November 13, 2013
Department of Biomedical Informatics
BMIF 300
Patient Engagement Tools
S. Trent Rosenbloom, MD MPH
Associate Professor
Departments of Biomedical Informatics, Internal Medicine and Pediatrics
Vanderbilt University Medical Center
Patient Engagement
• Guides patients to take an active role in their
healthcare delivery, starting with information
• Improves patients’ understanding of their
health and related conditions so they take a
more active role in their health care
• Encourages involvement of patients’ families
and support systems or caregivers
Delbanco T, Walker J, Bell SK, et al. Inviting patients to read their doctors' notes: a quasiexperimental study and a look ahead. Ann Intern Med. 2012 Oct 2;157(7):461-70.
Delbanco T, Walker J, Bell SK, et al. Inviting patients to read their doctors' notes: a quasiexperimental study and a look ahead. Ann Intern Med. 2012 Oct 2;157(7):461-70.
Palen TE, Ross C, Powers JD, Xu S. Association of online patient access to clinicians and
medical records with use of clinical services. JAMA. 2012 Nov 21;308(19):2012-9.
Wade-Vuturo AE, Mayberry LS, Osborn CY. Secure messaging and diabetes management:
experiences and perspectives of patient portal users. JAMIA. 2013 May 1;20(3):519-25.
Osborn CY, Mayberry LS, Wallston KA, Johnson KB, Elasy TA. Understanding patient portal
use: implications for medication management. JMIR. 2013 Jul 3;15(7):e133.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
• Flu Tool was deployed Feb 8 - Apr 13, 2011:
– 1017 patients seen at VUMC and affiliated clinics
received an ICD-9 encoded diagnosis for influenza
(i.e., ICD-9 codes 487.xx or 488.xx)
– Flu Tool accessed a total of 4040 times
• 684 times within MHAV
• 2928 times on the general VUMC website
• 428 times on the general Children’s Hospital website.
Rosenbloom ST, Daniels TL, Talbot TR…Muse S, Jirjis J, Purcell Jackson G. Triaging patients
at risk of influenza using a patient portal. JAMIA. 2012 Jul-Aug;19(4):549-54.
MHAV Original 2004 Login Screen
MHAV Statistics
As of August 30, ‘13 Total User Logins Distinct User Logins
Previous Month
208,117
44,714
Previous 3 Months
591,619
71,721
Previous 6 Months
1,183,962
92,850
Previous 12 Months
2,402,209
116,461
*Approximately 410,000 patients seen at Vanderbilt in the prior 12 months
MHAV Steering Committee
• Purpose
– The My Health at Vanderbilt Steering Committee is
charged with overseeing the structure, content, and
usability of the Vanderbilt patient portal.
– This committee is also responsible for drafting and vetting
policies and procedures for MHAV.
Osborn CY, Rosenbloom ST, Stenner SP, Anders S, Muse S, Johnson KB, Jirjis J,
Jackson GP. MyHealthAtVanderbilt. JAMIA. 2011 Dec;18 Suppl 1:i18-23.
A vision for MHAV
The goal for My Health at Vanderbilt is for it to
serve as a platform to:
– engage patients
– personalize care
– reduce disparities
– streamline intake
AHRQ R18 HS019276-01, Disseminating Adapted Diabetes Evidence
To Clinicians Through A Patient Portal, Rosenbloom PI.
Disparities in Adoption
Osborn CY, Idowu RT, Han X, Chen Q, Rosenbloom ST, Jackson GP. Disparities in access to
care over three years: Patient portal usage versus outpatient care. NIH Summit on the
Science of Eliminating Health Disparities Meeting; National Harbor, MD, Oct-Nov 2012.
Disparities in Adoption
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Age
Gender
Race and Ethnicity
Socioeconomic Status
Health Literacy
Computer Literacy
Health and Disease
Current MHAV Access Tiers
• Tier I Access (partial access)
– send secure messages
– request appointments
• Tier II Access (full access)
– view portions of the clinical record
– view educational materials, lab interpretations
– view past and upcoming appointments
Current MHaV Access Processes
• Patient registers for Tier I access from anywhere
• Patient shows ID onsite to gain Tier II access
• Challenges – Patients cannot easily get full access all at once onsite
– Patients cannot get full access after leaving
– Process requires manual steps and can be overlooked
Universal Full MHaV Access
• Automatically provide Tier II access for ALL
patients as part of standard intake procedures.
• Simplify account creation steps for patients.
• Streamline MHaV account creation for patient
services representatives and admissions staff.
Future Directions
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Patient-completed forms, -reported outcomes
Medications, Problems, Allergies reconciliation
Medication refills
Expand available medical record data
Robust mobile presence
Patient-directed decision support, care plans
Prescribed educational materials
Integrated social networks
• A BIG thanks –
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Gretchen Jackson
Chandra Osborn
Kevin Johnson
Sue Muse
Gaye Smith
Jim Jirjis
Amanda Scott
The MHaV Team
The iAdapt Team
– AHRQ R18HS019276
Questions?
http://www.youtube.com/watch?v=5eT1_L-w1Mo
Happy to hear from you: trent.rosenbloom@vanderbilt.edu