99 dots org Dashboard Guide 99 DOTS contact

99 dots. org Dashboard Guide 99 DOTS contact: E: contact@99 dots. org

Table of Contents • • • How to Login 99 DOTS Menu Overview Workflow Maintaining Staff Details • Adding a Staff at District Level • Viewing/Editing a Staff at District Level • Adding a Staff at TU Level 2

Table of Contents Contd… • Patient Registration • Adding a Patient • Viewing List of Current Patients Registered and undergoing Treatment • Viewing List of Past Patients who have undergone Treatment • Viewing Adherence Calendar of all the Current Registered Patients • Viewing Patients Details • Assigning Patients to TU under a District • Maintaining Treatment Supporters Details • Adding a Treatment Supporter at District Level • Viewing/Editing/Deleting a Treatment Supporter at District Level • Adding a Treatment Supporter at TU Level • Linking Patient’s to a Treatment Supporter • Difference between Staff and Treatment Supporter 3

Table of Contents Contd… • Patient Management • • • Editing a Patient’s Details Editing a Patient’s Medical Details Altering Attention Required for Patients Adding Notes and Setting Current Tags Modifying Tags for Previous Doses Marking/Removing Manual Doses Editing Treatment Center Closing a Case Reopening a Case Downloading Reports 4

How To Login? 1. Go to 99 dots. org and then Click Login. 2. Enter the username and password provided to login to the 99 DOTS web site. 5

99 DOTS Menu • Overview: Overview for all patients • Calendar: Month wise adherence calendar of all patients • Current Patients: List of all current patients • Past Patients: List of all patients who are no longer on treatment • Staff Details: Add Staff Details at District and TU Level • Treatment Supporters: Add Treatment Supporters Details at District and TU Level • Reports: Download 99 DOTS Reports • Profile: View / Edit own profile • Add Patient: Register patients on 99 DOTS Note: There are different login profiles (e. g. ART Login, RNTCP-District Logins, TU Logins). Depending on the profile, the menus appearing on the 99 DOTS website will vary. 6

Overview The Overview page provides a birds eye view of adherence for all patients. It displays: • List of patients requiring high attention • Various graphs and chart showing adherence and enrollment details 7

Workflow 8

Step 1 Step 2 Step 3 • RNTCP – District Login : Maintain Staff Details at District and TU level using the Staff Details menu in the 99 DOTS Website • ART Center Login: – Register Patient using the Add Patient menu in the 99 DOTS Website • RNTCP – District Login: Assign correct TU for all new patients using the Treatment Center tab under patient details page in 99 DOTS Website Step 4 • RNTCP – District Login: Add treatment supporters (relatives, community workers) under district and TUs using the Treatment Supporters menu in the 99 DOTS Website and link them to individual patients from patient details page. Do not add staff as Treatment Supporters Step 5 • RNTCP – District and TU Login – Monitor patients for adherence using the Calendar menu in the 99 DOTS website. Add Notes/Tags after interacting with patients, and perform various patient management tasks from the patient details page. 9

STEP 1: Staff Details Using the District Login, add District and TU staff details. These staff will get SMS alerts for patients listed under their district and TUs. This is mandatory and extremely important. (Slides: 11 – 16) STEP 2: Add Patient STEP 3: Assign Patients to TU Register Patient on 99 DOTS (using ART login) – When registering patient, select the correct District to which the patient belongs. This allows the relevant district to see the patient. From the list of Patients under District, select the required patient and allocate him/her to a TU within the district. Once patients are allocated a TU, TU Staff will start receiving alerts about the patient and see them from the TU login. (Slides: 32 – 34) (Slides: 17 - 31) STEP 5: Patient Management STEP 4: SAdd & Link Treatment Supporters Perform various on-going patient management tasks such as: Edit Patient Details, Edit Attention Required, Adding Notes and Tags, Editing Treatment Center, Marking Manual Dosage, Closing and Reopening a Case, Downloading Treatment Cards, Reports Add list of Treatment Supporters under district and TUs. The Treatment Supporters won’t be automatically linked to patient. You have to go to individual patient details page and link Treatment Supporters to the patient. Staff like DPS / STS / TBHV should not be added here. (Slides: 44 – 61) (Slides: 35 - 43 )

