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DisclaimerThis webinar may be recorded. This webinar presents a sampling of best

practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes that

there is not a “one size fits all” solution for the ideas expressed in this webinar;

we invite you to follow up directly with us for more personalized information as it pertains to your specific practice and

issues.

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Increasing Patient Satisfaction with the

NextGen® Patient Portal

ITENTIVE WEBINAR SERIES

Introductions

Lindsey LanningHealthcare Informatics

Coordinator

Cindi KincadeVice President,

Consulting Solutions

Karli SellsClient Advocate,

Services and Support

Patient Portal

What is it?• A web-based application

that allows physicians and patients to share health information remotely in an effort to boost patient engagement.

• Largely, driven by Stage 2 Meaningful Use requirements patient portal adoption has and continues to increase.

An Industry Perspective • Meaningful Use incentives are the reason behind the

increase in implementation of patient portal solutions. Unfortunately, many practices went with the least expensive and easiest to implement and did not consider patient satisfaction

• Many patient portals were not designed based on patient experience criteria and were just purchased to meet MU criteria. In some cases this resulted in: An upset patient population Incapable of delivering sustainable value long-term Unable to deliver a positive patient experience Missing core functionalities and user interfaces

Today’s Focus• Who is MaternOhio Clinical Associates (MOCA)

• Who is Kingsdale Gynecological (KGA)

• Why KGA chose to Implement Patient Portal

• Maximizing Patient Portal Utilization

• Preparing the Patients for the Portal

• Web Modules Deployed by KGA

• Benefits Summary

• Patient Feedback

• Questions

MaternOhio Clinical Associates

MaternOhio Clinical Associates, Inc. (MOCA) is Central Ohio’s largest and most experienced private OB/GYN practice. They provide specialized women’s healthcare services to more than 100,000 patients annually throughout 16 central and west central Ohio locations.

MOCA installed NextGen EPM in 2004 and currently has 6 of the 8 divisions live on EHR

Kingsdale Gynecological Associates a Division of

MaternOhio Clinical AssociatesKingsdale Gynecological Associates (KGA) is a 10 provider, OBGYN group located in Columbus, Ohio and a founding division of MOCA.

They implemented NextGen EPM in 2003 and followed with NextGen EHR in 2005. KGA added the Patient Portal in September of 2008.

They are fully paperless and in addition to EHR and Patient Portal utilize ICS, IMO, and multiple interfaces.

Why Did KGA Implement Patient Portal?

KGA implemented the patient portal before Meaningful Use requirements existed. Patient Satisfaction was always the driving factor

KGA was experiencing a significant increase in telephone calls and patient hold time. There were two phone rooms with 4 teams in each area just to manage the volume. They were consistently receiving over 5000 calls per week.

In addition, the check-in lines were becoming excessive while patients waited to reschedule follow up appointments or new patient information was entered.

They saw patient portal as a solution to this problem, and a way to add value to the patient experience.

Steps KGA has taken to Maximize Patient Utilization

1. Recognized the need to meet patient priorities A portal should be able to request a service, obtain information

regarding their health, and submit information needed from the patient

2. Integrated the portal into practice workflow Make sure you are actually using it. Make sure you have

designated staff to answer emails, communicate reminders over the portal, and monitor scheduling appointments

3. Identified patients who benefited most from portal use Usually those pregnant patients with questions, appointment

requests, waiting on an important test result, have another assisting with care, are recovering after a major traumatic event, or are receiving ongoing complex treatment

Steps KGA has taken to Maximize Patient Utilization

4. Promoted the portal Every encounter involved outreach to the patient about the

portal

Tips to promote the portal:• Made sure physicians and staff said the same thing (scripted it)

• Placed signs or notices throughout the office

• Included portal information for all new patients

• Highlighted benefits of portal during meetings with patient and caretakers

5. Evaluated portal use and make modifications Had others test the portal to see how easy it is to use

Continually identified ways to improve by identifying patients who are benefitting from portal use

The Flyer and Signage

This flyer was created by the practice and distributed topatients as they checked in. Inaddition, the flyer was postedin all exam rooms and in areastraveled by patients.

