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Patients

This section explains how to create, edit, discharge, and readmit patients. It also explains how to assign protocols to patients.

Patients Roster Page:
The patient roster page provides access to all patients previously and currently under the care of your care team(s). The patient table on this page display more abbreviated information than on the homepage: first and last name, patient status, MRN, DOB, mymobility ID, Persona IQ ID, and EMR status (if EMR integration is turned on). Selecting the vertical ellipsis at the end of a patient’s row will give you the option of linking your patient’s mymobility record to their EMR, viewing the patient’s details, or editing their profile information. (For more information on what’s available on the Patient Details page, please see Section 6: Patient Details Page.) The following controls appear on the patient roster page:

• Dashboard/Roster: This toggle allows you to switch between viewing the clinician dashboard and the patient roster page.
• My Patients Only: This toggle allows you to display only patients under the care of your care team(s).
• Active/Discharged/All: Use this filter to view a subset of the patient roster by selecting “Active” or “Discharged”. To view all patients, select “All”.
• EMR status: Use this dropdown to view only patients whose mymobility record is linked to their EMR, or only patients whose record has not.
• Add from EMR: Click on this button to create a new patient profile by importing the patient information from your EMR.
• Add manually: Click on this button to create a new patient profile. For more information, see the section below entitled ‘Add Manually’.
• Search: Use the search bar to find a patient in the patient roster table by selecting from the following search criteria – First name, Last name, MRN, mymobility ID, or Persona IQ ID.

Create New Patient Profile:

• Add using EMR integration: To add a new patient profile using EMR integration, please follow the steps below:
  1. From the Patient roster page, click on the “Add from EMR” button.
  2. In the patient search modal that pops up, enter the patient’s MRN and click ‘Find patient’.
  3. If there is a matching MRN in your electronic medical record database then it will return and display the patient name, MRN, and DOB for your confirmation.
  4. Required demographic fields: Mobile number, Care team, and Surgeon.
  5. Quick enrollment: To complete quick enrollment, select ‘Save record’ and you will return to the patient roster page.
  6. Full enrollment: To complete full enrollment, select ‘Continue’ and you will navigate to the patient profile. See below under “Create a Patient” for full enrollment requirements.
• Add Manually: To add a new patient profile, please follow the steps below:
  1. From the Patient Roster Page, click on the “Add manually” button.
  2. On the “Add a patient” page, enter details about the new patient:
     1. First name, Last name, Date of Birth, Mobile Phone Number, Care team, and Surgeon
     2. Allow the patient to read the consent language. The patient should check the box that they agree.
     3. Note: If your office collects patient consent through other means, the language here should reflect that fact and the patient will not have to read and consent during this step of enrollment. In this case, the clinical user will acknowledge that patient consent was already obtained.
  3. Select ‘Save record’ to quick enroll the patient and return to the Patient Roster Page.
     1. If the patient already exists in the system, that record will be returned upon selection of ‘Save record’ or ‘+ Procedure’. You may then decide to add a new procedure to the existing patient or create a new patient if the returned record is incorrect.
  4. Select ‘Continue’ to navigate to the patient profile page and continue entering the below patient information:
     1. Required Demographic Fields: First and Last Name, Gender, Date of Birth, Mobile Phone Number, Email Address
     2. Required Medical Fields: Care Team, Surgeon
     3. Required Language Field: Choose the language preferred by your patient so that their emails and text messages to activate their account appear in their preferred language. Their protocol and app will also appear in this preferred language unless changed by the patient themselves. (Note: this field only appears for clients that support multiple languages. If you are part of a client that does not support multiple languages, this field will not appear).
     4. Optional Fields: MBI, MRN, Zip Code, Procedure (Note: Once a procedure is selected, Procedure Date, Surgery side (laterality selection based on procedure) and Protocol will be required), Procedure Location, Notes
• Note: When you click the “Assign a Protocol” button, you will be directed to the “Assign a Protocol” page where you can select a protocol and routine level for the patient. For more about protocols, please see Section 8: Protocols.
• Once you have finished entering the patient information in all the fields, click the “Create patient” button on the bottom right corner of the page.
• If the patient profile has been successfully created, you will be directed back to the Patient Roster page and you will see a success message.
• Note: Patients being enrolled at a clinical study or hybrid site (commercial and clinical study combined) will have extra required fields:
  1. Hybrid only: Clinical Study (Yes/No)
  2. Study ID(s)

Link existing patient to EMR:
You can link an existing patient’s record in mymobility with their EMR.

• From the Patient Roster page, click on the vertical ellipsis at the end of the patient’s row and select ‘Link with EMR’. If the MRN is present in the patient’s mymobility record, it will automatically search the EMR. If the MRN is not present, you will be asked to enter the MRN before continuing.
• If a matching record is returned, select ‘Link profile to EMR’.
• You will select from a table which profile elements (if any) you want to import and overwrite from the patient’s EMR, including: First name, Last name, Gender, Date of Birth, Mobile, Email, and Zip code.
• Select ‘Confirm’ to complete the link between the patient’s mymobility profile and EMR and return to the Patient Roster page.

Add/Edit Procedure: You can add or edit a patient’s procedure on the Procedure page, which you can get to from the Patient Roster page. To add or edit a procedure please follow the steps below:

• From the Patient Roster page, click on the vertical ellipsis at the end of the patient’s row and select ‘Manage procedures’, which will take you to the Procedure page.
• To add a procedure, click on the ‘Add procedure’ button in the upper righthand corner.
• To edit an existing procedure, click on the ‘Edit’ hyperlink in the procedure list table for the corresponding procedure.

Discharge Procedure: You can discharge a procedure on the Procedure page, which you can get to from the Patient Roster page. A patient with no active procedures is considered “inactive.” To discharge a procedure, please follow the steps below:

• From the Patient Roster page, click on the vertical ellipsis at the end of the patient’s row and select  ‘Manage procedures’, which will take you to the “Procedure” page. In the far column of the procedure list table, you will have the option to discharge each individual procedure.
• Once you click “Discharge” you will need to confirm that you want to discharge that procedure.
• Once you click the “Yes discharge” button, the system will let you know if the procedure has been successfully discharged.
• Note: In addition to the successful discharge message, the word “Discharged” will be next to the patient’s name on their profile page when they have one or more discharged episodes of care but no active episodes of care.

