, the TOPF isn’t integrated, so you need to input the data into the scoring program to use this.

Later, a recap of the WAIS-IV on iPad and some more posts about other tests I am using.
Debbie Anderson