Making Patients Your Partners in Satisfying Meaningful Use Stage 2 Objectives: Case Studies in Patient Engagement DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
The Speakers Eric Manley ehealth System Manager The Mayo Clinic Dr. Simeon Schwartz President and CEO Westmed Medical Group Moderator David Rowe, Caradigm 2013 HIMSS
Conflict of Interest Disclosure David Rowe, MBA Director of Product Marketing Caradigm Has no real or apparent conflicts of interest to report.
Learning Objectives 1.Describe the requirements for patient and family engagement within Meaningful Use Stages 1 and 2, as well as proposed requirements under Stage 3 2.Observe how two healthcare delivery organizations have successfully engaged their staffs and their patients together to meet and exceed Meaningful Use requirements
Learning Objectives 3. Identify actionable ideas and tools that can be applied in their settings, resulting in greater levels of patient engagement using a combination of digital and physical channels of communications
Meaningful Use Stage 2: Capability for personal health IT to satisfy criteria 5 Directly Impact 4 3 2 1 4 Directly Impact Core Menu Disclaimer: analysis is provided for educational purposes only. No guarantee is made with respect to the capability of this information to satisfy actual Meaningful Use criteria.
25 Meaningful Use Stage 2: Capability for personal health IT to satisfy criteria 20 15 10 5 10 1 5 7 No Impact Potential Impact Complimentary Impact Directly Impact 4 Core T = 20 (17 for EP, 16 for EH/CAH) 4 with direct capability to satisfy 5 with complementary capability >2 may satisfy the criteria Disclaimer: analysis is provided for educational purposes only. No guarantee is made with respect to the capability of this information to satisfy actual Meaningful Use criteria. 2 Menu T= 9 (6 each for EP, EH/CAH) 2 with complementary capability >Both may satisfy the criteria
Potential impact of PHIT ITEM PHIT IMPACT USE OF PERSONAL HEALTH RECORD/PATIENT PORTAL IMPROVING QUALITY, SAFETY, EFFICIENCY, AND REDUCING HEALTH DISPARITIES Patient Lists Complementary Capture 5 of 6 measures including Problems, Medications, Medication allergies; Demographics; communication preferences using HRA or forms. Vital Signs Complementary Increase precision of vital signs data capture via self report, or consumer medical device. Core Menu Core Smoking Status Complementary Structured data capture in required SNOMED format via Health Risk Assessment (HRA), or standard pre visit forms. Demographics Recording Complimentary ($) Pre visit form capture structures data; creates economic value by eliminating paper; and moving tasks upstream in the patient's workflow Patient Reminders Complementary ($) Leverage PHR to opt in, set preferences, receive reminders Advanced Directives Complementary ($) Record and store advanced directives for patients 65 years or older. Family History Complementary ($) Record patient family health history as structured data.. ENGAGE PATIENTS AND FAMILIES IN THEIR HEALTH CARE Patient Access Direct ($) The PHR may serve as one of the preferred communications channels for patients to view, download, and forward their health information online. Clinical Summaries Direct ($) After visit summary provides a patient with relevant/actionable information. PHR is be most cost effective electronic medium. Patient education Complementary ($) Electronic media is not required, but may be the most cost efficient medium to ID and distribute patient specific content w/in the EHR. Secure Messaging Direct ($) Channels to access secure messaging, tethered to HIE or to the clinic EHR. Disclaimer: analysis is provided for educational purposes only. No guarantee is made with respect to the capability of this information to satisfy actual Meaningful Use criteria.
PATIENT ENGAGEMENT Eric Manley ehealth System Manager DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Learning Objectives 1.Understand Patient Engagement measures for Meaningful Use stage 2 2.Learn the importance of engaging patients at the right place, right time. 3.Understand what patients are saying about online services and how to use that to your advantage.
About Mayo Clinic Arizona, Florida, Minnesota, Health System Patient Care Total clinic patients 1,113,000 Hospital admissions 123,000 Hospital days of patient care 588,000 200,000 validated* patient accounts (15,000 new accounts per month, some patient seen at multiple sites) 120,000 Rochester 45,000 Florida 35,000 Arizona 40,000 Health System *Mayo Clinic has confirmed the patients identity 250 million unique web visitors per year to MayoClinic.org/.com/.edu
Meaningful Use Patient Engagement Categories Patient Health Information / ROI Secure Messaging Patient Education Patient Provided Information Patient Reminders
Patient Health Information / ROI Objective: Provide patients ability to view online, download and transmit their health info within 4 business days of the information being available to EP Objective: Provide patients ability to view online, download and transmit information about a hospital Objective: Provide clinical summaries for patients for each office visit Patient Portal will be used to meet these objectives
Secure Messaging Objective: Use secure electronic messaging to communicate with patients on relevant health information. Measure: More than 5 percent of unique patients (or their authorized representatives) seen by the EP during the EHR reporting period. Patient Portal will be used to meet this objective.
Patient Education Objective: Use Certified EHR technology to identify patient-specific education resources and provide those resources to the patient. Patient portal will not be used to meet this objective but will look to complement the paper process.
Patient Provided Information Objective: Record patient family health history as structured data. The portal will not be the primary method for collecting this information to meet this objective.
Patient Reminders Objective: Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminder, per patient preference. Measure: More than 10 percent of all unique patients who have had an office visit with the EP within the 24 months prior to the beginning of the EHR reporting period were sent a reminder, per patient preference The portal will be used in conjunction with our EHR system to deliver reminders to patients based on patients that have been seen within the reporting period.
Success??? So you ve now made the services available for patients that Meaningful Use called out so we re good right? WRONG!
