1. Health Information Technology Summit
“Let’s follow-up via secure ” Transforming care delivery across a Statewide health plan and delivery system
Ted Eytan, MD, MS, MPH
Health Information Technology Summit
October 22, 2004
Health Informatics Division
Group Health Cooperative
Seattle, Washington, USA

2. Why Group Health?
Member governed, not for profit financing and care delivery system
539,000 patients
860 Medical Staff
25 Medical Offices, 2 Hospitals
Washington and North Idaho
Exists to transform health care, working every day to improve the care and well-being of our consumers and communities

3. The Vision
“Enable unparalleled access and transparency by connecting members, staff, community providers, purchasers, and brokers with Group Health and with one another at the right place and the right time.” - April, 2000

4. A walk down memory lane...

5. AUGUST
2003

6. NOVEMBER
2003

7. OCTOBER
2004

8. OCTOBER
2004

9. Being There
“Picture a different scene - one with the physician’s chair empty, and the two distraught parents clutching a telephone receiver.” - AMA, Historical Postmortem, March, 2001

10. EMR Implementation Traditional: “Doctors First”

11. EMR Implementation Group Health: Patients First!
“Big Bang”
Messaging
Results Review
Problem List
Transcription Authentication

12. Information Therapy: Doctor as Teacher
“Ix” is effective, more affordable, and with less side effects than “Rx”
The same information, from the exam room to the living room
Image © 2004 Epic Systems, Inc.

13. Where Physicians and Patients Write the Medical Record Together
Image © 2004 Epic Systems, Inc.
Once a message is sent by a patient, the message appears in the LPN/MA pool InBox. The person who is in charge of managing the pool then answers the message or forwards it on to the appropriate person. After she has handled it, she will “Done” the message.
Messages from patients are always available in the patient’s chart. You can also retrieve messages that have been “doned” by using the search functionality.
The buttons on the right hand side of the page:
No Reply (needed) this “Dones” messages that don’t really need a reply, but let’s us know that someone meant to do that.
Sec Pt Msg initiates a message to the patient
Reply to Pt does just what is says
Review opens the patients chart and a reply window at the same time.

14. .. And secure E-mail is part of the process of care
This is the screen that let’s you reply or initiate a secure message.
Two check boxes on the right:
Do not allow patient to reply – the reply button doesn’t appear. Useful when a message thread is too long or has moved on to another topic that should be called out.
Allow reply directly to me – the message comes back to the practitioner’s inbox without going to the pool. Useful when you know there will be lots of back and forth over a short time.
Don’t forget to use the SmartTools available to you. You can make your own smarttext very easily.
Images © 2004 Epic Systems, Inc.

15. When your patients are going to send you a secure message, they go to this screen. Their PCP appears at the top of their dropdown list, with almost all doctors they have seen within the past 13 months in the dropdown list. Behavior Health practitioners won’t appear here
The free text box will let them send a message of up to 2000 characters. Long messages may seem a little overwhelming at first, but they can be used to your advantage. A perfectly good response is “I’ve read your secure message, and I think it would be good if you scheduled a visit to talk about these concerns.” Then when they come in for the visit, you’ll have the list of what you need to talk about .
When the patient clicks on Send, the messages goes to the pool inbox in Epic.

16. Your patients can review messages they sent and messages received by them from you. This is a useful tool in the communication between your patients and you. It promotes the feeling that your patient is part of the team. Don’t forget, all patient secure messages go into the patient’s chart so everyone can see them, even urgent care staff.

17. Images © 2004 Epic Systems, Inc.
Online test results
Then you’ll get a list like this. When you check a lab, you can then release it by clicking done at the bottom of the screen. If you want to send a message, click patient message and that will let you send a message, or you may click results comments and you can type a short comment attached to the result.
Images © 2004 Epic Systems, Inc.

18. Online test results and Information Therapy
Details are available on tests shown in MyGroupHealth. The details come from Healthwise. Test results are shown in some detail

19. Test result charting
Coming Soon: Members will be able to graph test results over time. Great for monitoring

20. Image © 2004 Epic Systems, Inc.
Shared problem list
When you are noting new problems or verifying present problems…you go to the Problem List on the Activity Bar to view, note or resolve allergies…when you do this….your patient sees…….
Image © 2004 Epic Systems, Inc.

21. State of CIS Implementation

22. MyGroupHealth Big Bang
Increasing Member Adoption of ghc.org Changing the point of care to “whenever and wherever” care is needed
MyGroupHealth Big Bang
8/14/03

23. Increasing Member Adoption of ghc
Increasing Member Adoption of ghc.org Changing the point of care to “whenever and wherever” care is needed
21.3%
Eligible Adults

24. Specialty Care Providers Added
Messaging takes off
Specialty Care Providers Added
8/14/03

27. Positive Perceptions increased in unadvertised areas
Taking into account everything you have heard/read/experience d about Group Health, do you agree that Group Health has...
Group Health 2003 Advertising Tracking Survey: 400 insured adults in Puget Sound and Spokane
In 2001, perception of GH physicians was 31%

28. The Year of the Lab Result

29. Working together

30. Paving the Future Financial & Clinical Integration CIS Provider
Employer
Broker
Member

31. Q and A