Readmit Procedure: You can see any discharged patient on the Patient Roster page by selecting the “Discharged” filter at the top of the page. Note: When you readmit a patient, the patient will be readmitted without a procedure, procedure date, procedure location, and protocol assigned. Make sure whoever readmits the patient also reassigns these items at the time of readmittance. To readmit the patient, please follow these steps:

• From the Patient Roster page, click on the vertical ellipsis at the end of the patient’s row and select “Manage procedures”, which will take you to the “Procedure” page.
• The patient’s profile will display with the word “Discharged” on the top of the page.
• Click on the “Readmit” hyperlink in the far column of the procedure list table for the corresponding procedure.
• Next, a modal will display to ask if you are sure you want to readmit the procedure, if you are, click the “Yes readmit”.
• Once you click the “Yes readmit” button, a success message will appear to let you know if the procedure has been successfully readmitted.

Edit Patient Profile:
If needed, you can edit a patient’s profile from the Home Page, Patient Roster page, or the Care Teams page, by clicking on the patient’s profile card.

• • From the Patient Roster page click on the vertical ellipsis at the end of the patient’s row in the patient roster table and select ‘Manage profile’.
  • From the Care Teams page, click on the patient’s profile card. However, from the Home Page, first click on the patient’s profile card, then click on the three vertical dots next to the “History” button and click on the “Manage profile” option.
  • The Patient Profile page will open, where you can edit any of the patient’s demographic information.
  • When you are finished editing the profile, make sure to click the “Save” button in the bottom right corner.

Deactivate Patient Profile: A patient profile may only be deactivated if they do not yet have an assigned procedure. Once deactivated, the profile becomes uneditable, the patient details page is inaccessible, and the patient can only be accessed from the Patient Roster page.

• • To reactivate a deactivated patient record, navigate to their patient profile and select the Reactivate button.

Patient Protocols:

• When assigning a protocol, all available protocols will appear on the Assign a Protocol page, which can be accessed on the Procedure page. For more information about protocols, please see Section 8: Protocols.

• Assign a Protocol: Assigning patient protocols initially happens when adding a procedure, however, you can edit the protocol later. To assign a protocol, please follow the instructions below:
  1. On the Procedure page, make sure the following information is entered before assigning a protocol:
     1. Procedure
     2. Surgery Side (Procedure laterality)
     3. Procedure Date
     4. Location of the Procedure
  2. Once all of the above information is added to the profile, the “Assign a Protocol” button will be enabled so you can click on it.
  3. You will be directed to the Assign a Protocol page, where you will see all the available protocol options.
  4. Within each protocol, you can select a level for the exercises. The level options are Level 1 or Level 2. This determines which exercise routines are assigned to the patient in the protocol. You also have the option to remove exercise routines by choosing No Exercises from the level dropdown. If you are not sure which routines are in a protocol, you may preview the protocol.
  5. You will also be able to enable or disable all education. Education will be automatically enabled for all protocols. If you are not sure what education is in a protocol, you may preview the protocol.
  6. Once you select the patient’s protocol and level, click the “Assign” button.
  7. You will be directed back to the Procedure page where you can click the “Save” button to save the protocol selection.
• Changing a Protocol: You can adjust a patient’s protocol from the following locations: Procedure page or Patient Details page – Protocol tab.

Patient Details Page

The Patient Details page includes a summary of episode of care specific information about the patient including the patient’s progress, protocol, messages, assessments, and an overall history of activity involving the patient. Within the Patient Details page, you will find there are multiple sections providing you with the following in-depth patient details:

Patient Details Page Layout:
The patient summary provides a static section of basic patient information throughout the Patient Details page. The information available in this header summary bar includes the patient’s basic demographic information, most recent location and disposition, procedure, surgery side, care team, assigned protocol and level, and a flag icon indicating attention is needed on a patient’s profile.

• Episode of Care header: sits atop the patient summary and provides the procedure name, laterality and date of service, and days relative to surgery. When there is more than one episode of care present for a patient (including both active and discharged) the header will become a dropdown menu which you can use to toggle between episodes.
• Patient Summary: provides a static section of basic patient information throughout the Patient Details page. The information available in this header summary bar includes the patient’s basic demographic information, procedure, surgery side, care team, assigned protocol and level, and a flag icon indicating attention is needed on a patient’s profile.
• Patient Information: The patient’s basic demographic information (i.e., profile photo, name, age, gender), as well as the MRN are displayed within the summary bar.
• Apple Watch Icon: If the patient uses or has used Apple Watch as part of the mymobility program, there will be a watch icon on the lower left corner of the patient’s profile photo.
• Clipboard Icon: If the clipboard is a shade of red or yellow, the patient’s specific episode has open clinical assignments (dark red = unacknowledged urgent, dark yellow = unacknowledged non-urgent , light red = in progress urgent, light yellow, in progress non-urgent). By clicking on the symbol, a widget appears which shows an overview of these open assignments. The following actions can be taken from the widget:
• • 1. Acknowledge an assignment
    2. Add a comment to an assignment
    3. Create a new assignment (will take you to a new page)
    4. Resolve an open assignment (will take you to a page)
    5. Edit an existing assignment (will take you to a new page)

