Download as PDF, PPTX
Uploaded byHealth IT Conference – iHT2
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience” with Lori Posk, MD, Medical Director for MyChart, Cleveland Clinic
The document outlines the Cleveland Clinic's efforts to move from enabling patients to actively engaging them through a patient portal. It details the development of a model for activating patients, releasing test results, and providing access to physician notes, highlighting the importance of patient education and involvement in healthcare decision-making. Key initiatives included the implementation of communication strategies, external features for patient engagement, and lessons learned in enhancing the patient experience.
More Related Content
Similar to iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience” with Lori Posk, MD, Medical Director for MyChart, Cleveland Clinic
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience” with Lori Posk, MD, Medical Director for MyChart, Cleveland Clinic
- 1. Moving an EnabledPatient to an Engaged Patient Our Patient Portal Experience Lori K. Posk M.D. FACP Medical Director MyChart Cleveland Clinic Foundation
- 2. Learning Objectives • Createa model to activate patients on a patient portal • Engaged a large institution in test result release to a patient portal • Develop a model for physician note release • How to educate patients and providers on test result and note release • Review the potential Impact on an engaged patient and provider team.
- 3. Agenda • Get toknow the Cleveland Clinic • History of the Patient Portal • Implementing an Opt Out Process for Patient Portal Sign Up • Tools Used to Move the Signed up Patient to an Engaged Patient • Next Steps
- 4. About Cleveland Clinic •Founded in 1921 and headquartered in Cleveland, OH • Non-profit multi-specialty academic medical center • 2,800 Physicians and Scientists • 4.6 million patient visits per year • More than 1,400 beds • Main hospital campus covers 166 acres and 46 buildings • More than 17 family health centers & locations in Florida, Las Vegas, Canada, and Abu Dhabi
- 5. H Ashtabula County Medical Center FHC Cleveland Clinic Toronto H EuclidHospital FHC Willoughby Hills Family Health Center HC FHC R.E. Jacobs FHC Health Center Elyria Family Health Center Cleveland Clinic H H FHC Lutheran Hospital FHC South Pointe Hospital Beachwood Family Health and Surgery Center FHC H Westlake Family FHC Health Center Lakewood Family Health Lorain Family Health Center And Surgery Center FHC Fairview Hospital Lou Ruvo Center for Brain Health Las Vegas, Nevada Hillcrest Hospital H Lakewood Hospital H H S.T.J. Health Center FHC Marymount Hospital FHC Twinsburg Family Health Center Solon Family Health Center FHC H Independence Family Health Center Medina Hospital FHC FHC Strongsville Family Health and Surgery Center Brunswick Family Health Center FHC Wooster Family Health Center H FHC Chagrin Falls Family Health Center Cleveland Clinic Florida
- 6.
- 7. Patient Portal • Implementedin 2002 with a few focused features in limited departments • 2005 in person and on line activation enterprise wide but primary care driven
- 8. Our 1st 10Years 2002-04 2007-08 2009 2010-11 In-person & online • Proxy In-person & online • Qnrs • Google Hlth • HealthVault • Surg Pre-Reg In-person & online • Auto Rslt Rel • HM Reminder • Pswd Reset In-person & online • Direct Sched • Mobile App • Minimal • Training by Department • Training by Dept / Inst • Train by Inst • Contests • Brochure • Minimal • Brochure • Folder • Brochure • Placards • Brochure • Focus groups • eNewsletters • Focus groups Activation Codes In-person New Features Communication Internal Patient • • • • • Diabetic Study My Med Record Requests Appt Review Health Maint 2005-06 New Activations 3,687 52,622 71,678 45,117 125,179 Activation % In-person Online 83 % 83 % 73 % 70 % 67 % - 92 % 71 % 75 % 85 %
- 9. Our Vision 2012and Beyond Inactive • Engaged patients • Engaged providers • Engaged support staff
- 10. Enabled Patients • Createda model to activate patients • Shifted from an Opt In message to an Opt Out message
- 11. MyChart Opt-Out Model •1.3 million accounts will be “Active” or “Newly Active” on day one ( October 15, 2012) • Patient asked to use the MyChart service, and given their already active authentication code • If patient declines their MyChart account will be deactivated • If patient does not use their authentication code they will be reminded at each of the next two visits • Patients who fail to authenticate their MyChart account after two reminders will have their MyChart account set to “Idle”
- 12. Moving the EnabledPatient to an Activated Patient
- 13. External Customer Features Inactive •Test results • Note Release • Messaging
- 14. The “Activated” Patient Inthe 21st century, value-based healthcare delivery system, patients will need to be actively engaged in their health, and their healthcare decision making. Cleveland Clinic will provide these new “activated” patients with both the tools, and the information (such as laboratory, pathology and radiology results, and clinician notes), they will need to make the healthiest choices and, with the education, guidance and expert advice of their providers, the best treatment decisions possible.
