Staff Guide — Where Everything Is

How to get in

1. Go to crewhq.bhwmedical.org/crewos on any phone, tablet, or computer.
2. Pick your name from the list, enter your PIN, tap Sign in.
3. You land on your home page — the front desk role lands on Front Desk, the care coordinator on Chronic Care, primary care providers on Primary Care, and so on.

Your pages

Safe publishing procedure Shade + designated staff

1. Open CrewHQ → Website Content and choose Announcement, Resource link, or Practice detail.
2. Write the exact public wording. The approved staff ChatGPT may help with wording, but never paste patient information, private links, passwords, API keys, or other credentials into it.
3. Review the on-screen preview, dates, links, display order, and optional start/stop time.
4. Check the no-patient-information confirmation, save the draft, and verify the page says Saved to BHW Cloud.
5. Select Submit for review. An operations manager or executive reviews the exact wording and selects Publish.
6. Open Care Connect after publication and verify the public result. If something is wrong or no longer current, archive it instead of silently overwriting history.

Front desk day Front desk role

1. At sign-in — open the 🔔 alert bell. Review urgent, escalated, overdue, and unassigned work routed to Front Desk.
2. Open Patient Requests. Assign each unclaimed front-desk request, then tap Start when work begins.
3. Work by urgency. Urgent/escalated first, then overdue, then routine requests in received-time order.
4. Check the shared inbox once at 9:00 and again around 3:00 as a backup for anything that did not enter CrewOS automatically. Do not create a second request if it is already present.
5. Before you leave: every urgent or escalated item is resolved, handed to the correct role, or has a documented next step.

What the colors mean

Purpose, scope, and pass standard Trainer + trainee

Purpose: teach staff to safely receive, claim, advance, communicate about, and close patient work in the Google-backed Patient Requests page.

15-minute trainer-led walkthrough

What the 🔔 alert bell means Everyone

• The bell appears in the CrewOS header while you are signed in. Its number is your unread routed-alert count, not the total number of requests in the practice.
• You receive alerts for new unassigned work in your service line, requests assigned to you, and urgent, overdue, or escalated work you are allowed to handle.
• Click an alert to open the exact record in Patient Requests. The alert itself contains workflow labels only—not patient names or request details.
• Opening the alert panel marks the alert as read. It does not assign, start, resolve, or otherwise change the request.
• Google Chat mirrors safe alerts and quick actions when configured. CrewOS remains the authoritative work queue.
• Open the CrewOS alert bell and choose Notifications on or Notifications off. This preference is saved for the signed-in staff member on that device.
• Google Chat has its own per-person space notification setting. Turning off the CrewOS bell does not mute Google Chat; each staff member can choose All, For you, or Off in Google Chat.

How to work a request Assigned role

1. Check the category mix or use the request-type filter, then select the request in the left work queue. The right side shows status history, route, owner, communications, and delivery results.
2. If it is unclaimed, tap Assign to me. Tap Start when you begin the work.
3. Choose the exact milestone that happened—do not skip ahead. Use Escalate when the request needs a higher role or cannot safely continue.
4. Use Notify patient only when it is available. Select or write a no-PHI message, confirm the no-PHI box, and send through the approved BHW line.
5. Check Communications and delivery. “Sent” means the channel accepted it. “Suppressed,” “queued,” or “failed” does not mean the patient received it.

Team Notes — internal staff coordination Signed-in staff

1. Open the request and use Team Notes below its status and patient-communication sections.
2. Write the coordination update and select one or more teammates under Mention teammates when their attention is needed.
3. Choose Add team note and wait for Saved to BHW Cloud. The author and timestamp are recorded automatically.
4. A New team note marker appears for unread discussion inside the request. The bell alerts staff only when the request is relevant to their role or they were explicitly mentioned. An explicit Mentioned in team note alert does not widen routine role routing.
5. Choose Mark notes read after reviewing. Use Load older notes for earlier history. A reply does not automatically mark other notes read.
6. If a save is not confirmed, use Retry save without retyping it. The same send key prevents a duplicate. Drafts remain only in the open page; save before leaving.

