Patient Engagement and Meaningful Use at Atrius Health
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1 Patient Engagement and Meaningful Use at Atrius Health Michael A. Lee MD, MBA Director, Clinical Informatics Atrius Health 1
2 Atrius Health Non-profit alliance of six leading independent medical groups in Massachusetts Dedham Medical Associates Granite Medical Harvard Vanguard Medical Associates Reliant Medical Group Southboro Medical Group South Shore Medical Center 2
3
4 Atrius Health Provide care for almost 1,000,000 adult and pediatric patients 1000 physicians, 1500 other healthcare professionals across 35 specialties
5 Atrius Health 100% on EMR combined with corporate data warehouse, used for managing quality and cost. Patient portal. Long history with global payments, currently about 50% risk across commercial, Medicare and Medicaid populations. Strong infrastructure to manage risk
6 Stage 1 MU Attestation and Payment 758 Eligible Providers 732 Successful Attestation and Payment for 90 days Stage 1 in 2011 About $8 Million received An additional 20 received for Medicaid at Atrius (not including Reliant) 6
7 Social and e-media at Harvard Vanguard Twitter e-newsletter Blog YouTube Facebook 7/25/2012 7
8 It starts with our Blog Launched in February, 2011 Use blogs for e- newsletter, FB and Twitter Over 128,000 visits in 17 months 7/25/2012 8
9 Facebook 1850 likers 23+ interactions per week Average 6 posts per week 7/25/2012 9
10 Twitter 7/25/
11 Healthy Matters Over 110,000 addresses every 6 weeks Use blog posts Links to key services Very successful 30.6% open rate 23.3% click-through 2% bounce 0.3% opt-out 7/25/
12 YouTube Channel
13 Meaningful Use Patient Engagement Meaningful Use Measures What do they really do? What are we trying to do? 13
14 Stage 1----P-117 Electronic Copy of Health Information More than 50 percent of all patients of the EP who request an electronic copy of their health information are provided it within 3 business days. Numerator The number of patients in the denominator who receive an electronic copy of their electronic health information within three business days. Denominator The number of patients of the EP who request an electronic copy of their electronic health information four business days prior to the end of the EHR reporting period. Exclusions If the EP has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period they would be excluded from this requirement. Only specific third party requests for information are included in the denominator. 14
15 Stage 1--P119 -Electronic Access for Patients At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP s discretion to withhold certain information. Numerator The number of patients in the denominator who have timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information online. Denominator Number of unique patients seen by the EP during the EHR reporting period. Exclusions If an EP neither orders nor creates any of the information listed in the ONC final rule 45 CFR (g) and therefore included in the minimum data for this objective during the EHR reporting period they would be excluded from this requirement. 15
16 Stage 2 --P219-Provide patients the ability to view online, download, and transmit their health information. 1. More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information. 2. More than 10 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. Numerator 1 The number of patients in the denominator who have timely (within 4 business days after the information is available to the EP) online access to their health information online. Denominator 1 Number of unique patients seen by the EP during the EHR reporting period. 16
17 Stage 2 measure --P219-Provide patients the ability to view online, download, and transmit their health information Numerator 2 The number of unique patients (or their authorized representatives) in the denominator who have viewed online or downloaded or transmitted to a third party the patient's health information. Denominator 2 Number of unique patients seen by the EP during the EHR reporting period. Exclusions Any EP who neither orders nor creates any of the information listed for inclusion as part of this measure may exclude both measures. Any EP that 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 4Mbps 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. The thresholds of both of these measures must be reached in order for the EP to meet the objective. If the EP reaches one of these thresholds but not the other, then the EP will fail to meet 17
18 Stage 1--P120-After Visit Summary Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days. Numerator Number of office visits in the denominator for which the patient is provided a clinical summary within three business days. Denominator Number of office visits by the EP during the EHR reporting period. Exclusions EPs who have no office visits during the EHR reporting period would be excluded from this requirement. 18
19 Stage 2 P220-After Visit Summary Clinical summaries provided to patients within 24 hours for more than 50 percent of office visits. Numerator Number of office visits in the denominator where the patient is provided a clinical summary of their visit within 24 hours. Denominator Number of office visits conducted by the EP during the EHR reporting period. Exclusions- Any EP who has no office visits during the EHR reporting period. 19
20 Stage 1 P121 Patient Education More than 10 percent of all unique patients seen by the EP are provided patient-specific education resources. Numerator Number of patients in the denominator who are provided patient education specific resources. Denominator Number of unique patients seen by the EP during the EHR reporting period. Exclusions None. 20
21 Stage 2 P221-Patient Education Resources Patient-specific education resources identified by Certified EHR Technology are provided to patients for more than 10 percent of all office visits by the EP. Numerator Number of patients who had office visits during the EHR reporting period who were subsequently provided patientspecific education resources identified by Certified EHR Technology. Denominator Number of office visits by the EP during the EHR reporting period. Exclusions Any EP who has no office visits during the EHR reporting period. 21
22 Stage 2 - P230-Patients Send Secure Messages A secure message was sent using the electronic messaging function of Certified EHR Technology by more than 10 percent of unique patients seen during the EHR reporting period. Numerator The number of patients in the denominator who send a secure electronic message to the EP using the electronic messaging function of Certified EHR Technology during the EHR reporting period. Denominator Number of unique patients seen by the EP during the EHR reporting period. Exclusions Any EP who has no office visits during the EHR reporting period. 22
23 What Works and What Doesn t? Access, View and communicate 250K active users of MyHealth Online After Visit Encyclopedia-really longappreciated but getting so long this will be prohibitive Patient Education-Too light out of the box for chronic or multi-factorial issues but great for many things Counting inbound Patient messages is problematic? Will survive in final leg. (OHKFS) 23
24 Where Do We Need To Go? Goal is really engage to change behavior Improve satisfaction Improve patient outcomes Need better ability to interact with things patients want us to see-photos, home tracking etc.. Need to work the dynamic for allotting time/compensation to these activities 24
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