KGA has over 25,000 patients enrolled in the portal and they did

it the hard way…One token at a time

Auto-EnrollmentWhat is it?

• Plug-in that automatically enrolls a practice’s patients into NextGen Patient Portal

• Purpose:

The patient does not have to complete registration documents in the office, this can be done prior to the visit online.

They are automatically considered enrolled bypassing the pending stage so information can be sent right away instead of waiting for the patient to log-on for the first time.

• Auto-Enrollment can also be used to transfer all of the non-NextGen patients that currently use another patient portal, into the NextGen Patient Portal

• As MU involvement has increased NextGen found a better methodology to fulfill requirements over the original token methodology

Auto-EnrollmentHow it works?

• The practice acquires patient emails through normal daily operations

• At night the BBP pulls the email addresses acquired that day

• It then sends out an email to patients with a temporary username, password, and link to the website

• Patients are then prompted to change their username, password, and other security information upon initial log-in

Auto-Enrollment

Prior to the development of Auto Enrollment, KGA met its objectives using the token generation.

KGA is planning to implement auto-enrollment for its new patients in order to sustain and increase patient participation with minimal staff involvement

Web Modules Deployed

• Appointments

• Documents

• Medications

• Secure Communications

• On Line Forms

• Personal Health Record

• Statements (not in production at KGA)

Patient Appointments

KGA elected to allow patients to request appointments only using the integrated function


The patient will login to Patient Portal to make the request based on the practice set up


The request is submitted and received at the practice through EPM via the Mailbox


Double click on the request in the mailbox and you are routed to the schedule using the criteria entered by the patient


The scheduler will follow normal standards to schedule the appointment


The practice books and charts to patient record and a response is sent to patient


The patient receives a notification that the appointment has been booked


The patient logs into the portal to review their message

Patient Appointments Benefits • The patient appointment has been scheduled and

notified without a single phone call • Less time was spent on the part of the practice

and the patient• No time was spent on hold• The request was not limited to only the practice

hours as the patient requested the appointment at their convenience and the practice responded at its convenience

• The entire transaction has a history at the patient level and the practice level eliminating questions or confusion

Patient Documents

Patient requests a document be forwarded from the practice

Patient Documents

Practice reviews the request and opens the patient chart, locates the document and

prepares to send to Patient Portal

Patient Documents

Practice receives request, goes to chart and right clicks on the document

Patient Documents

Patient is notified via email that document is received

Patient Documents

Patient connects to portal and views document

Patient Documents

The practice now has the ability to verify that the document was not only received but opened by the patient

Patient Documents Benefits

• The patient made a request and practice responded without a single phone call

• The patient was able to communicate outside of normal hours if required

• The practice/provider responded without the need for internal communications

• No paper or postage was required

• The correspondence was tracked and receipt was verified providing documentation that has not been easily verified in the past

Medication Renewal

Patient can request a medication renewal via the portal as well as add or change their

pharmacy

Medication Renewal

Medication Renewal

Request is received in Workflow Inbox. The provider opens the request as well as the chart and is taken directly to the medication module to be managed as requested

Medication Renewal

Practice notifies patient of approval

Medication Renewal

Patient receives notification via email and will access the portal from the link in the email

Medication Renewal

Patient receives notification that refill request has been approved with all pertinent

information displayed

Medication Renewal Benefits • Patient Requested refill without a single

phone call• The patient was able to communicate outside

of normal hours if required• The practice/provider managed the request in

his/her timeframe• No return call was needed• The refill was documented in the medication

module and forwarded to the pharmacy• Patient was able to add or update pharmacy

Secure Communication (Patient Questions)

Patient has the ability to send a secure medical question to their provider


The clinical staff receives the message in their Inbox. The patient chart can be opened if

necessary.


The appropriate response is documented and stored in the patient’s chart if desired


The encounter is created

The email and response are documented


Patient is notified via email that they have a response to their message


Patient accesses the portal using the link in the email


Patient opens and reads the response

Secure Communication Benefits

• Patient communicated a minor medical question without a single phone call


• The practice/provider managed the request in his/her timeframe

• No return call was needed

• The question was documented in its own encounter in the patient’s chart

Online FormsThe practice has the ability to create and forward intake forms to new patients as well as for predefined patient types such as New OB, ongoing disease management, etc.

