1. SMARTworks ® EffectiveResponse Training: Clinical Staff – Responders National Park Medical Center November 20, 2014

2. Training:Clinical Staff Responders Objectives of the patient follow-up program Overview of how SMARTworks ® EffectiveResponse works Review of the Patient Survey – the experience that patients will have with SMARTworks ® EffectiveResponse Notifications – Alerts received via email by the Clinical Staff Responders Overview of the Active Issues Manager (AIM) Module Questions Agenda 2

3. Training: Patient Registration Improve patient satisfaction with care Enhance patient well-being −Detect failure to improve −Address any questions or aftercare problems Catching patients who we are not reaching today Provide organizational feedback Objectives – Why This Program is Being Rolled Out 3

4. EffectiveResponse Overview 4 Generates Monthly Feedback Reports SMARTworks ® EffectiveResponse Daily Data Upload from Meditech EHR Nurse Manager Addresses Any Reported Patient Concerns First Layer Text/Email Contact with Patient Second Layer Call Center Contact with Patient

5. Patient Survey (This How Patients Are Contacted the Day After Discharge)

6. Patient Survey 6 Patient receives a text or email message inviting them to click on a secure link

7. Patient Survey 7 The first screen is a click-thru acknowledge ment that the survey is not a substitute for care.

8. Patient Survey 8 Question #1 checks on the patient’s well-being. (We hope to learn that the patient feels the same or better.)

9. Patient Survey 9 If the patient reports feeling worse they receive a “pop- up” instruction to contact their doctor or return to the ER.

10. Patient Survey 10 Patient can add comments as appropriate.

11. Patient Survey 11 Question #2 is a general question to check the patient’s understanding of discharge instructions, home care, medications and follow-up appointments. (We hope to hear that the patient has no questions.)

12. Patient Survey 12 If the patient reports having a question, they receive a “pop-up” instruction to call their doctor for answers.

13. Patient Survey 13 Patient can add comments as appropriate.

14. Patient Survey 14 Question #3 asks the patient to rate the nursing staff.

15. Patient Survey 15 Question #4 asks the patient to rate the medical staff.

16. Patient Survey 16 Question #5 asks the patient to share anything else about their experience.

17. Patient Survey 17 If the patient leaves a comment, it is noted that the comment will receive attention.

18. Patient Survey 18 Patient can add comments as appropriate.

19. Patient Survey 19 The final screen provides a link to National Park Medical Center’s portal – My Health Record.

20. Patient Survey 20 With a single click, the patient is with the log-in screen of My Health Record. (Note that the patient can click on the “Register” tab if they have not been issued a User ID or Password).

21. Responder Role When patients answer a survey question that triggers a notification, email messages will be sent to: −Lance.Lindow@npmchs.comLance.Lindow@npmchs.com −Patsy.Crumpton@capellahealth.comPatsy.Crumpton@capellahealth.com −Priscilla.Couch@capellahealth.comPriscilla.Couch@capellahealth.com Notifications 21

22. Responder Role A typical notification email will look like this. The patient, his or her complaint/ diagnosis and how to contact the patient will be presented. (Note that this is a sample and not an actual NPMS email.) Notifications 22

23. Responder Role How are you feeling today compared to when you were seen in the ER?  Better  Same  Worse Do you have any questions about your discharge instructions, including your home care, medications, or follow-up appointments?  No  Yes Please rate the nursing staff by the level of care and concern they provided.  Very High  High  Average  Low  Very Low Notifications (only notified for responses in red) 23

24. Responder Role Please rate the doctor by the level of care that he or she provided.  Very High  High  Average  Low  Very Low Would you like to add anything else about your experience?  No  Yes Notifications (only notified for responses in red) 24

25. Clinical Responder - Discussion Are you going to be over-run with notifications? −No. Typically only 5% of patients will require attention. FAQs 25

26. AIM Module Review

27. AIM Module The Active Issues Manager (AIM) module facilitates closing-the-loop with patients. You may access PHI via this module – please protect Usernames and Passwords accordingly. Patient responses that triggered a notification email may be quickly reviewed. If you have called the patient you can simply close the message. Email follow-up should not be used for anything of clinical significance (patient may not check email, email address may be wrong, etc.) Overview 27

28. AIM Module If the patient has not provided an email address or a smartphone number (so that the patient may be contacted via text), you will need to “close the loop” with patients via a phone call. o In those cases the issue will be identified as “Callback” and the categorization options will not be listed. Overview 28

29. AIM Module 29 Log in to the AIM Module at https://s.smart- er.net/AIM/index.html https://s.smart- er.net/AIM/index.html

30. AIM Module 30 A patient has entered a response to a survey question that triggered a notification – this is an “active issue.”

31. AIM Module 31 Opening the issue provides the details as to the patient’s comments.

32. AIM Module 32 Clicking the “Categorize” button presents a collection of common response templates. In this case, one would select the “Housekeeping – Complaint” category.

33. AIM Module 33 You are presented with a template email that may be edited if required. Clicking the “Send” button sends the email to the patient.

34. Clinical Responder - Discussion Comfort/Bed Thank you very much for sharing information about your recent visit to National Park Medical Center. Please accept my apologies for your negative experience. I have reviewed your comments regarding how uncomfortable you were in the Emergency Department and will use this feedback to seek opportunities to improve our performance in this area. We always aim to provide our community with a top-notch healthcare experience. Thank you for taking the time to offer your feedback. We value your opinion and appreciate your choosing NPMC for your family’s healthcare needs. Lance Lindow, RN NPMC Emergency Department Manager Lance.lindow@npmchs.com Typical AIM Module Email Template 34

35. AIM Module 35 The active issues have now been cleared.

36. Questions? Support Assistance from Standard Register Healthcare: Standard Register Support Line (M-F, 7:00am-7:00pm Central Time) 1-800-333-7782 Option 2 – Software Support Group After-Hours Service Desk (Emergencies) 1-888-598-8200 Option 6 – SMARTworks EffectiveResponse DSGHelpDesk@StandardRegister.com Non critical support requests