• Flag Icon: If a red or yellow flag icon appears in the upper right corner of the summary bar, this notifies clinical users that something in the patient profile needs attention. You can add or change a flag on a patient’s profile here or on the patient’s card on the Home page. Note: You must also include a note when changing a flag priority level. To change flag priority, please follow the instructions below:
  • Click the flag icon to add or change a flag.
  • If a flag has already been selected, you can read the attached note, who wrote the note, and see when it was added, by clicking on the flag.
  • If you need to add a flag, select the priority level for the flag (i.e., Red = High; Yellow = Medium; Clear = No flag).
  • Once you choose the flag priority level, you must include a note.
  • When you are done adding the note, click “Save.”
  • Note: All flag changes and associated notes can be viewed later in the patient’s history on the “History” tab.
• Tabs Bar: Below the Patient Summary bar is a set of tabs. Each tab has detailed, patient-specific information. The tab categories are Progress, Protocol, Messages, Assessments, and History. Only one tab can be selected at a time. For more information about what is included within each tab, see the sections below.
• Three dot menu: Click on this drop-down menu to choose one of the following options:
  1. View All Stats: Click here to view the entire history of the patient’s statistics.
  2. Edit Profile: Click here to edit the patient’s profile on the Patient Profile page. For more information on editing the patient’s profile, please see Section 5: Patients.
  3. Generate Report: Click here to generate a patient’s record.
  4. Discharge Patient: Click here to discharge a patient. For more information on how to discharge a patient, please see Section 5: Patients.
  5. View History: Click here to view a list of actions performed by care team members that involve a patient. The date and time that item occurred will be documented. By default, the items will be listed in ascending order (i.e., most recent at the top and oldest at the bottom).
  6. Clinical Assignments: Click here to open the Clinical Assignment page
• Notes Icon: Click on the notes icon to view all notes associated with the patient’s profile or to add a new note. Please follow the instructions below to add a note:
  1. Click on the notes icon.
  2. In the pop-up box, click “Add a note” in the upper right corner.
  3. In the “Note” field, enter your note. There is no character limit for entering a note. When you are finished, click “Submit.”
  4. The note will be added to the patient’s profile. Note: You can also see all profile notes, under the “History” tab. See below for more information about the “History” tab.

Progress Tab:
This tab will show cards displaying the patient’s statistics. Each card will have three informational sections—statistics, chart, and information. Statistics will always display by default, but you can expand each card by clicking on the chart icon at the bottom of each card to show the past 2 weeks of information for that statistic, by day. For more information about each card, click on the question mark icon in the upper right corner. Note: 1.) Each card will show pre-surgery and post-surgery information, depending on where the patient is in their episode of care. 2.) The following statistics are obtained through the patient’s wearable technology and have not been verified for accuracy: Steps, Stand Hours, Stairs, Heart Rate (Resting BPM and Walking BPM), and Heart Rate Variability. These statistics are based on the Apple Watch wrist wearable device or iPhone mobile digital device, which are not medical-grade devices. More detailed information on each statistic is listed below:

• Gait Speed: Displays an interactive graph of the patient’s daily average gait speed over time. By using your mouse cursor to move along the graph, each day’s specific average gait speed will be displayed on the graph. The overall pre- and post-surgery averages are visible on the top section of the card. Three-time windows can be selected at the bottom by clicking on the different options. If the day of surgery falls within the selected window, a vertical line and label will indicate this day on the visual.  Note: Gait speed predictions, exceptions, and recovery curves will be suppressed if a patient is assigned a second episode of care.
  • 1 week (1W)
    1. Show the last 7 days of average gait speed data for the patient.
  • 1 month (1M)
    1. Show the last 30 days of average gait speed data for the patient.
  • 3 months (3M)
    1. Show the last 90 days of average gait speed data for the patient.

• WalkAI^TM Patient Progress: You can view this patient’s progress for each metric i.e., walking sessions, steps or predicted 90-day gait speed. The toggle allows you to enable or disable the feature for your patient.  Note: This only changes this specific patient’s ability to view the WalkAI^TM Patient Progress in mymobility app. Note: The progress shown here and viewable to patients is based on the patient’s rank for the specific metric in their cohort.  Cohorts are based on procedure, age group, BMI group and sex. Patients are shown the following disclaimers in mymobility.

1. 1. 1. Patients ranking ‘high’
         1. If you notice increased pain or swelling, you may be overdoing some daily activities.
         2. It is important to follow your instructions in mymobility and any other instructions from your surgeon and care team.
      2. Patients ranking ‘low’
         1. Slow and steady improvements support healthy progress. Every patient’s progress is different. The success of your recovery is not based on these metrics alone.
         2. If you are not achieving your walking or steps goal, consider discussing this with your care team.
      3. Patients ranking ‘on track’
         1. Every patient’s progress is different.
         2. It is important to follow your instructions in mymobility and any other instructions from your surgeon and care team.

