Download What is Avastone Health Solutions?

Meaningful Use Stage 2 (MU2): The Patient Portal
and its Value for Increased Patient Engagement
Shelby Miller
Senior Health Solutions Consultant
Avastone Health Solutions
Who is Avastone Health Solutions?
A Heartland Technology Group company
 Joined by Heartland Business Systems and Avastone Technologies, LLC
 Heartland Business Systems founded in 1990
A Wisconsin Based Company
 Midwestern Presence: Offices in WI, IL, MN, IA
• Home office in Little Chute, WI
 Hired employee 500 in May, 2014
 Annual revenue over $160 Million
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What is Avastone Health Solutions?
Strategic and operational consultants with an average of 18 years of broad
health care experience
Areas of Expertise:
 Privacy, security and data governance
 Revenue cycle in an evolving landscape
 Business intelligence
 Compliance and regulatory implementation
 Strategy and leadership
Understanding each health care organization is unique, our team of
experienced consultants work collaboratively with clients using a customized
approach. Adopting best practice methodologies, the team identifies
improvement and optimization opportunities across a wide-spectrum of
operational areas. Synergy occurs when operations is integrated with
strategy and financial performance driving rapid, sustainable results.
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Why Avastone Health Solutions?
• Our experienced consulting team is emerged in the industry
 AHIMA, HIMSS, MGMA, HFMA, HCCA, AAPC and more
• Through partnership with Heartland Business Systems and Avastone
Technologies, offers
 Full circle operational, strategic and IT solutions
• Flexible to meet your unique needs
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Presenter
Shelby Miller
Senior Health Solutions Consultant
[email protected]
Telephone: (920) 687-4722
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Today’s Objectives
1. Review of MU2
2. The Importance of the Patient Portal
a. Meeting a MU2 Requirement
b. Offers the patient flexibility to can get their designated information
when it is convenient for them
c. The portal can allow the patient to research, pay their bill, see their
chart, change their demographics, etc.
d. Use of the patient portal can lead to an increase in the efficiency of the
office workflow by decreasing patient calls and increasing patient
engagement through messaging through the portal.
3. The Importance of the Portal for Increased Patient Engagement
a. Case studies
b. Patient Benefits of a Portal
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Requirements of the Patient Portal for Meaningful Use
Purposes – Stage 2
Requirements:
• Secure messaging
• Access to the patient record with the ability to view, download and
transmit health information
• Protection of the electronic health information
May be used to do the following:
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•
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Provide patient specific education resources
Reminders for prevention/follow-up care
Provide the clinical summary
Pay their bill
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The Importance of the Patient Portal
In an environment of clinical measurement being tied to
reimbursement, Patient Portals are a win-win in many areas for the
clinic.
1. Financial Gains
a.
b.
c.
MU2 successful attestation will gain incentives and avoid payment
penalties from CMS
Allows for payments to be collected securely online
Reduces administrative burden in the office of phone calls, copying,
and faxing, etc. (for example reducing the number of phone calls it
takes to reach a patient to talk about their results)
2. Patient Satisfaction
a.
b.
An effective portal can increase patient satisfaction
Prepares for the upcoming satisfaction and engagement metrics
coming
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Review of Meaningful Use
Stage 2 (MU2)
INTRODUCTION TO MEANINGFUL USE IS AVAILABLE AT THE FOLLOWING WEB ADDRESS:
HTTP://WWW.CMS.GOV/REGULATIONS-ANDGUIDANCE/LEGISLATION/EHRINCENTIVEPROGRAMS/DOWNLOADS/BEGINNERS_GUIDE.PDF
THIS PRESENTATION PRIMARILY COVERS STAGE 2 WITH EMPHASIS ON THE PATIENT PORTAL.
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Eligible Professional Core Objectives
There are 17 Core Objectives for EPs in MU Stage 2:
1.
2.
3.
4.
5.
6.
7.
Use computerized provider order entry (CPOE)
Generate and transmit permissible prescriptions electronically (eRx)
Record the required demographics
Record chart changes in the required vitals
Record smoking status for patients 13 years old or older
Use clinical decision support to improve performance
Provide patients the ability to view online, download and transmit
designated information*
*Utilize Patient Portal
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Eligible Professional Core Objectives (cont.)
