- Client profiles
- Service Types
- Background colours and portal channels
- Edge colours aka Appointment status
- Foreground colours aka Flags & Alerts
PowerDiary has a number of really sensible approaches to the scheduling of clients. They have kept complexity down by saying that a person that sees a psychologist or similar (a Provider) is a client. They then add client contacts as a way to represent parents or partners etc. But what happens if you run a parent session without the child? Who is the client? Perhaps we are better off thinking of everyone who attends as appointment at some point in the future as being "consumers" of mental health services. The identified client can also wander or split over time in family cases, so even if the archetypal teenager is presented as the identified client it doesn't mean that Mum might start doing some individual work or the couple some relational work. So while it might be possible to setup a "Family" or "Couple" client type we don't advocate doing this.
- Be able to schedule family treatments whereby different mixes of family members attend on different days.
- Be able to manage acrimoniously divorced couples where they must be individually contacted and must individually pay for their sessions
- Be able to manage parallel Medicare care plans for multiple family members depending on who is attending
- Be able to minimise reminder costs but at the same time send reminders with accurate first names of each attendee to them directly (or not send it if they nominate to not receive reminders) and also accommodate sending a CC type reminder to a parent if that parent wants to know when their child is scheduled for appointments.
- We want to be able to represent referrers like GPs as being both a professional and a client so that if a GP is seeking marital support that those records aren't visible to other clinicians that are collaborating with them around the GPs patients.
- We want one payment to be able to be applied to several open invoices even if that payment needs to cascade across multiple clients. Eg: "I'll pay for my appointment with Jill this morning and can I also fixup Jane's appointment for last week where the card declined".
- We want to be able to represent ongoing regular committed clients as having a space in your diary by default, but balance that with not jamming up your diary with clients that aren't committed and might slow down new clients from starting
- We want the things in your diary that need attention to stand out and to feel zen when things are all under control.
- Clients can have zero or one client type
- Clients can have zero or more contacts but each contact can have a single relationship type
- There is no concept of a treatment that is distinct from the client. Eg you can't bundle together three "consumers" between a start and a stop date and call it "Jane's Maudsley treatment" and nominate her Mum Jill as the primary contact and her Dad Jack as the primary payee but all three as attendees.
- Each person only has a single employer, work phone number and for referrers, a single provider number.
- You can't specify one or more locations you work from for each given working day (easily). It requires careful work arounds to function for the portal and receptionist to have quick visualisation.
- Every person that is likely to attend an appointment will be setup as a client
- 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.
- Each of the parent-child relationships in a family is added. For instance parent-child relationships but we don't add parent-parent or sibling-sibling relationships unless there is a billing purpose that requires this. Clinicians are free to add these relationships as they see fit. In addition if there are other significant relationships in a family, be it a grandparent or a nanny where that person may end up being involved in a treatment then we add them as both a client and then link them as a contact. NB: we also use relationships to manage professional relationships and in particular to augment the "How heard" field so that we can maintain a list of which professionals recommended your services.
- For children and adolescents, we will typically set their Billing > Billing Setup - "Bill To" to be one of their parents, seek the credit card authority from the parent and then add the credit card details to the parents Billing > Billing Setup
- Depending on limits imposed by court orders and the wishes of older children, we will set the disclosure and portal setting of the parent so that we can allow / disallow parents to have one view of all their children through the portal use it to create appointments and similar as necessary:
When you create an appointment it automatically creates an invoice. Even if that is a pending recurring appointment 99 weeks away the invoice is created! As we need to double up attendees for family sessions we need to render some appointments as unpaid. Ideally PowerDiary should not in our opinion be creating invoices for pending (or offered) appointments. We also feel that in a similar way to how they offer group appointments there should be a guest attendee list that does not have invoices created for them.
In addition to the usual service items like Standard session or short session, we create an item called "$0 Not Chargeable" Used for the non-paying guest of a fully paid attendee in couples and family sessions. As you might expect, only one attendee is charged and the rest have this item applied to their automatic invoice. See this article for more details on setting up the standard service items.
