The Remote Veterans Apnea Management Platform (REVAMP) App consists of a Patient Platform and a Clinician Platform. With the REVAMP App for Clinicians, as a sleep clinician, you will be able to set up patient accounts individually or in groups, enter sleep testing results, review patient Positive Airway Pressure (PAP) machine data, assign questionnaires, schedule appointments, write Treatment notes, assign home sleep test (HST) monitors and correspond with patients. Additionally, if you are an authorized user, you will also have the ability to create and manage educational material on sleep apnea and automated messages for patients.

In order to use the REVAMP App for Clinicians, you must be a Department of Veterans Affairs (VA) provider and be logged into the Single Sign-On Internal (SSOi) service. To log on with SSOi, you must select your credential service provider (CSP) and authenticate to that service. Available methods are PIV authentication, VA Active Directory (username / password) authentication and Integrated Windows Authentication. More information can be found on the AccessVA website.

The app's main features include:

• Treatment Results – Review the data from your patient’s PAP machine including the usage time, their Apnea-Hypopnea Index (AHI) and mask leakage.
• Sleep Testing & Questionnaires – Assign questionnaires and HST monitors to your patients to help with their treatment.
• Education – Create and publish educational pages for Veterans to view. (Super Administrators only)
• Messages – Send and receive secure messages between you, your patients and other members of the VA sleep care team.
• Administration – Add new VA sleep care team members and manage permissions.

There are two ways to view registered patients. From anywhere in the REVAMP App for Clinicians, tap Home in the top left corner of the screen. The Home screen will display all active registered patients. To see inactive patients, tap the checkbox next to ‘Show Inactive’ and inactive patients will be included in the list. You can also tap Management, and a drop-down menu will appear. Tap Case Management, and you will be taken to the Case Management screen, where you can select Show All Data (No Filter) from the Filter dropdown and tap Select to see a list of all active patients registered in your location. Tap the radio button next to All Patients, On PAP Treatment or Not On PAP Treatment to view only those on or off PAP treatment. Tap the checkbox next to Show Inactive to include inactive patients. A list of all patients registered at your location matching your filters will appear. Next to your patient's name, you will see a table of patient data.

You may customize the columns you are viewing on the Case Management screen by tapping the three-line icon next to the number of patients you are viewing on the right side of the screen. Tap the box to place a check-mark next to the fields you want to see in the table.

To export data to an excel compatible file, tap Export Data next to the filter menu. A window will appear asking if you want to Open, Save or Cancel this action. To view the data, tap Open and the spreadsheet will open in your computer’s default program (such as Microsoft Excel), or tap Save to save the data to your device and view it in a different app. To close the window without opening the file, tap Cancel or tap the X in the right corner of the pop-up window.

To create a custom filter, tap the Filter bar, and tap Create Filter from the drop-down menu. Tap Select, and type a filter name in the box provided. Tap Save or Save As to save the new filter, or Delete to permanently erase it. After creating a new filter, a pop-up Success window will appear notifying you your filter changes have been made. To select filter settings, tap Edit to be taken to a new filter customization screen. From there, you will be able to customize your filter settings, which are divided into four categories: Event Section, Data Section, Follow Up Section and Contact Information. To view a specific column on the Case Management screen, tap the checkbox next to the information you would like to view. To filter by column, use the radio buttons, dropdowns and numerical date fields to the right of the entry. If you want to view all columns, tap the checkbox next to Select All Columns. To apply the new filter, tap Apply. To Close the custom filter window without applying changes, tap Close. To set the new custom filter as a default filter, tap the check box next to Set as default.

