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Patient engagement is essential to improving care, but it can be a tough climb. For example, U.S. clients often note the most challenging government incentive measures are the ones that require patient response.
Health First (Brevard County, Florida, U.S.A.) recognized the importance of genuine patient engagement, including millions of dollars in potential Meaningful Use incentives. Below, Health First shares how – within just a few short weeks – it achieved 52.6% of patients with online access and encouraged 6.8% of patients to view information electronically.
Here are some of the successful strategies from Health First Vice President of Enterprise Applications/Informatics and Chief Nursing Informatics Officer Karie Ryan, RN, MS, BSN:
1. Remember that implementation is just a first step.
During the summer of 2014, Health First implemented Allscripts FollowMyHealth® patient portal (and rebranded it HFConnect). But just building a portal is not enough to achieve true patient engagement.
“…once it was implemented, we also knew we needed to dedicate time and resources to educating patients and helping them use HFConnect,” Ryan said.
2. Ascend faster by working with patients at registration, in rooms.
Because Health First staff was already working at peak capacity, leaders brought in additional resources and purchased FollowMyHealth Patient Engagement Consulting Services (PECS). Equipped with laptops, PECS concierges worked in the lobbies of the four hospitals and visited patients in their rooms. They explained benefits, addressed email/password issues and helped complete registrations.
“This one-on-one effort was highly successful…patients really appreciated the support and assistance, and immediately felt comfortable with the portal,” Ryan said.
3. Meet measures, but keep your eyes on the summit: improving overall health.
Health First focused on meeting the patient engagement measures for Meaningful Use Stage 2, which included 50% of patients with access to the portal and 5% of patients viewing, downloading or transmitting data through the portal. Between September 3, 2014 and the September 30 deadline, Health First more than doubled its numbers to exceed both targets.
“We were pleased with our success in meeting MU2…We are confident that this level of engagement will help us deliver better care and motivate patients to become active partners with us. Our ultimate goal is to improve the overall health and well-being of our community,” Ryan said.
It’s a simple concept: patients who are engaged in their own health care are more likely to experience positive outcomes. But how do we engage them? That’s the million-dollar question.
At our recent user conference, Population Health University, three clients shared patient engagement experiences, tactics they use to drive registration and participation, and how their approaches result in better care. Here are highlights from those presentations:
Baylor Scott & White: Achieved initial 10% adoption rate with phased “go-live”
Baylor Scott & White, one of the largest health systems in Texas, went live with FollowMyHealth™ this year in both its ambulatory and acute facilities.
According to its clinical coordinator of information technology, Paul Bassel, MD, the organization believes there is even more opportunity to engage patients through its ambulatory arm, Health Texas. “Here the value proposition is much greater, given the ongoing nature of the relationship with the patient,” said Dr. Bassel.
Baylor Scott & White triggers invitations to its ambulatory patients based on encounters with the office, and also sent invitations over the course of several weeks to 120,000 patients with email addresses on file.
“We registered about 15,000 active accounts in just a few weeks,” said Dr. Bassel. “It’s about a 10% adoption rate, and we’re pretty happy with that as a starting point.” Dr. Bassel also credits some of the success to an internal awareness campaign and training to encourage clinician acceptance.
On the acute side, Baylor Scott & White started a phased “go-live” approach throughout February and March. The hospitals sent emails inviting patients to register through the FollowMyHealth portal based upon two trigger events – admission and discharge. There are currently about 5,000 activated accounts, enabling patients to see medications, allergies, conditions, immunizations and discharge instructions.
“The potential of FollowMyHealth platform is very exciting,” said Dr. Bassel. “It’s like a beehive of possibilities and ideas, enabling our care coordinators to communicate with patients.”
UC Irvine Health: Measuring patient activation levels
UC Irvine Health (Orange, Calif., U.S.A.) uses FollowMyHealth in several ways to help patients navigate and engage with the organization. For example, UC Irvine uses electronic wellness tools with educational opportunities specific to each patient’s needs. It’s also using secure health messaging to improve communications between patients and caregivers.
