Clinician · Researcher · Deep Reference Guide — NP · PA · RN · MD · PharmD · CC

ATLAS Complete Feature Reference

Everything available in the Clinician · Researcher tier — daily intake, ZOE voice assessments, MTM audit documentation, PEACS longitudinal tracking, Sentinel follow-up flags, and all export formats. Applies to all $49/mo clinical roles: Nurse Practitioner (NP), Physician Assistant (PA), Registered Nurse (RN), Physician/MD (MD), Pharmacist (PHRM), and Care Coordinator (CC), as well as independent researchers (RES). Use the quick-ref card for daily use; come back here when you need to understand a feature in depth.

Version 2026.05 · Clinician · Researcher tier (NP- · PA- · RN- · MD- · PHRM- · CC- · RES-) · Full reference

Contents

  1. Getting Started — your first clinical session
  2. Signing in — workspace key and identity verification (MFA)
  3. Daily Intake Panel — Quick patient logging
  4. ZOE Voice Assessment — Full walkthrough · Remote Mode
  5. SOAP Note generation and use — editable textarea
  6. Follow-up scheduling, reminder links, and Patient Portal link
  7. Sentinel alerts — 3-stage escalation workflow
  8. MTM Session Timer — CPT 99605 · 99606 · 99607
  9. MTM Audit Log — CMS billing documentation
  10. PEACS — BASE · MVMT · STRATA explained
  11. MAP PE Domain Analysis — Architecture · Execution · Context
  12. Your cohort — reading the dashboard · benchmark comparison
  13. Data export formats
  14. Your Letter of Permission and certificate

Getting Started — Your First Clinical Session

New to ATLAS? This is the complete daily workflow from sign-in to closing your last patient. Use this page end-to-end on your first day, then switch to the Quick-Reference Card for everyday use.

1
Sign in once at the start of your shift

Open atlas.adherence.cc, click Tracks A+B · Researcher / Clinician, and enter your workspace key. The key prefix matches your role — NP-, PA-, RN-, MD-, PHRM-, CC-, or RES- for independent researchers. A 6-digit code is emailed to your registered address — enter it to open your workspace. You stay signed in for the session; you do not need to re-enter the key between patients. Full sign-in walkthrough →

2
Choose your intake path for each patient

Two paths are available. Use the Daily Intake Panel (collapsed at the top of your dashboard) for a rapid 3-item screen when a patient is picking up a refill and you have 60 seconds. Use Start New Patient Session for a full MMAS-8 or MMAS-8 + PEACS session when you have 5–10 minutes and need validated, publishable data. Daily Intake detail →

3
Start a full patient session (when time permits)

Click Start New Patient Session. The session modal opens — select the instrument: MMAS-8 Only, PEACS Only, or MMAS-8 + PEACS. Click Continue to Informed Consent →. ATLAS automatically generates a Patient ID (e.g. PT-B2C9) for this session — note it in your patient record before handing the device over. The patient sees the consent screen first, then the selected instrument(s).

4
Run ZOE for the full voice-guided experience

Once the MMAS-8 screen loads, activate ZOE from the instrument panel. ZOE guides the patient through all 8 questions verbally, interprets their spoken responses, and generates a SOAP note automatically when complete. ZOE requires Chrome or Edge and microphone permission. ZOE walkthrough →

PE Domain Profile on the result screen After any MMAS-8 submission (live or ZOE), the result modal shows a PE Domain Profile below the standard score and tips. It displays the patient's composite PE score, three colour-coded domain bars (Architecture · Execution · Context), and a one-line constraint interpretation identifying the primary barrier. Use this to immediately target your counseling — an Execution-constrained patient needs habit systems, a Context-constrained patient needs regimen simplification. Full PE Domain explanation →
5
Review the SOAP note and Sentinel feed

After the patient's session closes, the SOAP note appears in the result panel — copy it into your dispensing system or patient record. Check the Sentinel feed on the right of your dashboard for any red or amber alerts from today's patients. Sentinel detail →

6
Log MTM time and export for billing at end of shift

The MTM Session Timer (⏱ tab) tracks your service, documentation, and travel time per encounter and auto-suggests CPT codes. At end of shift, export the MTM Audit PDF for your billing department. MTM Timer detail →

Session summary bar While a patient session is active, a slim bar at the top of the dashboard shows the active Patient ID and instrument selection. Click End Session in that bar to close the session cleanly before starting the next patient. Do not start a new session without ending the previous one — the session bar confirms which patient is currently active.

