provider perspective on patient portal adoption

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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

27

29

31

33

35

37

39

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

[email protected]

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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


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Conflict of Interest Susan Hull, MSN, RN


© 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.”

http://www.nationalpartnership.org/research-library/health-care/HIT/engaging-patients-and-families.pdf











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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

31

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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

[email protected]

@SusanCHull

mailto:[email protected]




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Provider Perspectives on Patient Adoption

of Portals, Secure Messaging April 12, 2015

David C. Willis, MD

CMIO, CommunityHealth IT


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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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2) patient-friendly



Active patient consent

Fully transparent

HIPAA compliant

Securely hosted data

Controlled exposure of the data

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2) patient-friendly



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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2) patient-friendly



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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2) patient-friendly



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.

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

provider perspective on patient portal adoption

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