• Double Support Percentage: Displays an interactive graph of the patient’s daily average double support percentage over time. This represents the average percentage of time both of a patient’s feet are touching the ground during the walking cycle. By using your mouse cursor to move along the graph, each day’s specific average double support percentage will be displayed on the graph. The overall pre and post-surgery averages are visible on the top section of the card. Three time windows can be selected at the bottom by clicking on the different options. If the day of surgery falls within the selected window, a vertical line and label will indicate this day on the visual.
  • 1 week (1W)
    1. Show the last 7 days of average double support percentage data for the patient.
  • 1 month (1M)
    1. Show the last 30 days of average double support percentage data for the patient.
  • 3 months (3M)
    1. Show the last 90 days of average double support percentage data for the patient.
• Pain: Displays an interactive graph of the patient’s pain ratings over time. The solid line shows approximated trends throughout the selected time window, while the solid dots show exact pain ratings on that day as reported by the patient. Hover over a data point to display the date and pain level reported. Given that the date of surgery falls within the currently displayed time period, it will be displayed as a solid vertical line. Toggle between 2 time windows, episode of care and last 30 days, by clicking the buttons at the top of the card. Clicking the chart icon will expand the section and display the last 14 pain ratings, starting with the most recent. Use the buttons at the bottom to switch between pain ratings and reported medication usage.
• Exercises: Displays a patient’s exercise completion percentage. The calculation: Total number of repetitions completed (reported) by patient divided by total number of repetitions assigned to patient (to date). The percentage displayed will round to the nearest whole number. Keep in mind the following items related to the Exercises data:
  1. Clicking the chart icon will expand the section that will direct you to the patient’s protocol tab for a day by day description of a patient’s exercise completion.
  2. During the pre-surgery period, the following statistics will be available:
     1. All days: This exercise adherence ring will display with a number and color, as well as show a percentage within the progress ring. The percentage represents the patient’s exercise completion for all available days thus far.
     2. Last 3 days: This adherence ring displays the exercise adherence for the past 3 days.
     3. Difficulty Rating: After each exercise routine, the patient will rate the routine’s difficulty. The difficulty rating is the following: 2 = Way too easy; 1 = A little easy; 0 = Just right; -1 = A little hard; -2 = Way too hard. This is the average rating that shows underneath both adherence rings.
     4. ^*Note: While the All days pre-surgery exercise ring will display post-surgery, the other rings and exercise difficulties will reset after the patient’s day of surgery.
  3. During the post-surgery period, the following statistics will be available:
     1. Pre-surgery: The pre-surgery adherence ring will display the patient’s exercise adherence during this period, as well as a patient’s average exercise difficulty rating throughout the pre-surgery period.
     2. Post-surgery, Last 2 weeks: This adherence ring displays the exercise completion percentage for the past 2 weeks. An average exercise difficulty rating for the past 2 weeks is also displayed with a color that it corresponds to.
     3. Post-surgery, Last 3 days: This adherence ring displays the exercise completion percentage for the past 3 days.
     4. Difficulty Rating: After each exercise routine, the patient will rate the difficulty of the routine. The average of this rating for the time period shown displays under both adherence rings.
• Education: Displays the patient’s education completion percentage. The calculation: Total number of education items “completed” (opened) by a patient divided by total number of education items assigned to a patient. Note: These values reset once the patient transitions from pre- to post-surgery. Keep in mind the following items related to the Education data:
  1. Clicking the chart icon will expand the section that will direct you to the patient’s protocol tab for a day by day description of a patient’s education completion.
  2. During the pre-surgery period:
     1. All days: This education completion ring will show a percentage within the progress ring based for all available days of assigned education.
     2. Last 3 days: This education completion ring displays the education completion percentage for the past 3 days.
  3. During the post-surgery period:
     1. Pre-surgery: The pre-surgery ring will display the patient’s education completion percentage during this period by displaying a percentage within the progress ring.
     2. Post-surgery, Last 2 weeks: This adherence ring displays the education completion percentage for the past 2 weeks.
     3. Post-surgery, Last 3 days: This adherence ring displays the education completion percentage for the past 3 days.
• Steps: Displays the average number of steps for a period of time, with data pulled from Apple HealthKit and Google Fit. Note: Today will not be included in the calculations as only full days are included in the calculations. Keep in mind the following items related to the Steps data:
  1. Clicking the chart icon will display a chart with the last two weeks (14 days) of a patient’s steps data, beginning the last full day.
  2. During the pre-surgery period:
     1. All days: Displays a total average accumulation of steps from all available pre-surgery days.
     2. Last 5 days: Displays a step-count average for the past 5 days. Note: If the patient has less than 5 days of data, it will report based on the number of days available.
  3. During the post-surgery period:
     1. Pre-surgery: The total steps taken during pre-surgery will display as an average per day over the pre-surgery period.
     2. Post-surgery, Last 2 weeks: Displays an average per day step count for the past 2 weeks. Note: If there are less than 14 days available, the average will display with the amount of days that are available.
     3. Post-surgery, Last 5 days: Displays a step-count average for the past 5 days.
• Stand: Displays the hours a patient has stood for at least once per hour, averaged by day. Stand data is only available for patients using Apple Watch. Note: Today will not be included in the calculations as only full days are included in the calculations. If there are no stand time statistics available, a dash will replace the number. Keep in mind the following items related to the Stand data:
  1. Clicking the chart icon will display a chart with the last two weeks (14 days) of a patient’s stand hour data, beginning the last full day.
  2. During the pre-surgery period:
     1. All days: Displays a number that represents the average stand hours per day for all days available.
     2. Last 5 days: Displays a number that represents the patient’s standing average for the last 5 days. Note: If the patient has less than 5 days of data, the average will report based on the number of days available.
  3. During the post-surgery period:
     1. Pre-surgery: Displays the average number of stand hours for all days available during pre-surgery.
     2. Post-surgery, Last 2 weeks: Displays a number that represents the patient’s standing average for the last 2 weeks.
     3. Post-surgery, Last 5 days: Displays a number that represents the patient’s standing average for the last 5 days.
• Flights of Stairs: Displays the average number of floors per day, calculated based on an elevation of about 10 feet.  Flights of Stairs is only available for patients using iPhone. Keep in mind the following items related to the Flights of Stairs data:
  1. Clicking the chart icon will display a chart with the last two weeks (14 days) of a patient’s stairs data, beginning the previous full day.
  2. During the pre-surgery period:
     1. All days: Displays the average number of flights climbed for all available days.
     2. Last 5 days: Displays the average number of flights climbed for the last 5 days.
  3. During the post-surgery period:
     1. Pre-surgery: Displays the average number of flights climbed during all available pre-surgery days.
     2. Post-surgery, Last 2 weeks: Displays the average number of flights climbed during the last 2 weeks.
     3. Post-surgery, Last 5 days: Displays the average number of flights climbed over the last 5 days.
• Heart Rate: Displays the patient’s average Resting BPM (beats per minute) and average Walking BPM for a set number of days. The heart rate data is pulled from Apple HealthKit. Heart Rate is only available for patients using an iPhone. Keep in mind the following items related to the Heart Rate data:
  1. The heart rate data is displayed in a bar graph with a bar for both the Resting and Walking BPM. Note:The graph numbers can only display between 0-150. If the number is over 150, the graph will be maxed out, but the number will still show.
  2. Clicking the chart icon will display a chart with the last two weeks (14 days) of a patient’s resting BPM and walking BPM data, beginning with the previous full day.
  3. During the pre-surgery period:
     1. All days: Displays a number for both the resting and walking BPM average for all available days.
     2. Last 5 days: Displays a number for both the resting and walking BPM average for the last 5 days.
  4. During the post-surgery period:
     1. Pre-surgery: Displays a number for both the resting and walking BPM average during all available pre-surgery days.
     2. Post-surgery, Last 2 weeks: Displays a number for both the resting and walking BPM average for the last 2 weeks.
     3. Post-surgery, Last 5 days: Displays a number for both the resting and walking BPM average for the last 5 days.
• Heart Rate Variability: Displays the patient’s heart rate variability for a set number of days. The heart rate data is pulled from Apple HealthKit. Heart Rate Variability is only available for patients using an iPhone. Keep in mind the following items related to the Heart Rate Variability data:
  1. Clicking the chart icon will display a chart with the last two weeks (14 days) of a patient’s heart rate variability data, beginning the previous full day.
  2. During the pre-surgery period:
     1. All days: Displays a number for the heart rate variability average for all available days.
     2. Last 5 days: Displays a number for the heart rate variability average for the last 5 days.
  3. During the post-surgery period:
     1. Pre-surgery: Displays a number for the heart rate variability average during all available pre-surgery days.
     2. Post-surgery, Last 2 weeks: Displays a number for the heart rate variability average for the last 2 weeks.
     3. Post-surgery, Last 5 days: Displays a number for the heart rate variability average for the last 5 days.
• Apple Watch: If a patient has connected an Apple Watch, this statistic will appear and display data on how often the patient is wearing their Apple Watch to take into consideration when viewing other statistics. We suggest that patients wear their watch at least 8 hours a day, at least 4 days a week for the Clinician to benefit from their statistics. Keep in mind the following items related to Apple Watch wear statistics:
  • Clicking the chart icon will display a week by week history of the patient’s watch wear. Weeks that the patient has hit their wear goal, stated above, will have a green checkmark. Weeks start Sunday.
  • Per day: Average hours a day that a patient is wearing their Apple Watch.
  • Per week: Average days per week that a patient is wearing their Apple Watch.
  • Goal met: The goal met will begin being calculated once the patient connects their Apple Watch and if they are at least within 20 days before surgery. This will show the number of weeks the patient has met their goal over the number of weeks a patient has not met their goal.
  • ^*Note: only full weeks are counted. The day of surgery is not counted and therefore the week of surgery is not counted.

