November 2,2012           ISHMPR                     It Pays to Be Special                 Converting a Specialty Practice...
Illinois Neurological Institute (INI) &            OSF HealthCare OSF HealthCare, owned and operated by The Sisters of th...
Our Mission            In the spirit of Christ and the exampleof Francis of Assisi, the Mission of OSF HealthCare is to se...
Illinois Neurological Institute (INI) &                OSF HealthCare The Illinois Neurological Institute is the neurosci...
Primary,  Secondary &Tertiary Markets
Specialty Centers Brain Tumor                Headache Gamma Knife/SRS            Balance + Vertigo Multiple Sclerosis...
Our Problem Growth of our neuroscience service line is dependent on  consumer/self referrals and referrals from outside o...
How are We Going to Fix it? Worked with OSF Corporate Marketing  team and Web Developer (Imaginary  Landscape) to create ...
First Appointment Request Application
INI Patient/Referring Provider Experience                                                INI.org                          ...
Enter in patient information and                                        reason for request.                               ...
Red TapeAvoiding Breach and Risk
Bring Them to the TableBe Prepared
Bring Them to the Table   Layout the project scope        Present from the patient experience point of view as it       ...
Bring Them to the Table   Introduce your vendor to the team        Prep your vendor prior to meeting on the following:  ...
Bring Them to the Table   Goals        Get the approval from Compliance               Compliance approved the initiativ...
INI Patient/Referring Provider Experience     INI.org    Homepage              Find a Physician          (Link in left nav...
Physician ProfileSelect Physician by Specialty
Status:                                                          •Unread                                                St...
Patient                                                              Info                                    Patient      ...
Managing Appointment Requests   Who should manage requests?        Call Center or MOA in charge of phones.            A...
Appointment Request Management                                                            Request from                  Re...
Patient or                                                         Request from Referring Request from Patient            ...
Project TimelineTimeline
Project TimelineTimeline
Project Timeline   The first, First Appointment Request was submitted during the   first hour of launching, without promot...
How Does it Look and Work?
HIPAA
HIPAA      Breach Notification Requirements              Individual Notice              Media Notice              Noti...
HIPAAThe Breach Rollhttp://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationr
Caesar’s Cipher
Caesar’s Cipher Cvvcem cv fcyp.  Attack at dawn.
HIPAA                                                      Protected health information (PHI) is rendered unusable, unread...
HIPAA
HIPAA4.2.2.1 Advanced Encryption Standard (AES)The AES algorithm is specified in [FIPS197]. AES encrypts anddecrypts data...
What Does It Mean?If you…   Encrypt data in transit and at rest   Encrypt using AES-128   Put the encryption keys on an...
Results Between April 11, 2012 and June 30  2012, 53 patients requested  appointments online. 80% made a general request...
Results Of the 53 patients requesting an appointment only 11 were  marked “appointment made” in the database. An addition...
How Do We Track the Revenue              Without a CRM? Data is pulled monthly from the request database and sent to  Cor...
How Do We Track the Revenue               Without a CRM? Decision Support pulls the Medical Record Number (MRN) of each  ...
Obstacles to Overcome Less than half of those who request an appointment actually  receive an appointment. Staff Attitud...
Lessons Learned Know your data. Just because a record says “appointment not  made” doesn’t mean that’s the case. Involve...
What’s Next? Implement a Patient Experience Team Add a contact us form that is more prominent on the site. Mobile App f...
The $$ We invested approximately $20,000 in the  technology. Through 7/30 we know that those patients who  were seen had...
Questions?
 It Pays to be Special: Converting a Specialty Practice Web Presence into Dollars
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It Pays to be Special: Converting a Specialty Practice Web Presence into Dollars

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Presented by Scott Lungwitz; Vickie Parry and Brian Moloney at the ISHMPR Fall Conference 2012

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  • http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/businessassociates.html By law, the HIPAA Privacy Rule applies only to covered entities – health plans, health care clearinghouses, and certain health care providers. However, most health care providers and health plans do not carry out all of their health care activities and functions by themselves. Instead, they often use the services of a variety of other persons or businesses. The Privacy Rule allows covered providers and health plans to disclose protected health information to these “business associates” if the providers or plans obtain satisfactory assurances that the business associate will use the information only for the purposes for which it was engaged by the covered entity, will safeguard the information from misuse, and will help the covered entity comply with some of the covered entity’s duties under the Privacy Rule. Covered entities may disclose protected health information to an entity in its role as a business associate only to help the covered entity carry out its health care functions – not for the business associate’s independent use or purposes, except as needed for the proper management and administration of the business associate.
  • http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/businessassociates.html By law, the HIPAA Privacy Rule applies only to covered entities – health plans, health care clearinghouses, and certain health care providers. However, most health care providers and health plans do not carry out all of their health care activities and functions by themselves. Instead, they often use the services of a variety of other persons or businesses. The Privacy Rule allows covered providers and health plans to disclose protected health information to these “business associates” if the providers or plans obtain satisfactory assurances that the business associate will use the information only for the purposes for which it was engaged by the covered entity, will safeguard the information from misuse, and will help the covered entity comply with some of the covered entity’s duties under the Privacy Rule. Covered entities may disclose protected health information to an entity in its role as a business associate only to help the covered entity carry out its health care functions – not for the business associate’s independent use or purposes, except as needed for the proper management and administration of the business associate.