Simply making the services available won t cut it. Unless you engage your patients you will not meet your MU requirements. Services such as messaging must be a part of your practice and not looked at as a separate, second or third option for communicating to patients HOW DO YOU ENGAGE PATIENTS?
Engaging Patients Through Interaction Just simply offering the patient an account or asking them do you want an account doesn t work. Many patients turned down getting an account because they don t understand what it is The same patient that turned down an account, wanted to view their labs online
Poster Website Handout
Where do you not engage patients Check-in process What in the check-in process would benefit a patient if they had an account? Handouts Handout can support engagement but having this be your primary method of communication doesn t work Website Passive marketing doesn t cut it. If patients are looking to call to request an appointment, they must know they can do the same request online Having it not be the institutions preferred method won t make it the patients preferred method
MAKE IT MEANINGFUL TO THE PATIENT
Where do you engage patients Needs to be within the context of the visit When drawing labs or talking about how patient will get their labs When scheduling an appointment, let the patient know this is available online When on the phone, reminding the patient they could have made this request online At a follow up visit, provider reminds patient that next time they could have avoided the visit by sending a message
Patient Feedback We want these services!
Peace of Mind Knowing I can digest all my information at home makes the diagnosis and journey much less scary. I can really understand my condition and how to manage it.
Sharing the journey with my family My husband was diagnosed with a benign brain tumor. Our adult children were thrilled that they could read his clinical notes to understand what was going on.
Connected with my care team I feel `in touch` with my doctor - like I have access to her when I need or even just want that access -- more like it's a partnership, rather than this person I see who never remembers me or my problems.
Caring for family members "I love being able to manage care for my aging parent. No more missed appointments."
Coordinating with physician back home We live 200 miles from Mayo. Love that we can print results to take to our local doctor for advice.
Being in charge I like the easy access that I have to my health records. It puts me more in charge of my health decisions.
At the doctor s office you listen but are sometimes overwhelmed with what they are telling you. You can go home and read the notes and better understand and then ask questions. Much easier to e-mail than call and wait for a call back from doctor. I also like such easy access to my medical information. Love the quick return of test results, etc. Makes for a lot less worry and stressful waiting. It can get overwhelming in the doctor's office to hear everything and be sure that you have caught every detail. It's nice to go back home and re-read the notes and digest the information at a more leisurely pace. Makes the diagnosis and journey much less scary this way.
Takeaway Meaningful Use Stage 3 is coming up fast and looking to increase the % of patients they require to use these services Patient engagement must be about the patient and you must engage the patient where and when it fits Make online services part of the practice and not just something IT.
QUESTIONS?
Making Patients Your Partners in Satisfying Meaningful Use Stage 2 Dr. Simeon Schwartz, CEO DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
WESTMED Medical Group Established 1996 by 16 physicians 250 physicians caring for over 250,000 patients Over 30 specialties 4 polyclinics 90,000 sq. ft., 65,000 sq. ft., 100,000 sq. ft. and newest with 30,000 sq. ft. Lab and imaging services Advanced IT and shared EMR
WESTMED Practice Partners WPP is the MSO of WESTMED Medical Group Centralized administrative and clerical services for quality and efficiency Mature EMR and Practice Management IT platform Facilitate physician group development and empowerment New Polyclinic (Advanced Ambulatory Care Centers) for Mount Sinai in Brooklyn
Value Based Healthcare Meaningful Use, ACO. Provider accountability for the cost of care Capitation with traditional gatekeeper Provider risk sharing while maintaining point of service choice Quality Standard set of process and outcome measures Improve quality and cost of public health reporting Increased patient engagement Timely access to information Outreach Education
Clinical Analytics Meaningful Use Population management Preventative care Chronic disease management Gaps in care Appointments and referrals
Meaningful Use Dashboard
Disease Management Dashboard
Non-Compliance List of Patients
WESTMED Success Factor Analytically driven healthcare transformation We do not tell physicians what to do we show them what they do
Patient Relationship Management Extensive analytics required for coordination of patient outreach options and services Meaningful Use 2 requires >10% with preventative care or follow-up reminder
Patient Engagement Options Electronically Portal/Email Text messages Robo dial Snail mail Birthday letter Patient statements Provider visit Phone outreach and/or case management
Patient Portal for Patient Engagement Secure messaging with providers Incorporated in providers normal workflow Care summaries Reminders for preventative care/follow up Timely addition of signed laboratory and imaging reports CCD Online appointments Email marketing of portal to patient
Transition of Care Hospital discharge notification Physician initiated CCD Insurance Carrier list Transition Plan Check list Medication reconciliation
Case Management EMR template
ETM / Follow-up appointments
Patient Education Patient specific education resources for more than 10% of unique patients Document EMR based handouts EHR integration and documentation
Online Education for Patient Engagement Healthcare Professional talks to Patient about the 3 rd party education system. Office staff uses a portal to issue a unique code specific to patient s condition or procedure. Patient views 3 rd party education system from any computer with internet access, at their convenience. Office staff uses portal to verify patient has completed his/her program. Healthcare professional addresses patient questions at next office visit or consult.
Patient education orders in EMR
Clinical Decision Support
Leadership Opportunities that Support a Culture of Change Workflow, workflow, workflow Reliable, advanced, timely analytics Process control Checklists Accountability Someone needs to keep score Quality based provider compensation
For further information Dr. Simeon Schwartz, CEO WESTMED Medical Group sschwartz@westmedpartners.com Eric Manley, ehealth System Manager Mayo Clinc Manley.Eric@mayo.edu David Rowe, Director of Product Marketing Caradigm david.rowe@caradigm.com