emerging tools and technology for consumer … tools and technology for consumer engagement . in...
TRANSCRIPT
HMA HealthManagement.com
October 15, 2015
Emerging Tools and Technology for Consumer Engagement
in Health Care
Speakers: Matt McGeorge, Senior Consultant, HMA
Jean Glossa M.D., Principal, HMA
HMA
How is the doctor-patient relationship changing? It’s going electronic.
- Washington Post Headline April 27, 2015
5
HMA
Learning Objectives • Recognize the importance of information technology in driving
consumer engagement in healthcare. • Understand the meaningful use guidelines related to consumer
engagement. • Exposure to some of the tools and technology helping consumers
navigate the healthcare system, manage their health and wellness, and evaluate care options.
• Appreciate the role patients play in helping to keep electronic
health records and information up-to-date and correct. • Insight into the implications for clinicians as consumers more
actively utilize electronic tools and technology
6
HMA
FACTORS MEANINGFUL USE TOOLS
Matt McGeorge, Senior Consultant
7
HMA
Factors Driving the Use of Technology to Engage Patients
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform
8
HMA
Patient Centered Care – Gives patients the ability to communicate
effectively and immediately with their providers
– Provides patients access to information that is important and useful to them, when they need it
– Allows providers to look holistically at an individual and treat them through the coordination with other providers
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform
Empowering the Patient
9
HMA
Payment Reform
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform
Increased expectations for patients/consumers •Cost sharing •Availability of information •Choice and access
Engaged patients/consumers will: •Understand more about their health and the care provided to them •Participate in developing a treatment plan and strive to meet treatment goals •Demand higher quality for the care they receive
Results of engaged patients/consumers: • Increased transparency in care and cost •Focus on patient centered care
10
HMA
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform
Personal Access to Technology
11 http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/pi_2015-04-01_smartphones_05/
HMA
Personal Access to Technology
12
Pew Research Center http://www.pewinternet.org/data-trend/internet-use/internet-use-over-time/
HMA
Personal Access to Technology
13
Pew Research Center http://www.pewinternet.org/data-trend/mobile/device-ownership/
HMA
Lever: Meaningful Use (MU)
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform
“Eligible professionals, eligible hospitals, and critical access hospitals are in the best position to encourage patients to use health IT to better understand and participate in their own health care.” - Robert Tagalicod, Director, Office of E-Health Standards and Services
https://www.cms.gov/eHealth/ListServ_Stage2_EngagingPatients.html
14
HMA
Lever: Meaningful Use (MU) MU is intended to facilitate the movement of American healthcare and health IT toward delivering patient centered care
Implementing MU requires a balanced approach:
• If measures too difficult, providers would not participate in program • If too easy to meet, then healthcare outcomes would not significantly
improve
When providers adjust workflow for some patients, they will likely do it for all
15
HMA
Steps for MU Implementation for Health Information Technology (HIT)
Stage 1 Data Capture and Information Sharing 2011 - 2013
Stage 2 Advanced Clinical Practices (Clinical Decision Support) 2014 - 2016
Stage 3 Improved Outcomes 2017
16
The MU criteria are being implemented in three stages
HMA 17
HMA 18
HMA
Meaningful Use Patient Engagement Measures
(Evolution of Measures)
Stage 1
Stage 2
2015 -2017 Stage 3
Clinical Summaries of Care
Patient Reminders
Patient Specific Education Resources
Combined
Patient Access to Health Information (electronic access from 2014 on)
Combined
Electronic Access Menu Measure Prior
to 2014
Electronic Messaging
19
HMA
Patient Specific Education Resources Stage Measure
Stage 1 Menu: More than10% of patients are provided patient specific education resources
Stage 2 Patient-specific education resources identified by CEHRT are provided to patients for more than 10% of all patients with office visits seen by EP
2015-2017 Patient-specific education resources identified by CEHRT are provided to patients for more than 10% of all patients with office visits seen by EP
Stage 3 Combined with Electronic Access Measure (see next slide)
* Measure objectives summarized for illustration , exclusions may apply
20
HMA
Patient Access to Health Information
* Measure objectives summarized for illustration , exclusions may apply
