Description
The Annie App for Clinicians version 6.6 features an enhanced user interface to improve the app experience. See what has changed here
The Department of Veterans Affairs’ (VA) Annie mobile application (app) is a Short Message Service (SMS) text messaging capability that promotes self-care for Veterans enrolled in VA health care. Patients using Annie receive automated prompts to track and monitor their own health and motivational/educational messages. Annie also sends broadcast messages from the patient’s local VA medical center.
The Annie App for Clinicians allows clinicians to use and create care protocols that allow patients to easily submit their health readings back to Annie. Messages and patient data is stored in the Annie system where clinicians can view the texts and readings as needed.
Features:
- Request and receive health readings from patients, such as blood pressure, glucose, caloric intake and more
- Patient responses to messages are stored in the Annie system – not sent directly to you – but you can view Veterans’ messages whenever you want
- Enroll patients in protocols to receive automated messages from Annie. This includes automated alerts if patient health data readings fall below or above pre-set thresholds
- Create and send automated motivational and educational messages from Annie to patients, encouraging them to stay on track with their care plan and achieve their goals
- Send messages on behalf of your VA medical facility to quickly reach groups of patients who have opted-in to receiving messages and updates from your VA medical facility
- Certain authorized VA staff will have the ability to create protocols and send messages on behalf of their VA medical facility
Videos
The following video webinar series provides an overview of training for the Annie App for Clinicians. There are five sessions including:
-
Session One: Overview, Login, Patient Search
-
Session Two: Patient Consent and Registration
Session Two
-
Session Three: Protocols
Session Three
-
Session Four: Message History and Reporting
Session Four
-
Session Five: Admin and Broadcast Admin
Session Five
Outreach Materials
Annie App for Clinicians Promotional Toolkit
VA clinicians and other VA staff can use this toolkit to raise awareness about and promote the use of the Annie App for Clinicians. Outreach materials for other apps can be found in the Connected Care Promotional Toolkit Directory.
Navigation
Please navigate using the controls within the Annie App itself, rather than the back and forward buttons of the browser. Using the browser buttons may cause unexpected results.
Section 508/Accessibility
The Annie App is not yet Section 508 compliant and will not work properly with Assistive Technology devices, such as a screen reader, needed for individuals with visual disabilities.
Appointment Reminders
Appointment reminders are not functioning currently.
App Bookmarks
The Annie App bookmark must be explicitly specified. To bookmark the Annie App, use the URL in the documentation provided. NOTE: Creating a bookmark when the app is at the login web page will lead to login errors.
Forward Slash (“/”)
If you copy data from MS Word to create or modify protocol messages, please ensure that fractions are displayed full size, such as 1/2, rather than in a smaller size, such as ½. In some cases, messages sent from Annie that contain the smaller size fractions do not display properly as an SMS text, such as 1?2.
Logout
When you log out of the Annie App, you will be taken to the VA Staff Launchpad where you can access other VA apps. In order to access the Annie App, please use the provided URL.
Staff View – Veteran Middle Initial Not Displayed in Summary Information
In the Veteran summary information (above the navigational tabs: Patient Search, Protocols, Message History and Reports), neither the Veteran’s middle name nor middle initial is populated. However, the Veteran’s Last Name, First Name, Social Security Number, Age and Gender are displayed in the summary to help you easily identify the patient.
Staff View – Veteran Middle Name Not Displayed in Patient Info of Account Web Page
In the Veteran’s personal information that appears in the Patient Info section of the Account web page, the Veteran’s middle name nor middle initial is populated. However, the Veteran’s Last Name, First Name, Social Security Number, Age, and Gender are displayed in the Patient Info section to help you easily identify the patient.
Staff View – Staff Registration of a Veteran Not Functioning
Currently, clinicians cannot register Veterans to use Annie. A Veteran must first self-register, then a clinician can consent the Veteran.
Staff View – Patient’s Summary Information is Partially Obscured:
On an Android tablet, the patient’s summary information is partially obscured when you rotate from Landscape to Portrait. Rotate your device to Landscape, and the issue will go away so that you can see all the data in the patient summary.
Staff View - Duplicate Mobile Phone Number Error Message
Annie will not allow the entry of a mobile phone number that is already in use by another Annie user. If a user attempts to save a duplicate mobile phone number, the system displays an error message. At the end of the message it reads “if you still have a problem, contact our Help Desk at XXXX.” Instead, the error message should provide the following phone number: (855) 500 2025.
Staff View – Account Settings – Appointment / Info Messages
Some medical facilities are not listed in the facility dropdown of this Web page. Unfortunately, you can only select from one of the facilities listed.
Admin View – Measurement Areas
When creating a vitals protocol and selecting a measurement area, some of the system-provided threshold values may be incomplete or inappropriate for the protocol’s target audience. Additionally, when creating a protocol and changing back and forth among measurement areas, some of the original edited values may still appear. You can work around this issue by reviewing all threshold values in the readings/alerts section and ensuring they are appropriate before saving the protocol for use (assignment) by others.
