Recording Headspace encounters
If you provide Headspace services, you can assess and enrol the patient into Headspace and record Headspace encounters using specific clinical items.
To display and use the Headspace dataset, you must belong to a user group with the Common viewing right.
For each client, full biographics must be recorded in patient
details, including language, language spoken at home, country of birth, marital
status, client's name, sex, date of birth and address.
Tip: If the sex is neither Male nor Female, or the marital status is
Married (registered or de facto), specify further
detail in the Headspace;Initial Contact clinical
item.
To record Headspace activities:
- At initial contact, record referral and additional personal information in the Headspace;Initial Contact clinical item.
- For clients who want MH or AOD assistance, complete the Headspace;Assessment clinical item.
- For an assessment that accepts a client for treatment, complete the Headspace;Enrolment item.
- For each service after enrolment, complete the Headspace;Duration of Care clinical item and record complexity, location and nature.
- When the duration of care ends, complete the Headspace;Closure clinical item.
The Headspace;Duration of Care item cannot be added unless there is an enrolment prior to the duration of service and no closure after the duration of service. Enrol a client again by adding an enrolment after a closure.
Tip: Duration of service is recorded automatically by
Communicare by timing how long the clinical record is open. For a service that takes
longer, or is shorter than the time the clinical record is open, record the actual
time on the Details tab when you end the service or edit the
service from the Service Recording window.
Tip: You cannot add
activity items until after a patient has been enrolled in a program. However,
you can still add activity items after a patient has been exited from a program.
This allows for genuine backdating of clinical items. For example:
- If you are using an offline client and your clinical program enrolments and exits have got out of step, you can backdate an exit.
- If items are out of sequence, correct the items.
- For a patient who exited last week, record an action from two weeks ago.
Run the Headspace data export when required.