Exceptions Tab:
This tab will allow the user to view and manage the threshold exceptions for the patient. Exceptions are automatically detected by the system based on health data received from the patient’s device. An exception may only occur on a single day, or remain open for several based on trends in the patient’s physical activity. Exceptions always have a type – or the “trigger” for the exception being detected, the date the exception was detected, the patient’s required check-in response or in the case of disabled exceptions – the care team members reason for the action, and current status. Note: Each exception with ongoing data that spans across multiple days can be expanded by clicking the down arrow. This will display each day of the exception episode and the relevant metric for which the exception is triggered. The information on this tab is divided into the following sections:

• Active
  • The currently active exceptions detected for the patient. An active exception is an exception, either new or ongoing that is currently highlighted on the patient’s short card.
  • Actions that can be taken on exceptions in this view include:
    1. Message: directly send the patient a message. This message will appear in the normal messaging thread for both the patient and all care team members.
    2. Snooze: temporarily stop highlighting for the care team, giving the patient a chance to resolve the exception. If the patient doesn’t resolve the exception within the selected time window, it will again be highlighted once that period expires.
       • Available snooze periods
         • 3 days
         • 1 week
         • 10 days
         • 2 weeks
    3. Disable: permanently stop detecting and highlighting this exception type for the patient. Note: You must add a comment when doing this action.
• Snoozed
  • Exception instances that have been temporarily snoozed by a member of the care team. Once the snooze window expires, if the exception is not resolved, it will move back into the Active Exceptions The date the snooze period will expire is visible for each exception in this section.
• Disabled
  • When a care team member permanently disables an exception type from being detected and highlighted for the patient, it will be visible here. The disable exception types include a mandatory note, input by the care team member who disabled it. In this section, you can also “Enable” the exception type, allowing the system to being checking the patient’s data for this type of exception in the future.
• History
  • Past exceptions are listed in this section. When a patient resolves an exception, that exception instance with all of its relevant data will move to the history section.
• ^*Note: You may set up email notifications in My Profile to be emailed when a new exception is created on behalf of one of your patients or a scheduled summary email containing the number of currently active exceptions, listed by exception category, across all patients on your care teams.

Protocol Tab:

Clicking here will list the patient’s assigned protocol, if there is one available. If a procedure is discharged, the “Protocol Tab” will list their most recent assigned protocol. The following explains how to navigate and effectively use this tab:

• Change protocol button: By selecting this button you are able to edit the patient’s current protocol by changing the exercise level or enabling/disabling education.

• Protocol Tab Layout: The patient’s current, assigned protocol and level is available to view in a table format. The table includes the following columns:
  1. Day → The day of the protocol (e.g., -30, -25, +5, +11 etc.).
  2. Date → The date when that protocol event was assigned to be completed. Note: If patients do not complete assigned education and assessment items on the days that they are due, they have the opportunity to complete them in future days. Exercise items will not be available to be completed on days after they are due.
  3. Completed → Indicates the completion of each protocol item. A different indicator will appear, depending on the following activities:
     1. Checkmark: Education items and Surveys that are completed on their assigned date.
     2. # of days late: Education items and Assessments that are completed late.
     3. Missed: Exercise tasks not completed on their assigned day.
     4. Percentage of Reps/Minutes: Shows a percentage of completed reps/minutes vs reps/minutes assigned for Exercise items that were completed on their assigned day.
     5. Blank: Items in the future that have yet to be completed.
  4. Type → The type of protocol item (e.g., Education, Exercises, or Assessments).
  5. Title → Displays the name of the education items and assessments, as well as the title and level of an exercise.
  6. Drop-Down Arrow → Click on the drop-down arrow to expand the row and view more specific information about the protocol item.
     1. If the item is an education, the system will load the item below its protocol row.
     2. If the item is an assessment, the system will load the assessment and indicate if it has been completed. If it was completed, there will be a score and a link to view the results on the survey tab. Note: If you want to see the answers of the assessment, please click on the “Assessments” tab.
     3. If the item is an exercise, the system will load a table with the exercises included in the routine, the number of reps/minutes completed vs. assigned, and if the exercise was completed or missed.
• Protocol Filter Options: Click on the All Types drop-down menu to view a specific category of assigned tasks within a protocol including All Types, Education, Exercises, and Assessments.