Admin View – Specified Days
Creating protocols that are only active for a week or less can cause an issue where the protocol never sends a message after being assigned in Staff View. This can occur if you specify in the template the day(s) the protocol should deliver its message, but when it’s assigned, the intended day(s) does not fall within bounds of the Start Date and End Date created in the template. You can work around this issue by specifying a protocol duration that lasts longer than one week.
Broadcast Admin View – Erroneous Validation Messages
In certain circumstances, validation error messages for the Start Date and End Date fields appear even though you have selected/entered appropriate values. Even if these messages appear, you should still be able to save a valid Broadcast message.
Broadcast Admin View – Erroneous Validation Messages Occurring that Stop Message Save
The extent of the problem is still being determined, but appears to stop you from saving the message in certain cases. If the issue arises, contact 1-855-500-2025 to report the problem.
Broadcast Admin View – Not Displaying all Messages in Certain Cases
If the time period for messages is limited to the current date, in some cases the VA Facility Broadcast Messages page does not display the associated messages. You can work around this issue by selecting a Start Date of one day earlier.
Frequently Asked Questions
The Annie App for Clinicians allows clinicians to use and create care protocols that allow patients to easily submit their health readings back to Annie. Messages and patients’ data is stored in the Annie system where clinicians can view the texts and readings as needed.
- Staff View – Find and register a patient, view and assign a protocol, edit protocols, review messages to and from a patient, see charts and tables of patient data.
- Admin View – Create and edit protocols assigned to patients in Staff View.
- Broadcast Admin (Only certain staff members designated by the facility will have Broadcast Admin rights) – Send messages on behalf of your VA medical facility to all Veterans who are registered in Annie and opt in to receive messages from your VA medical facility.
- System Admin (only available to a limited number of users) - Manage permissions for staff users, edit the response messages for Annie’s text commands (Help, Pause, Resume, Start, Stop), set default values for measurements and create new measurement readings.
- Facility Team Admin (only available to a limited number of users) - Create and edit facility teams.
CONSENT NOTE: As part of receiving your patient’s Consent to Participate, please ensure that your patient understands and agrees to the following:
- Using Annie is voluntary and is designed to support patient self-care.
- Annie messages are automated and not regularly monitored by the health care team.
- Annie is not the right place to ask for help. Patients should contact their health care teams directly with health concerns.
- SMS text messages are not secure and there could be costs for sending and receiving texts.
- Collection of a patient's information by Annie is subject to federal law.
- Sending Start and Stop begins and ends participation in the program.
IMPORTANT: While the checkbox is only selected once, the patient’s informed consent to use Annie should be obtained each time a new protocol is assigned to the patient and the consent/assignment noted in the medical record.
SCOPE OF PRACTICE NOTE: With regard to Scope of Practice considerations, only licensed clinicians, such as the following, practicing within the licensure that they hold may solicit verbal consent from a patient to assign a protocol:
- Licensed Practical Nurses (limited)*
- Nurse Practitioners
- Pharmacists
- Physicians
- Physician Assistants
- Registered Dieticians
- Registered Nurses
- Social Workers
- Therapists
- Licensed clinicians are responsible for abiding by their relevant State Practice Act and any laws governing their profession and applicable to their location.
- *An LPN can obtain informed consent, if the protocol is ordered by a physician, registered nurse, or other appropriate clinician, and if the state in which the LPN is practicing allows it.
- A clinician need not be in the Annie system when obtaining a patient’s consent. If another team member will complete enrollment and assignment of a protocol, then the licensed clinician should create an order in CPRS (the medical record) to initiate.
- All clinical team members can review responses sent to Annie from VA patients.
- Using Annie is voluntary and is designed to support patient self-care.
- Annie messages are automated and not regularly monitored by the health care team.
- Annie is not the right place to ask for help. Patients should call their health care teams directly with health concerns.
- SMS text messages are not secure and there could be costs for sending and receiving texts.
- Collection of a patient’s information by Annie is subject to federal law.
- Sending Start and Stop begins and ends participation in the program.
- Vitals – Request and receive readings from patients, such as blood pressure. You will have the option for designating the lowest and highest valid readings for patients, as well as low level, critical low level, high level and critical high level readings that fall within the thresholds you set but are still of concern in the Reading/Alerts section of the Vitals template. Patients will receive alerts if their readings fall into these categories, if their readings are rising or falling rapidly or the repeat alert type and occurrence is reached. Because readings do NOT trigger alerts to a VA clinician or health care team, make sure all patient-facing alerts are clinically relevant and that the alert messages you create are easily understandable to your patient. Please ensure your patient understands that alerts will not trigger care team action and knows what to do if a reading invokes an alert. NOTE: Additional messages to the patient may be triggered depending on the patient response.
- Motivational/Educational – Send messages to patients that do not request a response, but help motivate or educate patients. NOTE: Pre-drafted Motivational/Educational messages are not built into Annie; you will need to write messages or edit a protocol that has already created motivational/educational messages.
- Categorical – Request and receive measurements and information from patients that may be more qualitative than vital readings, such as mood over time. You can designate accepted responses, and whichever response a Veteran chooses will invoke a specific response from Annie (e.g., acknowledging that a Veteran is “happy” or “sad”). NOTE: Additional messages to the patient may be triggered depending on the patient response.