You can forward your desired form set easily from the patient’s chart.

Online Forms

The practice selects the form set that will be sent to the patient

Patient is notified that they have online forms waiting via email

Online Forms

Patient connects to portal using the link in their email and begins the completion of the forms

that are waiting

Online Forms

Patient connects to portal using the link in their email and begins the completion of the forms that are waiting

Online Forms

Multiple forms are included in a set and are completed in order. This example is before

completion

Online Forms

Completed Medications and Allergies

Online Forms

Completed Social History

Online Forms

Completed Family History

Online Forms

Completed Past Medical History

Online Forms

After forms are completed by patient and saved, they are automatically returned to the practice

and removed from the patient’s inbox

Online Forms

Completed forms are now placed in the provider’s inbox

Online Forms

The completed forms are displayed in the message and at that time are accepted and imported/rejected

Online Forms

Once accepted, they are saved as a new encounter in the patient’s chart

Online Forms

The form is displayed in the chart exactly as it was created

Online Forms

In addition, the appropriate fields in the appropriate templates are updated

Online Forms Benefits

• Practice forwarded selected forms that would typically require chart abstraction prior to the patients arrival

• The patient was able to return the forms via the portal at their convenience

• The practice imported the forms eliminating data entry at registration or check-in

• No paper was needed to print the forms

• No postage was needed

• No scanning was required to save the original forms

Personal Health Record• Patients enrolled in the portal now have the

opportunity to upload their medical chart and view, download, or print the document. Patients will request the document and the document will upload without any staff involvement

• MOCA has the PHR setup to automatically send out when a patient has completed enrollment as well as when each office visit encounter locks. The encounters lock after 7 days so the PHR will update at that time.

• Patients can also manually request their PHR

Personal Health Record

To manually request their PHR:• Patient signs into their Patient Portal account and

will be directed to the patient portal dashboard


Patient selects the ‘My Chart’ tab, and clicks ‘Request Health Record’


Patient will then select the practice and click submit


Patient is notified via email that their PHR is available


Once the record is available, the patient will go to ‘My Chart’ and select ‘View My Chart’

Personal Health RecordOn the left hand side of a patient’s chart, a list of elements found within the health record will appear. There are also options to send, download, and track who has viewed the patient’s chart.

Personal Health Record Benefits Patient has access to:• Demographics

• Insurance

• Allergies

• Medications

• Reason for visit

Displays HPI details on most recent encounter only

• Lab Results

Only signed off labs. Provider comments from PAQ are not included

• Family History

• Immunizations

• Social History

• Vital Signs

• Plan of Care

Includes any care guidelines and labs that were ordered but not yet resulted

Personal Health Record Benefits

• The patient has access to chart at their convenience

• The patient is able to view important lab results without calling

• This increases patient involvement in care

• Patient is able to download/print chart if needed

• No postage, scanning, or paper is required

• The patient made a request and practice responded without a single phone call

Statements

Statements allow the NextGen patient portal user to: • View statements online

• Pay with a credit card online

*Not currently used at KGA other resources available

Statements

To view statements:• Patient selects the Payments tab or opens a

statement from their inbox. A list of statements will display. The patient can view a statement for a particular date by clicking the corresponding link

Statements

Patients are able to pay their statement balances online via NextGen Patient Portal

Statements Once a Patient’s payment has been processed they will receive notification via e-mail that their payment was delivered. They will also be able to print a copy of their receipt, as well as view a copy in their sent folder.

