Antonio Vega Health IT Advisor June 10th, 2015

Pati ent Portal

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Introducti on

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As the federally designated HIT Regional Extension Center for Iowa, we provide support for eligible providers, Critical Access Hospitals and rural hospitals with attesting to CMS EHR Incentive program.

– Telligen has helped 1200 providers and 84 critical access hospitals and rural hospitals attest to Meaningful Use

Telligen

Who We Are

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Antonio Vega I am a Health IT Advisor with Telligen and the regional

extension center. My work involves helping critical access hospitals and rural hospitals navigate the CMS EHR incentive program.

Contact Information Antonio Vega

avega@telligen.com(515) 362-8311

Introduction

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Objecti ves

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Patient Portal and Meaningful Use– Stage 2 Meaningful Use and the patient Portal – 2015 modified version of Stage 2

Implementing a Patient Portal

Registering a patient Developing talking points Creating a workflow

Objectives

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Benefits of a patient Portal – Encouraging Patient engagement – Setting expectations – Making a practice more efficient

Patient Portal and the Benefits to the Patient

Incorporating a patient portal into your practice

Potential obstacles to overcome

Objectives

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Meaningful Use

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Current Patient Engagement View, Download and Transmit

– Requires that at least 5% of your patient population access your organization patient portal

– This is for both Eligible Hospitals and Eligible Providers

Eligible Professionals secure messaging – Requires that 5% of patients use secure messaging throughout the

reporting period

Meaningful Use

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Proposed Changes to Patient Engagement The patient engagement requirements

View, Download and Transmit – Needing only one patient to view, download and transmit

Eligible Providers use of secure messaging will need: – Functionality enabled during the reporting period

Meaningful Use

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Patient Engagement Eligible Providers and Eligible Hospitals will still need to have a

patient portal

Getting patient engage with their own healthcare is a big part of using a patient portal – The Meaningful Use program is still encouraging participants to

actively engage patient in the use of the portal functionality

Meaningful Use

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Implementi ng a Portal

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The implementation of a patient portal can be similar to implementing a electronic health record

Things to consider:– Workflow redesign– Physician and staff buy in– Education of staff – Education of patients – Is the portal HIPPA compliant – How much customization can be done with the portal

Implementing a Portal

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Training Staff The importance of training staff:

– Will help to sell the patient portal to patients– Better understanding on how to leverage the functionality of the

patient portal – Answer questions that patients might have about portal – Alleviate potential concerns that staff might have in regards to the

implementation of portal

Implementing a Portal

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Testing of a Patient Portal As part of staff training it is important for staff to be able to

interact with the patient portal This will aid in staff understanding of

– How portal will interact with the EHR system– Designing a workflow with a patient portal in mind– Showing the functionality of a portal – Demonstration of the communication functions of the portal

Implementing a Portal

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What to consider during the implementation process – How are messages going to be filtered

Will the messages go directly to the doctor or be filtered by the front office staff

– What type of policies need to be in place to make the patient portal successful

How many days can pass before a message needs to be responded to What type of information will be shared over the portal; labs,

assessment and plan and the patient summary.

Implementing a Portal

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Other aspects to consider How is information handled within the portal

– Will it stay in the patient account – Or will if flow into the patient Electronic Health Record

How is sensitive information handled within the patient portal– Can abnormal lab/radiology results be withheld from going to the

patient portal

Implementing a Portal

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Registering Pati ents

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Incorporating a strategy on educating the patient on the patient portal is important to receive full buy in

Educating the patient should be the role of the entire clinic staff– Front office staff– Nursing – Doctor – Checkout staff

Registering Patients

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Strategy to receiving patient buy in– Distribute fliers around the office – Develop talking points for all office staff to use– Avoid just asking for an email address

Have clear benefits of why a patient should register– Have a laptop ready in the office to demonstrate how the portal works– Having a physician talk to the patient about the portal functionality

Registering Patient

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Example of Talking Points Do you use e-mail? The portal is just a secure e-mail system

that we can use to communicate You can send your provider a message and it goes right into

your chart, so all of your information at hand when I read and respond

It’s really very easy to use. If you use the internet, you’ll most likely find the portal helpful and easy to navigate.