“A lot of people are talking about patient engagement, but we’re really measuring the patient’s activation level,” said UC Irvine Health Informatics Outreach Architect Jamie Anand.
UC Irvine will soon incorporate a four-stage Patient Activation Measure (PAM) protocol to determine each patient’s engagement. This scale defines progressive activation levels as: (1) patient believes s/he is responsible for health, (2) patient has the confidence and knowledge to act, (3) patient takes action to maintain and improve health, and (4) patient stays the course even under stress. This scale will help UC Irvine understand the patient’s current activation level, and help caregivers track progress.
“Measuring this activation is predictive of behaviors, and research is showing that an engaged patient is more involved in preventative behaviors,” said Anand. “It’s really important to stimulate them and increase their activation.”
Pottstown Medical Specialists, Inc.: Big value for small practices
A physician-owned practice outside of Philadelphia, Penn., U.S.A., Pottstown Medical Specialists, Inc. (PMSI) signed up for FollowMyHealth in 2011. While acknowledging that being a small practice has its challenges, Clinical Applications System Specialist Kimberly Slifer, RN, said PMSI’s size helped it move quickly to launch its patient engagement initiative. “My IT budget would fit into a shaving bag if it was converted to cash…but being a smaller organization makes decisions a lot easier, and we selected FollowMyHealth after just two meetings.”
PMSI found that patients were immediately more engaged through FollowMyHealth. If patients detected an error or omission in their chart, for example, they called the office right away. “Everyone at PMSI is now more accountable to keep the chart leaner and cleaner,” said Slifer.
Slifer also offered advice for inviting patients to join the portal. “If you don’t invite the patient within two days of collecting their email addresses, they’re not going to join.” PMSI’s procedure is to send invitations to patients the same day that they are in the office.
Adding secure messaging in January 2013 has further enhanced communication between patients and clinicians. They’re hoping to improve clinical outcomes, such as increasing smoking cessation rates, by using FollowMyHealth.
One thing was clear after spending time with Allscripts FollowMyHealth users: Our patient engagement platform is encouraging people to become active members of the care team. To learn more, click here.
Patient engagement is a priority at Arnot Health, a regional integrated healthcare system serving patients in northern Pennsylvania and southern New York in the United States.
“We’re absolutely committed to adopting the very best way to deliver the very best care,” said Gregg Martin, chief information officer at Arnot Health. “And this means recognizing that healthcare is not episodic, but something that occurs along the entire continuum, including in the home.”
With various electronic health record (EHR) systems in its three hospitals and 250-member group practice, Arnot needed a solution that worked with disparate systems. It needed a patient portal that was “EHR-agnostic” and could help advance its long-term population health strategies.
Arnot found what it was looking for in Allscripts FollowMyHealthTM. This universal health record enables patients to manage their own information in a secure, online environment. It also delivers harmonized data back to care providers, which they can access from their existing EHR workflow.
EHR-agnostic solution helps patients and providers
When the search for a patient portal began at Arnot, Martin and his team evaluated options from other vendors. “During our search process, we found those portals to be very EHR-centric, built around the vendor’s own EHR—in some cases allowing patients to access only information from their own system,” said Martin.
Patients may receive care at multiple sites within the Arnot system that use different EHRs. With FollowMyHealth, patients can access any of their data from one portal. “It’s so much more valuable, to us and to our patients, to be able to access the information in a single place,” said Martin.
Martin says caregivers at Arnot have embraced FollowMyHealth. “The care team really appreciates the fact that information comes directly into their systems,” he said.
Ready to advance four key population health strategies
Though just getting started with Allscripts FollowMyHealth, Arnot recognizes that it is an important step towards managing health for defined groups of patients. Arnot Health’s future goals include:
1. Meet Meaningful Use Stage 2 requirements.
“We’re supporting electronic communications,” Martin explained, “and are giving patients the ability to request appointments, ask for medication refills and complete other basic tasks.”