Statements Benefits• Patient statements were delivered via the portal

reducing postage costs

• The patient was able to pay their bill via the portal at their convenience


• No postage was needed

• No phone call was needed

• The payment was tracked and receipt was stored in the portal sent folder providing documentation

Statements

• KGA has not yet implemented the statement functionality

• We are currently reviewing options for third quarter

• References of practices using statements are available from NextGen or Itentive

Overall Benefits Summary With over 25,000 patients enrolled so far, KGA has already experienced the following benefits:

• Reduced patient hold times by allowing patients access via the portal

• Reduced calls by encouraging patients to ask non urgent medical questions and prescription refill requests via the portal

• Reduced cancellations with the appointment reminder feature

• Reduced check-in time by utilizing the patient forms to import data in advance

Overall Benefits Summary (cont.)• Reduced outbound and inbound calls by sending normal

lab results from the PAQ using Patient Portal

• Reduced paper and mailing costs by forwarding documents and medical summaries directly to those patients with Patient Portal

• Improved patient communications

• Reduction in lost messages and call backs

• Notification options for improved tracking

• Verification that the patient not only has received the message but has opened the message

• Successfully achieved Meaningful use Stage I and Stage II

Patient Feedback

“I love the fact that I can request an appointment at any time without being concerned with office hours.”

“It is so nice to be able to send a quick question to my physician without having to spend time on hold.”

“Receiving the appointment reminders via email is great.”

“I was out of town and needed a refill. This made it easy to ask for the refill and provide the pharmacy information without multiple phone calls. It was really convenient.”

“I love the appointment reminders that I get via email. Right when I get the email I can check my calendar and confirm I'm all set! Being able to send emails to my doctor to ask quick questions is also nice. I don't have to wait on the phone for a nurse, and can just check my patient portal account for her answer. It really makes communicating much easier and less time consuming.”

Patient Portal 2.2 New Website Features

General Release Date was June 27, 2015

Main Website Features • Renaming Research tab to Patient Education• Improvements to Patient Education Tab• New Patient Education Search feature on header of website• Improvements to send PHR feature• Improvements to Login and Enrollment features• Improvements to User Name and Password Recovery pages• Improved Bulk/Auto-Enrollment workflow• Forced selection of patient name when:

Sending an email

Renewing medications

Booking or requesting appointments

• Renaming Labs to Results

Patient Portal Dashboard Enhancements• Research tab renamed to Patient Education

• Patient education search feature

• Labs renamed to Results

Patient Education Tab EnhancementsThe Patient Education tab now includes the following links:

• Patient Education: The patient portal user can click the Patient Education link to view a page that provides access to interactive tools, educational materials on health, and learning centers.

• Symptom Checker: An interactive tool that allows the patient to check their symptoms

• Medications: Patients can click the medications link to access topics that help make informed decisions about medications

• Health Decision Tools: Patients can click this link to access decision points that are designed to guide them through key health decisions.

Send PHR EnhancementsThe send PHR feature has been modified to separate the ‘I have my provider’s direct address’ field from the Search form. Patients can now search for a provider first.

They can also click the ‘I have my provider’s direct address’ button to use which will hide the Search form and only display the field to enter the direct address.

Login and Enrollment Enhancements

• Renamed the ‘Enroll Now’ button to ‘I Am New Here’

• Improved token-based workflow

• Improved Bulk/Auto-Enrollment workflow

• Increased the character limit for username and password fields

User Name and Password Recovery Enhancements

The options have been reorganized to improve user experience. The user can now select from a

list of options to recover their account details.

User Name and Password Recovery Enhancements (cont.)

When an option is clicked, the section expands displaying the relevant fields.

Patient Selection Made Mandatory

If the user logs on as a care manager, the user must select a patient on whose behalf they want to send a message, renew medications, request

health records, or book an appointment.

Bottom Line: This is important to you and your practice and can lead

to positive change.

Need Help Planning

Itentive can help by providing an EHR Workflow Assessment to review your processes. We can assess your EHR workflow and challenges with an onsite consultation.

We are currently offering a 3 day onsite assessment that includes:• Workflow Analysis

• Planning

• Written Report of Findings and Recommendations

• All Travel Expenses

Questions• Cindi Kincade

Vice President, Client Solutions [email protected] 224-220-5575

• Lindsey Lanning Healthcare Informatics Coordinator [email protected] 224-220-5621

• Karli Sells Client Advocate, Services and Support [email protected] 224-220-5561

Thank you