Design > Client & File Management

Contents

• Goals
• PowerDiary Capabilities
• PowerDiary Limitations
• Our Solution
  • Adult Treatment Setup
  • Child / Adolescent Setup
  • Couples Treatments

Goals

PowerDiary has a number of really sensible approaches to the scheduling of clients. They have kept complexity down by saying that a person who sees a psychologist is a client. They then add client contacts as a way to represent parents or partners etc. But in the wild this is actually a little too simplistic.

What happens if you run a parent session without the child? PowerDiary forces you to upgrade the parent to now being a client just to schedule them. What if the parents are acrimoniously divorced? How do you send out reminders without triggering one parent or the other? What about if you are running a couples treatment, then for instance the wife chooses to engage in individual work with a different psychologist in the same practice? Where do you store the notes in a way that is consistent with your ethics should your notes get subpoenaed by the husband? The wife might have disclosed something in the individual treatment that should not be revealed if the subpoena only covers the notes from the couples work. If the subpoena extends to the wife's individual work then there is likely to be grounds to object on the basis of this being a fishing exercise. If your notes are stored cleanly then this becomes easier.  

PowerDiary Capabilities

• People can be clients, contacts or referrers and this is set in their profile > Manage > Admin by toggling the roles on and off
• People relate to other people as contacts with a relationship type. You can even say that a person has a dual relationship such as being both Mum and GP. See profile > Contacts 
• People can be merged if there is duplication. See Profile > Admin > Manage
• Contacts of a client can be setup to pay the bill or get the appointment reminders. 
• Each client has a primary practitioner and additional users can be added with secondary access.

PowerDiary Limitations

• Unlike Nookal, PowerDiary has no representation of treatments. You can't say that there was a series of appointments relating to an anxiety treatment, then some time later there was a series of appointments that related to a personality disorder. You certainly can't say that there were multiple people that received treatment towards couples counselling. 
• Unlike Halaxy you can't add an extra "patient" to an appointment. All appointments have a single client. 
• Every client has a single stream of notes that is completely visible to both their primary and secondary practitioners (Profile > Admin > Manage), so if there is concurrent treatment with say individual and couples work then you need to be very careful with how you setup visibility for the couples clinician. 
• Each person only has a single employer, work phone number and for referrers, a single provider number. If you are trying to minimise children from the same school crossing over with each other in your waiting room then there is no visibility or warnings available. 
• Medicare claiming is dependent on accurate first names. 

Our Solution

Adult Treatment Setup

Setup adult individual clients as expected - they are a simple client. The notes and files are simply stored against the adult's file.

Note however, if a referrer presents as a client we set them up separately to keep their professional profile distinct from their personal profile and in fact the same referrer may have more than one professional profile to represent their separate Medicare provider numbers or to manage letters back to referrers correctly if they work in multiple locations possibly for multiple organisations. This also means that their personal mobile and similar will not be visible in their professional profile. However, while ever they are in treatment a simple search for their name will bring up both their personal and professional profile - (one will say client in red and the other referrer) but the search has no context and therefore will make plain the existence of a treatment for this professional. 

Child / Adolescent Setup

All notes relating to the child are stored against the child's file. If there is a parent session, then the notes are stored against the child, not the parent. That means that when setting up a parent session you need to also create a child appointment and immediately:

1. Turn off the reminder flag (parents will get their own reminder);
2. Set a flag of "Identified client not present";
3. Set the child's billing to "Not chargeable" and choose one both of the parents to pay for the appointment.  

When setting up the child profile we recommend:

• The child / adolescent is a client and they do not take their parent's email or phone number. This does slow down sending SMSes and similar to parents as you need to do it via the child's profile with the parent selected as the recipient but it keeps the communication history clean. Each parent is setup as a contact with:
  • accurate mobile and email addresses (don't enter an email address twice for instance)
  • one parent is setup as the primary contact for scheduling by turning on their "emergency contact" toggle. 
  • one parent set as the "Bill To" under profile > Billing > Billing setup and the credit card being saved against the parent not the child. 
  • With children over 14yo the disclosure is carefully set with partial disclosure equating to billing and scheduling only consent, and full disclosure meaning the child consents to all information being conveyed to the parent. 
  • Turning on portal access for both parents by default unless there is a reason to restrict visibility of child appointments
  • If you are likely to hold parent appointments then each parent will need the client toggle turned on > Profile > Admin > Manage AND they will need to have the new appointments unblocked. 
• If you are trying to deconflict with children from the same school crossing over in the waiting room then you can put the school name as their middle name in brackets - however this means that you must not use the preferred name as this will defeat the middle name being displayed. We generally recommend against this but its the best workaround available. 

Couples Treatments

With thanks to Kimberley Simmons we recommend her suggestion of creating the "Couple" as the client and then linking each person as contacts. For example you would create a client with first name "Marge and Homer", last name "Simpson" and setup the contacts to both get reminders but say Marge as the primary contact:

Throughout the course of the couples treatment all notes are stored against the "Couples" file. One of the contacts is set as the "Bill To" person. Medicare isn't available for couples anyway so there is no concern about first name data matching.  

If in the future one of the couple starts individual treatments then these notes should be stored in their individual client record, not the couples record. 

Last updated: 15 Feb 2023