Consumer Information Requirements

1. Consumer Information Requirements April 26, 2013

2. Overview of the Session • Welcome • Audience Participation • Three Views • Patient Engagement Meaningful Use Measures • Exploring the Use of Personal Health Records in Diabetes Management: A Pilot Study • Scaling Patient Engagement • Question and Answer

3. Audience Participation Question #1: What type of organization do you represent? • 1-4 physician practice • 5-10 physician practice • > 10 physician practice • Federally Qualified Clinic • Hospital System • Other

4. Audience Participation Question #2: What role/job duties are you responsible for at your facility? • Doctor • Nurse Practitioner • Nurse/MA • Office Manager/Administrative Staff • Consultant • Other

5. Audience Participation Question #3: Where are you and/or your organization in your meaningful use journey? • Have already achieved meaningful use • Presently in first reporting period • Chose not to participate in EHR incentive program • Other

6. Audience Participation Question # 4: Do you have a Patient Engagement program underway that is supported by electronic media? • Yes • No

7. Patient EngagementMeaningful Use Measures • Fran Reynolds • Medical Practice Consultant • April 26, 2013

8. Welcome! • Agenda: • Meaningful Use Goals • What is Patient Engagement? • Benefits • Who is Involved? • Patient Engagement Journey • Meaningful Use Stage One • Meaningful Use Stage Two • Wrap Up

9. Meaningful Use Goals (policy priorities) Improve quality, safety, efficiency and reduce health disparities Engage patient and families in their health care Improve care coordination Improve population and public health Ensure adequate privacy and security protections for personal information

10. What is Patient Engagement • Patient Engagement is “ actions individuals must take to obtain the greatest benefits from the health care services available to them” (Center for Advancing Health, 2010) • Taking responsibility for your or your family’s health • Participating in treatment/self-management • Promotes informed decision making

11. Benefits Improve Healthcare Cost

12. Who is involved? EVERYONE! • PATIENT and their FAMILY! • Doctor, Nurse Practitioner • Medical Staff • Administrative Staff (front and back office) • IT Staff • Your Vendor • The COMMUNITY

13. Meaningful Use Stage 1 – Patient Engagement

14. Meaningful Use Stage 2 - Patient Engagement

15. Patient Engagement is a Journey You need a plan!

16. Patient Engagement Framework http://www.nationalehealth.org/patient-engagement-framework

17. Patient Engagement is a Journey • Step 1: Assess Status • Assess where the practice is in the process • Define the goals of the practice • Reconfirm commitment of the EPs and staff • Assess where the patient population is in the process & Survey; focus groups

18. Patient Engagement Planning Best Practices Step 2: Stage Access • Consider launching functionality in stages • Push results • Collect data/documents • Send/receive secure messages • Send Patient Reminders • Appointments • Yearly exams/tests • Request appointments • Collect payments • Develop care plans that are shared documents

19. Patient Engagement Planning Best Practices Step 3: Redefine • Review and refine your work flows • ‘Right of first review’ of requests • Set expectations/turnaround time (internal and external) • Define and document new protocols

20. Patient Engagement Planning Best Practices Step 4: Engage IT • Engage your IT resources in the planning process • Do you need new equipment? • Confirm network, application and data security • User Name & Passwords - strong, easy to remember, reset capability • How will you distribute these? • Emails • Letters to home • Will office staff be handling IT questions … train them!

21. Patient Engagement Planning Best Practices Step 5: Develop Brand • Develop your office-branded ‘marketing plan’ • Initial launch – letters, preferred method of contact, in office introduction/support, kiosk • Instruction Sheets (handout) • Posters in the office and exam rooms • Tee shirts • Personal reminders during the visit • Front Desk (appointments; demographics/forms) • MA ( results; educational material) • Doctor (results; medication & instruction review) • Check Out (Clinical Summary; Billing questions)

22. Patient Engagement Planning Best Practices Step 6: Launch and CPI • Friends and Family first! • It’s a journey… continual process improvement • Communicate ‘new’ features • Run meaningful use reports for patient engagement – take action • Ask patients and staff about their experiences & suggestions • Re-survey

23. Patient Engagement Meaningful Use Measures

24. Patient Engagement Meaningful Use MeasureView, Download and Transmit (VDT) Objective: Stage 1: Provide patients with electronic copy of their health information (upon request ) Measurement: > 50% within 3 business days

25. Patient Engagement Meaningful Use MeasureView, Download and Transmit (VDT) Objective Expanded to: Stage 2: Measure 1: More than 50% of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the EP) online access to their health information. Measure 2: More than 5% 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

26. Patient Engagement Meaningful Use MeasureView, Download and Transmit (VDT) Best Practices: • Provide instruction sheet for patient to retrieve data/on line help • Provide appropriate educational resources • Review workflow to determine: • Determine who/how/when the information will be available to the patient • Set standard for review of outstanding request • Help patient sign on while they are in the office • Send questionnaire to patient • Ask patient to send you information (blood sugar levels, how medication is working)

