[humanser] Has Anyone Used Titanium (Electronic Health Records system) or MyOutcomes App?

[Ericka]

I really don't know how to help you with the computer stuff. I never solve that problem when I did some work with the Salvation Army. That was a nightmare major part of my internship. I wish you the best with your first client coming up and perhaps the client might feel empowered if they can't think of a questionnaire accommodation.  My clients didn't mind having an old-fashioned tape recorder with mini cassettes . I always ask permission and told them that it was just a backup in case I didn't get pertinent information written down to remind myself. And yes, I did tell them about my visual impairment. I never had a client freak out about it. Some told me they felt more comfortable sharing! I hope things go well for you Sara.

Ericka Short
"What is right is not always popular; what is popular is not always right."

 from my iPhone

> On Feb 6, 2016, at 2:30 PM, Sarah Meyer via humanser <humanser at nfbnet.org> wrote:
> 
> Good afternoon,
> 
> I am writing to you seeking help and guidance regarding two
> accessibility issues that I am encountering in my counseling practicum
> clinic: 1) Titanium (an electronic Health records system) with the use
> of JAWS (version 17) on a PC computer running Windows 7; and 2) the
> MyOutcomes App and its associated measures (specifically the Outcome
> Rating Scale, ORS, and the Session Rating Scale, SRS) with the use of
> VoiceOver on an iPad as well as JAWS on a PC computer.  I will provide
> some more information below but will do my best to not overcrowd this
> list, so if anyone has any experience with either one of these issues
> or any suggestions, please let me know; also, please let me know if
> you need further clarification.  I have been working with my practicum
> supervisor and the director of our clinic as well as Disability
> Services to try to come up with short-termsolutions, and we are also
> planning to engage in an interactive dialogue with the developers of
> the MyOutcomes app to ensure accessibility from this point forward.
> Even so with the support I am receiving, this process of encountering
> these barriers has been extremely frustrating and exhausting in trying
> to come up with solutions when I could be spending my time studying,
> working on schoolwork, and preparing in more fulfilling ways for
> working with my first client.
> 
> 1.    In Titanium, I am somewhat able to navigate the system, but once I
> find a client, I am not able to add a phone note or any other note for
> that matter.  I am also unable to read the information entered on the
> intake forms, which is a problem because I should be able to read
> through that information independently like any other counseling
> student would before his/her first session. Did I mention that I am
> seeing my first client early next week? So I need to be able to access
> this kind of information.
> 2.    Our clinic has every client fill out two evaluative measures during
> every session: the ORS and the SRS.  There are 4 questions on each
> measure and the client indicates their rating along a line ranging
> from values of 0 to 10.  On the ORS, which is administered at the very
> beginning of the session in order to provide the counselor with
> information on the client’s functioning over the course of the past
> week, the questions have to do with how the client is doing
> interpersonally and in relationships, emotionally, etc.  The SRS is
> administered at the end of the session and asks the client to indicate
> if he/she felt like his/her goals were addressed, if the counselor
> made him/her felt heard, etc.  The idea here is that once the
> counselor sees this feedback, if there are any significant problems or
> evidence of rupture, the counselor can address it in the present
> moment before the client walks out the door before the possibility of
> client not returning.
> It was suggested by my supervisor’s supervisor that another clinic
> staff administer the ORS to my client while she/he is in the waiting
> room and then tell me the results before I go to get my client so I
> can address any concerning results at the start of session.  Again,
> the same concept for accommodation was suggested for the SRS that
> someone would read me the results afterwards; however, in my mind this
> is problematic because I would not be able to address any concerns
> with the client unless she/he had felt comfortable to verbally bring
> them to my attention at the end of session before walking out the
> door. I think it will be my natural style to check in with clients at
> the end of each session anyway to see how we are doing interpersonally
> and to see how he/she is feeling about his/her needs being met and
> being listened to as well as other factors.  But I can’t help but
> wonder if there are other accommodations, such as tactile versions of
> the scales and tactile methods of marking responses, to allow me
> real-time feedback and processing just like other counseling trainees.
> I have been playing around with different ideas in my mind and have
> discussed options with our adaptive computer technology lab, and the
> consensus is that it doesn’t seem like they can create a regular,
> standard print version of the evaluation forms (which were used prior
> to the app) with a tactile overlay.  I thought about using wicky
> sticks to represent the lines and some kind of other material for the
> marks, but then I start to wonder if this would make clients
> uncomfortable to use such different techniques. Of course, they could
> still mark their responses with pen on paper and the responses would
> be entered into the app by clinic staff later.  The ideal will
> obviously be for the developers to respond quickly to our request for
> compliance with accessibility and that I will soon be able to read and
> interpret my client’s responses and progress over time through the
> app.
> 
> Thanks in advance for any feedback or suggestions.
> 
> All the best,
> 
> Sarah
> 
> 
> -- 
> Sarah K. Meyer
> Graduate Student, Clinical Mental Health Counseling/Social Psychology
> Ball State University
> Board Member, National Federation of the Blind Human Services Division
> Board Member, National Federation of the Blind of Indiana State Affiliate
> sarah.meyer55 at gmail.com
> (317)402-6632
> 
> The National Federation of the Blind knows that blindness is not the
> characteristic that defines you or your future. You can live the life
> you want; blindness is not what holds you back. Together with love,
> hope, and determination, we transform dreams into reality.
> 
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