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1 Patient Portals and Blue Button : Make your mark and meet Meaningful Use January 17, 2012 Sponsored by:

2 Guest Speakers Kim M. Nazi, FACHE, Ph.D. Candidate Management Analyst Veterans and Consumers Health Informatics Office Veterans Health Administration U.S. Department of Veterans Affairs James M. Speros Special Assistant to the Chief Technology Officer Office of the Secretary U.S. Department of Veterans Affairs

3 Guest Speakers Joshua J. Seidman, Ph.D. Director, Meaningful Use Office of the National Coordinator for Health Information Technology U.S. Department of Health & Human Services Michelle Schneider, RN Senior Manager Clinical Product Development Iatric Systems, Inc.

4 Kim M. Nazi, FACHE, Ph.D. Candidate Management Analyst Veterans and Consumers Health Informatics Office Veterans Health Administration U.S. Department of Veterans Affairs

5 What we know The Personal Health Record (PHR) Paradox : Consumer interest in PHR features is high Adoption of PHRs is relatively low (but growing) Consumers value: transactional services to accomplish tasks easy access to their personal health information Healthcare has lagged in leveraging technology Meaningful Use is crucial (both as an outcome and as a way of getting there) Increasing consumer access to data is a game changer

6 What we are learning A new paradigm: Consumer empowerment is half the equation Clinician endorsement, engagement with patient PHR use is crucial (could truly be transformational) Clinicians value: solutions that integrate with clinical workflow tools that engage, activate patients easy access to their patients personal health information Healthcare organizations need to integrate PHR use into the fabric of healthcare (in meaningful ways) Increasing consumer access to data is (still) a game changer

7 What we did Genesis of the Blue Button Markle Consumer Engagement Workgroup Determine best method to provide consumers with electronic access to data and incent market innovators to create Health Information Technology (HIT) solutions Breakthrough Idea Download button (a blue button in the portal that enables individuals to download their electronic health data) Multi-agency Blue Button Initiatives Department of Veterans Affairs (VA), Centers for Medicare & Medicaid Services (CMS), Department of Defense (DoD) integrate Blue Button: Download My Data feature on respective beneficiary portals in simple human readable/parsable format Blue Button, the Blue Button logo, and the slogan Download My Data are registered Service Marks of the U.S. Department of Veterans Affairs (VA), an agency of the United States Government and are used by permission of VA.

8 Why we did it Intended outcomes: Improve the quality, accessibility of personal health information for Veterans (start now and expand incrementally) Foster consumer empowerment and Meaningful Use Enhance patient safety, improve co-managed care Support Open Government principles by posting sample data sets at Data.gov and Partner with industry innovators Improve Veteran satisfaction, outcomes

9 Evolution PHASE I PHASE II PHASE III Demonstrate Develop Blue Button download capability for existing My HealtheVet data classes Address data attribute requirements Provide human readable format and support data parsing Ensure alignment with CMS and DoD efforts via strong collaboration Address Markle policiesin-practice Expand Expand data classes available for download to include additional extracts from VA Electronic Health Record Align with existing data standards as appropriate Ensure extensibility and sustainability Enable users to customize and choose file format Elicit user feedback and evaluate usage patterns and trends Share Provide option for interoperable standardized format to enable Veterans to authorize sharing via health information exchange Support innovations to extend value of data for Veterans Ensure ongoing evaluation to determine impact and outcomes

10 My HealtheVet 3-Tier Access Model: Visitors Registrants In-Person Authenticated (IPA) November 2011 More than 59 million visits Over 1.5 million registered users (76% are VA patients) More than 484,000 users have an authenticated account (IPA) Over 25.7 million VA Rx refills since August 2005

11 VA Blue Button Data Classes Data Class Demographics (Includes Emergency Contacts) Healthcare Providers Treatment FaciliAes Health Insurance VA Wellness Reminders* VA Appointments* VA MedicaAon History MedicaAons and Supplements VA Allergies* Allergies and Adverse ReacAons Medical Events ImmunizaAons VA Laboratory Results* Labs and Tests Vitals and Readings Family Health History (Self and RelaAves) Military Health History Source Self- entered Self- entered Self- entered Self- entered VA Electronic Health Record VA Electronic Health Record VA Electronic Health Record Self- entered VA Electronic Health Record Self- entered Self- entered Self- entered VA Electronic Health Record Self- entered Self- entered Self- entered Self- entered DoD Military Service InformaAon* DoD *requires In-Person Authentication

12 VA Blue Button: Download My Data

13 VA Blue Button: Download All or Customize

14 VA Blue Button: Download Results

15 VA Blue Button: Multiple File Formats

16 VA Blue Button: Statistics

17 VA Blue Button: Statistics

18 VA Blue Button: Statistics and User Feedback Since launched on August 29, 2010: 376,751 unique registered users submitted download requests 904,258 files were downloaded 415,927 Blue Button outputs were viewed in the browser American Customer Satisfaction Index (ACSI) Survey Results (Oct.10-Jan. 11):* 30% of users had used it more than once, some regularly 56% : VA Medication History is most useful information 9% have shared it with their VA provider (5% with their non-va provider) ü 61%: add more data ü 29%: let me customize Having access to my health information from everywhere pretty much: Good stuff! Share health information with my Primary Care Physician. Ability to obtain a list of current and past medications for another doctor. All my VAMC visits info in one spot and not on a bunch of sheets of paper. I can download txt file for when I travel. I printed my ENTIRE file info AND IT IS WONDERFUL!!! *N=16,016 representing a random sample of site visitors visiting four or more pages