Signing In

ATLAS uses a two-step sign-in process for all pharmacist and researcher workspace keys: your workspace key plus a one-time email verification code (OTP). This ensures that even if your key is accidentally shared, your cohort data remains protected.

1
Open atlas.adherence.cc and select your tier

Click the card labelled Tracks A+B · Researcher. A workspace key entry box appears at the bottom of the panel.

2
Enter your workspace key and press Verify Access

Type or paste your key (e.g. RES-HOSP-ABCD-2026). The system validates it against AWS SSM. This takes 2–3 seconds.

3
Check your email for the 6-digit verification code

A blue Identity Verification panel appears on screen. ATLAS simultaneously sends a 6-digit OTP to the email address registered to your workspace key. The code is valid for 10 minutes. Check your inbox (and spam folder) for a message from info@adherence.cc.

If the code doesn't arrive within 2 minutes, click Resend Code. Each resend generates a new code — the previous one is invalidated. If your workspace key has no email registered, contact info@adherence.cc to add one.
4
Enter the code and confirm sign-in

Type the 6 digits into the verification panel and press Verify →. Your workspace opens immediately. The MTM Session Timer at the top of the dashboard resets to 00:00 at each new session.

Daily Intake Panel

The Daily Intake Panel is designed for high-volume pharmacy practice — logging multiple patients per session without running a full MMAS-8 assessment on every one. It sits at the top of your dashboard and is collapsed by default. Click the header bar to expand it.

When to use the Daily Intake Panel vs Start New Patient Session

SituationUse
Quick check-in — patient picking up refill, 60 seconds availableDaily Intake Panel (rapid 3-item screen)
New patient, first adherence assessment, 5–10 minutes availableStart New Patient Session → MMAS-8 Only → full MMAS-8
Patient flagged low in rapid screen, needs full assessment todayDaily Intake → tick "Flag for full ZOE" → Start New Patient Session
Research study, need complete validated MMAS-8 data for publicationStart New Patient Session → MMAS-8 Only → full MMAS-8 always
Full clinical picture needed — adherence and predictive emergenceStart New Patient Session → MMAS-8 + PEACS (SDoH captured once for both)

The rapid 3-item screen

The three questions in the Daily Intake Panel are drawn from the full MMAS-8:

Maximum rapid score is 3. A score below 2 automatically triggers a Sentinel alert and is flagged in the MTM audit log for follow-up. This is not a validated standalone instrument — use it for triage only. The full MMAS-8 is required for any published research.

Daily counter The "Today:" counter in the Daily Intake header shows how many patients you have logged today. This resets at midnight. Useful for tracking your MTM consultation volume for billing purposes.

ZOE Voice Assessment

ZOE (an AI voice agent powered by Claude) guides patients through the full MMAS-8 verbally. The patient hears each question spoken aloud and responds in natural language. ZOE interprets the response, confirms it back, and moves to the next question. The entire 8-question assessment takes 4–6 minutes.

Technical requirements

Offline queue — for non-ZOE assessments Standard MMAS-8 assessments work without an internet connection. Submissions are saved locally and a yellow ⚡ Queued Submissions — Tap to Sync badge appears when you reconnect. ZOE requires a live connection since it processes voice in real time through the cloud.

Best practice for pharmacy use

In a dispensing environment, the best setup is a tablet on a small stand at the counseling window. Hand the patient the tablet with ZOE already open. They tap "Speak" when ready. You can attend to other tasks — you will see the completed assessment in your dashboard when they finish. ZOE handles the entire interaction including the result screen.

What ZOE does when it is uncertain

If ZOE cannot interpret a patient's response with confidence, it says "Let me make sure I understood you — could you say yes or no for that one?" and waits for clarification before recording the answer. This prevents misscored responses from unclear speech.

Skip button

If a patient cannot answer a specific question (for example, Q5 about whether they took their medication yesterday, when they started treatment that day), the Skip button records a neutral answer for that question. The final score is calculated on all 8 questions including the skipped one, which is assigned the non-penalising default.