Staff Chat — across signed-in staff pages CrewOS staff identity

1. Choose the floating Staff Chat button on a signed-in staff page. On your first visit to each staff site, or after switching staff accounts, sign in with your existing CrewOS account in the separate window. Later pages on that site reuse the chat sign-in.
2. Use BHW Team for general staff coordination or Message a teammate for a direct conversation. A teammate appears after opening Staff Chat once.
3. Confirm the message contains no patient or confidential personnel information, choose Send, and wait for Saved to BHW Cloud. This confirms storage, not that a teammate has read it.
4. Messages and your selected conversation follow you between staff pages. Unsaved drafts do not; send them before navigating. Reopen the button when switching sites.
5. The unread badge is optional and off initially. Enable Show unread badge across staff pages if you want it. The preference follows your account. No sounds, pop-up alerts, or browser push notifications are requested.
6. Choose Mark read after reviewing. The open panel checks for updates about every 12 seconds; closed panels check less often. This is not an emergency or urgent-clinical channel.

Who owns what

Exceptions and edge cases

Synthetic practice lab Trainee drives

The trainer prepares five de-identified BHW0000 requests. The trainee narrates each decision before selecting an action.

Competency check and sign-off

• □ Opens the exact request from an alert and explains that read is not resolved.
• □ Uses filters and confirms routed service line, urgency, ownership, and status history.
• □ Correctly uses Assign to me, Start, one exact milestone, Escalate, and Resolve.
• □ Correctly completes all five BHW0000 scenarios without skipping a milestone.
• □ Explains why Chat and SMS contain no PHI and why secure details stay in the patient-facing app.
• □ Correctly interprets sent, suppressed, queued, failed, quiet-hours, and automation-not-enabled states.
• □ States the urgent/emergency rule: the queue never replaces immediate provider notification, 988, or 911.

1 · Open Patient Requests Front desk

Use Patient Requests for the live communication workflow. Front Desk OS may show operational snapshots, but staff actions belong in the Google-backed request record:

• Assign to me — records who owns it.
• Start — records that work is underway.
• Notify patient — when available and enabled, sends an approved no-PHI message through Dialpad after consent and suppression checks.
• Resolve / outcome buttons — close only after the exact outcome occurred.

2 · Patient lookup Everyone

Type a phone number or name → their profile appears before you answer the call.

• Left side: allergies (red box at the top), phone, insurance, member #, last and next visit, medications.
• Right side: everything they've contacted us about, newest first — so you know if there's an open urgent item on their account.

3 · Referral finder Front desk, providers

1. Choose the specialty and the patient's insurance.
2. Tap Find in-network — preferred partners (⭐) come first.
3. Copy fax grabs their fax number, or → Use in referral loads them straight into the referral form.

4 · Generate a referral Front desk, providers

1. Look the patient up first, then tap use last lookup — name, DOB, phone, member #, and insurance fill in.
2. Pick the specialist from the dropdown (or use the finder's button) — their whole block fills, including the fax.
3. Provider fills in reason, brief history, what's being requested, place of service, number of visits.
4. Tap Generate referral PDF — it downloads and opens ready to print.
5. Then tap 📠 Fax to specialist to send it straight to the consultant's fax from the practice line — no printing or fax machine needed.

Primary Care providers NP role

• Land on: Primary Care page.
• Daily: check the alert bell for triage/provider questions, items assigned to you, waiting-on-clinician work, urgent or safety concerns, and escalations. Routine operational request alerts stay with non-provider staff.
• Tools: Positive ANA?, Hormone Analysis, Billing Toolkit for preventive codes, BHWCrewCare Portal for care plans and results.
• Referrals: Primary Care page → Front Desk OS — lookup & referrals → look up patient → find specialist → generate.

Care coordination Coordinator role

• Land on: Chronic Care page.
• Daily: check the alert bell, work care-coordination/referral requests, follow up on hospital discharges, and keep Referral sent, Ready to schedule, and Scheduled distinct.
• Requests come to you through the "Request care coordination" buttons any division can use — each arrives with a reason and timeframe already attached.
• Tools: Panel & Discharges, Billing Toolkit for care-management codes.

Behavioral health Psych / therapy roles

• Land on: Mind & Mood Recovery page.
• Daily: your visit schedule, clinical items routed to you, care plans through the BHWCrewCare Portal in your own voice.
• Crisis items never wait in a queue — 988 or 911, then tell a provider. See section 10.

