Our Patient Portal Experience

Transcription

1 Our Patient Portal Experience Pat Bracknell, CHDA May 13, 2016 Central Oregon 1

2 Goal Describe how our organization is working through the benefits and challenges of implementing a patient portal in response to the Meaningful Use requirement for active patient engagement, by elaborating our own experiences with the challenges of how to manage patient data for patient use, physician expectations, and our evolving access and privacy policies. Informational Objectives Meaningful Use measures that drive patient engagement and the impact they can have on a patient portal program Opportunities identified and processes that were developed to manage the program as we have established our community presence Infrastructure we have in place and are evolving to support our patient portal technology 2

3 Who we are 4 Facilities 2 Critical Access Hospitals 2 Acute Care Hospitals 3865 Caregivers 640 Volunteers 412 Active Medical Staff 318 Visiting Medical Staff 22 Clinics Family Care, Specialty and Behavioral Health Central Oregon (7,833 sq mi) Bend, Madras, Prineville, Redmond, Sisters Population 213,578 Payor Mix Medicare 50% Medicaid 23% Commercial 25% Self Pay 1.6% System Volume Total Beds 345 ALOS 3.88 Avg Daily Census 213 Average Monthly statistics Discharges ER visits 7743 Births 202 IP Surgery 827 OP Surgery 968 3

4 Our Patient Portal Environment All data is fed to our Repository Patients from our Ambulatory and IP environments of care both access the same Patient Portal Meaningful Use and Patient Engagement 4

5 Meaningful Use and Patient Engagement Measure 1 Timely Access Within 36 hours of discharge Patient possesses information needed to view, download or transmit their information Specified information is available Must use CEHRT to meet the objective 5

6 The following information must be available to satisfy the objective and measure: Patient name. Admit and discharge date and location. Reason for hospitalization. Care team including the attending of record as well as other providers of care. Procedures performed during admission. Current and past problem list. Current medication list and medication history. Current medication allergy list and medication allergy history. Vital signs at discharge. Laboratory test results (available at time of discharge)*. Summary of care record for transitions of care or referrals to another provider. Care plan field(s), including goals and instructions. Discharge instructions for patient. Demographics maintained by hospital (sex, race, ethnicity, date of birth, preferred language). Smoking status. Measure 2 Patients or their authorized representatives view online, download or transmit to a third party discharge information provided 6

7 Opportunities for Success Managing access Supporting patients Releasing results Supporting SCHS and the Community Admission notifications Secure office communications Outreach lab Tracking and promoting utilization Managing application specific functionality Managing access Providers, Staff and Patients Providers Vendor managed Staff Add and managed on site Administrators Add and managed on site Patients Auto invitations, self registrations, manually pushed invitations, dependent management all managed on site 7

8 Supporting patients Vendor vs Local support Knowledge Local requirements Provider and compliance specific decisions Ability to grant access to practice specific records Access to manually reset passwords Availability 24 X 7/ 365 vs 8am 4pm Monday thru Friday Resources St Charles in Central Oregon vs Vendor in Arkansas Releasing Results CMS MU Objective 8 vs ORS vs Culture Current auto release rule settings 8

9 Releasing Results Timely Access Within 36 hours of discharge Laboratory test results (available at time of discharge) Releasing Results ¹ Examination, specimens reports and results (3) A clinical laboratory shall provide the results of a test, examination or analysis of a specimen submitted by a patient in writing to the patient: (a) Not sooner than seven days after receiving a request for the results from the patient; or (b) Immediately upon receiving authorization from the doctor, dentist or other person who requested the test, examination or analysis to provide the results to the patient. [1969 c ; 2001 c ; 2003 c.376 1; 2009 c.583 1] 9

10 Supporting SCHS Caregivers Who we support Clinic Staff Health Information Management Lab Ortho Neuro Services Patient Access Services Periop Scheduling 120 Central Oregon participating practices Tools currently used Sharepoint , including broadcast messaging Tracking and Promoting Utilization Tools used Monthly patient portal utilization statistics Monthly secure messaging turnaround reports EMS events Annual patient portal satisfaction surveys for patients and SCHS caregivers 10

11 Information reviewed monthly Local support statistics # Cases Closed Average time to close Method of contact Provider Message Turnaround by Message Type Total messages % unread % unresponded Average Reply in Calendar Days Managing Functionality Practice and provider message and notifications settings Staff message and notifications settings Dependent management age ranges, site specific notification language, notification parameters Deceased patient workflow Monitor minor patient record management Duplicate patient record management 11

12 Oversight Governance Committee Working Group Patient and Family Advisory Council Governance Committee Executive level participation Direction and guidance from legal and compliance Representation across all domains and locations CIO, CMIO, CFO, Medical Group CEO, CNO/VP Quality, Hospital Presidents Sr. Director Rev Cycle, Sr. Legal Counsel, Chief Compliance Officer 12

13 Governance Committee Results Release Rules changes Dependent records access policy Policy approvals Issues escalation Working Group Empowered to make decisions on issues, parameters, deployments and work together to implement the strategies set by the Governance committee Work collaboratively in order to insure that the needs of all stakeholders are met when modifications and deployments are made to the Patient Portal Work collaboratively to gather, oversee and approve content for the St Charles Patient Portal Landing Page Escalate only if needed to the Governance Committee Take questions and issues escalated from various environment specific entities and collaborate on appropriate recommendations and responses. (ie: SCMG portal team, SC Acute portal team, Outreach lab, etc) Membership (Marketing, Compliance, SC Medical Group, SCHS Lab, Patient Access, HIM, Clinical Informatics, and IT) 13

14 Patient and Family Advisory Council Partner with St. Charles leaders, physicians, staff, patients and families in how care is delivered. Ensure the voice of the patient and family is heard and included in decisions. Patient Portal Connections 14

15 Patient Portal Staffing 2 FTE s in Clinical Informatics (0.5) 1 FTE in Medical Group Quality (0.5) Each of 22 practices provides on site support Patient Portal P&P SCHS Patient Portal Policy Documents the operational procedures required for the management and oversight SCHS Patient Portal Deceased Patient Record Procedure Documents the process followed for auditing and protecting deceased patient records SCHS Patient Portal Minor Account Monitoring and Maintenance Documents the process followed for auditing and monitoring minor patient accounts 15

16 Access to Minor Records Support for organizational education Overcoming the rumors What s next? 16

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