Messages:
Displays a message thread between the patient and his/her care team. You can view the messages from these two locations in the system: Home Page→Messages Icon→Messages Page or Patient Details Page→Messages Tab. Here are a few items to keep in mind when viewing messages:

• A magenta messages icon indicates an unresolved message between the patient and his/her Care Team.
• The message thread will be ONE ongoing chat between all clinical users who are part of a care team and the patient. The patient will see the same message thread as clinical users, along with the photos of each clinical user in the thread.
• You can respond to the patient by clicking in the “message box” and typing in your message. When you are done composing, click “Send” and the patient will receive a notification they have received a message.
• The message thread is specific to the episode of care, depending on the assigned Care Team you may see different people available in the message thread when you toggle between episodes of care.
• For more information on messaging, please see Section 9: Messages.

Assessments:
This tab will show the surveys and range of motion assessments that are assigned to and completed by patients, including the following information:

• In the left column, you can view:
  1. Date the survey or range of motion assessment was assigned
  2. Completion status
• In the right column, under a survey you can view:
  1. The entire survey, listed verbatim
  2. Score
  3. Survey answers
• In the right column, under a range of motion assessment you can view:
  1. A summary of the assessment results
  2. Max and min range of motion
  3. Difficulty and pain ratings
  4. Thumbnail of the patient performing the assessment
  5. Videoclip of the patient performing the assessment
• If no surveys have been assigned, this message will show: “No surveys have been assigned to date.”

• Care Team Assignments: This page allows the user to see and manage the clinical assignments for the specific episode of care of the patient. It contains a button to create new assignments (which require assignee(s) and a short description). Every assignment can be expanded to view its  history on the page via the “View Assignment History” button. There are two main sections on the page:

• Open Assignments: Here you can view all open assignments for the episode of care, this includes unacknowledged (brighter color) and in-progress assignments (lighter color). Assignments can be urgent (red) and non-urgent (yellow). A variety of actions can be taken on open assignments:
  1. Acknowledge: Any care team member can acknowledge an unacknowledged assignment, but they will become the assignee on it. This also moves the assignment to in progress
  2. Resolve: Any care team member can resolve an in-progress assignment. This will open a new page, where a short resolution message is required.
  3. Edit (pen button): Any care team member can edit the assignment. This will open a new page where the description, assignees, and urgency level can be edited. Comments can also be added to provide background on the edit.
  4. Commenting: comments can be added to the assignment in page by any care team members
• Resolved Assignments: Here you can view all resolved assignments for the episode of care. You can view the specific history of each assignment and expand it within the page, and you can reopen the assignment. Reopening the assignment will take you to a new page where you must assign new assignees and provide a reason for reopening before saving and updating the status of the assignment.

NOTE: You may set up email notifications in My Profile to be emailed when a new assignment is assigned to you or a scheduled email announcing that you have a new assignment.

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Protocols

In this section, you can learn about the available protocols and how to view them. You can access the Protocols page from these two locations in the system: Header→Navigation drop-down menu→Protocols OR Patient Profile Page→Assign a Protocol.

On the Protocols page, you can view all available protocols, sort by specific protocols, and preview the different elements (i.e., Education, Exercises, and Surveys) within each protocol.

• The Protocols page will consist of a “short card” view for each protocol available. By default, all protocols will be listed in alphabetical order by protocol name. Within each protocol card, you can see the following information:
  1. Protocol name, Protocol description (if there is no description, the space will be blank), Duration, Routines (will display all routine level options available for that protocol).
• You can filter the page by procedure by clicking on the All Protocols drop-down menu on the top-right side of the page.
• If you click on any protocol card, you will be taken to the Protocol Preview page.
  1. At the top of the Protocol Preview page will be the title of the protocol.
  2. Below that will be the following information:
     1. Description: The description of the protocol. If there is no description, the space will be blank.
     2. Duration: The length of the protocol
     3. Routines: The available routine levels (i.e., Level 1, Level 2, or no exercises)
  3. If you are part of a client that supports multiple languages, you will be able to change the protocol view to see each language version of each protocol.  If your client does not support multiple languages, you will only be able to see protocols in the language supported by your client.
  4. You can filter the protocol by clicking the All types drop-down menu so you can only view specific items (i.e., All types, Education, Exercises or Surveys) within the protocol.
  5. You can select the All types drop-down menu to filter the protocol by levels.
     1. If “All types” or “Exercises” is selected from the All types drop-down menu, the level filter will default to display all levels, but include the following two options: Level 1 or Level 2.
     2. If “Education” or “Surveys” are selected, the All types drop-down menu will be defaulted to the option “-“ instead.
• At the top of the Protocol page, there is a table that lists the following information about the protocol:
  1. Day→ The day of the protocol (e.g., -30, -25, +5, +11 etc.).
  2. Type→ The type of protocol item (e.g., Education, Exercises, and Survey).
  3. Level→ Displays “-“ for Education and Surveys; displays “1” or “2” for Exercises.
  4. Title→ Displays the title name of the Education, Surveys, and Exercises.
  5. Drop-Down Arrow→ Click on the drop-down arrow to expand the row and view more specific information about the protocol item. Note: Multiple rows can be expanded at once.
     1. If the item is an education, the system will load the item below the protocol row.
     2. If the item is a survey, the system will load the survey title and all survey text.
     3. If the item is an exercise, the system will load a table with the exercises included in the routine and the number of reps/minutes assigned for each exercise.