Registering Patient

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Benefi ts of a Pati ent Portal

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Reduce call volume Patient can use the portal to securely message their provider

or nurse Question tend to be more precise over secure messaging

oppose to phone call Less time to respond to messages then to phone call Communication through direct messaging is more efficient

then playing phone tag with providers and patient All information can potentially flow into the patient chart

allowing for better record keeping

Benefits of a Patient Portal

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Electronic Access Patient have the ability to have electronic access to there

health information– Can View, Download or transmit their health information onto a third

part via direct secure messaging – Access to normal lab values – Can directly ask for refills from providers without calling the clinic

Benefits of a Patient Portal

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Patient Engagement Patient have the ability to take control of their own healthcare

– With electronic access to there patient summary patient are able to see the medication they are on

– Reference the recommendation the physician made at the previous visit

– Monitor their own labs and vital signs

Benefits of a Patient Portal

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Areas to consider Setting reasonable expectation on how long it will take for a

message to be responded for

What types of lab results and radiology results will be displayed via the portal

What type of questions can be answered over the portal and what type of questions require an in office visit

Benefits of Patient Portal

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Making a Practice More Efficient Reduction in Call Volume

– Less phone tag– Questions are precise

Better documentation– Direct messages flow directly into the patient chart– Patient have access to labs and radiology results

Patient Engagement – Access to clinical Summary

Benefits of a Patient Portal

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Portal and Pati ent Benefi ts

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HealthCare Compliance Study conducted by Journal of Internal Medicine, examined

the benefits of allowing patients to view their physicians notes post visits

The study followed 13,564 patients over a one year period Of the 13,564 patients enrolled in the study 11,155 patients

opened one of there physician notes at least once over the one year period.

Portal and Patient Benefits

Source: Delbanco, Tom, Walker, Jan; “Inviting Patients to Read their Doctors Notes: A Quasi-experimental Study and a Look Ahead”; Journal of Annals of Internal Medicine: October 2nd 2012

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Healthcare Compliance Results:

– Study found that 60-78% of patients reported an increase in medication adherence

– 20-42% reported sharing notes with other members of their care team

– 77-88% of patients feeling more in control of their own health care– 99% of the patients enrolled in the study wanted the open notes

program to continue after the study was over

Portal and Patient Benefits

Source: Delbanco, Tom, Walker, Jan; “Inviting Patients to Read their Doctors Notes: A Quasi-experimental Study and a Look Ahead”; Journal of Annals of Internal Medicine: October 2nd 2012

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Benefits to the Patient Enhancing Care

– Patient are able to access the most up to date portion of their healthcare record

– Eliminate the number of phone calls that it takes to relay simple information like normal lab results

– Patients are more willing to ask difficult and embarrassing questions, because of the offer of private and direct level of communication

Portal and Patient Benefits

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Benefits to the Patient Better Customer Service

– Able to schedule appointments through portal– Request refills – Pay bills online through portal access– View labs and clinical summary– Download clinical summary and send to another healthcare provider

Portal and Patient Benefits

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Incorporati ng a pati ent portal into your practi ce

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Creating a Workflow Developing a workflow that incorporates patient engagement

with the portal or education about the portal is important – This starts at the check in process with asking for the patients email to

set up a portal account– Or working with a patient that has a portal account that has not used

the account yet– Having a designated staff to work with patient that would like further

education or help with setting up and creating their account

Incorporating a Portal

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Creating a Workflow Nursing and Provider Staff

– Having talking points that the nurse or doctor can reference Referring back to the use of portal can help create buy in with the portal Mention what information from this visit will be available on the portal Making sure the patient are aware they can communicate with their

provider via direct secure messaging

Incorporating a Portal

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Upon Checkout Having the checkout staff

– Work with the patient to schedule their next appointment

– Demonstrate how a patient can update key healthcare information via portal access

Health insurance, address change and next of kin

Incorporating a Portal

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Extra Training If the need is there

– Offering educational training to your patients to help them understand the functionality of the portal

– Have an in office staff train patients at their clinic visit

– Follow up phone calls to see if patient has set up their portal account

Incorporating a Portal

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Potenti al Barriers to Overcome

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Registration of Patients – Multi step registration process

Email address Unique password Completing of registration is often completed at home Managing multiply family member accounts

– Required Email address Some patients might not have email address Unwilling to give email address

– Internet access Slow internet connection can make access a patient portal more difficult

Potential Barriers to Overcome

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Patient barriers to using a patient portal – Slight learning curve for patients to understand on how to use the

portal

– Patients barriers Patients becoming an active participant of there healthcare Patient health literacy Patients level of cognitive understanding Language barriers

Potential Barriers to Overcome

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Thank You

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Questions Contact Information

Antonio Vega avega@telligen.com

(515) 362-8311

This material was prepared by Telligen, Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-IA-B4-6/2015-11065