Background colours and portal channels
The background colour of the calendar can be setup to represent where you're working on different days. Brilliant if you have a couple of different rooms you work from depending on the day of the week. It can also be structured to give you breaks and prevent clients from taking non-standard time via the portal. Finally it can also be used to indicate "work from home" days or (during Covid-19) we have used it extensively to manage lockdown and swapping to and from Zoom (blue) vs face to face (white) sessions. There's some work arounds needed to get around one of the PowerDiary limitations though - see the Roster section of our setup article for more details on the calendar colouring and read the PowerDairy knowledgebase article here.
Edge colours aka Appointment status
The appointment status is really central to the calendar management. The built in statuses are:
Cancel / Reschedule
We believe there are a couple of missing statuses and there is a lack of clarity in how a cancelled appointment is different to a rescheduled appointment - they are in some ways the same but have very different impacts from a client care perspective. One might expect that if a client phones in to cancel but needs to check their diary before committing to the next time then you would expect that they have "cancelled". If they subsequently book back in, does that mean that they in fact rescheduled? What if they SMS a cancellation like "Sorry I can't make Tuesday". If they have a regular spot but it is ambiguous about whether they are going to use it or not, then what status do we choose in the interim while we are disambiguating this? Ideally a client would be on a certain frequency and the system would determine the sub-type of the cancelled appointment. In the way we can reliably work with these two statuses we can't guarantee that the rescheduled / cancelled statuses can be maintained 100% of the time. We tend to err on the side of "Do they have a next appointment?" then they have "rescheduled", otherwise if at the time they cancelled there we no future confirmed appointments then they have "cancelled".
Problems with statuses
Ideally we would love to see PowerDiary introduce some new statuses and integrated communications templates to deal with offers from waiting lists and regular times. eg would would suggest:
We regularly send out offers and clients regularly decline some proportion of these offers. If a client does not have a future appointment and is constantly declining offers then that is a clinical issue. But you can't really see it in any of the stats available in the client > Appointments > Statistics nor client activity reports. If we create a pending appointment to hold an offer spot then we also need to remember to turn off the reminders. If we don't, then the client experience is that they get a message saying "would you like.. ?" and then a little while later "Confirming you have..." and they will often get disgruntled saying "I never agreed to that!". If they accept then we have to remember to turn reminders back on. So not having an offered / Declined status is a real problem.
Similarly we think PowerDiary should create a "Place-holding" status. That is this is a committed time from the clinician's point of view, but it is a precursor of a pending appointment where a pending appointment is a time that the client has agreed to but not hit "Y" on the reminder yet. Q: Why bother? Why not just create a recurring pending appointment for regular clients? A: If a client is committed to a longer term treatment and particularly if they have a busy work schedule that it can severely impact on the therapeutic relationship if "their" time is offered to someone else then we want to block out this time. But there's a couple of issues with the way PowerDiary implemented recurring appointments.
- There is a limit of 99 sessions in a recurrence cycle, beyond that you are reliant on task reminders to recreate this recurrence when that limit is approaching but in some modalities this might become an issue.
- More importantly, it creates an invoice for every session at the time you create the recurrence pattern rather than the time the appointment is imminent. This means that looking at the list of invoices for any reason is chaotic and this is compounded when session packs are at play particularly if you have set the client's standard item in their billing setup to the session pack it has regularly caused billing issues so we recommend against recurring pending appointments.
When we send out offers, we create a pending appointment, turn off the reminders, and set the flag / foreground colour to "Offered" plus add some notes to the appointment. If they decline, we change the flag to declined to reduce the visual noise and set the status to rescheduled or cancelled depending on whether or not they have a subsequent appointment.
When we create place-holdings, to avoid the billing problems we are forced to set them up using a personal appointment and setting a green "Placeholding" flag. When you confirm the "same time next week" these place-holdings are simply deleted as the pending client appointment is created.
See this adding to your diary article for more details on place holders
Foreground colours - Flags & Alerts
The diaries can become really overwhelming if there is a colour for everything and eventually you will end up seeing nothing as the visual cacophony builds, so we aim to keep things minimalist but also make the things that need attention, like tasks to pop out and the things that are hum drum sit in a muted colour palette.
We also need consistency across all of our customers in the flags that we use to track tasks and communicate with clinicians with. As such we have come up with the following list of flags as a minimum. You're welcome to add to it if you like but the colours need to be reasonably unique as well:
Last Updated: 31 Aug 2021