This guide provides essential resources and instructions for effectively supporting patients, including enrollment training, talking points, login guidance, managing patient messages, addressing issues, and handling consent digitally. It also covers clinical alerts, care team contact displays, out-of-office messaging, and insights from a patient’s perspective.
Supporting Patients
This guide provides resources and support options for assisting patients with ChronicCareIQ, covering self-help tools, communication tracking, and resolving common issues.
Key Resources:
Patient Self-Help: A dedicated help site (help.chroniccareiq.com), support line (888-996-8664), and email ([email protected])
Communications Panel: Tracks system-generated and manual emails, texts, and app notifications. Note that app push notifications are not trackable.
Common Support Requests:
Password Reset: Options to reset or set a custom password via the patient chart.
Pause Reminders: Instructions to temporarily pause patient monitoring.
Deactivate a Patient: Guidance for removing patients from the program.
Email Issues: Verify the patient’s email, check spam folders, and contact support for unresolved invalid email issues.
App Issues: Ensure the app is updated to the latest version. For further assistance, contact Patient Help.
For more information, please refer to this page: Supporting Patients
Patient Enrollment Training
Patient Enrollment training provides an overview of the enrollment process, including how to identify eligible patients, EMR flagging, communication tips, and patient activation.
The “Patients to Enroll” filter in ChronicCareIQ helps identify unclaimed patients suitable for the CCM/RPM program, based on criteria like age, phone call time, and qualifying diagnoses. This filter is accessible through the main filter page under Other Filters.
From the filter, you can review patient information and choose to activate them in the program, do nothing, or flag them as “do not enroll,” ensuring they won’t appear on future lists.
For more information, please refer to this page: Patient Enrollment Training
Patient Enrollment Talking Points
Chronic Care Management (CCM), Principal Care Management (PCM), Remote Physiologic Monitoring (RPM), and other care programs help patients with chronic conditions improve their health and care coordination. Research shows that many Medicare beneficiaries have multiple chronic conditions, and these programs provide enhanced care to help patients stay healthier longer.
Clinical Lead:
Before speaking to patients, ensure the enrollment process is patient-centered. Provide clear explanations about the program’s benefits, such as proactive monitoring, easier communication with the care team, reduced hospital visits, and a personalized care plan. Highlight that the service is often affordable with supplemental insurance and reduces the need for costly services like ER visits.
Sample Talk Track:
“Your doctor has recommended this program to monitor your health closely. It’s easy to use and helps identify issues early, improving your health outcomes. I’ll assist you with the setup today.”
Care Provider:
Engage patients by explaining the program’s benefits and how it helps manage their conditions. Ensure they understand that the care team will assist with the setup and answer any questions.
Sample Talk Track:
“You’re eligible for a new service that helps me monitor your health between visits. It’s designed to keep you healthy and out of the hospital. I believe it will help you, and (Clinical Lead) will explain the details and get you set up today.”
For more information, please refer to this page: Patient Enrollment Talking Points
Patient Login Instructions
Patient Login Instructions are available to assist patients with login and account setup. This helpful video is available within the patient’s welcome email and on the CCIQ Patient Help Site.
For more information, please refer to this page: Patient Login Instructions
Patient Messages
CCIQ’s messaging tool provides a simple and secure way for care teams and patients to communicate. It allows bidirectional messaging for sharing health updates, scheduling requests, and status updates.
Care Team Messaging Use Cases:
Re-engage patients to submit health updates.
Provide positive feedback on patient health.
Respond to patient requests, such as appointment scheduling.
How to Send Messages:
Go to the patient’s chart in CCIQ.
Select the “Comments” tab and click “Send Message.”
Compose and send the message.
Patients receive notifications based on their reminder settings and can view messages through the CCIQ website or app.
Patient Messaging:
Patients can send short, text-only messages to the care team, typically about medication refills, referrals, or health updates. These messages are limited to 250 characters and cannot include attachments for security reasons.
Message Alerts:
Unread patient messages are marked with a red alert on the CCIQ Monitoring Dashboard. Users can view messages and clear alerts after reading them.
Deactivated Patients:
Messaging is still available for deactivated patients, but these patients won’t appear on the dashboard unless a message is sent. A special task is created to manage messages from deactivated patients. Patients can be blocked from logging in if necessary.
For more information, please refer to this page: Patient Messages
Alert Notifications for Clinical Staff
ChronicCareIQ allows clinical staff to receive notifications when a patient triggers a “Red Alert” based on set thresholds in their protocol. Clinical case managers can receive notifications via email or text when a patient’s vital readings or protocol responses exceed these thresholds.