Stage Objective Measure*
Stage 1 More than 50% of all patients who request an electronic copy are provided I within 3 business days
Menu prior to 2014: More than 10% of all patients seen are provided electronic access within 4 business days after info available to EP
Stage 2 More than 50% of all patients seen are provided online access to their health info within 4 business day after info available to EP; more than 5% of all patients view, download or transmit to a third party their health information
2015 – 2017 (2 measures)
1. More than 50% of all patients seen are provided online access view, download, and transmit to a third party their health information 2. in 2015 & 2016, at least 1 patient views, downloads or transmits his or her health info to a third party; in 2017 more than 5% of patients seen by EP views, downloads or transmits health info to third party
Stage 3 (optional 2017; required -2018 on)
2. measures)
1.For more than 80% of patients, patient is provided timely access to view, download or transmit their health info or is given access of their choice that meet the API Specs in the provider’s CEHRT 2. EP must use clinically relevant info from CEHRT to identify & provide electronic access for more than 35% of patients
21
HMA
Electronic Messaging/Coordination of Care through Patient Engagement
Stage Objective Measure* Stage 1 Not required
Stage 2 A secure message was sent using the electronic messaging function of CEHRT by more than 5% of patients
2015-2017
In 2015, the capability for patients to send and receive a secure message with the EP was fully enabled during the EHR reporting period; in 2016, EP must send or respond to a secure message sent using CEHRT function; in 2017, EP must send or respond to messages from 5% of patients (or patent representative) using CEHRT function
Stage 3 (optional 2017; required -2018
on)
(EP must meet 2 of 3 measures)
1. In 2017, more than 5% of patients seen by EP actively engage with EHR provided by EP, in 2018, requirement applies to more than 10%; 2. In 2017, for more than 5% of patients seen a secure message was sent using messaging function of CEHRT or in response to message from patient, after 2017, the requirement rises to 25%; 3. Patient generated health data from non-clinical setting incorporated into CEHRT for more than 5% of patients seen
* Measure objectives summarized for illustration , exclusions may apply 22
HMA
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Identify andprovide patient-
specific educationresources
View, Downloadand Transmit
information fromtheir
health/medicalrecord online
Request anamendment tochange/update
theirhealth/medical
record
Scheduleappointments
online
Request refills forprescriptions
online
Submit patient-generated data
(e.g., bloodglucose, weight)
US Hospital Adoption of Patient Engagement Functionalities
2012 2013 2014
Office of the National Coordinator for Health Information Technology. 'U.S. Hospital Adoption of Patient Engagement Functionalities,' Health IT Quick-Stat #24. dashboard.healthit.gov/quickstats/pages/FIG-Hospital-Adoption-of-Patient-Engagement-Functionalities.php. October 2015 23
HMA
Health IT Tools
Office of the National Coordinator for Health Information Technology. 'Trends in Individuals Use of Health IT: 2012 - 2014,' Health IT Quick-Stat #46. dashboard.healthit.gov/quickstats/pages/FIG-Individuals-Health-IT-Use.php. June 2015
Patient Centered
Care
Personal Access to
Technology
EHR Incentive programs
Payment Reform 24
HMA
Health IT Tools
• Patient portals - A patient portal is a secure online website that gives patients
convenient 24-hour access to personal health information from anywhere with an Internet connection.
– Office of the National Coordinator for Health IT - Uses:
- View discharge summaries, lab reports, medications - Request appointments and prescription refills
- Challenges: - Having a portal does not equate to patient engagement - Patients with multiple providers have multiple sign-ons
25
HMA
NOTE: *Significantly different from prior year (p<.05). Not useful includes not at all useful or not very useful; Useful includes somewhat or very useful. Number of respondents ranged from 384 (2013) to 474(2014). SOURCE: 2013-2014 Consumer Survey of Attitudes Toward the Privacy and Security Aspects of Electronic Health Records and Health Information Exchange Patel V., Barker W. & Siminerio E. (October 2015). Trends in Consumer Access and Use of Electronic Health. ONC Data Brief, no.30. Office of the National Coordinator for Health Information Technology: Washington DC
Usefulness of information within online medical record reported by individuals who used their online medical record at least once within the past year, 2013-2014.