ZOE Remote Mode

When a patient cannot attend in person, use the Remote Assessment panel in the follow-up card. Enter the patient's mobile number (or leave blank to copy a link instead) and click Send SMS or Copy Link. The patient receives a URL that opens a self-guided ZOE assessment on their phone — no app download required. They answer the same questions at their own pace, and results are automatically submitted to your workspace linked to their patient ID.

Use case: post-discharge follow-up, rural/remote patients, between-visit check-ins without requiring a clinic visit.

SOAP Note Generation

After completing all 8 questions, ZOE automatically generates a clinical SOAP note using the patient's verbatim voice responses and the computed adherence data. The note is ready within 2–3 seconds of the last question.

SOAP note structure

How to use the SOAP note

The SOAP note appears in the result modal after submission. Copy it directly into your pharmacy management system or patient record. Many pharmacists paste it into their dispensing software's notes field. You can also email it to the prescribing physician using the "Send to Researcher" button if your workspace has email notification enabled.

Editable SOAP textarea

The SOAP note generated by ZOE is now displayed in an editable text area, not a read-only panel. You can directly edit any section of the note before copying or saving. Click the Copy SOAP Note button to copy the full text to clipboard for paste into your EHR.

SOAP notes are AI-generated Review before adding to a patient record. ZOE generates the note from the voice transcript — it does not have access to the patient's medical history, other medications, or diagnosis. Clinical judgement always takes precedence.

Follow-Up Scheduling

After every ZOE assessment, ATLAS automatically calculates a recommended follow-up date based on the score and pattern:

Score / PatternIntervalUrgency
INA pattern, clinical flags, or score < 47 daysUrgent
Medium adherence (score 4–6)14 daysModerate
High adherence (score > 6)30 daysRoutine

The follow-up card

A card appears below the ZOE panel after assessment showing the recommended date, the reason for that interval, the patient ID, and the score. The card has two buttons: "Copy reminder link" and "Dismiss."

The reminder link

Clicking "Copy reminder link" generates a URL that pre-fills the ATLAS assessment with your workspace key and the patient ID. Share this with the patient by SMS, email, or WhatsApp. When they open the link and complete a new assessment, their result is automatically added to your cohort under the same Patient ID — enabling longitudinal tracking over time.

Patient Portal link

When you copy a follow-up reminder link, the clipboard now automatically includes a second line with the patient's portal URL: https://atlas.adherence.cc?portal=<patient_id>. Share this with the patient directly. When they open it, they see their own score history, PE domain profile, personalised adherence tips, and your care team contact card. No login required — the link is pre-authenticated for that patient only.

Sentinel Alerts

The Sentinel system monitors your cohort for adherence events that warrant clinical attention. Alerts appear in the right sidebar of your dashboard.

What triggers a Sentinel alert

Alert urgency levels

Marking alerts as reviewed

Click "Mark Reviewed" on any alert card to clear it from the active feed. Reviewed alerts are faded but not deleted — they remain visible in the feed for audit purposes. The "Export Sentinel Log" button at the bottom of the feed exports all alerts (reviewed and active) to CSV.

Sentinel Escalation Workflow

Sentinel alerts now use a 3-stage structured escalation rather than a single "Mark Reviewed" button:

Stage 1 — Assign: Enter the care team member's name responsible for follow-up and click Assign.

Stage 2 — Contact Outcome: Record what happened when contact was attempted: Reached · No Answer · Declined · Referred.

Stage 3 — Resolve: Once the clinical situation is addressed, click Resolve. A full audit trail (assigned to, contact outcome, resolution timestamp) is logged.

Escalation state persists across page refreshes. Alerts leave the active queue only when explicitly Resolved.

MTM Session Timer

The MTM Session Timer is a live stopwatch built into the pharmacist dashboard for documenting consultation time for CMS billing purposes. It runs three independent clocks simultaneously — one for each billable time component — and auto-suggests a CPT code based on total elapsed time.

The timer is located in the MTM Services tab of your workspace dashboard (the tab with the ⏱ icon). It is available exclusively on the Pharmacist · Researcher tier.