- 15. Test Result Release •2009 Lab release 2 day TDRR • Oct 2012 Plain film xray release 3 day TDRR • April 2013 Additional Imaging release 10 day TDRR • June 2013 Pathology release 20 day TDRR • July 2013 Procedure release 20 day TDRR • September 2013 Problem List release • Nov 19th 2013 Ambulatory Progress Note Release
- 16. MyChart Data andDocumentation Timeline by Quarter- 2013 Navigator Sign-Up Procedures • Inpatient Additional After Visit Summary Note Imaging (AVS) Release • Pathology and Problem List Message My Cytology Doctor Opt Out ED, UC & EC Quarter 1 Quarter 2 Quarter 3 2013 Quarter 4
- 17. Tools used forsuccessful Implementation • Physician Advisor Group • Communication
- 18. Physician Advisor Group •Multiple Physicians From All Institutes • Regular Meetings with active dialogue • Utilize the physicians experience and feedback and implement where possible
- 19. Physician Advisor Group LessonsLearned • Do not make it exclusively physicians • Include nursing, social work, pharmacy, other allied health professions, legal, medical records
- 20. Physician Advisor Group LessonsLearned • Give members of the group communication tools to disseminate information to their providers at all levels • Communicate to the Organization the members of the group and how they represent various levels of providers
- 21. Data Released • Over5 million test results released in 2013 • Minimal Patient and Provider Complaints
- 22. Note Release toEngage and Educate Patients
- 23. Note Release • AmbulatoryProgress Notes • Excluded ages 13-17 and Behavior Health • Created a sensitive note type not to be released • Go Live 11/19/13
- 24. Keys to Successof Note Release • Physician Advisor Group Engaged Legal, Health Information Management, Privacy Office in addition to multiple other departments • Special working groups with Pediatrics and Behavior Health • Multiple presentations at Institute Level
- 25. Keys to Successof Note Release • Listened to feedback • Created a Sensitive Note Type Not Released to the patient but visible to all providers • Recognized we were not ready for inpatient release
- 26. Keys to Success •Education Materials for Patients • Education Materials for Providers
- 27.
- 28.
- 32. Additional Provider Education • ChartEtiquette Do’s and Don’ts of Charting • Copy and Paste Etiquette • Medical Student Education
- 33. Lessons Learned • Communicatefrequently, often and at department level • Examine all work flows, know community hospitals • Engage many different levels of providers
- 34. Lessons Learned • Beaware of how you communicate and where
- 35. Lessons Learned Physician Concerns Communicated •Allowed Physicians to post comments, not all were constructive which created negative energy • Those that did communicate with name or directly to a member of the advisory group had more constructive criticism allowing the advisory group to implement a sensitive note type.
- 36. Note Release • GoLive 11/19/13 • Over 100,000 notes released first three weeks of Dec • Less than 2% of the time a sensitive note type was used
- 37. Note Release • Callsto MyChart Help Desk since Go Live • Calls to HIM Department since Go Live
- 38. Increasing Patient Engagement withMessaging • Meaningful Use Stage 2 Requirement • A secure Message was sent using the electronic messaging function of Certified EHR Technology by more than 5 percent of unique patients seen during the EHR reporting period.
- 39. Patient Engagement with Messaging •August 2012 pilot project to message doctors Office • 2013 Implemented in all the Family Health Centers • 42,373 Messages Sent • 292 Providers • 72 Departments
- 40. Patient Engagement with Messagingnext Steps • Complete the Implementation for the rest of the enterprise first quarter 2014
- 41. Patient Messaging Lessons Learned •Set up expectations for patients • Educate patients • Work flow will follow telephone encounter work flow. It will not fix it. • Don’t expect telephone encounter volume to go down.
- 45. Have we increased activations? • Over 500,000 activated patients
- 46.
- 48. Have we increased engagement? •Messaging over 43,000 messages sent by patients • Over 5000 patients have reviewed our educational material on line regarding what a chart is in the first 6 weeks • Data pending on how many notes have been read
- 49. Have we savedmoney ? • Direct appointment scheduling • Electronic messaging instead of letters for results • Apt reminders • Refills
- 50. Next Steps • Additionalnote release • Examine Office Practice Work Flows and drive efficiency