SECURE MESSAGING Our MU2 Nemesis

Why is this measure so hard? Difficult to get patients to sign up for portal due to: Lack of internet/computer Sign on process is too difficult Patients get frustrated with the process and give up Do not know or understand what features are available on the portal Apathy/disinterest in medical care Even if they are on the portal they don’t know how to “send a message” What other reasons have you found?

Where we started and where we are now… We use Follow My Health as our patient portal. Prior to FMH we used Navigating Cancer but changed due to better integration and cost. We currently have 2,253 patients with accounts on Follow My Health. Between January, 2014 and September, 2014 (8 months) we had 642 new patient accounts created. In comparison between September, 2014 and the present (5 months) we have had 1,611 accounts created.

How MOHA increased our numbers… We technically started pushing the portal in September, 2014 starting with training our front desk staff on talking to patients about the portal and the importance of obtaining emails upon check in. Oct, 2014-Present Jan 2014-Sept 2014

However, the buy in by our staff was not sufficient enough to increase our numbers as much as we were going to need to meet MU2. So, we went to plan B which was to hire a two part time hourly employees to approach patients in our lobby with portal sign on computers and help them create an account while they waited for their appointments.

We also have chemotherapy suites at all 3 offices where our patients go to get their chemotherapy treatments from 30 minutes to 8 hours. They were a captive audience. Once we helped them create an account we would show them the features of the portal, how to look at their results on the portal (View, Download and Transmit measure) and then we would show them how to send a message to our providers. No one was forced to participate but if any interest was shown we would sign them up.

We watched our numbers climb…

Other “tactics” we used… While sign ups in the lobby helped tremendously, physician buy in and pushing the portal was almost equally as effective. The physicians decided to stop printing off lab results and giving them to the patients. They were advised to sign up for the portal and look at their results online. We asked first time chemo patients to send us a message 24 hours after their treatment to let us know how they were doing in place of 24 hour chemo call backs.

On our Patient Connection Accepted email the patient receives when they are connected we added the following paragraph: Please login to your account and request future prescription renewals and also send messages to your provider with non-emergent questions. Please send your provider a message when you receive this message to update us on how you are doing. Thank you, we appreciate it.

But how to keep the momentum going for 2015… On January 8, 2015 we sent this broadcast message to our portal patients: Happy New Year from Medical Oncology and Hematology Associates! Many people have insurance changes at the beginning of the new year. Did you know you can update your insurance information with our office via the patient portal? Just follow these simple steps: 1. Log in to your portal account. 2. Go to the blue "My Info" tab. 3. Now select the blue "Insurance" tab. The fields will be populated with your insurance information as we currently have it in our system. 4. If any of the information is incorrect simply type in the correct information and then push "Save" and "Send". That will send a request right to the appropriate staff in our office and your information will be updated. This will save you valuable time when you check in for your next appointment with us. Thank you.

These FMH messages all count toward the measure: FMH Update Demo Within 3 hours of sending that message we had 45 separate patients send a message requesting insurance or demographic changes. These FMH messages all count toward the measure: FMH Update Demo FMH Patient Message FMH Referral Request FMH Provider Consult* FMH Rx Renewal FMH Update Ins FMH Update Pharmacy

Issues with broadcast messages for our office anyway: At some point this year we plan on sending another broadcast message reminding patients to renew their prescriptions online. Issues with broadcast messages for our office anyway: message fatigue number of phone calls generated with issues

Pros to online messaging… Saves staff time playing phone tag for non-emergent questions Saves staff time returning phone calls; it is never just one question they need answered Staff can answer messages at any time, doesn’t have to be during office hours Messages don’t have to be answered by the physician if the nurse can answer the question Messages are set up to be one and done to prevent ongoing back and forth communication One message can count for multiple physicians

Cons to online messaging… Patients use it for inappropriate situations Some patients think they have a direct line to the physician and use it for friendly messages Staff can answer messages at any time and may not read/answer them in a timely fashion Some patients use it for “free” medical advice Other cons?

Tracking messaging for 2015… One issue we have come across this year is keeping track of the “true” number of messages a provider has on the MU2 report because the message doesn’t count in the numerator until the patient has an arrived appointment in the reporting period.

Any questions and or comments…