Moving an Enabled Patient to
an Engaged Patient
Our Patient Portal Experience
Lori K. Posk M.D. FACP
Medical Director MyCh...
Learning Objectives
• Create a model to activate patients on a patient
portal
• Engaged a large institution in test result...
Agenda
• Get to know the Cleveland Clinic
• History of the Patient Portal
• Implementing an Opt Out Process for
Patient Po...
About Cleveland Clinic
• Founded in 1921 and headquartered in
Cleveland, OH
• Non-profit multi-specialty academic medical
...
H
Ashtabula County
Medical Center

FHC
Cleveland
Clinic
Toronto

H
Euclid Hospital

FHC

Willoughby Hills
Family Health Ce...
About Cleveland Clinic
Patient Portal
• Implemented in 2002 with a few focused
features in limited departments
• 2005 in person and on line activ...
Our 1st 10 Years
2002-04

2007-08

2009

2010-11

In-person &
online
• Proxy

In-person &
online
• Qnrs
• Google Hlth
• He...
Our Vision 2012 and Beyond
Inactive

• Engaged patients
• Engaged providers
• Engaged support staff
Enabled Patients
• Created a model to activate patients
• Shifted from an Opt In message to an
Opt Out message
MyChart Opt-Out Model
• 1.3 million accounts will be “Active” or “Newly
Active” on day one ( October 15, 2012)
•

Patient ...
Moving the Enabled Patient to
an Activated Patient
External Customer Features
Inactive

• Test results
• Note Release
• Messaging
The “Activated” Patient
In the 21st century, value-based healthcare delivery
system, patients will need to be actively eng...
Test Result Release
• 2009 Lab release 2 day TDRR
• Oct 2012 Plain film xray release 3 day TDRR
• April 2013 Additional Im...
MyChart Data and Documentation
Timeline by Quarter- 2013
Navigator
Sign-Up

Procedures
•
Inpatient
Additional After Visit ...
Tools used for successful
Implementation
• Physician Advisor Group
• Communication
Physician Advisor Group
• Multiple Physicians From All Institutes
• Regular Meetings with active dialogue
• Utilize the ph...
Physician Advisor Group
Lessons Learned
• Do not make it exclusively physicians
• Include nursing, social work, pharmacy,
...
Physician Advisor Group
Lessons Learned
• Give members of the group
communication tools to disseminate
information to thei...
Data Released
• Over 5 million test results released in
2013
• Minimal Patient and Provider
Complaints
Note Release to Engage and
Educate Patients
Note Release
• Ambulatory Progress Notes
• Excluded ages 13-17 and Behavior
Health
• Created a sensitive note type not to ...
Keys to Success of Note
Release
• Physician Advisor Group Engaged
Legal, Health Information Management,
Privacy Office in ...
Keys to Success of Note
Release
• Listened to feedback
• Created a Sensitive Note Type Not
Released to the patient but vis...
Keys to Success
• Education Materials for Patients
• Education Materials for Providers
Example
Chart Review Example
Additional Provider
Education
• Chart Etiquette Do’s and Don’ts of
Charting
• Copy and Paste Etiquette
• Medical Student E...
Lessons Learned
• Communicate frequently, often and at
department level
• Examine all work flows, know
community hospitals...
Lessons Learned
• Be aware of how you communicate and
where
Lessons Learned
Physician Concerns
Communicated
• Allowed Physicians to post comments,
not all were constructive which cre...
Note Release
• Go Live 11/19/13
• Over 100,000 notes released first three
weeks of Dec
• Less than 2% of the time a sensit...
Note Release
• Calls to MyChart Help Desk since Go
Live
• Calls to HIM Department since Go Live
Increasing Patient
Engagement with Messaging
• Meaningful Use Stage 2 Requirement
• A secure Message was sent using the
el...
Patient Engagement with
Messaging
• August 2012 pilot project to message
doctors Office
• 2013 Implemented in all the Fami...
Patient Engagement with
Messaging next Steps
• Complete the Implementation for the
rest of the enterprise first quarter 20...
Patient Messaging Lessons
Learned
• Set up expectations for patients
• Educate patients
• Work flow will follow telephone
...
Have we increased
activations ?
• Over 500,000 activated patients
Cumulative MyChart
Activation by Period
Have we increased
engagement?
• Messaging over 43,000 messages sent
by patients
• Over 5000 patients have reviewed our
edu...
Have we saved money ?
• Direct appointment scheduling
• Electronic messaging instead of letters
for results
• Apt reminder...
Next Steps
• Additional note release
• Examine Office Practice Work Flows
and drive efficiency
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
iHT² Health IT Summit San Diego – Case Study: ”Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experie...
Upcoming SlideShare
Loading in …5
×