- Yes/No – Request and receive a response to yes/no questions, such as “did you exercise today?” NOTE: Additional messages to the patient may be triggered depending on the patient response.
- Scaled Response – Request and receive a numeric response to a question, such as asking the patient to rank their pain on a scale of one to ten. You can designate a value for the lowest and highest valid reading. NOTE: Additional messages to the patient may be triggered depending on the patient response.
To add templates to the protocol, tap Add a Template, and select the template you would like to use (Vitals, Motivational/Educational, Categorical, Yes/No or Scaled Response). To copy a template from another protocol, tap Insert Template Copy. Please choose a meaningful name for the template as the patient will see this name in the Veteran facing side of the app. Next, complete the settings for the template. Tap the headings of the settings you may need to complete, which will expand the template details below. Set the details of the setting and tap Save. A pop-up box will appear confirming that your changes have been saved. Tap OK, and you will return to the Protocols screen.
When Annie requests this information | The patient must start the message response with |
---|---|
Blood Pressure | BP or BLOOD |
Pulse Oximetry (SpO2) or Oxygen level | OX or OXYGEN |
Blood Glucose or Sugar | BG or GLUCOSE or SUGAR |
Glucose Before Eating | BGB or BEFORE |
Glucose After Eating | BGA or AFTER |
Weight Loss | WE or WEIGHT |
Caloric Intake | CAL or CALORIES |
Amount of Exercise | EXE or EXERCISE |
Temperature | TEMP |
Pulse | PULSE |
NOTE: Before you assign a protocol, make sure the health readings information (e.g., blood pressure) requested is not already requested by another protocol. If more than one protocol asks for the same patient data, the duplicated data will not be properly tracked, and patients may be sent conflicting messages. For this reason, the system will not allow a clinician to assign a protocol that collects a duplicate reading.
IMPORTANT: Please ensure that your patient understands the basics of the protocol, such as benefits, content of messages (PHI, PII, condition) and consents to its use with the understanding of the CONSENT NOTE and SCOPE OF PRACTICE below. The patient’s informed consent to use Annie should be obtained each time a new protocol is assigned to the patient and the consent/ assignment noted in the medical record.
CONSENT NOTE: As part of receiving your patient’s Consent to Participate, please ensure that your patient understands and agrees to the following:
- Using Annie is voluntary and is designed to support patient self-care.
- Annie messages are automated and not regularly monitored by the health care team.
- Annie is not the right place to ask for help. Patients should call their health care teams directly with health concerns.
- SMS text messages are not secure and there could be costs for sending and receiving texts.
- Collection of a patient’s information by Annie is subject to federal law.
- Sending Start and Stop begins and ends participation in the program.
SCOPE OF PRACTICE NOTE: With regard to Scope of Practice considerations, only licensed clinicians, such as the following, practicing within the licensure that they hold may solicit verbal consent from a patient to assign a protocol:
- Licensed Practical Nurses (limited)*
- Nurse Practitioners
- Pharmacists
- Physicians
- Physician Assistants
- Registered Dieticians
- Registered Nurses
- Social Workers
- Therapists
- Licensed clinicians are responsible for abiding by their relevant State Practice Act and any laws governing their profession and applicable to their location.
- *An LPN can obtain informed consent, if the protocol is ordered by a physician, registered nurse, or other appropriate clinician, and if the state in which the LPN is practicing allows it.
- A clinician need not be in the Annie system when obtaining a patient’s consent. If another team member will complete enrollment and assignment of a protocol, then the licensed clinician should create an order in CPRS (the medical record) to initiate.
- All clinical team members can review responses sent to Annie from VA patients.
To see the data in graphical or table format, tap Combined Report (to view all measurements selected) or Reports next to a specific measurement. You will go to a graph of the selected data. Tap Table to view the data as a table and Chart to return to the graph from the table.
The graph data shown in the chart depends on how you use the Date Range, and Navigator. Any one of these can be used to limit or expand the data shown.
When Annie requests this information | The patient must start the message response with |
---|---|
Blood Pressure | BP or BLOOD |
Pulse Oximetry (SpO2) or Oxygen level | OX or OXYGEN |
Blood Glucose or Sugar | BG or GLUCOSE or SUGAR |
Glucose Before Eating | BGB or BEFORE |
Glucose After Eating | BGA or AFTER |
Weight Loss | WE or WEIGHT |
Caloric Intake | CAL or CALORIES |
Amount of Exercise | EXE or EXERCISE |
Temperature | TEMP |
Pulse | PULSE |
NOTE: Once a protocol is disabled in Admin View, it cannot be assigned in Staff View.
- Flagged - Flag patients you view routinely for quick access.
- Associated – View all the patients you work with.
- Teams – View the teams you are associated with, as well as join/unjoin teams.
To add patients to your Flagged tab, tap the flag icon on the Associated Patients tab. To prioritize and order the patients on the Associated Patients tab, tap Flag, 1 or 2. The patients will be ordered with the flagged patients on top, then the ones marked as 1, then those marked as 2. You can change the sort order by tapping My Priority.