Provider Perspective on Patient Portal Adoption
Transcript of Provider Perspective on Patient Portal Adoption
4/11/2015
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Provider Perspective on Patient Adoption of
Portals, Secure Messaging April 12, 2015
Judy Derman, Director Care Anywhere Anytime
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
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Conflict of Interest
Judy Derman, RN, MHS
Has no real or apparent conflicts of interest to report.
© HIMSS 2015
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Learning Objectives
• Summarize best practices in achieving patient adoption of portals and secure
messaging
• Review the key success factors for the 3 best practice examples
• Analyze obstacles to adoption and the role of change management in
overcoming these
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About Kaiser Permanente
• Nation’s largest nonprofit health plan
• Integrated health care delivery system
• 9.6 million members
• 17,400 physicians
• 48,000 nurses
• 174,000 employees
• 38 hospitals
• 608 medical offices and other
outpatient facilities
• Serving 8 states and the District of
Columbia
• $56.4 billion operating revenue (2014)
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1900
Age of Manufacturing Mass manufacturing makes industrial powerhouses successful
1960
Age of Distribution Global connections and transportation systems make distribution key
1990
Age of Information Connected PCs and supply chains mean that those who control information flow dominate
2010
Age of the Consumer Empowered buyers demand a new level of expectations
The New Empowered Consumer
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Digital Adoption in Healthcare
Mobile’s Rapid Increase in Share of Traffic
23%
37%
77%
63%
2012 2013Mobile (smartphone & tablet) Desktop
Increasing Range of Online Health Activities
13%
21%
28%
33%
54%
50%
24%
30%
46%
52%
70%
72%
Consult online reviews of drugs
Got information, care, or supportfrom others with the same condition
Go online for a diagnosis
Participate in any online social activityrelated to health in past year
Got information, care, or supportfrom friends and family
Gather health information online
Caregivers Non-Caregivers
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Ground Taken Metric 2012 2013 2014 Projection
Healthcare
Tra
nsfo
rmation
Health Management Tools
Virtual Care
Health & Preventative Care
Total eligible KP members registered on
kp.org
4.2M (66%
adoption rate)
4.4M (68%
adoption rate)
4.8M (69%
adoption rate)
Total lab test results viewed online 32.3M 34.5M 36.5M
Total kp.org site visits 116.4M 131.6M 160.2M
Total emails sent to providers 15.1M 17.1M 19.8M
Total # of members who participated in
Healthy Lifestyle Programs on KP.org
341K 309K 310K
Afford
abili
ty
Financial Tools
Consumer Self Service
Total online prescription refills 11.9M 14.8M 18.2M
% of online refill orders 64.8% 64.4% 65.0%
Total appointments made online 3.2M 3.7M 4.2M
Total medical bill payment transactions online
N/A 80K 184K
(Q1-Q2 only)
Kaiser Permanente Adoption of Patient Portal kp.org provides 4.8 million members meaningful access to health plan and care services and to their personal health record ... from any place, any time
“My Health Manager received a Best in
Class Award from the 2014 Interactive
Media Awards – the program’s highest
honor”
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Best Practice– Integration into Care
• Extension of Care: Touchpoints can replace a visit or provide follow-up after a visit
• Teachable Moments: Data-driven insights fuel promotion and marketing
• Seamless Transactions: Mobile prescription refills, etc
• Simple Communication: Members, physicians and Care Team initiate messages
• Digital Image Sharing: Photo attachments can be used to display rash
• Integration with Procedures: Patient instructions for preparation
• Patient-Generated Data: Structured questionnaires
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0
5
10
15
20
25
30
35
2011 2012 2013 2014
# Messages Initiatedby Members (inMillions)
# Provider InitiatedMessages (inMillions)
Success Criteria: Secure Messaging Growth
*: In 2014 responses to physician/provider initiated emails began to be counted, and the
numbers here may be partially skewed for that year accordingly
*
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Best Practice– Marketing to Members
KP’s integrated marketing efforts have been crucial to portal adoption.