How to Enable Notifications:
The Account Admin must enable notifications for the assigned clinical user.
Navigate to the “User Summary” and select the clinical user.
Under the “Monitoring” tab, activate “Patient Alerts” and choose the alert type.
Enter the clinical user’s contact information (email or text) and save the changes.
When a patient triggers a red alert, the clinical user receives a notification to log into ChronicCareIQ and respond. Notifications are only available for red alerts; yellow warning alerts do not trigger notifications. Text notifications will direct the user to the mobile browser for login.
For more information, please refer to this page: Alert Notifications for Clinical Staff
Addressing Patient Issues
Patient Issue Reporting
ChronicCareIQ enables users to track patient issues such as missing information, non-compliance, or system-identified problems. The “Patient Issue” report lets users filter and generate reports on specific issues, such as missing care plans, diagnoses, locked accounts, no logins, bad emails, non-responsiveness, and consent issues.
Identifying Non-Compliant Patients
Patients who haven’t logged in or updated their health status are marked with yellow status symbols. Non-compliant patients should be contacted to address any barriers to engagement.
Patient Outreach Methods
Phone: Call patients to understand why they haven’t logged in or reported their health data. Reinforce the program’s importance.
Letter: If phone outreach fails, send a letter emphasizing the necessity of patient participation.
In-Person: During appointments, physicians should engage non-compliant patients to identify barriers and provide re-education or technical assistance.
Troubleshooting Patient Logins
Common issues include forgotten usernames or passwords, failure to log in, waiting for family assistance, or not receiving welcome messages. Staff can reset passwords, resend invitations, or guide patients through the login process.
Missed Updates and Non-Responsive Patients
For patients who miss reporting periods or are unavailable (e.g., due to hospitalization), staff can pause monitoring temporarily. Patients who are not responding should be contacted to ensure they are engaged with the program.
Adjusting Frequency
If the reporting frequency isn’t suitable for a patient, it can be modified in consultation with the care provider, based on the patient’s needs.
Messaging Patients
Staff can send messages through ChronicCareIQ to patients who may prefer text communication. Notifications are sent to alert patients of new messages.
For more information, please refer to this page: Addressing Patient Issues
Digital Patient Consent
Digital Consent Process
When a patient logs into their ChronicCareIQ account for the first time, they are prompted to provide consent via an electronic consent form. The form can either be the standard CCIQ consent template or a customized version provided by the practice.
Customization & Support
Client Admins can upload their consent language for customization or use the default consent template. If needed, users can contact their support representative for assistance in enabling or setting up the consent form.
Consent Status and Tracking
Once a patient gives or declines consent, the status is documented in the patient’s audit log. Staff users will receive an alert in the Task panel for patients who decline consent, allowing them to take action such as deactivation or outreach. Consent status is visible in the patient’s chart, under the Billing Type section, and on the dashboard. If consent is not completed, a warning appears in the chart and dashboard.
Manual Consent Entry
Staff users can manually update the patient’s consent status by editing the Billing Type section. Options in the drop-down menu include:
Consent Given
Consent Declined
Consent Needed
Externally Documented
Not-Documented (phone patient)
For more information, please refer to this page: Digital Patient Consent
Patient’s Perspective
The page features testimonials from patients discussing their experiences after participating in a Chronic Care Management (CCM) program. These patient insights provide valuable information on why they value the program and highlight its positive impact on their health and well-being.
For more information, please refer to this page: Patient’s Perspective
Display Care Team Phone Number to Patient
Care teams can display specific phone numbers to patients by selecting the “Show to Patient” checkbox in the user’s account settings. Once this option is enabled, the patient will be able to see the direct contact number for the care team, alongside the general practice number. Admin users can edit these settings under the “Account” section to update the clinical or provider user information.
For more information, please refer to this page: Display Care Team Phone Number to Patient
Out-of-Office Message
Admin users in CCIQ can set up “Out of Office” notifications to display to patients during non-office hours on both the web and CCIQ Mobile App (versions 8 and higher).
To set up the notification:
Admin users log in and navigate to “Admin Settings” from their profile.
Go to “Customize Pages” and select “Out of Office Warning.”
Create a customized message in the “MarkDown” box and click “Update.”
Set the schedule for when the message should appear by using the “Edit Schedule” button. Options include built-in templates for weekends, weekdays, holidays, or custom hours.
The out-of-office notice can be set in military time, with options for full-day notifications or specific time ranges. When patients attempt to send a message during out-of-office hours, they are prompted to confirm they’ve seen the message. This acknowledgment is recorded in the Patient Audit Log for staff reference.
For more information, please refer to this page: Out-of-Office Message