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

1,138 views

Published on

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

Read her full interview here - http://bit.ly/1f9enfC
View photos from the program here - http://on.fb.me/1cZFDpO

Case Study "Moving an Enabled Patient to an Engaged Patient: Our Patient Portal Experience"

Presentation will include a discussion on our patient portal activation and release of data. A review of our Opt Out model for portal activation will be discussed and our journey of data and documentation release to engage patients. The discussion will include how we used a Physician Advisor Group to release lab, imaging, procedures, pathology, problem list, provider notes and how we educated patients. Lessons learned on data release will be shared. Our implementation of message to engage patients and next steps will also be included in the discussion.

Learning Objectives:

∙ Create a model to activate patients on a patient portal
∙ How to engage a large organization in test result release to a patient portal
∙ Develop a model for physician note release with the option of having sensitive notes not released to the patient
∙ How to educate providers and patients on test result and note release
∙ Review the potential impact of an engaged patient and provider team

Published in: Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,138
On SlideShare
0
From Embeds
0
Number of Embeds
43
Actions
Shares
0
Downloads
20
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

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. 1. Moving an Enabled Patient to an Engaged Patient Our Patient Portal Experience Lori K. Posk M.D. FACP Medical Director MyChart Cleveland Clinic Foundation
  2. 2. Learning Objectives • Create a 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. 3. Agenda • Get to know 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. 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. 5. H Ashtabula County Medical Center FHC Cleveland Clinic Toronto H Euclid Hospital 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. 6. About Cleveland Clinic
  7. 7. Patient Portal • Implemented in 2002 with a few focused features in limited departments • 2005 in person and on line activation enterprise wide but primary care driven
  8. 8. Our 1st 10 Years 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. 9. Our Vision 2012 and Beyond Inactive • Engaged patients • Engaged providers • Engaged support staff
  10. 10. Enabled Patients • Created a model to activate patients • Shifted from an Opt In message to an Opt Out message
  11. 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. 12. Moving the Enabled Patient to an Activated Patient
  13. 13. External Customer Features Inactive • Test results • Note Release • Messaging
  14. 14. The “Activated” Patient In the 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. 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. 16. MyChart Data and Documentation 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. 17. Tools used for successful Implementation • Physician Advisor Group • Communication
  18. 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. 19. Physician Advisor Group Lessons Learned • Do not make it exclusively physicians • Include nursing, social work, pharmacy, other allied health professions, legal, medical records
  20. 20. Physician Advisor Group Lessons Learned • 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. 21. Data Released • Over 5 million test results released in 2013 • Minimal Patient and Provider Complaints
  22. 22. Note Release to Engage and Educate Patients
  23. 23. Note Release • Ambulatory Progress Notes • Excluded ages 13-17 and Behavior Health • Created a sensitive note type not to be released • Go Live 11/19/13
  24. 24. Keys to Success of 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. 25. Keys to Success of 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. 26. Keys to Success • Education Materials for Patients • Education Materials for Providers
  27. 27. Example
  28. 28. Chart Review Example
  29. 29. Additional Provider Education • Chart Etiquette Do’s and Don’ts of Charting • Copy and Paste Etiquette • Medical Student Education
  30. 30. Lessons Learned • Communicate frequently, often and at department level • Examine all work flows, know community hospitals • Engage many different levels of providers
  31. 31. Lessons Learned • Be aware of how you communicate and where
  32. 32. 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.
  33. 33. Note Release • Go Live 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
  34. 34. Note Release • Calls to MyChart Help Desk since Go Live • Calls to HIM Department since Go Live
  35. 35. Increasing Patient Engagement with Messaging • 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.
  36. 36. 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
  37. 37. Patient Engagement with Messaging next Steps • Complete the Implementation for the rest of the enterprise first quarter 2014
  38. 38. 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.
  39. 39. Have we increased activations ? • Over 500,000 activated patients
  40. 40. Cumulative MyChart Activation by Period
  41. 41. 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
  42. 42. Have we saved money ? • Direct appointment scheduling • Electronic messaging instead of letters for results • Apt reminders • Refills
  43. 43. Next Steps • Additional note release • Examine Office Practice Work Flows and drive efficiency

×