We reach our members at every touchpoint:
• Email announcements
• Flyers in clinics
• Newsletter articles
• Advertising (TV & Radio)
• Employee engagement programs
• Integrated into the care experience with MD, nurse
• Included in the After visit summary
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Best Practice– Access to My Data
My Health Manager allows members to easily access:
• Online test results
• Bill pay
• Email my doctor
• Prescription refill info
• Appointment management
• Contextual health education
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Success Criteria: Test Results Online
Online test results are the most popular feature at KP.org, and also have consistent growth in usage
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2011 2012 2013 2014
Member First Time Views of Test Results (in Millions)
First T
ime V
iew
s (
in M
illio
ns)
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Factors for Continued Growth
• Act For A Family Member: Proxy for Adult/adult adult/child and limited adult/teen relationships
• Multi-Language: Spanish navigation available
• Healthy Lifestyle Programs: Stress reduction, weight reduction, etc.
• Guided Resources: Health Encyclopedia/Drug Encyclopedia
KP Members with chronic conditions were surveyed about KP.org use:
• 90% say online access makes it more convenient to interact with care team
• 82% say access to kp.org helps me make informed decisions about my health
• 80% say kp.org enables me to more effectively manage my chronic condition
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Obstacles to Adoption
• Services needed in multiple languages
• Must engage diverse populations
• Aligning service across digital channels
(like Netflix)
• Data driven personalization is ideal but
difficult to achieve
• Engagement with low contact members
• Need for parents to manage young
teens’ care while protecting adolescent
confidentiality
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The Future of Online Healthcare
• Designing Experiences
• Data-Driven Personalization
• Emotional Engagement
• Access Care Anywhere, Anytime
• Omnichannel Access
• Seamless Transactions
• Social Integration
• Synched Devices
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Questions?
Judy Derman, Director Care Anywhere, Anytime
Digital Services Group
(925) 598-2787
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Provider Perspectives on Patient Adoption of Portals, Secure Messaging
April 12, 2015
Judy Derman, MHS
Susan Hull, MSN, RN
David Willis, MD
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
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Conflict of Interest Susan Hull, MSN, RN
Has no real or apparent conflicts of interest to report.
© HIMSS 2015
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Learning Objectives 1. Summarize best practices in achieving patient
adoption of portals and secure messaging.
2. Analyze obstacles to adoption and the role of
change management in overcoming these.
3. Review the key success factors for 3 best practice
examples.
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Connecting Health & Care for the Nation
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http://www.healthit.gov/sites/default/files/ONC10yearInteroperabilityConceptPaper.pdf
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
http://www.nationalpartnership.org/research-library/health-care/HIT/engaging-patients-and-
families.pdf
“Despite its promise, we have yet to fully realize the
potential of health IT to engage patients and
families meaningfully and consistently…
Consumers do not perceive the EHRs as helpful to
patients as they are to physicians.”
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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National Partnership Harris Poll of 2045 Adults, December 2014 (Follow-up to 2011)
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2015 State of Connected Patient Salesforce.com
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2015 State of Connected Patient Salesforce.com
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What is next? Social, Behavioral & Environmental DoH
“Psychosocial Vital Signs”
Let patients, families, caregivers help
Data captured, stored and integrated as needed
To learn more visit iom.edu.ehrdomains2
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Continuity of Care Maturity Model Going Beyond Stage 7 EMRAM
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Continuity of Care Maturity Model New HIT capabilities
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Consumers pushing a fragmented market February 2015
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The Internet of Things Patient & Device Generated Data Blurring Boundaries
Sensors increasingly embedded in smartphones, smart television & other
smart/wearable devices
• Internet of Things (advanced interconnectivity between systems and services)
• It is now possible to pack 19 million transistors into 16 nm
• There are more than 2 billion transistors in some current smartphone models
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“Nurses are the most-trusted
health professionals and have
a long history of patient
advocacy.”