Messages

This section will explain the messaging capabilities between patients and clinical users throughout mymobility. You can access the messaging thread from a few different places: Header→Messages Icon→Messages Page OR Home Page→Patient Details Page→Messages Tab OR Home Page→Messages Page.

You can message patients, along with the patient’s other care team members in one messaging thread. Each patient will have only ONE ongoing message thread and any member of the patient’s care team can send/receive messages in the thread. Please follow the instructions below to send a patient a new message:

• From the “message thread,” enter the message in the dialog box next to the “Send” button.
• When you have finished composing your message, click the “Send” button.
• Your message should now appear on the bottom of the thread, since it is the most recent message. The patient will receive a notification when they receive a new message.
• Underneath each message in the thread, there is a line that says who sent the message, the date the message was sent, and the time it was sent. Next to each message, a user’s profile photo will display.
• Note: If you do not have a profile photo in the system, the patient will see a placeholder photo instead.
• In the right column (next to the message thread) is the patient’s contact information, along with a list of names of the clinical users who are in their care team.

Messages Icon:
Clicking the messages icon from the Header will you take to the Messages page where you can see unresolved message threads for all of your patients. The “Messages” icon in the main mymobility header bar will have a magenta-coloured superscript number in the upper right corner if there are any unresolved message threads.

Messages Page Layout:
The Messages page includes a variety of information about the type of message sent and ways to sort your messages. Keep in mind the following items for easier navigation on this page.

• Within the Messages page, there is a header bar with different sorting options as well as several columns of message information.
  1. In the Messages page header bar, you can see the following items:
     1. Number of unresolved messages you have.
     2. A toggle bar with the option to view unresolved or resolved messages.
        1. The unresolved view will only display unresolved messages.
        2. The resolved view will only display resolved messages from the past thirty days. To view older messages, go to the patient’s Patient Details Page > Messages.
     3. Most recent drop-down menu → Click here to sort your messages in the following ways:
        1. Most recent: Sort the messages so the most recent messages are at the top and the oldest messages at the bottom.
        2. Last name: Sort messages alphabetically (in descending order, A-Z) by the patient’s last name.
  2. Within the messaging columns, you can see the following information:
     1. Profile Photo and Patient Name: The patient’s profile photo will show first, with his/her name.
     2. Most recent text: This column will show up to two lines of the message text, depending on the text. If there is additional information beyond those two lines, there will be an ellipsis (…) to indicate more text. If there is a photo or video in the most recent message, there will be an icon depicting that type of message in the content line of the message.
     3. Date/Time: If the most recent message was sent today, this column will show the time the message was sent. If the message was sent yesterday, it will read “Yesterday.” If it was sent within the last week, (but not today or yesterday) it will show the day of the week. If the message was sent longer than a week ago, it will display the date in MM/DD/YY format.
     4. Resolved/Unresolved: If a message has not been resolved yet, an exclamation point will appear on the far-right side of the message line. If a message has been resolved, there will be no exclamation point.
• An unresolved message is a message that has not yet been taken care of and therefore needs action by a care team member. When a message is unresolved, all care team members will see the unresolved icon.
• Any care team member can mark a patient’s message as resolved. Keep in mind that marking a message as resolved will dismiss all notifications from other care team members’ dashboards and messaging screens.
• By default, the messages list will show the most recent messages received at the top of the list and the older messages at the bottom. Note: If you have no messages yet, the screen will say: “No messages have been received.”
• Clicking on a message line will take you directly to the message thread on the Patient Details page.
• When a patient is discharged from the mymobility program, their message string will be removed from your message list.

Message Notifications

• To set up preferred options for message notifications, visit My Profile. You will have the following options to receive email notifications for messages:
  1. Immediately – You can choose to receive email notifications immediately upon receipt of a new patient message or newly detected exception. These notifications are on a slight delay so that if you are active in the application, you will not receive a notification.
     1. You may choose to receive immediate message notifications either All Days, Monday-Friday, or not at all.
  2. Scheduled – You can choose to receive email notifications as reminders for the amount of unresolved messages or active exceptions for patients in your care team.
     1. You may choose to receive these reminders at all or some of the following times:
        • 8:00 AM
        • 12:00 PM
        • 4:45 PM
     2. You may also choose to receive these notifications All days, Monday-Friday, or not at all.

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Administrative Access

The Clinical User with “Administrative Privileges” has additional access beyond other Clinical Users or Clinical Users with “Surgeon Privileges.” As a clinical user with “Administrative Privileges,” you have access to create, edit, deactivate, and reactivate Clinical User profiles, and create, edit, and delete Care Teams. To see more specific “Administrative Privileges” access information, please refer to the User Types Table in Section: Home Page.

Home Page:

• My profile: In addition to being able to upload and edit your profile photo and change your password, you may also edit all other fields on this page. Note: You will have access to edit other clinical user profiles as well.

Create New Care Teams:
You have access to create new care teams. Please follow the steps below to create a new care team:

• Click on the “Care Teams” button from the Main Navigation drop-down menu, available on any page in the mymobility main header bar.
• From the Care Teams Page, click on the Create drop-down menu and then select “Care team.”
• You will be taken to the Create a Team page where there will be three fields:
  1. Team Name (required field) → Enter the care team name.
  2. Clinical Users (optional field) → You can choose to add the clinical users now or later. Keep in mind that if you don’t add users when creating the care team, that care team will not appear when creating a patient profile. To add clinical users to the care team, a list of all clinical users in the system with a checkbox next to each of their names, will display. To choose users, click the box to add a checkmark. This will indicate the user has been selected for the care team.
• When finished, click the “Create Team” button on the bottom of the page. Note: If you choose a care team name that is already being used, the system will notify you when you click the create button.
• If your Care Team was created successfully, you will be taken back to the Care Teams Page and a success message will be displayed.