19 James M. Speros Special Assistant to the Chief Technology Officer Office of the Secretary U.S. Department of Veterans Affairs

20 Blue Button: The Electronic Clipboard How patients keep track of their health data Memory devices: Thumb drives Mobile apps: Northrop-Grumman iphone app More in pipeline platform independent Low tech paper: Envelope on the refrigerator Hand-carried hey, it works!

21 Blue Button: Beyond the Clipboard How patients relate to their providers and providers relate to patients Clinically-based data: Hospitals, doctors many new products emerging Labs: proposed CLIA rule change: 76 FR Health claims: Medicare: Health plans: Aetna, United Health, many others Transmitting health data: BB file component of trusted transmission streams Patient to provider, provider to provider

22 Blue Button: Beyond Healthcare The emerging symbol for how consumers download their data Empowering consumers with their own data: Green Button: Energy usage Launch: January, 2011 Purple Button: Education data In development

23 Joshua J. Seidman, Ph.D. Director, Meaningful Use Office of the National Coordinator for Health Information Technology U.S. Department of Health & Human Services

24 National Quality Strategy

25 Fewer Premature Deaths (CV) Demographics Blood Pressure Smoking BMI Problem List Med List Lab Data Quality Measurement CDSS Registry

26 Safer Care Demographics Blood Pressure Smoking BMI Problem List Med List Allergy Lab Data Quality Measurement CDSS Registry CPOE Drug-Drug, Drug-Allergy erx emar* * Recommendation of the Health IT Policy Committee

27 Patient-Centered Care Demographics Blood Pressure Smoking BMI Problem List Med List Allergy Lab Data Patient Education Patient Preferences* Quality Measurement CDSS Registry CPOE Drug-Drug, Drug-Allergy erx After Visit Summary Reminders Patient Copy Online Access View & Download* * Recommendations of the Health IT Policy Committee Secure Messaging*

28 More Coordinated Care Demographics Blood Pressure Smoking BMI Problem List Med List Allergy Lab Data Patient Education List of care team members* Electronic progress notes* Quality Measurement CDSS Registry CPOE Drug-Drug, Drug-Allergy erx After Visit Summary Reminders Patient Copy Online Access Medication Reconciliation Share Care Summary Shared care plan* * Recommendations of the Health IT Policy Committee

29 MedLine Plus Connect EHR, EMR, PHR, etc. MedlinePlus Connect MedlinePlus Problem code or medication code Code to topic or medication mapping MedlinePlus topic or medication results

30 Coding Systems Problem Codes (Diagnoses) ICD-9-CM SNOMED CT CORE Problem List Subset Medication Codes RXCUI NDC

31 Patient View from EHR - Diagnoses

32 MedLine Plus Connect for Diagnoses

33

34 Spanish MedLine Plus Connect for Diagnoses

35 The Great Beyond: Enhancing MU and Stage 3+ Go mobile Meet people where they are Ethnographic research Multimedia & interactive Tailoring to the individual Incorporation of patient-generated data Patient survey data Remote monitoring data More accurate records 1/17/12 Office of the NaAonal Coordinator for Health InformaAon Technology

36 Michelle Schneider, RN Senior Manager Clinical Product Development Iatric Systems, Inc.

37 What are patients hearing? Personal Health Records allow you to: Manage your health information Improve communication with caregivers Improve quality of healthcare Improve coordination of healthcare

38 What are patients hearing? Personal Health Records allow you to: Access information anywhere you have internet access Share health information in an emergency

39 What are patients hearing? EHRs enable physicians to: Join a network to securely share your records Decrease medical errors Decrease duplication of tests

40 Challenges Physician Concerns: Loss of control Patients may see results before physician Internet (or other) research without physician consultation Physicians want to see it first!

41 Challenges Security Management: Patient identification In person With visits at registration or discharge

42 Challenges Security Management: Guardianship Custodian relationship Expiration of access Data sharing , printing, invitation

43 Challenges Marketing and Community Education: Include marketing from the start Have a plan Monthly newsletter Adult Education Newspaper

44 Challenges User Support: Ensure operators know the plan Direct patient queries to appropriate party HIM/Medical records IT

45 Challenges Measuring Success: User Satisfaction User Usage

46 Ensuring Success ü Champion ü Consumer Education ü Plan for patient support ü Secure access ü Data gathering

47 QUESTIONS Submit your question to today s speakers by typing your question into the box on the right side of your screen and then hitting send. Sponsored by:

48 To learn more: Thank you for attending! Visit Iatric Systems Booth 7905 at HIMSS Join us to see PtAccess, the advanced patient portal from Iatric Systems. Register at Webcast Date Day Time January 31, 2012 Tuesday 2:00pm ET February 8, 2012 Wednesday 2:00pm ET Sponsored by:

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