ANI + ANA Consumer eHealth Task Force
3.1 Million Nurses
Empowered to use eHealth
Touching 18 Million Patients/Yr
Our Pledge
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New Competencies Needed
ANI Member Organization Survey (February 2014)
• Nurses’ personal experiences (as a patient/family member/caregiver) with:
– Other consumer tools, including mobile health apps, telehealth, digital health
– View, Download, and Transmit (VDT) of personal health data
– Blue Button
– Patient Generated Health Data
– Patient Reported Outcomes (e.g., H-CAHPS, PROMIS)
– Patient Governance (e.g., Shared Care Plan/Decision Making)
• Rates of nurse adoption as individual/family member
• Rates of consumer adoption
• Barriers to adoption as individual/family member
• Barriers to adoption for other consumers
• Barriers to adoption for nurses’ employers
Twitter: @SusanCHull
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New Competencies Needed
• Nurses’ knowledge base to support
– Patient advocacy for a variety of consumer eHealth tools (PHR, Patient
Portals, Mobile Health Apps, Telehealth, Digital Health, VDT, Blue Button,
PGHD, Shared Care Plan/Decision Making)
– ++ Integrating patient portals and other mHealth tools into care episodes
• Nursing Informatics knowledge base to support:
– Design, implementation and evaluation for a variety of consumer eHealth
tools (PHR, Patient Portals, Mobile Health Apps, Telehealth, Digital Health,
VDT, Blue Button, PGHD, Shared Care Plan/Decision Making)
– Integration of patient generated health data with provider generated health
data, ++ new data sources devices, sensors, genomics
– Capture and reporting of patient reported outcomes data (e.g., H-CAHPS,
PROMIS)
– Analytics for consumer engagement and population health
– Strategic planning for consumer eHealth
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Thank You and Questions
Susan Hull, MSN, RN
@SusanCHull
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Provider Perspectives on Patient Adoption
of Portals, Secure Messaging April 12, 2015
David C. Willis, MD
CMIO, CommunityHealth IT
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
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Conflict of Interest
David C. Willis, MD
Has no real or apparent conflicts of interest to report.
© HIMSS 2015
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Learning Objectives
1. Patient Adoption in small and rural practices
2. Community-based health information exchange and its benefits
3. How Consumer-Mediated Exchange increases the value for patient
engagement
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Small and Rural Practice Patient Engagement
• The need for Meaningful Use:
• 50% health summary
• 5% patient utilization
• Benefits to PCMH
• Enhanced patient access and patient care
• Improved coordination of care
• Challenged with limited knowledge and resources
• Competing for patients’ online attention
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Patient
Physician
Pharmacies
Laboratories
EMS Services
Hospitals
Hospitalist
The Current State of Care Confusion
Specialist MD
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Patient Physician
EMS Services
Hospitals
Pharmacies
Laboratories
Hospitalist
Specialist MD
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Community Principles
To give healthcare providers and their patients
immediate access to relevant medical information
anytime healthcare happens in a way that is:
1) secure and private
2) patient-friendly
3) physician-responsive
4) community-activated
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1) secure and private
2) patient-friendly
3) physician-responsive
4) community-activated
Active patient consent
Fully transparent
HIPAA compliant
Securely hosted data
Controlled exposure of the data
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1) secure and private
2) patient-friendly
3) physician-responsive
4) community-activated
Readily accesible
(webpage, mobile device)
Portable health information
(BlueButton)
Easy to navigate
Patient empowering
Provides value
(lab/test results, messaging)
FREE
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1) secure and private
2) patient-friendly
3) physician-responsive
4) community-activated
Enables better workflow (referral process)
Easily accessible information (consolidated health information at
the point of care)
Assists with Meaningful Use
Secure patient messaging
New business opportunities
(WebVisits, telemedicine)
Introduction to population
management tools
(PCMH, ACO, Future payment models)
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1) secure and private
2) patient-friendly
3) physician-responsive
4) community-activated
Community involvement
Diverse participants (Neutral sandbox)
Economic Development
(New job opportunities)
Healthier workforce
Wellness Programs
(small business benefits)
Healthier Communities
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Community
HIE
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• Patients
• Physicians, PAs, NPs
• Mental Health Providers
• EMS Services: trauma agencies
• Hospitals
• Hospice
• Home Health Care
• Healthcare Therapies: PT/OT/ST
• Social and Human Services
• Patient Advocacy Groups: disease management
• Patient Communities: population wellness
• Employers: worksite wellness
CDC Community Transformation Grant
Three year project with a focus of connecting
community linkages for chronic care through a
community-based online referral and messaging
system.
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VIECC Leads Consumer-
Mediated Exchange Efforts
• Joint national exchange initiative with
VA:ONC:HHS
• 24,000+ veterans using MyHealtheVet in
North Florida-South Georgia
• Supported by the White House Rural
Council. See VIECC blog on White House
website at:
http://www.whitehouse.gov/blog/2014/04/
01/transforming-veterans-care-rural-
practices-using-health-it.
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Questions
David C. Willis, MD
CMIO, CommunityHealth IT
Email: [email protected]
Twitter: dwillisFP