1. 0 Patient Portal Medical Informatics 404 Section 55 Dr Sameer Badlani Julie Bayless Felix Carpio Joseph Gabel Joseph Gabel Jodi Kellermann Jodi Kellermann Midwestern Community Hospital Board Presentation December 1, 2013

2. 1 Midwestern Community Hospital Goals and Objectives To be the best place for physicians and associates to work Increase market share for continued sustainment Support innovative approaches to achieve excellence Core Values –Innovation Finding new ways to improve the quality of health services –Compassion Providing "radical loving care" for everyone –Accountability Accepting responsibility for our actions and attitude –Respect Valuing diversity, inclusion and working well together –Excellence Achieving the best results in all we do

3. 2 Patient Portal Steering Committee Scott Leader – Chief Executive Officer John Knowledge – Chief Information Officer Kevin Moneybags – Chief Financial Officer Ann Operations – Chief Operating Officer Kathleen Nightingale – Director of Nursing Leonard McCoy – Chief Medical Officer, VP Physician Operations Anthony Informatics – Chief Medical Informatics Officer Jane Ambulatory – VP Ambulatory Services

4. 3 Reason for Action – Patient Portal Increase market share –Helps create in network “stickiness” Keep patient in our network Provides access to network services within portal –Increase use of network services More complete patient record Increase care efficiency Improve care coordination Improve quality of care Improve management of chronic illness Increase patient satisfaction Avoid penalties of not providing patient portal access

5. 4 Reason for Action – Patient Engagement Engage – Empower Patients Patients as own chief life officers Increase involvement in planning patient’s own care Puts patient in control of life decisions –Request/make own appointments –Review health summary –Review medications / allergies –Request refills –Ask questions to health care team –Review bill / insurance payments made to account

6. 5 Reason for Action – Improve Community Health Access patient education library Convenient online communication Group communication –Subgroup of patients due for specific screening –Subgroup of patients prescribed a specific medication –Subgroup of patients who have a recalled medical device

7. 6 What Is a Patient Portal? Definition: –“Secure online website that gives patients convenient 24- hour access to personal health information from anywhere with an Internet connection” [http://www.healthit.gov/providers-professionals/faqs/what-patient-portal] –Deloitte study results: 80% want access to integrated medical records online 72% would pay bills, make appointments, and contact physicians online

8. 7 What Is a Patient Portal? Features: –Enables Patients to View Health Information After Visit Summaries Current / Past Medications Lab / Procedure Results Allergies Immunizations Benefits & Coverage Educational Materials

9. 8 What Is a Patient Portal? Features: –Enable Patients to Communicate with Providers Secure Email Exchange Request Prescription Refills Schedule Appointments Fill Out Forms / Questionnaires –Pre-Visit –PHQ9 Make Payments

10. 9 What Is a Patient Portal? Benefits: –“With patient portal implementation, your organization can enhance patient-provider communication, empower patients, support care between visits, and, most importantly, improve patient outcomes” [http://www.healthit.gov/providers-professionals/faqs/what-patient-portal]

11. 10 Meaningful Use Requirements Stage 2 Final Rule – SGRP 204A – Engage Patients & Families in Their Care –Eligible Hospital Objective “Provide patients the ability to view online, download, and transmit information about a hospital admission” “More than 50 percent of all patients who are discharged from the inpatient or emergency department … have their information available online within 36 hours of discharge” [HIT Policy Committee: Meaningful use workgroup request for comments regarding meaningful use Stage 3]

12. 11 Proposed Patient Portal Implementation Timeline Allow approximately 2 weeks for each stage of process Design time increased to accommodate holiday schedules Marketing time increased to allow for physician / provider and patient engagement

13. 12 Implementation Strategy Monthly meeting with steering committee Pilot at 1 location Physician champion at each location Phased approach 1.Clinical summaries 2.View labs / test results 3.Email provider 4.Ask a nurse 5.Request / schedule appointments 6.Billing summary

14. 13 Marketing – General Strategy – Broad Approach Website –Promote patient portal –Provide access on hospital’s website Newsletter –Mail to patients –Email to patients Flyers – post in elevators, hallways Tent cards in waiting areas Buttons for staff – Ask Me About the Portal! Elevator speech Videos –Rolling videos in waiting areas, inpatient TVs