8. Provide clinical summaries*
9. Protect electronic health information*
10. Incorporate clinical lab-test results into Certified EHR*
11. Generate lists of patients by specific conditions
12. Use clinically relevant information to identify patients who should
receive reminders
13. Use clinically relevant information to identify patient-specific
education resources and provide them to the patient*
14. Perform medication reconciliation when relevant
*Utilize a Patient Portal
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Eligible Professional Core Objectives (cont.)
15. Provide a summary care record for each transition of care*
16. Capability to submit electronic data to immunization registries
17. Use secure messaging to communicate with patients*
*Utilize a Patient Portal
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Eligible Professional Menu Objectives (6)
1. Capability to submit electronic syndromic surveillance data to
public health agencies
2. Record electronic notes in the patient record
3. Imaging results consisting of the image and a report in the EHR*
4. Record patient family history as structured data
5. Capability to identify and report cancer cases to appropriate agency
6. Capability to identify and report specific cases to a specialized
registry (other than cancer)
*Utilize Patient Portal
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Clinical Quality Measures (9)
CQMs measure many aspects of patient care including:
•
•
•
•
•
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•
•
health outcomes
clinical processes
patient safety
efficient use of health care resources
care coordination
patient engagements
population and public health
adherence to clinical guidelines
Measuring and reporting CQMs helps to ensure that our health care
system is delivering effective, safe, efficient, patient-centered,
equitable, and timely care. CQMs may be reported electronically, or via
attestation. These also align with the triple aim strategy which is part
of the national quality strategy.
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Early Adopters of the MU Process are Rewarded with Greater
Incentives
Starting in January 1, 2015 Penalties will be as follows:
2015 – Reimbursements drops by 1% to 99%
2016 – Reimbursements drops by 2% to 98%
2017 – Reimbursements drops by 3% to 97%
2018 – Reimbursements drops by 4% to 96%
After 2018 it can go to 5% and 95%
See timeline in the resource section at the end of this presentation.
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Current Attestation for 2014 MU Stage 2 as of August 1, 2014
To read the full article:
http://www.ihealthbeat.
org/articles/2014/8/7/c
ms-meaningful-usestage-2-attestation-seesslight-increase-in-july
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CMS Announcement August 29, 2014
To read the full article:
http://cms.gov/Newsroo
m/MediaReleaseDatabase
/Press-releases/2014Press-releasesitems/2014-08-29.html
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The Patient Portal
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What is the definition of a Patient Portal?
According to Healthcarenews.com, a patient portal is a Web-based
access point that allows doctors and patients to communicate and
share health information remotely, supplementing the ongoing
management of the patient's care. While portals can't replace an inoffice visit, they have many benefits: They are "designed to boost
patient's involvement in their care," as portals encourage viewing test
results and health documentation and can facilitate an ongoing doctorpatient dialogue. Additionally, portals can reduce costly paperwork by
serving as online billing and payment centers. As part of the
meaningful use Stage 2 requirements, providers must have "at least
five percent of their patients using an online patient portal" to get
incentive payments.
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Acceptable Methods of Transmitting CCD/CCR
•
•
•
•
•
•
•
•
•
•
•
•
Acceptable transmission methods include, but are not limited to:
Secure email (encrypted)
Point-to-point interfaces
Secure web portals
Batch transfer over secure connections
Health information exchanges (HIEs), SDHL
Secure health information service providers
(Direct/HISP)
The Nationwide Health Information Network (NHIN)
Unencrypted email or simple mail transfer protocol
(SMTP) is acceptable when transferring
Hypothetical data
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Do you NEED a Patient Portal?
•
•
•
•
It is a requirement for Meaningful Use Stage 2
It can be used as a tool to engage patients in their care
It is good for the continuity of care for patients
Makes the transfer of records easier for patients traveling,
vacationing or moving in the United States
• Ultimately prevents payment penalties, see MU requirement above
• Gives the patient more access, whether it is for the family who are
managing the patient’s care or the patient who is demanding more
access via technology
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Benefits of a Patient Portal
• Access to up-to-date information
• Typically reduces the number of phone calls by 4.2 calls per patient
called to relay lab results
• Faster delivery of information to the patient and provider
• Can provide a private conversation for a patient to provider for
those difficult or embarrassing questions by using a secure
exchange
• Patients can make appointments, request refills, see lab results or
ask a question at their convenience via the portal
• Improves workflow for staff by allowing the portal to do the work
• Facilitates coordinated care
• Increase patients ownerships in their own healthcare
• Can act as a billing and payment center
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Improving Patient Engagement
The patient portal is a crucial tool in creating patient engagement. The
portal can help the patient or family members stay informed of current
appointments, test results and other pertinent information.