Maintaining Staff Details 11

Adding and Editing Staff Details The Staff Details menu is used to add staff working under the particular district/TU (e. g. DPS, DTO, TB HIV Coordinator -> district level and STS, TBHVs -> TU level). • When a patient is registered, he/she is linked to the District. Any staff added under that “District” will receive a notification SMS whenever this happens. Such staff will also receive weekly SMS updates about all patients. • The DPS (or someone appointed by the DTO) will then select the correct TU for that patient. Any Staff added for that TU will receive a notification SMS immediately and also receive daily alerts about that patient. • Add a Staff– go to Staff Details from the menu, click the Add Staff tab and fill out the form to add a staff for that district. • View/Edit staff details– go to Staff Details from the menu, and click on the name of the staff. IMPORTANT: The STS and TBHV staff added under the TU will get SMS alerts for all the patients registered under that TU. There will be an option to select the SMS frequency. Note: If you want the TBHV staff to get alerts for particular patients only, add them under Treatment Supporters and link them to the patient individually. Important: For TU staff to get SMS alerts, the patient must be first allocated to a TU under a district. For more information on assigning TU to a patient, see Assigning Patient to a TU. 12

Add a Staff – District Level Go to Staff Details from the menu, click the Add Staff tab and fill out the form to add a staff for that district, and then click Submit. 13

Add a Staff – Important Field Descriptions. Field Name Field Description Alert Frequency You can choose how frequent the staff should get SMS alert. The options are: • None: No SMS alerts are sent • Daily: SMS alerts are sent daily • Twice a Week (Mon/Thu): On Monday: SMS alerts are sent with details of patients who missed more than 2 days dose from Thursday-Sunday On Thursday: SMS alerts are sent with details of patients who missed more than 1 day dose from Mon-Wednesday Send Weekly Summary SMS of Patients If this option is selected, the staff will receive a weekly summary of patients missing doses. If the staff does not want the weekly summary, remove the tick from the check box. Send Notification SMS when RNTCP Patients are registered If this option is selected, the staff will receive a notification as soon as a new TB patient is registered at RNTCP centre. If the staff does not want the notification, remove the tick from the check box. Send Notification SMS when ART If this option is selected, the staff will receive a notification as soon as a new Patients are registered TB patient is registered at ART centre. If the staff does not want this notification, remove the tick from the check box. 14

View/Edit Staff Details - District Level Details Page Go to Staff Details from the menu and click on the name of the staff. You can edit details of the staff and then click Submit. 15

Add a Staff – TU Level Go to Staff Details from the menu > Under the list of TUs, select the TU for which you need to add the staff > click Add Staff. Important: For TU staff to get SMS alerts, the patient must be first allocated to a TU under a district. For more information on assigning TU to a patient, see Assigning Patient to a TU. 16

Patient Registration 17

Add a Patient Go to Add Patient from the menu and fill out the form to add a patient. Ensure to select the correct district , the correct primary phone number, and the weight band. It is recommended that you add multiple phone numbers as secondary numbers. 18

Step 1 Fill basic details, like name, surname and address Sr. No Field Name Field Description 1. First Name Enter the name of the patient 2. Surname Enter the surname of the patient 3. Address Enter the complete address where the patient is residing currently. Also mention the landmark of the address. 4. Age Enter the current age of the patient 5. Gender Select gender from the drop down list

Step 2 Fill contact details Sr. No Field Name Field Description 1. Primary Phone Enter the mobile number of the patient which will be used most to make the toll free call. This phone should be available to the patient always. Do not suffix 0, 91, or +91. 2. Secondary Phone 1, Phone If patient or relatives staying with patients have 2, Phone 3 phone, register them as secondary numbers. Patient can call from either Primary or any of these secondary phone numbers. Note: The SMS reminder to patient will be sent to the Primary number only.

Step 3 Select correct District and TU location Sr. No Field Name Field Description 1. District VERY IMPORTANT: Select the district where the patient is currently residing from the drop down list. Note: Once you add patient, this district staff will get the new patient registration SMS alert. 2. TU When you select the district, the relevant TU is available for selection from the drop down list. Select the correct TU. Note: Once you add patient, the TU staff (if added in staff details) will start getting SMS alerts for this patient.

Step 4 Select TB Category Sr. No Field Name Field Description 1. Nikshay Id The Nikshay Id is generated by the RNTCP department later and can be updated by editing patient details. 2. TB Number The TB Number is allocated to the patient by RNTCP department later and can be updated by editing patient details. 3. TB Category Select the category of the TB from the drop down list. The TU staff calling should give you the category of TB. It can be either category 1 or category 2

Step 5 Select Dates Sr. No Field Name Field Description 1. Date on which patient started using 99 DOTS Select the date on which patient started calling the 99 DOTS toll free number 2. Date on which patient started TB Treatment Select the date on which patient started TB treatment. Note: This date can be either same as date on which patient started using 99 DOTS or earlier than that. If both dates are same, select the same dates in both the fields.