Edit Care Teams:
From the Care Teams page, you can edit care teams. Please follow the instructions below to edit a care team:

• From the Care Teams page, make sure the “Care Teams” toggle button is selected.
• From the list of care team cards, select the care team that needs to be edited.
• On that care team’s page, if you need to edit the care team name, click on the pencil icon next to the care team name.
• Click the “Edit clinical users” button on the right side of the screen.
• You will be directed to Edit Clinical Users page with a list of all clinical users in the overall system.
• The users that are in the specific care team will have a checkmark in the box next to his/her name.
• To remove a user, click the boxes next to the clinical user’s name. This action will uncheck the box, indicating you would like that user removed from the care team.
• When you are finished editing the users within the care team, click the “Save edits” button on the bottom right corner of the page and you will return to the Care Team page.

Delete Care Teams:
You may delete a Care Team from the system by following these instructions:

• From the Care Teams Page, make sure the “Care Teams” toggle button is selected.
• From the list of Care Team cards, select the Care Team that needs to be deleted.
• On that care team’s page, click the “Delete this team” button at the bottom of the page.
• Keep in mind the following items when deleting a Care Team:
  1. If there are clinical users who are still a part of that care team and only belong to that care team, there will be a message saying: “There are care team members who need to be added to another care team before deleting this care team.”
  2. If there are still patients in the care team, a message will pop-up saying: “Please reassign <# of patients> patients to a new care team before deleting this care team.”
  3. If both patients and clinical users are still a part of the care team, you will receive a message saying: “There are care team members and patients who need to be added to another care team before deleting this care team.”

Create New Clinical Users:
You have access to create new clinical user profiles. Please follow the instructions below to create a new clinical user profile:

• From the Care Teams page, click on the Create drop-down menu on the right side of the screen and select “Clinical user.”
• On the Create a Clinical User page, enter the new user’s demographic information in the following fields:
  1. Required Fields: First and Last Name, Title, Email Address, Mobile Number, Care Team(s)
  2. Optional: Permissions box for “Admin” or “Surgeon,” Prefix, Suffix
• Note: The “Permissions” field will allow you to give extended access to the user. If you are unsure what the differences are, click on the question mark icon for more information.
• Once you have entered in the required user information, click “Create” to finish the new Clinical user profile. Note: This process will trigger the system to send the new user a welcome email with instructions on how to log in, as well as a separate temporary password email.
• When setting up a new user account, it’s a good practice for the user to utilize a hospital or practice-based email address. However, if the user does not have that kind of email address, a personal email address can also be used.

Edit Clinical User Profiles:
Only clinical users with “Administrative Privileges” may edit a clinical user profile. Please follow the instructions below to edit a clinical user profile:

• Click on the “Care Teams” button from the Main Navigation drop-down menu, available on any page on the Header.
• From the Care Teams page, click on the “Clinical Users” button to show only the clinical users.
• Scroll until you find the user profile card and click on it. You will be directed to the Clinical User Profile page.
• Edit the necessary fields and when you are done, click the “Save profile” button in the bottom right corner.
• You will be directed back to the Care Teams page and a success message will appear.

Remove Clinical User from Care Team:
Clinical users can be moved from one care team to another in two different ways.

• To remove a clinical user from the Care Teams page, follow the instructions below:
  1. From the Care Teams page, make sure the “Care Teams” toggle button is selected.
  2. From the list of care team cards, select the care team that needs to be edited.
  3. On that care team’s page, click the “Edit clinical users” button on the right side of the screen.
  4. You will be directed to the Edit Clinical Users page with a list of all clinical users in the overall system.
  5. The users that are in the specific care team will have a checkmark in the box next to her/his name.
  6. To remove a user(s), click the boxes next to the clinical user’s name. This action will uncheck the box, indicating you would like that user removed from the care team.
  7. When you are finished editing the users within the care team, click the “Save edits” button on the bottom right corner of the page.
• To remove a clinical user from the user’s profile page, follow these steps:
  1. From the Clinical User Profile page, under the section labeled “Care Teams,” uncheck the box next to the care team to remove the user from that specific care team.
  2. Once you are finished editing the user’s care team selections, click the “Save profile” button on the bottom right.

Deactivate Clinical Users:
Clinical users should be deactivated if they will no longer be involved with patient care at your facility. A clinical user with Administrative Privileges is the only user able to deactivate other clinical users, but please note that a user with Administrative Privileges cannot deactivate themselves. If a clinical user with Administrative Privileges needs to be deactivated, please contact mymobility support. To deactivate Clinical Users, please follow the steps below:

• From any page within the system, click on the Navigation main drop-down menu in the header. Then, choose “Care Teams.”
• From the Care Teams page, click on the “Clinical Users” button to show only the clinical user profile cards.
• The page will display all active clinical user profiles. Scroll until you find the clinical user profile you would like to deactivate and click on it.
• That user profile page will appear. On bottom of the profile, click on the “Deactivate Profile” button.
• Before profile deactivation is complete, a message will appear asking if you would like to deactivate the clinical user. Click “Yes” to deactivate the user profile.
• If the user profile has been deactivated successfully, you will be directed back to the Care Teams page and will see a success message displayed.
• Once a clinical user has been deactivated, the user will not be able to log in to the system or initiate password requests for their accounts. It also means the user will be removed from all care teams so their patients will no longer see the user as part of their Care Team in the mymobility app.

Reactivate Clinical Users:
You can see any discharged Clinical User on the Care Teams page. Please follow the instructions below to reactivate a clinical user:

• Click on the Navigation main drop-down menu in the Header, in the upper right corner. Then, click on the “Care Teams” button.
• From the Care Teams page, click on “Deactivated users.”
• The next page will display all deactivated clinical user profiles. Scroll until you find the clinical user profile you would like to reactivate and click on it.
• The user’s profile page will appear. At the bottom of the profile, click on the “Reactivate Profile” button.
• Before profile reactivation is complete, a message will appear asking if you are sure that you’d like to reactivate the clinical user. Click “Yes” to reactivate the user profile.