In-Basket Enhancements Kaiser Permanente Mid-Atlantic States

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1 In-Basket Enhancements Kaiser Permanente Mid-Atlantic States Allan Rogers, MD Ambulatory Physician Lead KP HealthConnect National Team KP HealthConnect Mid-Atlantic States Kaiser Permanente For Internal use only page 1

2 Mid-Atlantic States In-Basket Journey, Ambulatory rolling implementation Out-of-the box In-basket message types implemented Required infrastructure of a department pool with a standard naming convention for each department in a medical center Optional Clinic Assistant pools providerlastname_providerfirstname_ca Kaiser Permanente For Internal use only page 2

3 Mid-Atlantic States In-Basket Journey, 2006 and In-basket challenges In-basket report indicating the need to address message management Call Center advice nurses began using Kaiser Permanente HealthConnect TM and needed to route messages to providers Kp.org (MyChart) implemented needed plan for routing member messages Solutions Created pools with a common naming convention for routing (MSG providerlastname_providerfirstname) for kp.org and Call center messages Began working with a regional operations team to improve response time to member initiated messages Kaiser Permanente MessageConnect TM strategy developed we understood the solution to our continued In-basket challenges required a multi-faceted approach that had the support of regional leadership Kaiser Permanente For Internal use only page 3

4 Mid-Atlantic States In-Basket Journey KP MessageConnect Merging of various regional In-basket/messaging efforts KP HealthConnect Ambulatory Application Coordinator (AC) team In-basket modifications and enhancements KP HealthConnect End-User Support Team Plans to work with individual end-users in each medical center Message Management Team Re-design of Health Care Team/Call Center patient initiated messaging workflows to improve response time to members Kaiser Permanente For Internal use only page 4

5 KP MessageConnect Project Description KP HealthConnect proficiency support in targeted areas as necessary to support effective message and In-basket management Full implementation of the recommended workflows for efficient and effective management of patient initiated communications Establishment of service level targets for leadership introduction Development of supporting monitoring methods Leadership training to support roll-out activities and KP MessageConnect initiatives Redesign of the KP HealthConnect In-basket system functionality This being the focus of today s discussion Kaiser Permanente For Internal use only page 5

6 KP MessageConnect In-Basket Modifications and Enhancements Kaiser Permanente For Internal use only page 6

7 In-Basket Configuration Requirements Recommendations from end-user/focus groups and analysis done by KP MessageConnect team: Assure In-basket consistency and uniformity in order to promote easier use and trainability (Where possible, extend this consistency throughout the application.) Provide access to pertinent patient information from within the In-basket (without opening the chart) and improve readability of patient information Provide more pertinent information to make it easier to triage messages Reduce clutter in heavily-used folders such as the one holding patient initiated communications Create new buttons in order to save time and clicks Remove responsibility from the Patient Call (Patient Communication) folder to reduce dual workflows for done ing messages Improve In-basket report tools to accurately reflect the use of the In-basket Kaiser Permanente For Internal use only page 7

8 In-Basket Configurations Types of modifications/enhancements Change folder names so it is more intuitive to user what to expect in them Report changes for efficiency in viewing important information at the top Create hyperlinks within In-basket the In-basket reports to display information so that the user does not have to leave the In-basket Creating new buttons patient info, problem list, and close encounter Submenu clustering of buttons, and use of Close & QuickNote buttons to do work from In-Basket Columns for viewing additional information in the In-basket Columns for managing In-basket (particularly for pools) Reminder/tickler workflows- Postpone, Pt Reminder & Public Searches Remove responsibility from Patient Call (MAS Patient Communication) folder Combined responsibility and pool tool This feature still works well in folders that do not have pool messages coming to them Reduce clutter in the Patient Communication folder Add Nurse Triage/Call Center encounter that displays messages in the Call Center folder Add Send to Hold Folder section to the navigator which displays message in HOLD folder within the In-basket Provide valuable user help information within the In-basket Staff message use Letter workflow Kaiser Permanente For Internal use only page 8

9 In-Basket Configurations General Modifications and Enhancements Kaiser Permanente For Internal use only page 9

10 Folder Named for Ease of training & use Rx Request (instead of Rx Authorization & Response) for Telephone type refill encounters Rx Refill- for all msgs related to Pharmacy generated RAR s. Patient Communicationsbecause nearly all routable encounters end up here HOLD is Epic Callback - used in Nurse Triage & telephone type encounters Kaiser Permanente For Internal use only page 10

11 Report Modifications Put pertinent information at top of In-Basket report Use Blue Style Reports when possible. Create Hyperlink report for use across In-Basket messages for consistency For Hyperlinked Reports use compact Native HTML print groups For significant training points, put training info in header print group w/ SmartText print group Kaiser Permanente For Internal use only page 11

12 Report Links Patient level data available via report links patient related In-basket message reports Linked reports use compact Native HTML print groups for efficient use of space These same reports are seen on Snapshot, Patient Lists and Schedule for consistency across the application. Links button in the In-basket gives quick access to these report links Kaiser Permanente For Internal use only page 12

