v.05/22/2015 MYSFHEALTH / Enterprise Patient Portal FAQ Help Desk: (415) 206-2200 1. Why have we activated the MYSFHEALTH or the Enterprise Patient Portal? 2. What will patients see? 3. What will patients NOT see? 4. Why are we releasing laboratory and radiology / diagnostic test results? 5. What laboratory results can’t go to the portal? 6. Will patients be able to contact the clinic staff or clinicians through the Portal? 7. Why did we rename some ICD-9 assessments? 8. What should clinicians do? 9. What should clinic staff do? 10. Are there any concerns or accommodations for special populations? 11. How many patients need to sign up for Meaningful Use? 1. Why have we activated the MYSFHEALTH or the Enterprise Patient Portal? This website lets our patients and their English-Speaking adult proxies to access: Pertinent parts of their medical record that includes: o Inpatient hospitalization summaries o Outpatient visits to clinics using CareLinkSF (eCW). Access to Healthwise, a high quality patient education resource certified by Medicaid for patients with limited health literacy. MYSFHEALTH will meet one of the Meaningful Use requirements for CMS incentive payments for both the clinics and the hospital. To provide patients with an electronic copy of their health information within 3 business days upon request. 2. What will patients see? The patient portal includes only the basic features required for Meaningful Use attestation. This will include: Inpatient discharge documents: o Summary of diagnoses, tests, follow-up appointments, and discharge instructions Visit summaries from outpatient clinics using CareLinkSF: o The following will show on the portal even before the note is locked: Reason for the visit (from LCR, when the appointment was made) can be seen in eCW under Reason column Allergies Today’s Diagnoses Medications Immunizations Therapeutic injections and office procedures Ordered labs and diagnostic tests Problem lists Treatment notes Text written in Notes tab at the bottom of Treatment window will be v.05/22/2015 shown Text written in Clinical Notes tab at the bottom of Treatment window will not be shown Personal health records (can be downloaded): o Problems o Allergies o Social History: ONLY smoking status. This will pull the information from the HPI section where we document smoking status. o Plan of Care: Tests and procedures ordered and pending o Vital Signs o Medications o Results Labs: Test result, reference ranges, standardized comments about test interpretation, and text entered in the “Result” summary box (see below) Radiology results: only text used/entered in the “Result” summary box o Procedures Personal Health Record section (downloadable): v.05/22/2015 Example of a laboratory result: Example of a diagnostic imaging result : 3. What will patients NOT see? Some parts of the record are not visible, including: (see images below: Info in Green circle goes to the portal. Info under Red X will NOT go over.) Under Assessment window: o Clinicians' free-texted notes NEXT to the ICD-9 code and diagnosis o Notes at bottom of Assessment window v.05/22/2015 “Paper clip” text result reports or internal notes related to lab and diagnostic imaging Alerts Scheduled appointments (which originates in Invision) o We do not want to confuse patients about appointments that are not visible in eCW Ie: physical therapy or non-eCW clinics. Medical history Social history Family history 4. Why are we releasing laboratory and radiology / diagnostic test results? To meet Meaningful Use requirements, we have to enable the release of all laboratory and diagnostic imaging, except for labs prohibited from electronic release (See next question). The results in the yellow grid, reference ranges and comments, AND the text used/entered in the “Result” summary box will go to the portal automatically after a result has been marked “reviewed”. v.05/22/2015 5. What laboratory results can’t go to the portal? (CA Health & Safety Code 123148) “HIV antibody test; Presence of antigens indicating a hepatitis infection; Abusing the use of drugs; and Test results related to routinely processed tissues, including skin biopsies, Pap smear tests, products of conception, and bone marrow aspirations for morphological evaluation, if they reveal a malignancy.” The laboratory staff has helped us identify any test falling within these categories to prohibit their release from outpatient and inpatient records. (Note: we will also block “fake labs/DI” like DM foot exam, DM eye exam, pain agreement, and CURES reports.) 