The portal has worked very well for clinics across the United States but
it was not easy. Clinics successfully implementing the portal had
several things in common:
• Intentional communication to patients
• Staff and provider input and buy-in
• Staff and provider have to understand the benefits of the system to
convey them to the patient
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Four Best Practices for Launching a Patient Portal
1. Branding
2. Usability
3. Functionality
4. Reliability
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Branding
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Use a catchy phrase in naming the portal
The “message” should be clear and concise
The “message” should be consistent
Ability to access the portal should be three clicks or less
Marketing should include items like brochures, ads, etc. (t-shirts)
Have a “kick off” for the go live with lots of fanfare
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Usability
•
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Make it easy to activate for the patient
Portal should be accessible through many options
It should be easily navigable
Possibly integrated into a preexisting social media platform
Utilize marketing so that it is easy to find through google, etc.
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Functionality
• Offer fast, easy and informative secure communication between
patients and providers
• Ability to check the patient’s medical records for notes, results etc.
• Allow patients to schedule appointments
• Allows patients to request a medication refill
• What is becoming common is the ability to utilize functionality to
send an automated message three days after the message is closed
asking the patient how they are doing and if they have any further
questions or concerns
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Reliability
•
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Stability
Secure
Consistent upload schedule
Consistent time frame for results or notes
Consistent response times for patient inquiries
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Patient View
THIS WAS STATED BY A DIABETIC PATIENT AT THE DANVILLE, KENTUCKY BIG SANDY HEALTH CARE FACILITY.
CASE STUDY BIG SANDY HEALTH CARE
HTTP://WWW.HEALTHIT.GOV/PROVIDERS-PROFESSIONALS/NO-DIGITAL-DIVIDE-RURAL-KENTUCKY-PRACTICE
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Benefits of Secure Messaging
To read the full article:
No Digital Divide in this Rural Kentucky Practice
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If each provider sees twenty patients per day,
one patient per day must send the provider a
message!
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Improve Communication Between Patients and Providers
• The patient portal give the patient an opportunity to ask a question
of the provider and get an answer within hours to days as
determined by the practice.
• Provides an opportunity for providers to ask questions or respond
and not be held up on the phone.
• Case Study Blackstone Valley Community Health Care
http://www.healthit.gov/providers-professionals/blackstone-valleycommunity-health-care-case-study
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Assessing the Security Risk of Your Patient
Portal
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Security Risks
• Login Security
Delicate balance between ease of use and HIPAA secure
• Unauthorized Access
Improper actions by employees
• Shortage of Technical Staff
With increase access to the patient’s record, this access and the
patient’s right to amend their record makes managing patient
information securely more difficult.
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Options for Mitigating these Security Risks
• Train and secure quality Security Specialists
• Partner with a consulting agency to provide this service
• Investing in training super users who can assist with proper training
and security checks
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Improving Patient Engagement
Improving Patient Engagement Through Your Portal
Basic portals should have the following features:
• Securely view and print portions of your medical record, including recent
doctor visits, discharge summaries, medications, immunizations, allergies,
and most lab results anytime and from anywhere you have Web access.
Features that enhance more engagement from the patient are the
following capabilities:
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•
•
•
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•
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Exchanging secure e-mail with your health care team
Requesting prescription refills
Scheduling non-urgent appointments
Checking your benefits and coverage
Updating your contact information
Making payments
Downloading or completing intake forms
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PHMG Case Study
Idaho Medical Group Discusses EHR Implementation and Patient
Portal Benefits
Case Study (Winter 2011)
Primary Health Medical Group's (PHMG) patient portal benefits
patient care and provider workflow when combined with its integrated
electronic health record (EHR) system.
http://www.healthit.gov/node/462
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PHMG Results
PHMG established a team specifically focused on achieving meaningful
use. The team identified process changes that would be required to
achieve meaningful use and led the implementation of these changes.