The three clocks

ClockWhat to timeCMS category
⏱ Service Time spent face-to-face or in direct consultation with the patient — reviewing medications, discussing adherence barriers, providing counselling Direct patient care time
⏱ Documentation Time spent writing the SOAP note, completing the MTM record, entering data into ATLAS — any documentation activity for this encounter Indirect patient care time
⏱ Travel/Review Time spent reviewing the patient's medication history before the encounter, or travelling to a patient's location (home visit, ward round) Pre-encounter review time

Each clock has a Start / Pause button and a Reset (↺) button. Clocks run independently — you can pause Service time while writing the SOAP note and run Documentation time instead. The total combined time drives the CPT badge.

CPT auto-badge

A CPT badge in the upper-right of the timer panel updates in real time based on total elapsed Service time:

Elapsed service timeCPT suggestionDescription
0 – 14:5999605 / 99606Initial (99605) or follow-up (99606) MTM — first 15 minutes
15:00 – 22:5999605/99606 + 99607Base code plus one add-on unit
23:00++ additional 99607One additional 99607 per 8–22 minute increment beyond 15 min
The CPT badge is a documentation aid, not a billing guarantee. Always verify the final CPT code against your payer's requirements, your actual clinical notes, and your organisation's billing policies before submitting a claim. The timer does not submit to any billing system — it provides the time documentation you need to assign codes manually.

Recommended workflow

  1. Patient arrives → start the Service clock immediately.
  2. At the end of the patient consultation → pause Service, start Documentation.
  3. Complete SOAP note and MTM audit entry in ATLAS → pause Documentation.
  4. Read the CPT badge — note the suggested code(s).
  5. Reset all clocks before the next patient.

A note on 99605 vs 99606

99605 is for the initial MTM service — a patient new to your MTM programme, or one you have not seen within the past 12 months. 99606 is for follow-up MTM — a patient you have previously billed 99605 for within the last year. The ATLAS MTM Audit Log auto-assigns one or the other based on whether the patient has prior records in your cohort — but you can override this in your billing documentation.

MTM Audit Log

The MTM Audit Log is a formatted record of every patient encounter in your cohort, with CPT codes auto-suggested based on encounter type and adherence pattern. It sits in the MTM Services tab of your dashboard (below the Session Timer) and updates automatically whenever a new assessment is logged.

CPT code auto-assignment logic

These are suggestions based on encounter data. Always verify against your specific payer's requirements and your own clinical documentation before billing.

Exporting for reimbursement

PDF export produces a formatted audit document suitable for CMS auditors, with your workspace name, date range, total encounters, and a formatted table including patient ID, date, CPT code, score, adherence level, pattern, condition, and intervention documented. The document includes the MAP license reference and ATLAS platform attribution.

CSV export produces a spreadsheet for import into electronic billing systems. Each row is one encounter with all fields as separate columns.

International billing reference

For UK pharmacists: the MUR and NMS consultations document a review of medication usage and adherence. The ATLAS MTM export serves as the structured assessment component of this documentation. For Australian HMR: ATLAS data constitutes the adherence screening component of the clinical assessment. Always check current DVA and PBS requirements.

PEACS — Predictive Emergence Assessment

PEACS (Predictive Emergence Assessment for Clinical Services) measures three behavioural dimensions that together predict whether a patient will sustain adherence over time. The composite PE score is calculated as: PE = (BASE × MVMT × STRATA)^(1/3).

The three dimensions

BASE — Behavioural Foundation (30-day window)

Measures how consistently a patient follows their medication regimen under normal, everyday conditions. A patient with high BASE takes their medication reliably when nothing disrupts their routine. A patient with low BASE struggles even in stable circumstances — often indicating habit not yet formed or significant avoidance.

Clinical implication: Low BASE suggests the patient needs structured habit-formation support — linking medication to an existing daily anchor (meals, brushing teeth, bedtime).

MVMT — Behavioural Flexibility (7-day window)

Measures whether a patient maintains adherence when life changes — travel, illness, shift work, family disruptions, schedule changes. A patient can have high BASE (great at home routine) but low MVMT (falls apart when travelling). This is the most predictive dimension for medication holiday risk.

Clinical implication: Low MVMT patients benefit from a travel kit protocol, pre-loaded pill organisers for trips, and a simple rule for what to do when a dose is missed due to disruption.

STRATA — Social Determinants (90-day window)

Captures the structural barriers and enablers around adherence: housing stability, transport access to pharmacy and clinic, support network quality, health literacy, and beliefs about treatment necessity. Low STRATA almost always co-occurs with Poor PE zone scores.

