A Bigger Bang Patient Portal Strategy: How we activated 100K patients in our First Year

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A Bigger Bang Patient Portal Strategy: How we activated 100K patients in our First Year Saturday March 25 th, 2017 Lindsay Altimare, MPA Director, LVPG Operations Lehigh Valley Health Network Michael Sheinberg, MD Medical Director, Informatics Lehigh Valley Health Network

Who We Are 8 hospital campuses 1 children s hospital 160+ physician practices 17 community clinics 16 health centers 81 testing and imaging locations 12 express care locations 18,000+ employees 2,005 physicians 834 APC s 1,838 acute care beds

Agenda Review of our EHR implementation and patient portal functionality Break down milestones achieved to accelerate patient portal activation Employ strategies to involve colleagues in cultural transformation Gain an understanding of new targeted, digital marketing strategies to enroll patients Demonstrate operational and outcomes analytics

Background 4

EHR Implementation Timeline 2013 2014 2015 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D Kickoff Ambulatory Go-Live Phase 1: Project Planning & Certification Phase 2: Validati on Phase 3: Re-engineering & System Build Out Phase 4: Testing & Training Phase 5/6: Optimization Inpatient Go-Live Phase 1: Project Planning & Certification Phase 2: Validati on Phase 3: Re-engineering & System Build Out Phase 4: Testing & Training Phase 5/6: Optimization

MyLVHN Portal

MyLVHN Portal

MyLVHN Portal Provider/Network Perspective Reducing Costs with Online Test Results Reducing Phone Calls Reducing Time Spent Charting with Online Questionnaires Reducing No-Shows and Saving Money with Online Scheduling Increasing Patient Loyalty Reducing Costs with Online Bill Pay Increasing Revenue and Saving Time with E-visits

MyLVHN Portal: Challenges New functionality Change management Requires patient activation Need high percentage rates for ROI

Portal Governance Steering Committee MyChartAdvisory Group (Marketing Chair) Project Legal/Risk Epic Ambulatory Manager MyChart Analyst Epic Medical Lead Cadence Manager Organizational Development Data Analytics HIM

Patient Portal Strategies 11

MyLVHN Portal Journey: Roadmap to Success Wave 1: Ambulatory Go-Live All LVPG Practices Promotion Wave 2: Inpatient Go-Live All Patient Promotion Televox Autocalls To Patients Direct Scheduling Enabled Consumer Relationship Management System Email Campaign Feb 2015 Apr 2015 Jun 2015 Jul 2015 Aug 2015 Sep 2015 Oct 2015 Dec 2015 Jan 2016 Mar 2016 Jun 2016 LVPG Pilot Practices Promotion Colleague Promotion FY16 Goal Setting Text Message Reminders Mass Media Campaign Patient Entered Questionnaires Pilot E-visit and Virtual Visit Pilots Launch App Optimized

Pilot Practices Pilots induce learning from controlled environments Goal was to define roles, workflows, patient engagement, impact on practice work load (increase vs. economies) 14 practices selected-cross section of disciplines Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

Pilot Practices On paper processes tested and refined Best practices brought out through daily communication Practice Feedback/presentations yielded replicable methodology and success Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

FY16 Goal Setting LVHN sets annual Triple Aim Network-Wide Goals One of two goals under Better Health set as Patient Engagement was MyLVHN patient activations A network goal along with its inclusion under our Shared Success Plan ensured the engagement of all colleagues Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

FY16 Goal Setting Given experience of other systems, modest goals were set with a threshold of 25,000 and max of 40,000 patients Early in Q2 the goals were revised at the request of the Board of Directors given our trajectory-max set at 55,000 As we blew past this goal we were in unchartered territory Percentage versus n LVHN FY 16 NETWORK GOALS Increase patient portal engagement as measured by total number of patients activated Threshold Target Maximum 25,000 32,500 40,000 Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

Colleague Engagement FY16 Goal tracking Video for how to enroll Email blasts LVHN Daily articles Leader-to-Leader presentation Department meetings Scripting Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

Mass Media Campaign Launched December 2015 Patient Flyers Billboard TV, Radio Print Social Media Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

Mass Media Creative

Nurture Email Campaign 80,000 patients identified February 2015 to January 2016 Patients had code, but not enrolled Email address on file MyLVHN Active Resent code with reminder MyLVHN Expired Provided new code and encouraged activation Ambulatory Go-Live LVPG Pilot Practices FY16 Goal Setting Colleague Engagement Inpatient Go-Live Call/Text Reminders Mass Media Campaign Patient Entered Questionnaires Email Campaign E-Visit Pilot

