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, schedule patients for sleep testing and enter their results, review patient Positive Airway Pressure (PAP) machine data, assign questionnaires, schedule appointments, write Treatment notes, 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 has four main features, which include:

• Treatment Results – Review the data from your patient’s PAP machine including the time they sent it, their Apnea-Hypopnea Index (AHI) and mask leakage.
• Sleep Testing & Questionnaires – Assign questionnaires 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.

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 App 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 screen:

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. Tap the button next to the row of the patient you would like to select, and you will be taken to the Patient Summary screen.
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 Summary screen.
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 screen will appear.

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 Summary screen of the Veteran you would like to view. From anywhere in the Patient Summary, 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 Events. 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 are highlighted pink and have a red caution sign in the Event column.

To control the specific questionnaires assigned to the patient for Follow-up Questionnaires events, tap the + icon next to the follow up questionnaire 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.

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 Summary screen 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).

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).

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.

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 or Cancel to discard it. 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.

All Super and Site Admins have the ability to enter and edit information for their clinics to be shown on the Contact Info pages in the Help menus of the Patient and Provider Platforms. From anywhere in the REVAMP App, tap Management, and a drop-down menu will appear. Mouse over Content Management, and tap Edit Sleep Center Info. On the Edit Sleep Center Info screen, edit clinic contact and address information that will be shown on the Contact Info pages in the Help menus of the Patient and Provider Platforms. To upload an image, tap Load Image File, and tap the image file you wish to upload from your device. To remove an uploaded image, tap the box next to Remove Image. A Preview area at the bottom of the screen shows an approximation of what the contact information will look like on the Contact Info pages in both platforms. To save, either tap the floppy disk icon, or tap File and then Save.

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.

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 Quick Start Guide and Slideshow, can be found on mobile.va.gov/appstore.

If you need assistance with the REVAMP App for Clinicians, dial 1-844-482-6624 to speak with a VA Mobile Solutions Service Desk Representative. The VA Mobile Solutions Service Desk is open Monday - Friday from 7 a.m. to 7 p.m. CST. 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.