Presentation on theme: "Patient Portal Ann Guilmette, eHealth Specialist, VITL"— Presentation transcript:
1 Patient Portal Ann Guilmette, eHealth Specialist, VITL Rick Dooley, PA-C, Thomas Chittenden Health Center
2 Agenda Ann- MU Measures related to the Patient Portal Rick- Implementing a portal/share experienceQ&A
3 What is a Patient Portal? Patient Portals are:Healthcare-related online applications that allow patients to interact and communicate with physicians and hospitalsAvailable on the Internet at all hours of the day and nightPortal applications:Exist as stand-alone web sites that sell services to healthcare providersIntegrate into existing web sites of healthcare providerModules added onto an existing EHR systemAll of these services share the ability to interact with patient medical information via the Internet
4 Features and Benefits?Provide individuals access to their protected health information (PHI) securely through the InternetAllows patients to interact with health care providersQuestions, comments, or directly with healthcare providersBenefit patients and providers by increasing efficiency and productivityA key tool to help physicians meet Meaningful Use requirements
5 Features and Benefits, cont. Some applications enable patients to register and complete forms online, which can streamline visits to clinics and hospitalsMany portal applications empower patients to:Request prescription refills onlineOrder eyeglasses and contact lensesAccess medical recordsPay billsReview lab resultsSchedule medical appointments
6 Why Consider a Patient Portal? To achieve MU and other industry initiativesEnable patients to become partners with their PCPPatients will likely have several portals(PCP, Hospital, Payer)
7 Patient Electronic Access MU Core Measure ObjectiveProvide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP.Measure 1:More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the EP) online access to their health information.Measure 2:More than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.
8 Exclusions: Any EP who: Neither orders nor creates any of the information listed for inclusion as part of both measures, except for "Patient name" and "Provider's name and office contact information, may exclude both measures.Conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period may exclude only the second measure.
9 Definition of TermsAccess – When a patient possesses all of the necessary information needed to view, download, or transmit their information.This could include providing patients with:Instructions on how to access their health informationThe website address they must visit for online accessA unique and registered username or passwordInstructions on how to create a loginAny other instructions, tools, or materials that patients need in order to view, download, or transmit their information
10 Definition ContinuedView – The patient (or authorized representative) accessing their health information onlineTransmission – Any means of electronic transmission according to any transport standard(s) (SMTP, FTP, REST, SOAP, etc.)However, the relocation of physical electronic media (for example USB or CD) does not qualify as transmission although the movement of the information from online to the physical electronic media will be a downloadBusiness Days – Business days are defined as Monday through Friday, excluding federal or state holidays on which the EP or their respective administrative staffs are unavailable
11 Portal Helps Meet Other MU Measures Clinical summaries provided to patients or patient- authorized representatives within one business day for more than 50 percent of office visits.Measure 12:More than 10 percent of all unique patients who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference, when availableMeasure 13:Patient-specific education resources identified by Certified EHR Technology are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period
12 Online Access Information Required The following information must be made available:Patient nameProvider's name and office contact informationCurrent and past problem listProcedures/ laboratory test resultsCurrent medication list and medication historyCurrent medication allergy list and medication allergy hxVital signs (ht, wt, BP, BMI, growth charts)Smoking statusDemographic information (preferred language, sex, race, ethnicity, date of birth),Care plan field(s), including goals and instructionsCare team members including the PCP
13 Thomas Chittenden Health Center Patient Portal Experience
14 Patient Portal Uses: Enter/update demographics Enter/update PM/Family/Social HXReceive/view lab resultsView upcoming appointments or request an appointmentCommunicate messages securelyRequest Prescription RefillsView Rx educational materialDownload summary of their chart (CCD/PDF)
15 What We Don’t Allow Patients directly scheduling appointment Change insurance information
16 Patient Invitation:Nurse gives each patient a portal invitation letter at the office visit which incudes login information and authorization code.Patients login from home and create their acct. with unique user ID, password, 3 security questions, etc.If no interest, patient marked as “declined” so we don’t ask them over and over.At first login, patient is asked to update all info, meeting MU measure for active use.
17 Updating Demographic Info: Practice controls which fields the patient is allowed to update.Changes are “requested” by the patient, routed to Medical Records, reviewed and accepted there.We do NOT allow changing of any insurance info
18 Past Medical, Surgical, Family History Patients may enter as much detail as they wish, with both discrete and text fields.Patients may choose from lists for more common procedures/conditions, or may free text in less common conditions/surgeries.Changes are sent to the nurse for review.Accepted items automatically enter into the HX, which can be pulled into a progress note.
19 Lab Results Provider can send results to the portal (1click) Provider controls which labs get sent, as well as accompanying info (ref. ranges, H/L flags)Personalized messages can be attachedPatient is notified by , labs to reviewLab marked as “sent to portal, not yet viewed”, until the patient views the results, changes to “viewed”
20 Secure Messaging Patients can only message provider they have seen Message may be routed to nurse or providerProviders can:Respond immediatelyTask/triage messages to the nurse for more informationMessage back to patient will NOT include office dialogueMessage to patient can include:Documents, handouts, excuse from work/school lettersImaging studiesAnything else that is in the recordEntire message thread is saved in the chart for future use.Patients can be shut off from portal!
21 Prescription Refills/Med List Patients can request refills, routed to the nurse with pharmacy info automaticallyPatients receive a message when the med has been renewed, or a request for more infoPatients can view when a medication was prescribed, and when they are next due for refillPatients can request to add or remove a med from the med listPatients can change their primary or secondary pharmacy
22 Appointments Patients can: View previous and upcoming appointmentsCancel appointments on portal, message routed to schedulersWe do NOT allow patients to schedule their own appointments, although that is an option.
23 Advantages to Practice Decreased phone calls to practiceImproved documentation (patient/nurse/provider)Increased detail in medical/family HxMedical/social/family Hx imports to chartProviders can respond to messages on their own schedule (great for night owls)Information or requests are routed to appropriate party (scheduling, med records, nursing)Online cancellations = less no-showsPractice can control what info is updatedIt’s GREEN-no paper CVS or result letters
24 Advantages to Patient Access to view the EHR for accuracy Ability to order medication refills at night“Direct” access to provider via secure messaging, ensuring the message won’t get misconstrued.Quick access to lab results, lettersCan cancel appointment online anytimeCan download info for travel or other appt.Again, it’s GREEN!
25 Pitfalls Difficulty getting patients to sign on “Frequent messagers”-multiple messages in a day about an ongoing issueOver-detailers (3 page family history)Managing patient expectations for response time. This is NOT a place to report chest pain!Patients disagreeing with an actual diagnosis on the problem list that the provider has forgotten to block. Trying to explain why you feel that patient has Delusional Disorder can be tricky!
26 Our Experience: Went live with Medent September, 2012 Portal live 2/7/13Seen 8,732 patients, 7,857 have been given the portal letter, and 1,477 have signed on and activated their portal account (17%)Patients who are on it, LOVE it!Nurses are generally positive about messages that are already charted, rather than taking off phone messagesNurses LOVE the ease of refillsProviders like the ability to respond on their own time, including from homeWell positioned to meet MU 2014
27 Patient Portal TipsHow well does the portal interface with your EHR? Will the information automatically update, or will you be entering it manually?How easy is the entering of information for patients? Are there dropdowns for PMH, PSH, PFH, etc. Does it store discrete data in EHR?Is there flexibility in routing of types of messages? Who at your practice will be getting what types of messages?How easy is the initial enrollment process?Are their safeguards in place so patients can’t make critical changes without approval?