Patient Engagement Strategy Year 1 Optimization Project Timeline 2015-2016: MyLVHN Initiatives August Sept Oct Nov Dec Jan 2016 Feb March April May June Patient Entered Questionnaires ROS, HPI, Subset Specialty Questionnaires Wave 1 Optimization Comprehensive strategy to drive MyLVHN signup and utilization. Pilot Go Live LVPG Go Live E-Visit Pilot Go Live MyLVHN echeck-in Go Live Video Visit Pilot Go Live Appointment Cancellation Patient Self Scheduling Well Visits- Primary Care Pilot Go Live MyLVHN Bedside Patient Self Scheduling Well Visits- Pediatrics Pilot Go Live Completed Items: View labs, graphs View/download/transmit AVS Text message appt reminders Request refills Proxy access/view Care everywhere auth Mobile App Enhancements

Patient Engagement Strategy Year 2 **ADD FY17 GANNT Optimization Project Timeline 2015-2016: MyLVHN Initiatives July Aug Sept Oct Nov Dec Jan 2017 Feb Mar April May June July Aug Sept Oct Nov Dec Video Visit Go-Live Open Scheduling Pilot Go Live Open Scheduling Expansion Direct Scheduling (Sick Visit) Expansion Pilot Go Live Waitlist Appointment Offers (Fast Pass) Go Live echeck-in Welcome Tablets E-Visit Expansion 22

Outcomes and Operational Analytics

Portal Activation MyLVHN Activations - Monthly 140000 120000 100000 Consumer Relationship Management Email Campaign 80000 60000 40000 20000 LVPG Pilot Practices Promotion FY16 Goal Setting Mass Media Campaign 0

Number of patients Portal Activations Monthly 125000 115000 105000 95000 85000 75000 65000 55000 45000 35000 25000 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Enrollment 26375 33269 40468 47727 54355 61963 74107 85836 95788 105939 112836 118617 Target 29257 33314 37771 42028 46285 50542 54800 54800 54800 54800 54800 54800 Max 61000 61000 61000 61000 61000 61000 61000 61000 61000 61000 61000 61000 Enrollment Target Max

Portal Activation Enterprise Activation Rate 60% 40% 20% 0% Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Epic Top 5% Epic Average Lehigh Valley Health Network

FY16 Key Patient Engagement Metrics # of Hits Unique Patients Patient Medical Advice Request 84,952 25,313 echeck-in 65,529 11,236 Appointment request (non-direct) 38,251 20,793 Patient Medication Renewal Request 26,109 11,115 History Questionnaire Submission 20,306 18,377 Patient Appointment Direct Cancel 17,938 9,407 General Questionnaire Submission 15,928 11,050 Patient Appointment Schedule Request 12,071 7,961 Copay payment 3,632 2,221 Appointments Scheduled through MyLVHN 2,359 n/a E-visit 56 43

FY16 Key Patient Engagement Metrics

FY16 Key Patient Engagement Metrics

FY16 Key Patient Engagement Metrics

FY16 Key Patient Engagement Metrics

FY16 Key Patient Engagement Metrics

Lessons Learned

Lessons Learned Patients were interested in having their health information at their finger tips Patients found the portal prior to active promotion Cultural change needed to support new model of patient engagement Include MyLVHN workflows with Go-Live Engaging patients with activation codes, but not activated Critical Success Factors (included in recipe) FAQs, Tip Sheets, Workflows

Lessons Learned Challenges/Potential Risks Proxy Access Contest attributing activations within practices Patient Enrollment Barriers Changed from needing MRN to using SSN Code expiration Prioritizing Optimization and responding to patient demand

Conclusions

Patient Portal Recipe for Success Prep Time Cook Time Serves Due Diligence Planning Pilot before Launch Your organization to achieve patient portal success

Patient Portal Recipe for Success 38

Questions & Answer Contact Information: Lindsay Altimare, MPA Director, LVPG Operations Lehigh Valley Health Network Lindsay.Altimare@lvhn.org Michael Sheinberg, MD Medical Director, LVHN Informatics Lehigh Valley Health Network Michael.Sheinberg@lvhn.org