Consumer Information Requirements April 26, 2013 1 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 2 Audience Participation Question #1: What type of organization do you represent? A. B. C. D. E. F. 1-4 physician practice 5-10 physician practice > 10 physician practice Federally Qualified Clinic Hospital System Other Audience Participation Question #2: What role/job duties are you responsible for at your facility? A. B. C. D. E. F. Doctor Nurse Practitioner Nurse/MA Office Manager/Administrative Staff Consultant 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 Engagement Meaningful Use Measures Fran Reynolds Medical 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) 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 9 What is Patient Engagement Patient 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 Benefits Provider & 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 selfmanagement 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! Assess Status Stage Access • Where is the • When practice? and what • Where is do we your Patient introduce Population? first? A c c e s s Redefine Engage IT Develop Brand • Who • What • What needs about message and/or network? do you can • Security? want to address • Train send to request? Office your • Document Staff to patients? address questions! Launch & CPI • Friends/ Family • What is working • What needs to change? Patient Engagement Framework http://www.nationalehealth.org/patient-engagement-framework 16 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 Measure View, 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 Measure View, 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 25 Patient Engagement Meaningful Use Measure View, 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 Measure View, 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 27 Patient Engagement Meaningful Use Measure Clinical 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 Measure Clinical 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 29 Patient Engagement Meaningful Use Measures Record 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 Measures Record 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 31 Patient Engagement Meaningful Use Measures Patient 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 Measures Patient 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 33 Patient Engagement Meaningful Use Measures Patient –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 Measures Patient –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 process http://partnershipforpatients.cms.gov/p4p_resources/tsppatientandfamilyengagement/tsppatient-and-family-engagement.html 35 Patient Engagement Meaningful Use Measures Secure 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 Measures Secure 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 Measures Secure 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 38 Wrap Up How can we engage the patient and their family in their healthcare? 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 In the course of doing these things you will meet your patient engagement meaningful use objectives! Tools • The Patient Engagement Framework www.nationalehealth.org/patient-engagtementframework • Interactive Forms (Vendor specific) • Educational Forms and Suggestions • http://partnershipforpatients.cms.gov/p4p_resources/ts p-patientandfamilyengagement/tsppatient-and-familyengagement.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/CincinnatiOH/HealthBridge/128672340540952 41