Clinical implication: Patients with low STRATA need systemic support — pharmacy delivery, social prescribing referral, simplified regimen negotiated with prescriber, or connection to community support services. Clinical counseling alone will not be sufficient.

PE Zones

ZonePE ScorePredicted behaviourRecommended action
Optimal≥ 0.85High behavioural stability — likely to sustain adherence long-termRoutine monitoring. Positive reinforcement.
Good0.70–0.84Generally stable with occasional instability riskPeriodic check-ins. Address any single low dimension.
Moderate0.55–0.69Instability risk present — may sustain short-term but likely to relapseIdentify which dimension (BASE/MVMT/STRATA) is lowest and target it specifically.
Poor< 0.55High risk of sustained non-adherencePriority intervention. Check STRATA first — often the root cause. Consider social prescribing referral.

MAP PE Domain Analysis

The PE Domain Analysis applies the Theory of Predictive Emergence (TPE) to every MAP (Multidimensional Adherence Parameters) response in your cohort. Rather than stopping at a total score, it asks: why is this patient non-adherent, and which specific domain of behaviour is the primary constraint? This is available on the Researcher tier and above — it is computed automatically from the Q1–Q8 responses already stored on every assessment, including historical records.

The PE formula

PE = (A × E × C)1/3

This is a non-compensatory multiplicative model. A high score in one domain cannot offset a collapse in another — if any single domain approaches zero, the PE collapses regardless of the other two. This mirrors clinical reality: even a patient with perfect beliefs and manageable burden will fail if their execution reliability is near zero.

The three domains

Architecture (A) — Belief and decision layer

Derived from the mean of Q2, Q3, and Q6. These questions capture whether the patient forgets due to inattention (Q2), sometimes decides to skip a dose (Q3), and stopped taking medication without telling their doctor in the past two weeks (Q6). Together they represent the cognitive and motivational architecture around taking medication.

Low A means: The patient has belief-level or motivation-level barriers — side effects they haven't reported, doubts about necessity, cost-related avoidance, or a deliberate pattern of skipping. Counseling focus: motivational interviewing, addressing beliefs about the medication, shared decision-making with prescriber.

Execution (E) — Behavioural reliability layer

Derived from the mean of Q1, Q4, Q5, and Q8. These questions capture everyday forgetfulness (Q1), stopping without telling the doctor (Q4), missed doses yesterday (Q5), and frequency of difficulty remembering (Q8). Together they measure whether the patient's daily behaviour reliably translates intention into action.

Low E means: The patient wants to take their medication but their behaviour is unreliable — habits are not formed, routines are broken by schedule changes, or reminders are not in place. Counseling focus: habit stacking (linking medication to a daily anchor), pill organiser, phone alarm, blister packs, pharmacy-delivered packaging.

Context (C) — Burden and friction layer

Derived directly from Q7 — "Do you ever feel hassled about sticking to your medication regimen?" This single question captures the patient's experienced friction with their regimen: complexity, cost, administration burden (injections, timing constraints, side effects), and social stigma. Context is the amplifier — a patient with moderate A and E can sustain adherence if Context is low-friction, but even a motivated patient with good habits will degrade over time if the regimen feels unmanageable.

Low C means: The regimen itself is the barrier. Counseling focus: regimen simplification discussion with prescriber (once-daily formulation, combination pill), medication delivery services, cost support programmes, addressing stigma or administration anxiety.

Reading the PE composite score

PE ScoreInterpretationClinical action
≥ 0.85High behavioural stability — all three domains strongRoutine follow-up. Positive reinforcement. 30-day cycle.
0.70–0.84Generally stable, one domain showing mild weaknessIdentify the weak domain from the bar chart and address it specifically.
0.55–0.69Instability risk — likely to relapse without targeted supportDomain-targeted intervention. Follow-up in 14 days.
< 0.55High risk of sustained non-adherencePriority intervention. Identify dominant constraint domain. Consider PEACS for deeper structural assessment.