Billing & operations Ops role

• Land on: Front Desk / Admin Master.
• Daily: monitor urgent/overdue alerts, work billing requests routed to RCM, oversee claims/insurance, and audit suppressed or failed communications.
• Tools: Admin Master for the whole-practice view, Billing Toolkit, Panel & Discharges for payer-facing numbers.

Using the existing patient page Providers, care coordination

1. Find and select the patient’s existing Google-backed Patient Master record. Do not create a second patient because a link is missing.
2. Open the patient-facing page from the approved CrewOS/patient workflow link. Medication and status routing already belongs to that patient page.
3. Keep detailed status, instructions, medication information, appointment details, and payer information behind the authenticated patient page.
4. Use SMS only as a no-PHI nudge telling the patient that a secure update is available.
5. If the patient page or link is missing, report the missing link to the operations lead. Do not build a replacement page or a new patient record.

Building or updating a care plan Providers

1. Open BHW CrewCare → Health 360.
2. Pick the verified Patient Registry patient and open Health 360, or start the program care-plan form.
3. Save the draft to BHW Cloud. A licensed clinician reviews it before marking the patient copy “It’s Ready.”

Lab results and between-visit work

1. Add interpreted lab results in Health 360 Care Plans; do not post them to an older patient page.
2. Use Patient Requests for between-visit follow-up so Front Desk and CrewOS see the same work item.
3. Send only the approved no-PHI “It’s Ready” notice after the Blueprint passes clinical review.

Use the current program rules before enrolling or billing Care coordination, providers, billing

Open the Care Program SOP from the CrewOS rail or BHW HQ. It contains the common intake assessment, program-specific qualification questions, consent and initiating-visit requirements, Whole Person Care Plan standard, monthly readiness checks, combination safeguards, operational risk score, outreach tiers, and 2026 Baltimore Medicare fee reference.

1. Start with the existing Patient Registry patient; never create a second patient identity for program work.
2. Record potential eligibility separately from practitioner-approved enrollment and monthly billability.
3. Use the program branch and readiness checklist, then create or update the protected Health 360 care plan.
4. Use Care Management Log for monthly activity, time, device/data evidence, interaction, follow-up, and missing-requirement review.
5. Send green rows to the billing practitioner and RCM for final attestation. Green is never automatic claim approval.

BHW HQ — the staff launchpad Everyone

BHW HQ is the tile page that links the big destinations (crewOS, the RCM platform, the onboarding portal) plus the Staff Tools row. Each tool opens on its own page and reuses your crewOS sign-in to pull patients.

Draft with AI — describe it, it writes the first draft Providers, staff

1. Open the Document Builder and pick the document type at the top (handout, after-visit summary, care plan, or letter).
2. Tap ✨ Draft with AI.
3. Optional: search a patient in the box — it pulls their name, DOB, allergies, and medications so the draft is tailored to them.
4. Type what you need in plain English, e.g. "a nutrition plan for a patient with high homocysteine and stage 3 CKD — foods to favor, foods to limit, and simple daily targets."
5. Tap Draft it. The document fills in — headings, bullets, key-point callouts — right in the builder.
6. Read it, fix anything that needs it, then Print / Save PDF.

Purpose and scope Everyone who prepares patient materials

Create branded HTML or PDF patient education, after-visit summaries, care plans, letters, medication lists, check-ins, and trackers without creating a second chart or work queue. A builder draft is a local working document until reviewed and intentionally shared.

Detailed steps Trainee drives, trainer observes

1. Start: open CrewHQ → Patient Education & Documents. Choose Templates for a structured starting point or choose the correct document type manually.
2. Build: replace every bracketed placeholder. Use Build sections for structured editing or Paste text for headings, bullets, tables, and callouts. Use larger text or icons when the patient needs them.
3. Review: verify the patient, date, provider, plain-language accuracy, warnings, links, accessibility, and every role boundary. A licensed clinician approves all patient-specific diagnoses, medication directions, thresholds, treatment advice, orders, and return precautions.
4. Export: use Download HTML or Print / Save PDF. Open the exported file and read it once more; export success is not clinical approval or patient delivery.
5. Share only when authorized: open Patient Materials & Feedback, select the verified Patient 360 record, upload the reviewed file, set the assignment and expiry, send the exact private link through an approved channel, attest, and Record as sent. Generated means not yet recorded as sent; recorded sent is a staff attestation, not carrier delivery.