Step 6 Click +Add patient button Sr. No Field Name Field Description 1. Once you fill all the fields, click the +Add Patient button to add this patient in 99 DOTS. 2. If you want to clear all the fields which you have filled, and start filling the form again, click the Clear Fields button.

View Current Patients List To view the list of all current patients – select Current Patients from the main menu. Note: If you use the district login, click on the TU name to see the current patients under that TU. All patients that do not have TU allocated will be listed under Unknown (Click here to assign TU). 25

View Current Patients List 26

View Past Patients List To view the list of all current patients – select Past Patients from the main menu. Note: If you use the district login, click on the TU name to see the past patients under that TU. All patients that do not have TU allocated will be listed under Unknown (Click here to assign TU). 27

View Past Patients List 28

View Patients Adherence Calendar To view the adherence calendar of all the patients for the current month – select Calendar from the main menu. Note: If you use the district login, click on the TU name to see the adherence calendar of patients belonging to that TU. Adherence for patients that do not have TU allocated will be listed under Unknown (Click here to assign TU). 29

View Patients Adherence Calendar 30

View Patient Details Page Click on the relevant patient’s name from the Current Patients or Calendar page. 31

Assigning Patients to TU 32

Assigning Patient to a TU Once a Patient has been added and allotted a district by the ART Data Manager, you can assign him/her to a particular TU under the district. Go to patient’s page -> click on Treatment Centers -> Click on Edit Details, select the TU to which you want the patient to be assigned and then click Submit Changes. Note: For more information on how to navigate to the patient’s detail page, see View Patient Details Page. 33

Assigning Patient to a TU Once you assign a patient to a particular TU, the staff added to the TU will get a notification SMS immediately and start receiving alerts on non adherence by the patient on a daily basis. Note: For more information on how to add staff details at the TU level, see Maintaining Staff Details. 34

Maintaining Treatment Supporters Records 35

Maintaining Treatment Supporters The Treatment Supporters menu is used to additional care providers at TU level. For example, you can add community DOT providers workers / relatives of patients who would like to get SMS regarding adherence of the patience treatment. • Add a Treatment Supporter at TU level – go to Treatment Supporter from the menu, click the name of the TU, click the Add Treatment Supporters tab and fill out the form to add a Treatment Supporter. • View/Edit Treatment Supporter details at district level – go to Treatment Supporters from the menu , click the name of the TU, and click on the name of the Treatment Supporter who’s details you want to view/edit. IMPORTANT: The treatment supporter added under the TU will need to be assigned to individual patients. Once they are linked to individual patients, they will start getting SMS alerts for that patients only. There will be an option to select the SMS frequency. Note: If you want the treatment supporter to get SMS alerts for all patients of the TU then add them as staff under that TU. For information on how to link Treatment Supporters to patients, see Link Patients to Treatment Supporters. 36

Add a Treatment Supporter – District Level Go to Treatment Supporter from the menu, click the Add Treatment Supporters tab and fill out the form to add a Treatment Supporter. 37

View/Edit a Treatment Supporter Details - District Level Go to Treatment Supporters from the menu and click on the name of the Treatment Supporter who’s details you want to view/edit. 38

Deleting a Treatment Supporter Details - District Level Go to Treatment Supporters from the menu and click on the Delete button for the supporter you want to delete. Important: If you delete the Treatment Supporters he/she will no longer receive alerts for the linked patients. This operation cannot be undone. If you delete any supporter accidently, you will need to add it again and then link them to the Patients. 39

Add a Treatment Supporter – TU Level Go to Treatment Supporters from the menu > Under the list of TUs, select the TU for which you need to add the staff > click Add Treatment Supporters. Then follow the same procedure as for District Level. Note: As explained in the slides for district level, you can also edit/delete Treatment Supporters specific to a TU under a specific district. The process remains the same. You need to select the TU listed under the district and then perform edit/delete action on the listed supporters under the TUs. 40

Link Patients to Treatment Supporters Staff when added under a District or TU are linked automatically to the patient registered under the district and the TUs. They will get SMS alerts. But, in the case of Treatment Supporters, after you add them under TUs, you will need to link them individually to the patient. To do so: • • Go the page of the relevant patient. Click on the Treatment Supporters tab to see/edit the patient’s Treatment Supporters. Click Edit Treatment Supporters tab to link any Treatment Supporter for this particular patient. Click the Add button, select the treatment supporter name, select the SMS frequency, and then click the Submit button. Add as many Treatment Supporters as required. Note: To remove a treatment support linked to a patient, click the Remove button. Note: For information on how to add Treatment Supporters, see Maintaining Treatment Supporters. 41