Constraint interpretation labels

The result modal and the PE Domain Analysis panel both display a one-line constraint label based on which domain is lowest:

The PE Domain Analysis dashboard panel

Below the standard MMAS-8 summary panel, click PE Domain Analysis ▾ to expand the cohort-level PE panel. This shows:

Historical records are included automatically PE is computed on-the-fly from Q1–Q8 scores already stored on every assessment. You do not need to recollect data — the moment you open the PE Domain Analysis panel, it computes PE for every record in your cohort, including all historical submissions. New submissions get PE values stored directly on the record and appear in your CSV exports.

PE domain columns in your CSV export

When you export your MMAS cohort data (Export MMAS CSV), four additional columns are included at the Researcher tier and above:

ColumnContents
mmas_peComposite PE score (0–1, 4 decimal places)
mmas_aArchitecture domain score (mean of Q2, Q3, Q6)
mmas_eExecution domain score (mean of Q1, Q4, Q5, Q8)
mmas_cContext domain score (Q7 value)

These columns are computed from the same Q1–Q8 values already present in your export, so you can verify the calculation independently. A null value in mmas_pe indicates that one or more required questions were missing from that record (uncommon — ATLAS requires all 8 questions for submission, so nulls typically appear only in bulk-uploaded records with incomplete source data).

Cite TPE in publications If you report PE domain data in a publication, add this citation: Morisky, P. (2025). Theory of Predictive Emergence: A geometric behavioral stability framework [Preprint]. Zenodo. https://doi.org/10.5281/zenodo.18209699

Reading Your Dashboard

Your dashboard has two main panels (Track A — MMAS-8, Track B — PEACS) plus several additional analytics sections below. Here is what each component shows:

Benchmark comparison

Each cohort summary and individual score view now shows a benchmark strip comparing your result against two reference points: the published literature mean (Morisky et al., J Clin Hypertension, 2008: mean 5.93, 31.4% high adherence) and the ATLAS global dataset 2026 mean (6.21, 34.2% high adherence). Use this to frame patient counselling ("your score is above the global average…") and to contextualise cohort reports for case rounds or institutional reporting.

ComponentWhat it showsHow to use it
Pulse bar (top)Live global totals — all ATLAS users worldwideContext only — not your cohort
Mini globe (MMAS)Map of your cohort's geographic distributionVisual check of data spread
INA / UNA / Mixed / High boxesPattern classification breakdownHover for clinical tooltip. Determine primary intervention approach for your cohort
Adherence Phenotyping Engine5-phenotype probabilistic model of your cohortPopulation-level intervention planning
Drug · Condition StratificationMean score by drug class and conditionIdentify which drug types have lowest adherence in your population
Longitudinal TrajectoriesScore over time for patients with 2+ assessmentsMonitor individual patient improvement or deterioration over repeat visits
Active Patients tableIndividual patient records with score, pattern, dateSearch by Patient ID. Review individual history.
PE Domain Analysis panelCohort-level PE scores, constraint distribution, domain average bars, lowest-PE patient tableExpand with PE Domain Analysis ▾. Identify which domain (Architecture / Execution / Context) is the primary constraint across your population. Prioritise follow-up using the lowest-PE patient table. Full detail →
MTM Audit LogCMS-formatted encounter log with CPT codesExport for billing reimbursement

Data Exports

ExportFormatContainsUse for
Export MMAS CSVCSVAll cohort MMAS-8 records with individual Q scores, pattern, demographics, timestamps. Includes PE domain columns: mmas_pe, mmas_a, mmas_e, mmas_cStatistical analysis, research publication, PE domain analysis
Export PEACS CSVCSVPEACS records with BASE, MVMT, STRATA scores and PE compositeLongitudinal analysis, PEACS research
MTM Audit PDFPDF (print)Formatted audit table with CPT codes, patient IDs, scores, interventions, license referenceCMS reimbursement, audit documentation
MTM Audit CSVCSVSame data as MTM PDF in spreadsheet formatElectronic billing system import
Sentinel Log CSVCSVAll sentinel alerts with urgency, reason, patient ID, score, reviewed statusQuality audit, JC documentation
SOAP NoteText (copy/paste)Individual patient SOAP note from ZOE sessionPatient record, prescriber communication

Your Letter of Permission

Your workspace key comes with a Letter of Permission for the MAP, sent as an HTML attachment in your welcome email. This letter:

To print your letter: open the attached HTML file in Chrome → File → Print → Save as PDF. Keep a copy in your patient records folder and submit it with any research ethics application.