patient engagement and health transparency
Post on 22-Dec-2021
6 Views
Preview:
TRANSCRIPT
History – Untethered – Tethered
Current State – Scheduling – Billing – ePrescibing – Get Medical Advice – Results – Proxy – eVisits/Anywhere Care
Future – Open Notes – Chronic conditions – Social Network
Presentation Overview
2
“Now is the perfect time to change” - Mark Bertolini HIMSS 2014
3
Patients don’t stop being consumers – customers – when they put on a hospital gown Micah Solomon, Forbes Contributor
• Pros – Patient/consumer controlled – No HIPAA concerns – Most up-to-date
information
Untethered Personal Health Record
4
• Cons – Consider the source – Tools vary – Synchronizing multiple
databases – Little/no security – No secure communication
with provider
“Consumer empowerment versus consumer populism in healthcare IT, “JAMIA, Simborg, 370-372 (April 2010)
• Pros – Open communication with
provider – Patients don’t need to re-
enter data – Secure and HIPAA compliant – Tied to MU – Optimize time utilization for
physician and patients
Tethered Personal Health Record
5
• Cons – Office/physician MUST
USE EMR, not just have it in their practice
– Less flexible – Untethered PHR’s
“Consumer empowerment versus consumer populism in healthcare IT,” JAMIA, Simborg, 370-372 (April 2010)
• Implemented September 2004
• Aggressive implementation began September 2008
• 239,815 MyUPMC users • 23,000+ Mobile App users
MyUPMC – Current State
6
373
83574
121831
225182
0
50000
100000
150000
200000
250000
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Num
ber o
f Pat
ient
s
MyUPMC Registered Users
• Renew prescriptions • Requests refills • Helps meet secure
messaging measure for Meaningful Use Stage 2
Prescription Renewal
9
• >4.5 million results released • Approximately 250K MyUPMC patients have received auto-
release results
Auto-Release – Overall Statistics
20
Results Automatically Released to MyUPMC
Results
21
The test results you are about to review may contain information that may be confusing or cause concern. If you have not already communicated with your provider we recommend you contact him/her to discuss and clarify the meaning of your results.
• Care Taker vs Care Partner • Patient portals
• Should the Care Partner
have access to this information?
Proxy
22
“Care Partners and Online Patient Portals,” JAMA, Sarkar & Bates, E1-E2 (January 2014)
• Barriers – Access to share patient portal – HIPAA – No broadly adopted standards for Care Partner access
• Benefits to breaking down barriers
– Distance – Between-visit chronic disease self-management – Asynchronous modes of communication
• It’s solvable
– Provide separate credentials – Document Care Partner in EHR – Tie to MU
Proxy
23
“Care Partners and Online Patient Portals,” JAMA, Sarkar & Bates, E1-E2 (January 2014)
• Continuity Care – Available to patients that have
had an appointment in the last 3 years with a UPMC PCP practice that participates in the UPMC AnywhereCare program
– Patients expected response time will be within 1 business day
eVisits/Anywhere Care
26
• Convenience Care – Available to any user physically
located in the state of Pennsylvania (at the time of submission)
– Available 7 days per week, 24 hours per day
– Patients expect a 30 minute response time
– Video option available for patients (9 am – 9 pm)
• Coverage provided by – UPMC Urgent Care Centers
Advanced Practice Providers and Physicians (6 am to 9 pm)
– Emergency Medicine Command Center Physicians (9 pm – 6 am)
UPMC AnywhereCare
27
eVisits/Anywhere Care
28
• Adults – Adult Patients (18 years of age or older) – A proxy of an Adult Patient (18 years of age or older)
• Pediatrics – Proxies of Pediatric Patients (3 - 17 years of age)*
– Limited to 3 medical conditions/diagnosis and video only – Cold, Cough and Pink Eye
*Pediatric UPMC AnywhereCare visits will be responded to by: 1. Children’s Community Pediatrics Physicians (Convenience
Care Model) 2. Participating Family Medicine Physicians (Continuity Care
Model)
• Benefits of eVisit ‒ Convenience and efficiency ‒ Lower costs - $38 ‒ Provided by Primary Care
Physician/ Advanced Practice Providers
• Potential drawbacks of eVisit ‒ Can a physician make an accurate
diagnosis? ‒ Are correct tests and follow up
ordered? ‒ Are drugs being overprescribed? ‒ Medical Malpractice issues ‒ Technical issues of video vs text
only ‒ Connected devices ‒ State licensure in order to be able
to prescribe across state lines
eVisits/Anywhere Care
29
eVisits vs. Office visits
“A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection,” JAMA INTERN MED, Mehrotra et al 173 (NO. 1), 72-74 (JAN 2013)
Findings: eVisit vs. Office Visit Sinusitis and Urinary Tract Infection • UTI
– Less likely to order UTI-relevant test at eVisit
– Number of follow up visits were the same
– Less likely to order preventative care at eVisit
– More likely to prescribe antibiotic at eVisit
• Sinusitis – Follow up visits were the same – Less likely to order preventative
care at eVisit – More likely to prescribe antibiotic
at eVisit
eVisits/Anywhere Care
31 “A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract
Infection,” JAMA INTERN MED, Mehrotra et al 173 (NO. 1), 72-74 (JAN 2013)
• Medical device integration (MDI) -process of taking the data from those devices and integrating it to an EHR.
• Examples include defibrillators, electrocardiographs, vital signs monitors, ventilators and infusion pumps – Diabetes Mellitus – glucometer – Obstructive Lung Disease – spirometer – CHF – scale
Chronic Conditions
36
An Engaged Patient is a Healthy Patient
40
“How Doctors Rate Patients,” Wall Street Journal, Landro, March 31, 2014
• Just because we can – Clinical Messaging – Research interests – Surveys – Advertising
• Caution based on clinical decision support alerts
Communication with Patients
45
top related