Susan Woods, MD, MPHMedical Informatics Office, VHA

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Leveraging Technology for Patient Centered Medical Home:

Patient Facing Resources

New Models of Care

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..enhance ability of veterans and families to access health information. One example is…tools such as MyHealtheVet. These systems will facilitate the veteran involvement in his or her own care…VA Universal Services Task Force Report, 2009

PATIENT-FACING IT DEFINED

• Health IT used by patients & familes

• Information and services targeting patients

• Tools to promote self-care and enable decision-making

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PARTICIPATORY MEDICINE

• Patients as engaged participants

• Health professionals and patients working as partners, facilitated by modern tools

• Outcome of Medical Home: patient-centered teams focused on communication

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Functions Engaging Patients in Their Own Care

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Patient Delivered“Push”

Reminders

Patient Library

Resource Links

Patient Entered“Pull”

Medication Refills

Peer Online Support

Shared Care“Participatory”

Secure Messagin

g

Home Telehealt

h

Kaiser – Patient Portal Usage

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

1Q 0

7

2Q 0

7

3Q 0

7

4Q 0

7

1Q 0

8

2Q 0

8

3Q 0

8

4Q 0

8

1Q 0

9

2Q 0

9

3Q 0

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LAB results

Secure Emails

Courtesy of Jan Oldenburg, Kaiser Internet Services Group

Rx Refills

After Visit Review

MyGroupHealth Survey 2006 N=630 (2004), N=646

Courtesy of Matt Handley, MD

Shifting Demand:If e-mail were not available, would you...

20042006

Complementary Tools: EHR & PHR

Comprehensive record At all care sites Decision support Clinical reminders Patient safety

Secure web-based portal Patient & family centered Information and services Multiple levels of access Increasing offerings over time

VA ElectronicHealth Record(EHR)

My HealtheVet Personal Health Record (PHR)

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1. Hypertension2. Influenza Vaccine3. Pneumococcal Vaccine4. Colorectal Cancer Screening5. Lipid Measurement6. LDL Target7. Body Mass Index (BMI)>25.08. Diabetes Foot Exam9. Diabetes Hemoglobin A1C10.Diabetes Retinal Exam11.Mammography Screening12.Cervical Cancer Screening

My HealtheVet Button in CPRS

• Synchronization of MHV account with VA Master Patient Index

• Button for authenticated MHV users

• Button links to MHV website

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My HealtheVet Use (May 31, 2010)

1, 012, 224 Registered

199,202 Authenticated Requires in-person process Required to use secure messaging

Over 15 million Rx Refills Processed Averaging 111,000 refills weekly in 2010

PATIENT-FACING IT

• Secure Messaging• Laboratory Results• Interactive Health Risk

Assessment• Point-of-service Kiosk

– Current information– Medications– Surveys

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MyGroupHealth Satisfaction Survey, N=645 (2004), N=666(2006)

How would you rate the value of secure e-mail in enhancing in-person visits?

“This is the best health care I have ever had! I love the online services the friendly employees and GHC's overall desire to help me be healthy. I'm from California and GHC beats any health care they had to offer.”

Secure Messaging Medical Home

• Is patient centered– Patients find it convenient and personal

• Takes a team– Triage = specific roles– Efficient for all staff

• Increases knowledge of the patient– Predictor of outcomes, satisfaction

EXAMPLES: PATIENT-FACING INFORMATION & SERVICES

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Information &

Transactions

Manage Appointment

s

Manage Medications

Request or Update

Information

Financial & Benefit

Services

Expert Care

Home Telehealth

Secure Messaging

Health Risk w/

Feedback

Tailored, Interactive Interventio

ns

Self-Care & Community

Patient Library

Peer Online

Support

Self-Monitorin

g

Symptom Checker

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