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Consumer Information Requirements

April 26, 2013

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

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Audience Participation

Question #1:

What type of organization do you represent?

A. 1-4 physician practice

B. 5-10 physician practice

C. > 10 physician practice

D. Federally Qualified Clinic

E. Hospital System

F. Other

Audience Participation

Question #2:

What role/job duties are you responsible for at your facility?

A. Doctor

B. Nurse Practitioner

C. Nurse/MA

D. Office Manager/Administrative Staff

E. Consultant

F. Other

Audience Participation

Question #3:

Where are you and/or your organization in your meaningful use journey?

A. Have already achieved meaningful use

B. Presently in first reporting period

C. Chose not to participate in EHR incentive program

D. Other

Audience Participation

Question # 4:

Do you have a Patient Engagement program underway that is supported by electronic media?

A. Yes

B. No

Patient EngagementMeaningful Use Measures

Fran ReynoldsMedical Practice Consultant

April 26, 2013

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

Meaningful Use Goals (policy priorities)

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1. Improve quality, safety, efficiency and reduce health disparities

2. Engage patient and families in their health care

3. Improve care coordination

4. Improve population and public health

5. Ensure adequate privacy and security protections for personal information

What is Patient EngagementPatient 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

BenefitsProvider & Staff Patient & Family

Patients better prepared for visit and self-management

Reference/record of visit/instructions

Can monitor patient’s health between visits

Informed decision making

Communicate within their schedule Communicate within their schedule

Generate revenue - bill collections, reminders to schedule routine care

Supports self-awareness and self-management

Promotes partnership of care with patient and their family

Enhances communication with provider

Streamline office flow - who and when Increases patient satisfaction

Enhance recruitment efforts Provide patient access to data anywhere/anytime

Improve Healthcare Cost

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

Meaningful Use Stage 1 – Patient Engagement

Core:Provide patients with electronic copy of their health information

Provide patients with a clinical summary of the office visit(3 business days – 50%)

* Enter or modify personal or demographic information

Menu:

* Send reminders to patients for preventive and follow-up care

Provide patients with timely electronic access to their health information(within 4 business days)

Identify and provide patient-specific educational resources

Meaningful Use Stage 2 - Patient Engagement Core:

Provide Patient the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP (Expanded from: Provide patients with timely electronic access)

Use secure electronic messaging to communicate with patients on relevant health information

Provide patients with a clinical summary of the office visit(1 business - day 50%)

* Enter or modify personal or demographic information

Identify and provide patient-specific educational resources

* Send reminders to patients for preventive and follow-up care

Patient Engagement is a Journey

You need a plan!

Access

Assess Status Stage Access

Redefine Engage IT DevelopBrand

Launch & CPI

• Where is the practice?

• Where is your Patient Population?

• When and what do we introduce first?

• Who needs and/or can address request?

• Document

• What about network?

• Security?• Train

Office Staff to address questions!

• What message do you want to send to your patients?

• Friends/ Family

• What is working

• What needs to change?

Patient Engagement Framework

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http://www.nationalehealth.org/patient-engagement-framework

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

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

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

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!

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)

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

Patient Engagement Meaningful Use

Measures

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

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

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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)

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

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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

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

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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

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

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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

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

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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

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 processhttp://partnershipforpatients.cms.gov/p4p_resources/tsp-patientandfamilyengagement/tsppatient-and-family-engagement.html

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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

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)

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

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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!

Develop a marketing plan Involve the entire healthcare ‘community’

Be committed – Engage the patient and the staff

Work with your vendor and IT resource

Set Expectations Follow-up

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

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

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