  • Cautioned that we must be sure we are following through with all security measures related to internal business processes and workflows associated with the web initiative in order to satisfy any future security by the FTC.
  • It Pays to be Special: Converting a Specialty Practice Web Presence into Dollars

    1. 1. November 2,2012 ISHMPR It Pays to Be Special Converting a Specialty Practice Web Presence into DollarsVickie Parry Scott Lungwitz Brian MoloneyMarketing Manager Web Content Specialist Managing PartnerIllinois Neurological Institute OSF HealthCare Imaginary Landscape, LLC
    2. 2. Illinois Neurological Institute (INI) & OSF HealthCare OSF HealthCare, owned and operated by The Sisters of the Third Order of St. Francis, Peoria, Illinois, includes:  Eight acute care facilities  One long-term care facility  Two colleges of nursing  A primary care network consisting of over 600 primary care, specialist physicians, and advanced practice providers. Ranked 25 of 600 Integrated Health Networks.
    3. 3. Our Mission In the spirit of Christ and the exampleof Francis of Assisi, the Mission of OSF HealthCare is to servepersons with the greatest care and love in a community that celebrates the Gift of Life.
    4. 4. Illinois Neurological Institute (INI) & OSF HealthCare The Illinois Neurological Institute is the neuroscience service line for OSF HealthCare Employs +60 neurosurgeons, neurologists, physiatrists and mid- level providers The INI has approximately 95,000 patient visits/year with a DCM of +$100M
    5. 5. Primary, Secondary &Tertiary Markets
    6. 6. Specialty Centers Brain Tumor Headache Gamma Knife/SRS Balance + Vertigo Multiple Sclerosis Stroke + Cerebrovascular Spine Institute Movement Disorders Physical Medicine +Rehab Epilepsy Neuromuscular Pediatric Neurosurgery/Neurology Sleep Medicine Pituitary Neuro Ophthalmology Neuroradiology
    7. 7. Our Problem Growth of our neuroscience service line is dependent on consumer/self referrals and referrals from outside our health care system. Needed to attribute revenue to web efforts – without a CRM.* Not meeting needs of our patients who are searching for us and our services online.*this is important 
    8. 8. How are We Going to Fix it? Worked with OSF Corporate Marketing team and Web Developer (Imaginary Landscape) to create an online appointment request feature that meets the needs of our patients and enables us to track patient revenue.
    9. 9. First Appointment Request Application
    10. 10. INI Patient/Referring Provider Experience INI.org Homepage Request Appointment Find a Physician Button (Link in left navigation) First Appointment Physician Directory Listing by General (non-physician- Specialty specific) Request Form Physician Profile Page with Request an Appt. Button First Appointment Request Form (Physician Specific)INI Patient/Referring Provider Experience – Part 1
    11. 11. Enter in patient information and reason for request. Referring Patient Provider Provider enters in Submit referring information about patient Submit Success Request Submitted Fax Patient RecordsINI Patient/Referring Provider Experience – Part 2
    12. 12. Red TapeAvoiding Breach and Risk
    13. 13. Bring Them to the TableBe Prepared
    14. 14. Bring Them to the Table  Layout the project scope  Present from the patient experience point of view as it relates to privacy/HIPAA.  Assure the room that you have processes and workflows in place to accomplish the project safely and securely.Be Prepared
    15. 15. Bring Them to the Table  Introduce your vendor to the team  Prep your vendor prior to meeting on the following:  Can you create a secure online tool for this project?  How do you create and deliver such a tool?  Will the tool be in a HIPAA secure environment?  Will you commit to a Business Associate Agreement?Be Prepared
    16. 16. Bring Them to the Table  Goals  Get the approval from Compliance  Compliance approved the initiative from a patient privacy/HIPAA point of view  Accepted Business Associate Agreement from vendor  Get the approval from Security  Security approved our initiative.  CAUTIONED that we must comply with future FTC security measures.Be Prepared
    17. 17. INI Patient/Referring Provider Experience INI.org Homepage Find a Physician (Link in left navigation) Request Appointment Button 6,000 Visits MonthlyINI Website
    18. 18. Physician ProfileSelect Physician by Specialty
    19. 19. Status: •Unread Status •In Progress •Appointment Made •Appointment Not Made Contact Info Cancel Reasons •Insurance Conflict Contact •Not an appointment Info request •Hours conflict Reason ReasonSubmit Admin View Online Patient ViewAdministration Screens
    20. 20. Patient Info Patient Info Referral Referral Info Info Insurance Insurance Info Info Admin View Online Referral ViewAdministration Screens
    21. 21. Managing Appointment Requests  Who should manage requests?  Call Center or MOA in charge of phones.  Already fielding phone requests.  All are trained nurses that can triage patient situations.  How should we manage requests?  Application sends an email notification.  Individual vs. role based email accounts.Request Management
    22. 22. Appointment Request Management Request from Request from Referring Patient Provider Email Client Inbox Clicks Link Contained in Email NotificationAppointment Request Management – Part 1
    23. 23. Patient or Request from Referring Request from Patient Referring Provider Provider? Call Patient for history Records Received Create Record in EMRContact PCP for Patient Create Record in EMR Records Call Patient to Records Received Schedule Appt. Call Patient to Notify Referring PCP of Schedule Appt. Appt. Update First Appt. Update First Appt. Success Appt. Made Status StatusAppointment Request Management – Part 2
    24. 24. Project TimelineTimeline
    25. 25. Project TimelineTimeline
    26. 26. Project Timeline The first, First Appointment Request was submitted during the first hour of launching, without promoting anywhere!!!!!!!!!!!!Timeline
    27. 27. How Does it Look and Work?