6. Will patients be able to contact the clinic staff or clinicians through the Portal? Soon after late 2015, we will activate patient’s ability to request routine appointments for the patient’s primary care clinic through the patient portal. For Meaningful Use, patients must be able to send a secure message to their providers, but we want to limit this to routine appointments in this initial phase. We will be able to limit this to the primary care clinic visited by the patient, and the request will route to the Call Center once each clinic is phased in. The system will warn patients not to use this and to call 911 for emergencies. Later phases of the portal can include: refill requests, requests for tests, and other messages for the provider, but we will not activate those now. 7. Why did we rename some ICD-9 assessments? Our system does not allow different patient-facing portal names for these codes. So we solicited input from the CareLinkSF Standards Committee, our behavioral health colleagues, and several clinicians using eCW to rename some codes to be more patient-centered, while still remaining identifiable to clinicians. 8. What should clinicians do? Assessments and Problem Lists: o Behavioral health experts recommend caution with diagnostic terms related to paranoid, delusional, or personality disorders. We cannot "hide" any assessment codes from patients, so please be careful choosing these codes for encounters. o ICD-9 codes related to interpersonal violence are not hidden from legal caregivers accessing children’s portal records. Clinicians caring for children should work with care teams to be cautious about portal enrollment for children under 11 if this would pose danger to the child or the child’s caregiver. o Clinicians wishing to remove any diagnoses from patients' problem lists can remove them at anytime. However, patients signing up for the portal anytime in the future will be able to view old visit summary assessments names dating back to the portal activation. Labs/Diagnostic Imaging: o Starting on the date of the portal activation (XX/XX/XX), whatever you type / select for the “Result” box will go into the Patient Portal after you click the “reviewed” button, v.05/22/2015 along with anything in the yellow grid. Normal ranges and interpretation information also are conveyed to the portal. “Paper clip” reports will not go over. Therefore: o Be thoughtful about what you type/select for the “Result” box. o Type your interpretation in this box for diagnostic imaging results to communicate with your portal patients, since they will not see the actual report. 9. What should clinic staff do? Be careful about what you enter into the “Reason for visit” in Invision and eCW. This will go into the Patient Portal. Review and use the attached instructions to activate the patient portal for any patient requesting portal access or “an electronic copy” of their records. Please also remind patients that they may request paper copies of their complete medical records through the usual mechanisms. Clinicians caring for children should work with care teams to be cautious about portal enrollment for children under 11 if this would pose danger to the child or the child’s caregiver. Adolescents (ages 11-17) and their guardians cannot be enrolled at this time (see below). Direct patients who have further questions to the MYSFHEALTH Help Line 415-206-2200. 10. Are there any concerns or accommodations for special populations? We are not allowing adolescents (ages 11-17) or their guardians to have Portal access because we cannot "hide" particular diagnoses, procedures, or medications that relate to sensitive services for adolescents. Also, hospital CCDAs for all <18 yrs patients will not flow to the portal at this time. The Portal is only available in English at this time. o In 2015, eClinicalWorks will release a Spanish version of the portal. o Adult patients who do not read English enough to use the portal can sign a consent to allow an adult English-literate proxy to access the portal on their behalf (see attached). They should think of this like a release of medical records to that adult English-literate proxy. 11. How many patients need to sign up for Meaningful Use? 50% of an eligible provider’s patients who visit during the attestation period must be “webenabled” (enter their email address and click on the box to send them an invitation email) any time before, after, or within 4 business days of the appointment. 5% of an eligible provider’s patients must log on to MYSFHEALTH during the attestation period. 12. How soon with the email arrive in the patient’s inbox after he/she has been webenabled? The MySFHealth welcome email usually appears in the patient’s email inbox within 5-7 minutes after web enabling, but we are currently working to reduce that time to 2-3 minutes. v.05/22/2015 13. Can I change a typo in an email address entered into eCW? Not at this time. Please have the patient call the help desk number to reset their web enabling. 14. When do visit summaries and lab results start to appear in the MySFHealth website? Since the portal information in MySFHealth is prospective, only visits from the web enabling onward will show up in the website. More specifically, if a patient writes down his/her email address on a visit registration form on Monday and then the clinic staff web enables that email address in eCW later that week, the Monday visit summary and/or lab result will NOT be populated in MySFHealth. Instead, the next visit summary will show up when the patient logs in at a later date. Enter email address in appointment screen. Click on the box next to “w” to “web enable.”