From anywhere in the REVAMP App for Clinicians there are three ways to access the Patient Record:

1. From the Home screen, enter the patient’s last name or first initial of last name plus last four SSN digits in the Search Clinic field. The list of patients below will narrow down to patients who match the criteria being entered. To include inactive patients in the results, tap the check-box next to Show Inactive. Inactive patients will be shown with a pause symbol to the left of the name. Tap the button next to the row of the patient you would like to select, and you will be taken to the Patient Record.
2. From anywhere in the app, tap File, and tap Search Clinic. A pop-up Search Clinic box will appear. Type in the patient’s last name or last initial plus last four SSN digits in the Search Criteria field. A table with patients will populate below as the search criteria is entered. Tap the button next to the row of the patient you would like to select, and you will be taken to the Patient Record.
3. Case Management – From anywhere in the app, tap Management, and a drop-down menu will appear. Tap Case Management, and you will be taken to the Case Management screen where you can select Show All Data (No Filter) from the Filter drop-down list and tap Select to see a list of all patients registered at your location with outcomes and treatment pathway event data. Show All Data (No Filter) may already be your default view in Case Management. Tap the name of the patient you want to view. The Patient Record will appear.

The patient you are registering must be in VA’s Master Veteran Index (MVI). From the Home screen tap File, and a drop-down menu will appear. Tap Add / Transfer Patient, and a pop-up Add / Transfer Patient box will appear. Type in the patient’s last name, first name and full SSN, and tap Search. Tap the plus button next to the row of the patient you would like to select. Verify that the Veteran’s pre-populated information on the screen from MVI is correct, and fill in any missing fields. Required fields are marked with a red asterisk. In the righthand column are questions that ask you to designate whether the patient being added is already on PAP treatment (which can affect questionnaire assignments) and whether they must complete the Initial Questionnaires.

If the patient is required to complete the Initial Questionnaires, a list of questionnaires to be assigned for the event is shown. If the patient is not required to complete the Initial Questionnaires, they will skip the initial process and be able to access the full Patient Platform the first time they log in. Check the checkboxes of any optional questionnaires to assign them to the patient. Required questionnaires are shown with read-only checkboxes and will also be assigned to the patient.

NOTE: The list of questionnaires as well as the PAP treatment and Initial Questionnaire questions become locked and read-only after the patient has started completing the initial process.

After filling out as much patient information as possible, you can finish registering the patient in REVAMP by tapping the floppy disk button on the icon bar, or by tapping File and then Save.

Any REVAMP provider can add multiple patient accounts at once via a spreadsheet upload. From anywhere in the app, tap File, and a drop-down menu will appear. Tap Add Multiple Patients. To download a blank copy of the required spreadsheet format, tap Download Standardized Data Entry Spreadsheet. Enter information for up to 50 patients in the spreadsheet, including each patient’s full SSN in the Search ID column, and make sure to save the file in a known location. Tap Upload Enrollment Spreadsheet, and then tap the spreadsheet you would like to upload. An Adding Patients to REVAMP screen will show the uploaded information with any errors highlighted. After making any necessary changes, tap the floppy disk icon on the icon bar to continue. If REVAMP receives multiple matches or incomplete information from MVI for an uploaded record, an MVI Response screen will appear. Select the correct record or the record with the most complete information from each list and add any missing data, and then tap the floppy disk icon on the icon bar. The Results Summary screen will show a report with a list of the patients who were added, as well as a list of the patients who were not added with an explanation of the error(s).

The patient you are transferring must be registered in REVAMP. From the Home screen tap File, and a drop-down menu will appear. Tap Add / Transfer Patient, and a pop-up Add / Transfer Patient box will appear. Type in the patient’s last name, first name and full SSN, and tap Search. If the search returns a list, tap the plus button next to the row of the patient you would like to select. A pop-up Clinic Conflict box will appear. Tap Transfer Patient to This Clinic, and a pop-up Confirm Patient Transfer will appear. Tap OK, and a success message will be shown. You will then be taken to the Demographics screen for the transferred patient. Transferred patients retain all data, notes and diagnoses from their previous clinic(s). On the Events tab, visits and assigned questionnaires that the patient has not started are cleared.