Link Patients to Treatment Supporters 42

Difference between Staff and Treatment Supporters Type of Linkage STAFF TREATMENT SUPPORTERS Description Official RNTCP Staff should be added – • District Level -> DTO, DPS, TB-HIV coordinator, DPC, PPM Co-ordinator etc. • TU Level -> STS, TBHV Once a patient is linked to the correct District and TU, the staff added on the website will automatically start receiving SMS alerts (District staff on weekly basis, TU Staff on Daily basis) for all the patients of that District/TU. They can be anybody who would like to track patients adherence. E. g. • a relative of the patient would like to get SMS whenever the patient doesn’t call • Any field, or community workers like ASHA workers used by RNTCP can be linked as treatment supporters. Treatment Supporters added under the TU list do not get automatically linked to patients. You have to link them individually for a patient from the patient details page. They will get SMS alerts of patients linked to them. 43

Patient Management Note: Most of these Patient Management tasks are done from the patient’s details page. For more information on how to navigate to the patient’s detail page, see View Patient Details Page. 44

Edit Patient Details Go to the patient’s page. Select the Details tab and then click Edit Details to change patient details. 45

Edit Patient Medical Details Go to the patient’s page. Select the Medical Details tab and then click Edit Details to change the patient’s medical details. Here you can add the TB Number, Nikshay Id, and other details. 46

“Attention Required” for Patients • Attention required signifies the level of follow-up which is required for the patient. It can be set as low, medium, or high. • Automatically set to HIGH for new patients. • Patients who have missed recent doses without explanation are also changed to HIGH. Whenever this happens a note is added by the 99 DOTS server. • This can also be toggled by users by going to the patient’s individual page and clicking on Change Attention Required. 47

Altering “Attention Required” for Patients Go to the patient’s page. Select the Adherence tab and then click Change Attention Required to change the Attention Required status for the patient. 48

Adding Notes and Setting Current Tags • To add a note and set the current tags for the patient: Click on the Tags and Notes Tab after going to the relevant patient’s page and then click on Alter Tags / Add Note • Tags help add more information for doses and patient behavior. • Current tags are sticky and are automatically added for future doses. 49

Adding Notes and Setting Current Tags Go to the patient’s page. Select the Tags & Notes tab and then click Alter Tags/Notes. Select the Tag you want to add or enter any note you want to add and then click Submit. 50

Modifying Tags for Previous Doses • Besides setting the current tags (which carry forward to future does), it is also possible to edit tags for past doses. • To do this click on Add/Remove Tags in the Adherence Tab. After selecting all the required days, you can add the relevant tag(s). 51

Modifying Tags for Previous Doses Go to the patient’s page. Select the Adherence tab and then click +Add/Remove Tags. 52

Marking/Removing Manual Doses • For days on which the patient has not called, it is possible to mark the dose as “manually taken”. This will turn the dose color to light green. • This should be done after verifying with the patient that he/she had taken the medicine but had not called. • To mark/remove manual doses, click Mark/Remove Manual Doses, and select the relevant days. 53

Marking/Removing Manual Doses Go to the patient’s page. Select the Adherence tab, then click +Mark/Remove manual doses and select the relevant days to mark/remove manual doses. 54

Editing Treatment Center When a person changes his/her address due to which the treatment center has to be changed there is a provision to edit the current treatment center. • Go to the page of the patient • Select Treatment Centers > Click Edit Details > Select the new center where the patient needs to be transferred and then click Submit Changes. 55

Editing Treatment Center Go to the patient’s page. Select the Treatment Centers tab, click Edit Details, modify the treatment center and then click Submit Changes. 56

Closing a Case • Once a patient is no longer on treatment, the case can be closed. • To do this, go to the Close Case Tab. • The Treatment Outcome and the end date (<=today) have to be set. A note can also be added optionally. Note: If you change the ART Center/District/TU to something outside your jurisdiction, you will lose access to that patient - so please be CAREFUL. 57

Closing a Case Go to the patient’s page. Select the Close Case tab, then select the Treatment Outcome reason and then click Submit. 58

Reopening a Case • A closed case can also be reopened if the patient gets back on treatment. • For patients no longer on treatment, there is a new tab called Reopen Case. • After changing the end date (>today) and adding a note (optional) the patient can be put back on treatment. 59

Reopening a Case Go to the patient’s page. Select the Reopen Case tab, and then click Reopen Case. 60

Download Reports Go to Reports from the main menu and then select the report to download. 61