15. 14 Marketing – Patient Engagement Hospitals / Physician Offices Computer kiosks –Provide enrollment opportunities while patient waits –Step by step access instructions on computer kiosks Engage office staff to assist/enroll in portal –Guide assistance with computer –Provide interpreters as needed Provide instructions at each touch point –Patient arrival to hospital/office – capture email address –Patient discharge/ check-out – capture email address Informational videos in waiting areas –Instructions on how to enroll –Testimonials on benefits of participation

16. 15 Legality and Privacy Issues Examples of data accessibility concerns that will be managed by relay clearinghouse Proxy issues: Minors –Reproductive information that parents are not legally privy to Power of Attorney Mental/behavioral health information Access to this sensitive information will be patient controlled and the responsibility of the vendor, should any breaches of security ensue (we are protected by our agreement with the vendor)

17. 16 Technology Challenges to be addressed Match the correct information with the correct patient. –Without precision, inaccurate information has the potential to cause patient harm Help desk/support staff – IT department can expect an increase in inquiries from the patient population unless the portal support is outsourced. Infrastructure of the patient population –Do our patients have the technology or access to the Internet to access our portal?

18. 17 Patient Portal Business Impact Improved organization administrative efficiency by –reducing phone calls and paperwork, –enabling electronic communications, and –cutting costs on printing and postage. Increased patient satisfaction Increased provider-patient interactions Increased provider productivity Increase patient’s participation in the management of their own healthcare Increased Likelihood that patients keep information current through Patient Portal’s easy-access, user-friendly interface

19. 18 Hospital successful attestation to the Meaningful Use Stage 2 criteria. Scorecards to measure utilization and patient enrollments –Minimum: 10%. Goal: 15% Satisfaction surveys: Patient, physician, and employee –Goal: 90% Improved efficiency and revenue – self service scheduling and access to information shifts burden from employees –Contact call volume reduction of 10% –Increase revenue 5% Measures of Success

20. 19 Financial considerations Patient portals provides financial savings and it is an easy place to start-especially when looking for a concrete ROI. –Increase efficiency by controlling call center volumes. Estimated reduction in 20% of calls –Increase efficiency by allowing online registration and scheduling Estimated savings of $7 per online scheduled event –Increase collections by facilitating patients to pay online Estimated savings of $17 per online inquire Can capture some volume because it's the way some patients prefer to interact. Studies show a risk adjusted ROI of 11% with a breakeven point (payback period) of between 1.68 and 2.17 years after deployment – This does not take in consideration the MU incentive which substantially increase the ROI and reduce time to breakeven.

21. 20 MU Stage 2 Financial Impact MU incentives are conditional to meeting all Objectives and Clinical Quality measures. –Patient portal is a key component of core objective measure 15 Not having a patient portal will: –Make the hospital ineligible for MU incentives in 2014 and beyond Approximately $2.5 million –Risk Medicare penalties starting in 2015 1% reduction per year in Medicare reimbursement

22. 21 Patient portal is a key component of our hospital strategy to improve efficiency, increase market share, Improve care coordination and quality of care. Meaningful Use incentives for stage 2 require the implementation of a patient portal to communicate with patients. The implementation of Patient portal will help hospital –Qualify for MU incentives –Eliminate CMS penalties Financially speaking, the implementation of the patient portal can have a ROI of > 11% and a breakeven point of less than 2 years. Conclusion

23. 22 Bell, Heath. Portals Hold Promise for Patient Engagment But Challenges Remain. June 14, 2012, retrieved November 20, 2013 from http://www.ihealthbeat.org/perspectives/2012/portals-hold-promise-for-patient- engagement-but-challenges-remain Emont, S. Measuring the Impact of Patient Portals: What the literature tells us? CHCF. May 2011 Erikson J; Didee, The total economic impact of IBM patient portal. October 2007 Woodcock, Elizabeth. How Patient Portals Create Value for Patients and Fulfill Meaningful Use Requirements. Retrieved November 2013 from http://healthcare.intuit.com/portal/docs/patient-portals-mu-whitepaper.pdf Reference