    28. 28. HIPAA
    29. 29. HIPAA  Breach Notification Requirements  Individual Notice  Media Notice  Notice to the Secretaryhttp://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/index.html
    30. 30. HIPAAThe Breach Rollhttp://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationr
    31. 31. Caesar’s Cipher
    32. 32. Caesar’s Cipher Cvvcem cv fcyp. Attack at dawn.
    33. 33. HIPAA Protected health information (PHI) is rendered unusable, unreadable, or indecipherable to unauthorized individuals if one or more of the following applies: 1. Electronic PHI has been encrypted as specified in the HIPAA Security Rule by “the use of an algorithmic process to transform data into a form in which there is a low probability of assigning meaning without use of a confidential process or key” and such confidential process or key that might enable decryption has not been breached.  To avoid a breach of the confidential process or key, these decryption Guidance to Render tools should be stored on a device or at a location separate from the Unsecured Protected data they are used to encrypt or decrypt.  The encryption processes Health Information identified below have been tested by the National Institute of Unusable, Unreadable, or Standards and Technology (NIST) and judged to meet this standard.  Indecipherable to Unauthorized Individualshttp://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/brguidance.html
    34. 34. HIPAA
    35. 35. HIPAA4.2.2.1 Advanced Encryption Standard (AES)The AES algorithm is specified in [FIPS197]. AES encrypts anddecrypts data in 128-bit blocks, using 128, 192 or 256-bit keys. Thenomenclature for AES for the different key sizes is AES-x, where x isthe key size. All three key sizes are considered adequate for FederalGovernment applications.
    36. 36. What Does It Mean?If you…  Encrypt data in transit and at rest  Encrypt using AES-128  Put the encryption keys on another deviceThen…  No breach, even with a custodial loss
    37. 37. Results Between April 11, 2012 and June 30 2012, 53 patients requested appointments online. 80% made a general request vs. 20% requesting a specific physician. 59% completed the request form when our call center was OPEN. Mixture of former/current patients (old $)and new patients (new $).
    38. 38. Results Of the 53 patients requesting an appointment only 11 were marked “appointment made” in the database. An additional 9 were referred to Priority Consult. * This is a problem  Of those new patients who were seen, the majority of them were from outside our primary service area and a greater percentage had commercial insurance vs. managed care, Medicare or Medicaid.
    39. 39. How Do We Track the Revenue Without a CRM? Data is pulled monthly from the request database and sent to Corporate Decision Support. We need Patient Name and DOB for tracking.
    40. 40. How Do We Track the Revenue Without a CRM? Decision Support pulls the Medical Record Number (MRN) of each patient and attaches dollars. It is our intent to track these patients for at least one year. Pull data for EVERYONE on the list, not just those identified as “appointment made”.
    41. 41. Obstacles to Overcome Less than half of those who request an appointment actually receive an appointment. Staff Attitude – not receptive to self referrals and data is incomplete in the database. Access. Some physicians unwilling to accept self referrals and some have lengthy (+4 month) wait times. Lack of ability for referring physicians to attach patient records. Some using appointment request form to ask general questions vs. request an appointment.
    42. 42. Lessons Learned Know your data. Just because a record says “appointment not made” doesn’t mean that’s the case. Involve ALL staff from your call center from the very beginning – not just the manager. Be in agreement on how you attribute dollars to the project. Monitor your data and be prepared to take action if you don’t like what the data is telling you.
    43. 43. What’s Next? Implement a Patient Experience Team Add a contact us form that is more prominent on the site. Mobile App for Referring Physicians Sharing of Patient Records through Epic and Illinois HIE. Second Opinion Campaign Tracking First Appointment Request entry sources  PPC; Display; Social Media; Organic Search; Directory Listing Other OSF Websites; etc.
    44. 44. The $$ We invested approximately $20,000 in the technology. Through 7/30 we know that those patients who were seen had a DCM of +$186,710. And there will be additional revenue from these patients in coming months. Of the $186,710, $183,120 was new $ and $3,590 was old $
    45. 45. Questions?

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