Currently, REVAMP supports the registration of Philips and ResMed PAP machines, with plans to include other manufacturers in the future. To register a patient’s PAP machine, first, navigate to the Patient Record of the Veteran you would like to view. From anywhere in the Patient Record, tap Demographics on the Treatment Tree on the left. The Patient Demographics will appear on the right side of the screen. Tap the PAP Machine tab, and type in the Serial Number of the PAP machine. Tap the radio button next to the Type of Unit: APAP (Automatic Positive Airway Pressure), BPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) or ASV (Adaptive Servo Ventilation), and fill out the field(s) in the PAP Pressure Range section. Tap the Manufacturer bar, and select Philips or ResMed. To save, either tap the floppy disk icon, or tap File and then Save.

For Super Admins, Site Admins and Provider users to schedule visits for patients and assign clinical questionnaires, use the Events tab on the Patient Summary screen. To start this process, begin by looking up the patient by name or by the last name initial and last four numbers of the patient’s SSN (see the Looking Up a Patient section for instructions on how to look up a patient), or select the patient from the Home screen or Case Management screen (see the Case Management Screen section for instructions on how to access the Case Management screen). From the Patient Record, tap Summary on the Treatment Tree. Tap the Events tab. The items in the Event column represent steps in the REVAMP treatment pathway, from Account Setup (when the patient is registered to REVAMP) to PAP Data (when the patient’s PAP device begins sending data to REVAMP) to clinical follow-up visits. For each event you will see four columns: Scheduled Date, Performed Date, Status and Comments.

NOTE: When the scheduled date for an event has passed and there is no performed date, the event is considered overdue. Overdue events have a red border and have a red caution sign in the Event column.

To control the specific questionnaires assigned to the patient for the Initial or Follow-up Questionnaires events, tap the + icon next to the questionnaire group you want to edit and tap the box next to the questionnaire to include or remove it. To save, either tap the floppy disk icon, or tap File and then Save.

Super Admins, Site Admins and users who have permission will be able to create and edit treatment notes as well as lock and unlock treatment notes to make them editable again. To create and edit a treatment note, look up the patient. From the Patient Record, tap the calendar icon, or tap File and then New Note. A pop-up New Note box will appear, and tap the blank bar. From the drop-down menu, tap the type of note, and the drop-down menu will show the status and date of the Questionnaire Group. Tap Yes to continue or No to cancel. The new note will appear in the Treatment Tree, and a new blank form will appear. Type in the date in MM/DD/YYYY format. In order to save the new note, you must choose a Note Title. Tap the Set Title button below the Date field. Tap the Note Title drop-down, select from the list, and tap OK. If you are authorized, you may select Other Title from the list and enter free text to create a new title. After you click OK, the new note title will be applied to the Note and appear in the list of the clinic’s titles.

You can add text to the Note by typing in any of the tabs or by selecting from the Note Template drop-down and clicking Load Template to populate the Note with data from REVAMP. To copy all text of the Note, click Copy All Tabs to launch a popup containing the concatenated text from all tabs of the Note. To save, either tap the floppy disk icon, or tap File and then Save.

Yes, if your patient’s PAP machine is registered in the REVAMP App for Clinicians, you can view how often the machine has been in use and the patterns of use. You can also view the patient’s AHI, apnea event types and mask leak data. To view your patient’s PAP machine data, navigate to the Patient Record of the Veteran you would like to view. Tap the PAP Data tab.

With the REVAMP App for Clinicians you can view several types of sleep apnea related patient data.