Reasons for not accessing online medical record cited by those who did not access their online medical record, 2013-2014
Health IT Tools
26
HMA
• Patient Portals - Opportunities:
SOURCE: 2014 Consumer Survey of Attitudes Toward the Privacy and Security Aspects of Electronic Health Records and Health Information Exchange Patel V., Barker W. & Siminerio E. (October 2015). Trends in Consumer Access and Use of Electronic Health. ONC Data Brief, no.30. Office of the National Coordinator for Health Information Technology: Washington DC
Health IT Tools
27
HMA
• Patient Portals - Opportunities:
SOURCE: 2014 Consumer Survey of Attitudes Toward the Privacy and Security Aspects of Electronic Health Records and Health Information Exchange Patel V., Barker W. & Siminerio E. (October 2015). Trends in Consumer Access and Use of Electronic Health. ONC Data Brief, no.30. Office of the National Coordinator for Health Information Technology: Washington DC
Health IT Tools
Role of Health Information Exchange: - Provider Initiated - Patient Initiated
Reinforces importance of interoperable systems
28
HMA
Secure Messaging: Any electronic communication between a provider and patient that ensures only
those parties can access the communication.
Messaging is private, tamper
resistant and authenticated
Patients can send care related
questions to providers and promotes their
role in the relationship
Providers can understand if
there significant issues that need addressed, can
improve patient satisfaction
Health IT Tools
29
HMA
Secure Messaging
Challenges: Expectations about
responsiveness (from both patient
and provider perspective)
• Is it really part of the work flow?
Opportunities: Establishes
communication channel to allow
provider gain insight into patient health status outside of practice setting.
Best Practices: Adopt active role in
promoting, teach patients how to use
and be willing to use
Health IT Tools
30
HMA
•Patient-generated health data are health-related data created, recorded, or gathered by or from patients (or family members or other caregivers) to help address a health concern. - Office of the National Coordinator for Health IT
•Patients and/or caregivers can generate their own health information that would focus on health history, vital signs, symptoms
Patient Generated Data Facilitation
Health IT Tools
31
HMA
•Challenges: •Is the data good? •Is it timely? •How does it get appropriately incorporated
into record? •Opportunities: •Gain insight into patient health status •Develop capacity to take action more quickly
Patient Generated Data Facilitation
Health IT Tools
32
HMA
State and Plan Perspective
Using text messaging to
support enrollment or
other initiatives
Portals and mobile
applications to provide
beneficiaries information
Support for providers with implementation
Health IT Tools
33
HMA
PROVIDERS’ PERSPECTIVE- MANAGING INFORMATION
Jean Glossa, MD, MBA, FACP
34
HMA
Providers’ Perspective
35
HMA 36
HMA
Information overload for the physician
• Info coming in from multiple sources • Info from sources that you need to go get • Info may be repeated/redundant • Info may be incomplete or wrong
Leads to: • Medical errors and omissions; poor quality care • Low productivity, inefficiency or unfocused work • Provider burnout • Patient and provider low satisfaction and drop out
37
HMA
Surviving strategies
Solutions: • Transitioning to team based care • Screening data before it gets to you- who
else on the team can review and interpret this data?
Transition to alternative payment models- where your reimbursement isn’t all about volume and visit counts- but its about quality metrics and clinical outcomes
38
HMA 39
PROVIDER PATIENT
Nurse
Medical Assistant
Admin Scheduler Lab/Rad
Specialty Care
Case Mgr/Coord
Traditional Model
HMA
Provider Led Member Centric Care
Patient and family
Provider
RN
Home care
ER or hospita
list Ancillary
Care coordinator
Medical Asst
40
HMA
Patient and Provider
• Getting the unengaged provider involved • Role of the provider in supporting patient
engagement.
41
physician
technology patient
HMA
Getting providers engaged in the technology movement
• Team based model • Show them the evidence that technology
improves clinical outcomes…
42
HMA
Strategies to keep your patients engaged- the role of the physician
• Recent survey -shows the influence of providers: – 48.2% of respondents said they would use such
a device if their physician provided one – 44.2% said they would be more inclined to use
one to attain better health care advice from their physician.
43
HMA
Stakeholder Role(s) Patients/Consumers • User
• Data Generation • Director
Providers • User • Promoter • Facilitator
State Agencies • User • Distributer • Convener
Health Plans • User • Supporter • Supplier
44
HMA HealthManagement.com
October 15, 2015
Q & A
Matt McGeorge, Senior Consultant, HMA [email protected]
Jean Glossa M.D., Principal, HMA [email protected]
Izanne Leonard-Haak, Managing Principal, HMA