13 Snapshot Link Kaiser Permanente For Internal use only page 13

14 Recent Vitals Link Kaiser Permanente For Internal use only page 14

15 Future and Past Appointments Link Kaiser Permanente For Internal use only page 15

16 Problem List and Health Maintenance Link Kaiser Permanente For Internal use only page 16

17 Current Medications Link Kaiser Permanente For Internal use only page 17

18 Recent Labs Link Kaiser Permanente For Internal use only page 18

19 In-Basket Buttons Using New Sub-menu functionality to cluster similar buttons: Creating new Buttons to take one directly to the desired activity- ie Problem List Using Quick Note and Close buttons to do work from the In-Basket when possible. Kaiser Permanente For Internal use only page 19

20 In-Basket Buttons Shortcut buttons to other functionality: Opens order section of original encounter associated with result (Copy of Epic Reflex Order HIC record) Kaiser Permanente For Internal use only page 20

21 In-Basket Buttons and Columns To reduce the need to leave the In-basket: Patient name defaults when patient list window opens Enter documentation in the chart from the In-basket Close the encounter from the In-basket Is the encounter open? Are there orders in the encounter? Patient s Home Center The patient s personal physician See next slide Kaiser Permanente For Internal use only page 21

22 In-Basket Configurations Patient Info Button Pertinent patient information from Demographics, Benefits, Snapshot, Pharmacy, FYI, and other places all in one report Kaiser Permanente For Internal use only page 22

23 In-Basket Buttons and Columns To support managing work in the In-basket. Select a flag and/or date that will display in a column for yourself or others to see Note a free text comment that will display in a column for yourself or others to see Kaiser Permanente For Internal use only page 23

24 In-Basket Columns- Creating Actionable columns that reduce the need to read the In-Basket Report Refills Requested is Actionable- between choosing Approve and EZApprove The Medications Requested column also can be actionable, or clue the provider that multiple are requested, to review report Kaiser Permanente For Internal use only page 24

25 In-Basket Class Button On Toolbar Users have access to edit themselves in and out of classes via the In-basket class button. This functionality had been buried in toolbar menus. Kaiser Permanente For Internal use only page 25

26 Pt Reminder Button On Toolbar Pt Reminder button on toolbar allows a user to quickly open a Pt Reminder msg (flag defaulted) and Automatically sets current patient context from open patient workspace Reminder can be sent at a future date using the options tab. Kaiser Permanente For Internal use only page 26

27 Public In-Basket Searches Kaiser Permanente For Internal use only page 27

28 In-Basket Communication Tools Staff Message type used for conveying urgent messages Staff Message type used for communicating KP HealthConnect enhancements, fixes, and upgrades, etc. Kaiser Permanente For Internal use only page 28

29 In-Basket Configurations Specific Message Type Modifications and Enhancements Kaiser Permanente For Internal use only page 29

30 Staff Message Folder SmartText print group used explain the workflow SmartText print only displays if the staff message is patient related Kaiser Permanente For Internal use only page 30

31 Letter Folder SmartText print group used explain the workflow Kaiser Permanente For Internal use only page 31

32 Results Folder Study Information is added on the result note, order comments move up to the top. Kaiser Permanente For Internal use only page 32

33 Results Folder View Encounter hyperlink is added to the report Kaiser Permanente For Internal use only page 33

34 Results Folder When the Order Details hyperlink clicked, the report displays an order view which includes diagnosis on the top of report Kaiser Permanente For Internal use only page 34

35 Results Folder Toolbar Changes Kaiser Permanente For Internal use only page 35

36 Patient Communication Folder Close encounter button allows you to close the encounter without leaving the In-basket Green Balls of Responsibility are removed along with the associated buttons. Messages can be done d with one button again Kaiser Permanente For Internal use only page 36

37 Patient Communication Folder Report changes to put call information at the top of the report to reduce scrolling Kaiser Permanente For Internal use only page 37

38 Patient Secure Message Navigator updated to put the messaging section at top of the encounter for easier access Kaiser Permanente For Internal use only page 38

39 Patient Secure Message Folder Button Enhancements Adding the done action to reduce clicks Nesting buttons similar in Action Route button- opens encounter, satisfies responsibility, and done s the message Nesting buttons similar in Action Report Enhancement Report changes to put message information at the top of the report to reduce scrolling. New report format to reduce number of lines used to display message. Kaiser Permanente For Internal use only page 39

40 Nurse Triage/Call Center Encounter Allows for encounter form the Call Center to go into its own folder (Reducing clutter in Patient Communication folder.) Call Center encounters quickly identified and managed Kaiser Permanente For Internal use only page 40

41 Nurse Triage/Call Center Folder Kaiser Permanente For Internal use only page 41

42 HOLD Folder Select HOLD section in visit navigator and complete Exit workspace Message enters HOLD folder (see below) Kaiser Permanente For Internal use only page 42

43 In-Basket Configurations In-Basket Configurations Customized In-Basket Reports Kaiser Permanente For Internal use only page 43

44 In-Basket Reporting In-Basket Reporting MessageConnect Report The percentage of patient initiated messages that have a turnaround of less than 24 hours Tabs include other views of the report: Kaiser Permanente For Internal use only page 44

45 In-Basket Reporting In-Basket Reporting In-basket report of all patient related message types Includes individual and pool recipients In Draft stages The number of users edited into the class associated with the pool Status of user record or pool record Kaiser Permanente For Internal use only page 45

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