• Treatment Adherence – Shows the total number of hours that the patient used the PAP device each night. Bars are colored red if they are below the 4-hour minimum and green if they are at or above the minimum. You may hover over a bar in the graph to see a tooltip with the date and value of the bar.
• PAP Patterns of Use – Shows a 24-hour display of the actual times that the patient used the PAP device each day or night. The bars are colored red if the total number of hours for the date was below the 4-hour minimum and green if it was above the 4-hour minimum. You may hover over a bar in the graph to see a tooltip with the date and value of the bar.
• Apnea-Hypopnea Index – Shows the patient's average AHI each day or night he or she used the device. Bars are colored green if they are below the 10-events-per-hour threshold and red if they are at or above it. You may hover over a bar in the graph to see a tooltip with the date and value of the bar.
• Apnea Event Types – Shows stacked bars that add up to the patient's total AHI for each day or night that he or she used the device. The segments of the bars represent the different apnea types: Unknown Apnea Index (grey), Clear Apnea Index (Light Blue), Hypopnea Index (Purple), and Obstructive Apnea Index (Dark Blue). You may click on any of these types in the graph legend to show or hide the segments of that type in the graph.
• Mask Leak – Shows the patient's average mask leak in liters per minute each day or night that he or she used the device. A threshold line is shown at 24 L/min.

To view the raw data of the selected parameter, while in Single Graph view tap the Raw Data tab in the top left corner of the graph (tap the Graphs tab to return to the graph).

Authorized users in REVAMP can assign and track home sleep test monitors for patients. From anywhere in the app, tap Management, then tap HST Tracking/Inventory. Tap Assign/Track Device, and a new row will be added to the top of the table where you can enter loan information. Select a device for the loan using the Device ID dropdown menu.

• If the patient IS in REVAMP, search for and select the patient you want to assign the equipment to.
• If the patient is NOT in REVAMP, tap Assign to Non-REVAMP Patient. A pop-up Assign to Non-REVAMP Patient box will appear. Enter the patient’s first name, last name and last four digits of the SSN, and tap Assign.

Next, select a delivery Method (Mail or Pickup), and tap Save.

From anywhere in the REVAMP App for Clinicians tap Administration. A drop-down menu will appear. Tap User Administration, and you will be taken to the User Administration screen. Tap Add User, and a blank Details tab will appear on the right side of the screen. Type in the new user’s first and last name and VA email. If you are a Super Administrator, tap the blank Clinic bar, and a list of clinics will appear. Tap the name of the clinic to which the user is assigned. To add the new user’s permissions, tap the Rights tab, and tap the radio button next to the User Type you would like to assign to the new user (Provider, Site Administrator, Super Administrator). Under User Rights, tap any of the checkboxes next to the rights you would like the new user to have (if not already checked). To save, either tap the floppy disk icon, or tap File and then Save.

From anywhere in the REVAMP App for Clinicians, tap Administration. A drop-down menu will appear. Tap User Administration, and you will be taken to the User Administration screen. Tap the Search User bar, and begin typing the first or last name of the user you are searching for. The list of users will update to match your search (NOTE: Site Administrators will only have access to users at their sites, whereas Super Administrators will have access to users at all sites). Tap the name of the user whose permissions you would like to edit. The right side of screen will default to the user’s Details tab. Tap the Rights tab, and tap the radio button next to the User Type you would like to assign to the user (Provider, Site Administrator, Super Administrator).

When you receive a message in REVAMP, an email will be sent to your VA email address informing you that you have an unread message. There are two ways to access your messages.

1. If you have unread messages in your inbox, tap the envelope icon to the right of your name. The icon will show the number of unread messages you have.
2. From any screen, tap Messages in the menu bar.

A pop-up Secure Messaging box will appear displaying your Inbox. On the Inbox tab (Sent tab for messages you have sent to patients, Draft tab for draft messages and Deleted tab for messages you have deleted), you will see a list of your received messages with their titles, senders and the dates and times they were sent. Any unread messages will have blue text and a closed envelope icon to the left. Tap the message you would like to read, and the full message will be displayed on the right side of the Secure Messaging screen. Clinicians who have 'Receive supply requests from patients in Secure Messaging' enabled will receive a message in their inbox every time a patient at their clinic submits a Request Supplies form.

