MyHealthPoint Patient Portal: Identifying the Barriers & - - PowerPoint PPT Presentation

MyHealthPoint Patient Portal: Identifying the Barriers & Improving Utilization at HealthPoint Kent

Herman Lee, Midwestern University - AZCOM 2018 HealthPoint Community Health Centers Seattle, WA

Introduction

• Electronic patient portals
• Patient at the top (HealthPoint’s mission)
• Tools to manage & understand their health status
• 24/7 access to personal health information
• CMS Incentive Program (2011)
• EHRs
• Meaningful use (for eligible professionals)
• 3 stages (Currently in stage 2)
• Advanced Clinical Processes  Patient + family engagement
• October 2013  introduction to patient portal at HealthPoint Kent

Background

• Meaningful use at HealthPoint
• $790,500 (1.2% of HealthPoint’s annual budget)
• Core objective 7  patient electronic access (VDT)
• Measure 1: >50% of all unique patients seen by providers during EHR

reporting period are provided timely online access to their health info

• Measure 2: >5% of all unique patients seen by providers during the EHR

reporting period view, download, or transmit (VDT) health info

• Core objective 17  use secure electronic messaging
• >5 % secure message was sent using electronic messaging function
• Lack of widespread adoption
• Disparities between English speaking & non-English speaking
• Resistance from both patients and providers

Methodology

• Patient portal workflow
• Patient check-in  check-out
• Barriers from patient & providers point of view
• Surveys & literature review
• PDSA (Plan, Do, Study, Act)
• New workflow
• Font desk staff
• How are we inviting our patients?
• How are we receiving credit from NextGen reporting?
• Patient portal cards
• Provider endorsement
• One liner cards in all exam rooms
• Check-out front desk support
• Portal laptops

Results

2 4 6 8 10 Increase in Portal Messages Reduction in Patient Visits Strengthen Relationships Improve Patient Outcomes Increase in Portal Messages Reduction in Patient Visits Strengthen Relationships Improve Patient Outcomes Don't Know 1 2 2 No 3 4 2 2 Yes 6 4 8 6

Provider Patient Portal Survey

• 14 providers at Kent; 10 providers participated in this survey
• 1 provider concerned about loss of profits & reimbursements
• 1 provider concerned about patient portal security

Results

• Patient Portal Survey
• 58 English
• 30 have heard (51.7% of patients)
• 28 have not heard (48.2% of patients)
• 1 chose NOT to answer (1.7% of patients)
• 10 Spanish (delay in survey translation)
• 3 have heard
• 7 have not heard
• ALL are NOT enrolled in the patient portal
• Limited sample; not distributed to all patients at the time of check-in
• Various reasons

Results

• Patient Portal Survey (both English & Spanish speaking)
• Computer Access:
• Yes: 30
• Self (26), Family (3)
• No answer (1)
• No: 14
• Didn’t answer: 23
• Internet Access:
• Yes: 40
• Mobile (28)
• Laptop/Desktop (11)
• Tablet (1)
• No: 6
• Didn’t answer: 15
• Public Library Internet Access:
• Yes: 40
• No: 2
• Didn’t answer: 15
• Lobby Computer:
• Yes: 27
• No: 21
• Didn’t answer: 20

Results

• Responses:
• Positive:
• “I forgot about the portal. I prefer to call. I will think about using the portal

now that I’m reminded.”

• “Useful. Great to know I can access it (health records) anytime.”
• “Can be very helpful to view lab results and schedule visits.”
• “I can access my records, appointments and keep track that way much

more convenient.”

• Negative:
• “Nothing displays correctly; I’m only able to log in!”
• “Not a lot if info I need. Payments are difficult to make.”
• “No one helped me to understand how to use the portal. It’s too

complicated.”

• “Can’t remember how to log in.”

Results

Discussion

• Electronic patient portal systems can exacerbate

disparities in access to & quality of care across all groups

• More patient education needed; minimize missed opportunities
• System workflows need to be standardized across all

HealthPoint sites AND within the same site

• Based on surveys, patients are enthusiastic about the

patient portal if more time was spent learning the system

• Providers are willing to support and recommend the

patient portal; guidelines on what is considered “portal appropriate work” is needed

Recommendations

• Focus groups:
• Determine user-friendliness
• Remove negative perception over security concerns
• How to improve patient portal education
• Use in-house translators to their full potential:
• Educate patients on the patient portal during office visits
• Translate portal messages written in other languages
• Additional portal features:
• DM-II patients - daily blood sugar levels (Clemens et. al, 2015)
• Portal patients healthier than non-portal patients?
• Quarterly monitoring of office staff workflow
• Consistent
• Allow for patients to use pharmacy delivery through portal

Conclusion

• Identified some of the barriers to patient portal enrollment
• Plans in place to test future of portal
• Increase enrollment & usage
• Must standardize workflow at HealthPoint sites
• Communication
• Patient handouts
• Training
• Continue to keep patient satisfaction as #1 priority
• How can we get them more engaged, etc.
• Patients are more likely to adopt and use a patient portal if

their providers recommend and support the portal use

Acknowledgements

• GE Foundation
• National Medical Fellowships
• Chris Schei
• Dr. Ruth Michaelis
• Juana Ledezma
• Aline Swisshelm
• Duane Nakamura
• Michelle Matt
• Grace Sandoval
• Jeanne Ziltener
• Rahul Jathar
• All staff members at HealthPoint