Who owns each step RACI

Template library Filter by role in the builder

Role-specialized synthetic practice BHW0000 only

Use synthetic patient BHW0000. Do not enter a real name, birth date, diagnosis, medication, phone number, email, private patient link, payer detail, or appointment. Do not complete a live share.

Asking care coordination for help Any division

On the Chronic Care page, the "Request care coordination" card has a button for each reason:

• SDOH resources — housing, food, transportation, utilities, benefits
• Acute follow-up — what happened, what was done, and by when
• Chronic follow-up — which condition and the interval needed
• Managing multiple specialists — what's falling through the cracks
• Care plan hard to manage — which part, and the barrier the patient named
• Needs more time between visits — what they're asking for and why
• Monitoring equipment — which device and the clinical reason

What each one does Providers

Start from the authoritative patient identity Patient-facing staff

1. Open BHW Capture and choose Capture for patient audio.
2. Select the patient only from the protected Google Cloud Patient Registry. Match the displayed name and canonical BHW ID to the scheduled patient before recording.
3. If the patient is missing, duplicated, or does not match, stop and route the identity issue to the Registry owner. Do not use the historical Patient Index Guide, create a substitute record, or record under another patient.
4. Verify the current signed recording/AI-transcription consent and confirm that the patient and everyone who may be heard agrees to recording today.

Long visits and five-minute protected segments

1. Keep the Capture tab open and visible for the entire visit. Confirm the screen-awake indicator is active; if it is not, keep the device awake manually.
2. The recorder automatically closes, secures, and transcribes each five-minute segment while the next segment continues. Do not end a longer visit merely because a segment is processing.
3. At the end of the encounter, select Finish once and wait until every segment reports transcribed before closing the tab.
4. Review the assembled transcript for missing transitions, repeated text, speaker errors, and the segment immediately before and after any interruption.

If recording is interrupted

1. Pause for an intentional interruption or when anyone withdraws agreement. Resume only after agreement is reconfirmed.
2. If the session expires or a segment fails, leave this tab open. Use the new-tab CrewHQ sign-in, return to the same Capture tab, and choose Retry retained audio.
3. Do not refresh, close the tab, switch patients, or press Clear audio and draft while a segment is retained. Those actions can remove audio still held only in page memory.
4. If the browser, device, or tab closes, document the interruption and notify the provider. Never claim the transcript is complete; reconstruct missing clinical content through provider review and the legal-record workflow.

Competency check and sign-off Training owner

Before independent real-patient use, the learner must complete all four checks with synthetic patient BHW0000. Attendance or reading the guide is not sufficient.

What's on your Space page Everyone

• Your role & responsibilities — what you own, so a new team member knows exactly where to start and nothing falls through when someone is out.
• The office calendar — holidays, meetings, coverage, and closures for the whole practice.
• Your availability — the hours you're reachable, so handoffs route to someone who's actually in.

The systems and what belongs in each

Safety and privacy

• Crisis: if a patient is in danger or talking about harming themselves — 988 (call or text) or 911. Do not leave it in a queue. Tell a provider immediately.
• Chest pain, trouble breathing, stroke symptoms, heavy bleeding: 911 first, then tell a provider.
• Never text or email PHI to a personal phone or personal email — yours or anyone's.
• SMS and Google Chat stay no-PHI. Do not include patient names, diagnoses, medications, DOB, member IDs, appointment details, or clinical summaries. Put detail in the authenticated patient/CrewOS experience.
• Patient information stays in the systems. No screenshots, no photos of screens, no forwarding to personal accounts.
• Verify in Charm before acting on anything clinical you read on a dashboard.
• Log it, don't remember it. If a patient asked for something, it goes in the queue — even if you're about to handle it.
• An alert is not a completed task. Opening the bell or Chat card never replaces assigning, starting, or recording the exact outcome in Patient Requests.
• Never overstate a milestone. PA submitted is not approved; referral sent is not scheduled; “suppressed” is not sent.

When you're not sure