A total of 21 PHMG physicians were eligible for meaningful use and all
were successfully attested by October 2011. The practice has applied
for Medicare incentive payments and received the first payment in
November 2011.
What did they achieve with their portal?
• Shared patients specific education resources
• Provided clinical summaries to patients
• Offered access to health information
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PHMC Improved Patient Engagement
• They appreciate the direct communication with providers
• They appreciate the ability to ask questions in-between visits and
convenience of requesting medication and referrals online
• Some patients have told them they selected PHMG (and “fired”
their other providers) in part because of the availability of the
portal
http://www.healthit.gov/node/462
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First Healthcare
First Healthcare put an initiative to Put Patients First servicing patients
in 21 counties in Missouri.
After implementing the patient portal they experienced an increase in
patient satisfaction and engagement through the patient portal.
"For the doctors who use [the portal] regularly, the patients love it,
love it, love it. They don't have to call. Because it's hard to get through
our [phone] system sometimes, they really like that a whole, whole
lot." (Medical Assistant)
http://www.healthit.gov/providers-professionals/patients-first-health-care-case-study
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How Does a Patient Portal Engage Patients?
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•
•
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Provide the capability to share information with patients
Gives patients an opportunity to message the provider
Allows patients to schedule an appointment
Allows patients to view their results
Keeps the patient in touch with the provider
Allows the patient to request a refill or ask a question about a
medication
• Can provide education resources that the patient can review at
their convenience and then send questions back to the provider
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Could a Mobile Solution be Better?
• Mobile applications offer the convenience of using a phone or
portable device that the computer on a traditional patient portal
does not
• They are just about everywhere allowing greater portability and
accessibility
• Generally they are easier to navigate, as the information is given in
small chunks
• Facilitate distinct task-based activities, like scheduling
appointments, requesting a medication refill, etc.
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Potential Limitations to Mobile Applications
• Mobile applications offer a limited amount of data in a specific
format designed for presenting small chunks of data to the user
• For patients desiring a larger quantity of data or research from a
portal, this is not available
• The portal is generally used on a computer with a large screen for
easier viewing of data
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The Importance of Implementing a Patient Portal
• Portals are here for to stay
• It can improve your office workflow
• Increase patient engagement especially if using both the portal and
mobile portal functionality
• Provide patients and providers with timely information
• Increased patient satisfaction
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Do I need to obtain consent from my patients to implement a patient
portal?
•
No. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
permits the disclosure of health information to the patient without requiring the
patient's express consent. Additionally, patients nearly always have a right to
access their own health information. A portal is an excellent way to afford patients
access to their own information and to encourage them to be active partners in
their health care. When implementing a portal, work with your vendor to ensure
that privacy and security safeguards are put in place. For example, it is important
to have strong practices in place to ensure that the patient who is accessing a
portal is who they say they are, including unique user IDs and passwords and
potentially two-factor authentication (for example, a code being sent to a cell
phone in addition to a password). Patients should also be educated on appropriate
use of the portal and the importance of safeguarding their log-in credentials as
well as where they store any information they download or print.
http://healthit.gov/providers-professionals/faqs/do-i-need-obtain-consent-my-patientsimplement-patient-portal
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Resources
Audits from CMS Meaningful Use
• Supporting documentation must be retained for 6 years
• Notification will come from Figliozzi and Company, CMS’ chosen
contractor
• Beginning January 2013, Medicare providers may be subject to prepayment audits
For more information, see the link below.
http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/Downloads/EHR_SupportingDocumentation_Audits.pdf
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2014 EHR Incentive Payment Schedule
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Meaningful Use Timeline
To read the full article:
New CMS rule allows flexibility in
certified EHR technology for 2014
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Attestation Options for 2014
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Link to this page:
An Introduction to the
Medicare EHR Incentive
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Resources
• Beginners Guide to EHR Incentive Programs
http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/downloads/Beginners_Guide.pdf
• Reference Grid for Stage 2
http://www.healthit.gov/sites/default/files/meaningfulusetablesseries2_110112.pdf
• Audits
http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/Downloads/EHR_SupportingDocumentat
ion_Audits.pdf
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Contact Information:
Shelby Miller
Senior Health Solution Consultant
Avastone Health Solutions
A Division of Avastone Technologies, LLC
Phone: (920) 687-4722
Email: [email protected]
Website: www.avastonetech.com/healthsolutions