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Online Access: Communication Matters!. Paul Tang, MD Chief Medical Information Officer Palo Alto Medical Foundation Sutter Health. Outline. Patients’ information needs PAMFOnline Benefits and experiences. Desired Online Services Online Users. Harris Interactive, 2002.

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Online Access: Communication Matters!

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Online access communication matters

Online Access: Communication Matters!

Paul Tang, MDChief Medical Information OfficerPalo Alto Medical FoundationSutter Health



  • Patients’ information needs

  • PAMFOnline

  • Benefits and experiences

Desired online services online users

Desired Online ServicesOnline Users

Harris Interactive, 2002

Online patients want their information online

Online Patients Want Their InformationOnline

  • Online survey of 1000 healthcare consumers

  • Want online option to traditional access:

    • 84% - electronic alerts (e.g., flu vaccine, HM)

    • 83% - lab test results

    • 80% - personalized information after an office visit

    • 69% - online charts to monitor chronic diseases

    • 43% - willing to select physician based on availability of Internet services

Harris Interactive, 2000

Overview of pamfonline

Overview of PAMFOnline

Creating a Online Healing Relationship

Online access communication matters



Early experience with pamfonline

Early Experience with PAMFOnline

Pamfonline enrollment


Pamfonline patients age distribution general release

PAMFOnline PatientsAge Distribution, General Release

Pamfonline tiered service model

PAMFOnlineTiered Service Model

  • Basic services

    • Access to selected information from EMR

    • Custom-tailored health information

    • Appointment requests

    • Prescription renewals

    • Administrative communication

  • Messaging services ($60/yr)

    • Clinical communication with physicians

    • Medical advice request

Quality and efficiency

Quality and Efficiency

Rx Renewal

Prescription renewal turn of the century circa 2000

PAMF pharmacyenters requestinto pharm computer

Pharmacy faxesrequest to PAMF

Prints request

Send requestto MD via ID Mail

To MA inbox

Return to


MD approves/

denies req

MA orderschart

Patient picksup Rx


calls pt

FAX or callRx back to pharmacy

Prescription RenewalTurn of the Century (circa 2000)

Medication renewal through pamfonline

MD/RN approves/

denies req

Medication RenewalThrough PAMFOnline

Patient specific information resources

Patient-Specific Information Resources

Customizing educational material to the patient

Customizing Educational Material to the Patient

  • PAMFOnline provides patients with access to their record including:

    • Diagnoses

    • Medications

    • Lab test results

    • Patient instructions

  • Unfamiliar words or phrases can generate questions or concerns

Patient and physician satisfaction

Patient and Physician Satisfaction

Online access communication matters

PAMFOnline Patient SurveyValued Services

*Subscribers only

Physician pamfonline survey are you satisfied with pamfonline

Physician PAMFOnline Survey“Are you satisfied with PAMFOnline?”

Physicians with 100+ PAMFOnline patients

Critical success factor integration with emr

Critical Success FactorIntegration with EMR

  • Information from EMR available

  • Common workflow with messages

    • Messages automatically included in EMR

    • Lab release

    • Rx renewal

  • EMR-level security

Leadership challenges

Leadership Challenges

  • EMR infrastructure

    • Leadership (vision and guts)

    • Capital

    • Expertise

  • NHII (e.g., standards, laws, policies, identifiers)

  • Reimbursement

    • Conditions

      • Established patient

      • Documentation

      • E&M guidelines



  • Patient-centered, safe, continuous care is an expectation of 21st century health care

  • Secure, online communication with patients

    • Improves care

    • Convenient for patients

    • Streamlines workflow, increases efficiency

    • Increases patient satisfaction

    • Generates patient loyalty

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