27. Patient Engagement Meaningful Use MeasureView, Download and Transmit (VDT) Benefits: • Supports coordination of care • Increased Patient Satisfaction- they are in control of the health data • Information is available to the patient anytime and from any location • Office staff does not have to handle these requests

28. Patient Engagement Meaningful Use MeasureClinical Summary of Office Visit Requirement: Provide Clinical Summary of Office Visit Measure: > 50% of all visits within 3 business days Stage 2: 1 business day Best Practices: • Provide instruction sheet for patient to retrieve data/ on line help • Provide appropriate educational resources • Review workflow - give verbal reminder to the patient

29. Patient Engagement Meaningful Use MeasureClinical Summary of Office Visit Benefits: • Helps keep patients more engaged in their healthcare • Increased Patient and family satisfaction - informed decision making • Gives patient 24 hour access to Information from any location • Eliminates need for office staff to preform this function • www.healthit.gov

30. Patient Engagement Meaningful Use MeasuresRecord Demographic Data Objective: Record Demographics- preferred language, sex, race, ethnicity, and date of birth Measure: Stage 1 > 50% Stage 2 : 80 % of all unique patients

31. Patient Engagement Meaningful Use MeasuresRecord Demographic Data Best Practices: • Review integration between PM and Clinical System • Present ‘short list’ of responses Benefits: • Capture accurate/changes in data • Patient ‘owns’ this information (expand to other areas: insurance, family history) • Streamlines/eliminates need for staff to address sensitive area

32. Patient Engagement Meaningful Use MeasuresPatient Reminders Objective: Send reminders to patients for preventive and follow-up care Measure:Stage 1 - More that 20% of all patients 65 years or older or 5 years old or younger Stage 2 - CORE item 10% of all unique patients

33. Patient Engagement Meaningful Use MeasuresPatient Reminders Best Practices: • Automate the process • Review resources provided by vendor • Build into care plan/treatment set • Determine how information is captured for reporting • Inform patient that information is available electronically Benefits: • Patients are better informed to make health care decisions • Patient satisfaction is increased – confidence in doctor’s attention

34. Patient Engagement Meaningful Use MeasuresPatient –Specific Education Objective: Identify/provide patient-specific educational resources Measure: More that 10% of all unique patients seen by the EP Stage 2: CORE objective

35. Patient Engagement Meaningful Use MeasuresPatient –Specific Education Best Practices: • Automate this process • Review resources provided by vendor • Build into care plan/treatment set • Determine how information is captured for reporting • Inform patient that information is available electronically Benefits: • Patients are better information to make health care decisions • Patient satisfaction is increased – confidence in doctor’s attention • Streamline process http://partnershipforpatients.cms.gov/p4p_resources/tsp-patientandfamilyengagement/tsppatient-and-family-engagement.html

36. Patient Engagement Meaningful Use MeasuresSecure Electronic Messaging Objective: Use secure electronic messaging to communicate with patients on relevant health information. Measure: A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients (or their authorized representative) seen by an EP during the EHR reporting period. Secure/Encrypted - Secret, Tamper Resistant and Authenticated; Relevant health information - medication refills; referrals; billing questions

37. Patient Engagement Meaningful Use MeasuresSecure Electronic Messaging Best Practices: • Check with your vendor to review functionality and MU reporting • Show patients how to use this functionality (in office or instruction sheet) • Give patient information regarding ‘secure message’/protecting their PHI data • Give patient examples as to when it is appropriate to use this tool (or post it on site i.e. not if life threating) • Ask patient to send a response for follow up (no expectation that EP must personally respond…but)

38. Patient Engagement Meaningful Use MeasuresSecure Electronic Messaging Benefits: • Promotes care coordination between visits • Addresses patient questions and concerns • Allows providers to adjust patient care plans in a timely manner • Patients are better information to make health care decisions • Patient satisfaction is increased – confidence in doctor’s attention • Reduces phone calls to practice • Automatically documents communication with the patient • www.healthit.gov

39. Wrap Up • How can we engage the patient and their family in their healthcare? In the course of doing these things you will meet your patient engagement meaningful use objectives!

40. Tools • The Patient Engagement Framework www.nationalehealth.org/patient-engagtement-framework • Interactive Forms (Vendor specific) • Educational Forms and Suggestions • http://partnershipforpatients.cms.gov/p4p_resources/tsp-patientandfamilyengagement/tsppatient-and-family-engagement.html • www.healthit.gov

41. Contact Us • Visit us online at www.tristaterec.org • Email us at rec@healthbridge.org • Call us at 513-469-7222, ext. 3 • Follow us on Twitter: @HealthBridgeHIO • Like us on Facebook: www.facebook.com/pages/Cincinnati-OH/HealthBridge/128672340540952