You can use the REVAMP App for Clinicians to send secure messages to patients and other clinicians. To send a message, access the Message Center. Tap Compose, and a pop-up Compose Message box will appear. Type in the subject and message you would like to send. Tap Select Patient(s) or Select Provider(s), and a Select Patient or Select Provider pop-up will appear. Select the checkbox(es) next to the name(s) of the intended recipient(s). Tap Select, and you will be taken back to the Compose Message pop-up with the chosen patient(s) or provider(s) listed on the To line. If you wish to remove a patient or provider, tap the X next to their name. Tap Send to send the message. To discard the message or save as a draft, tap Close. A pop-up Alert box will appear, asking you if you want to save the message as a draft. Tap Yes to save the message as a draft, tap No to discard the message or tap Cancel to return to the message.

To send a message you have already drafted, tap the Draft tab in Secure Messaging. The draft message will appear on the right side of the screen. Edit the message as you would normally, and tap Send to send the message. Tap Save to save your edits without sending, or tap Delete to discard the draft message.

To use REVAMP’s HST monitor tracking feature, you must first create an inventory of HST monitors at the clinic. From anywhere in the app, tap Management and tap HST Tracking/Inventory. Tap Inventory, and you will see a table of all HST monitors that have been added to the clinic inventory. To add a device to the clinic inventory, tap Register New Device, and a new row will be added to the top of the table. Type in the Device ID (required), Manufacturer, Model, Serial Number, and EE Number. Tap the floppy disk icon to save and add the device to the clinic inventory.

All Super and Site Administrators can access the Questionnaire Management screen to control what questionnaires are offered and required at their clinic or clinics. From any screen, tap Management. Mouse over Clinical Management, then tap Questionnaire Management. Under the Select Event Type tab, the screen will default to Initial Questionnaires. To change the event and patient type combination, tap the drop-down next to Select Event Type and Select Patient Type, and tap Select. The questionnaires and current settings will update below. Each questionnaire will have a radio button selected under: Required, Optional, or Not Offered. You will also see an Apply to All Clinics column on the right side of the screen. Super Administrators can check the checkboxes in this column if applicable to the questionnaires they are managing. To save changes, tap the floppy disk icon, or tap File and Save. All changes made on the Questionnaire Management screen will be applied to relevant questionnaires from that point forward but will not affect any questionnaires that have already been assigned or completed.

From anywhere in the REVAMP App for Clinicians tap Management, and a drop-down menu will appear. Mouse over Content Management, and tap Patient Education Pages. You will go to the Create/Edit Patient Education Page screen, where you can:

• Create a New Page - If you are not already on the Create Page option, tap the radio button next to Create Page. The Title and HTML editor text box will be blank, the Author drop-down will default to you and the drop-down Status bar will default to Un-Published. Tap the blank Title bar, and type in the title (which will be listed in the Select Page pop-up in the Provider Platform and, when published, the Education menu in the Patient Platform). To change the author, tap the Author bar, and a drop-down will appear. Tap the name of the Super Administrator you would like to list as the author. Enter text, images and/or video for the HTML page using the HTML editor text box.
• Edit a Page - Tap the radio button next to Edit Page. Tap Select Page, and a Select Page pop-up of the existing pages in the content management system with their Titles, Authors, and Statuses will appear. Filter by Author or Status by tapping the drop-down menu, selecting the author or status and tapping Filter. Tap the page you would like to view. Tap Select to begin editing the page as you would while creating it, or tap Close to exit without selecting a page.

To save, either tap the floppy disk icon, or tap File and then Save. When you wish to make the page available in the Education menu of the Patient Platform, select Published as the status. Tap the floppy disk icon, or tap File and then Save. NOTE: A status of Un-Published, even if saved, means the page will not be available in the Education menu.

From anywhere in the REVAMP App for Clinicians, tap FAQ, and a drop-down menu will appear. Tap Sleep Apnea 101, and you will see several frequently asked questions and answers on sleep apnea.