2. Activate revenue cycle management functionality. Integrating financial components will enable Arnot’s back office to post billing statements to the patient portal. Patients will be able to check their balances, review charge details and make payments.
3. Enable patients to proactively add health information to their records.
Physicians will be able to ask patients to input blood sugar readings twice a day or log their weight each morning, for example. FollowMyHealth can integrate that data with information in the EHR as part of a trending report. Caregivers can use this information to quickly reach out with reminders, additional instructions or to schedule an office visit if needed.
4. Integrate electronic medical devices at the patient’s home.
FollowMyHealth can capture and upload data from personal medical devices, such as scales and blood pressure monitors, using wireless and other remote-access technologies. Martin admits there are challenges around cost of devices, connectivity and patient comfort with new tools. But he said, “Having access to these sources of information will advance our ability to manage health and disease states immeasurably.”
A big-picture approach to patient engagement
“We’ve been very impressed that Allscripts ‘gets it,’” Martin said. “True patient engagement is not simply represented by a communications portal—it’s about empowering patients and involving them as genuine partners in their care. FollowMyHealth has the capabilities and functionality to help Arnot achieve this.”
You can read more about Arnot Health’s experience in a recent case study.
With the rise of wireless health monitoring devices, people are collecting more data about themselves than ever before. When this information feeds the electronic health record (EHR), the results can be pretty powerful.
We’re helping connect this data through our newest solution, FollowMyHealthTM Achieve. It provides opportunities for patients and caregivers to work together to set goals, mark progress and achieve better health.
How FollowMyHealth Achieve works
We designed Achieve to help manage health for all patients, particularly those with high-risk, high-cost chronic conditions such as congestive heart failure, diabetes, hypertension and obesity. Here’s an overview:
1. Caregiver enters orders into Allscripts TouchWorks® EHR, with rules that trigger alerts. For example, a physician may require a patient to weigh herself every day. Patient-specific rules define expectations for frequency (e.g., daily), and a target for maintaining, gaining or losing weight within a certain period (e.g., lose 10 pounds in two months).
2. Patient accesses health goals via FollowMyHealth and links the wireless device to the portal. The patient can access health goals and track her progress from home. Wireless devices can include scales, blood pressure monitors and blood glucose meters.
3. Patient follows health goals. Connectivity enables patients and providers to continue to interact between visits, which can help patients change daily behaviors that impact their conditions.
4. Care team remotely monitors patient. Achieve watches for non-compliance and analyzes data in context with the orders and rules for that patient. For example, Achieve will trigger alerts if the patient who does not weigh herself for several days, or records weight gain or loss outside of the parameters.
5. EHR messaging alerts care team if patient doesn’t comply with care plan or exceeds parameters. Achieve provides results to the TouchWorks EHR, where it is automatically integrated with the patient’s record. Caregivers can access the information within their normal clinical workflow. If results are out of range or the patient is non-compliant, the solution notifies the care team. At that point the team may decide to call the patient or schedule a follow-up appointment to intervene.
Studies show remote patient monitoring is effective
Caregivers are employing new tools and care delivery models to combat chronic disease and its devastating effects. Chronic disease has a worldwide estimated price tag of $47 trillion by 2030 (that’s a billion dollars every day for the next 128 years). According to the World Health Organization, chronic disease will account for three of every four deaths globally by 2020.
Remote patient monitoring is one of the tools that is working. One study forecasts that it could save $36 billion in healthcare costs by 2018. And the U.S. Veteran’s Health Administration found that remote monitoring reduced hospital admissions by 20% and bed days by 25%.
FollowMyHealth Achieve can help caregivers looking for ways to improve the health of patients. With access to real-time indicators of patient health, they can intervene before the condition escalates. We’re excited about the potential FollowMyHealth Achieve offers to help build a healthier population, one patient at a time.