From anywhere in the REVAMP App for Clinicians, tap FAQ, and a drop-down menu will appear. Tap My PAP Unit, and frequently asked questions, basic information, tips and external links on PAP machines and sleep apnea will appear.

From anywhere in the REVAMP App for Clinicians, tap FAQ, and a drop-down menu will appear. Tap Troubleshooting PAP Treatment, and frequently asked questions, basic information, tips and external links on troubleshooting problems with PAP treatment will appear.

If you are a Super or Site Admin with the User Right “Create and edit Note Templates for user’s clinic” go to the Management menu. Hover over Data Management and tap Template Management. Tap Create New Template to create a new note template from scratch, or tap the note template you would like to edit and tap Update. To save the template or the edits, tap Save.

‘Tags’ are specific pieces of dynamic patient data that can be pulled into a note when a template is applied. Tags are entered into templates as text strings surrounded by brackets. When a template is applied to a patient’s note, the tag will be replaced with the relevant information from the patient record. For example, the [AGE] tag would be replaced with the patient’s age. To view a list of tags that can be used in the sections of the note template along with their descriptions, tap View Tags Reference.

If you have the User Right to create and edit Note Titles for a clinic, tap the Management menu and hover over Data Management. Tap Note Title Management. Authorized providers can enter text in the Note Title field and tap Add (+). The new title will appear in the Note Titles at My Clinic and Note Title dropdown lists. To edit an existing Note Title, authorized providers can choose a title from the Note Titles at My Clinic list and tap the Note Title. Modify the text for the note title, then tap Save, or tap Remove to delete the note title.

Super Admins can use the Notification Messages Management screen to create and manage emails and secure messages that are automatically sent to patients whose email addresses are saved when certain events occur. From anywhere in the REVAMP App, tap Management, and a drop-down menu will appear. Tap Notifications, then tap Email, and the Notification Messages Management screen will appear. Tap the Select Message drop-down, and tap either one of the pre-existing messages or Create New Message. Enter information in the subsequent categories as needed, then tap the checkbox next to Enabled to make the message active. To save, either tap the floppy disk icon, or tap File and then Save.

All Super and Site Admins can access the REVAMP Metrics Report screen to review REVAMP usage statistics for their clinic as well as global numbers. From anywhere in the REVAMP App, tap Reports, and tap Metrics Report from the drop-down menu that appears. You can view the usage statistics either monthly or cumulatively by tapping on the Monthly or Cumulative tabs at the top of the report.

To view metrics from a specific clinic, tap the drop-down next to View and select the clinic you want to view. Tap Update Metrics, to update the displayed statistics.

To change the date range, tap As of, and a drop-down menu will appear. Tap Today (Current Month), Date Range (only available on the Monthly tab), or choose from a list of previously generated end of month reports. Tap Update Metrics to update the displayed statistics.

To download the report, tap Export to Excel. A CSV file of the report will download to your browser where you can save it for future reference.

To print the report, tap Printable Version. A printable version of the report will open in a new browser window where you can print as you would normally.

Additional information about other available VA apps can be found on mobile.va.gov/appstore as well as mobile.va.gov.

A built-in user manual is available. To access the built-in user manual, tap Help. The Help sub-menu will expand, and tap User Manual. More resources, such as a User Manual and Slideshow, can be found on mobile.va.gov/appstore.

If you need assistance with the REVAMP App for Clinicians, dial (866) 651-3180 to speak with a VA Mobile Solutions Service Desk Representative. For TTY assistance, dial 711.

If you feel that your information may have been compromised, contact your local VA facility to obtain the contact information from your Privacy Officer. To identify your local VA facility, visit VA’s Facility Locator, or by copying and pasting the following link into your browser: http://1.usa.gov/1TTdj42. Note that you should never use this app in an emergency. If you encounter an emergency, call 911.