As part of ongoing change to the healthcare industry, exploring and taking advantage of the potential benefits of the "e-revolution," a phenomenon that includes everyday use of the internet by the general public, would be a wise strategy for healthcare systems to deploy. Part of this approach involves giving patients the ability to schedule appointments, request prescription refills, view medical records, and perform a variety of other simple healthcare tasks via the internet.
What’s more, a recent study from the New York-based consulting firm Accenture found that 77 percent of respondents view booking appointments online as important, and four out of five consumers surveyed believe that they should have full access to their electronic health record (EHR).
Additionally, meaningful use Stage 2 requires physicians to ensure that more than 50 percent of all unique patients seen during the EHR reporting period are provided timely online access to their health information. In addition, more than 5 percent of those patients must actually view, download, or transmit their health information to a third party administrator. In doing so, often the easiest and most effective option for physicians and hospitals is to install patient portals for engagement, which can be altered based on the patients proficiency with utilizing technology, such as a kiosk, online site, or mobile app.
At New Mexico Orthopedics, the Albuquerque, N.M.-based multi-disciplinary, musculoskeletal condition center, data is often latent and in silos, and manual and inefficient processes can overburden the clinical staff, says James Jones, director of healthcare information systems. Jones knew that federal mandates required that patients have the ability to download and transmit medical records, but he says even beyond that, he wanted a solution to address more than meeting the requirements, and actually provide something meaningful to the patient.
HAVING SKIN IN THE GAME
After migrating from an Allscripts solution, Jones decided on a patient self-service system from the Cambridge, Mass.-based vendor Vecna, which has allowed New Mexico Orthopaedics to increase accessibility, communication, and convenience while decreasing patient wait-times, increasing accuracy, eliminating paperwork, and improving satisfaction and outcomes, he says. Starting in March 2012, each month, New Mexico Orthopaedics brought one of its seven sub-specialties live on Vecna’s self-service system.
“Looking at the development of the web portal, we wanted to take it a step further and have patients complete as much of the [questionnaire] as humanly possible. We wanted to capture the onset of everything, not just medical and family history. I learned that this was kind of like building an EHR, with a dynamic set of questions. I didn’t have ability to sit down and train my patients on how to use this. I needed an intuitive piece of software that was straightforward enough so that my 75-year old patient who was getting both of his or her hips replaced can walk through it and know exactly what to do.”
At New Mexico Orthopaedics, Jones explains, the patient completes his or her clinical intake questionnaire prior to even showing up for the appointment. “It is something that is complicated and is encoded into the EHR system, it and takes a clinician or a clinician’s assistant a substantial amount of time to complete with the patient. Having the patient complete the questionnaire before arriving onsite or in the waiting room not only changes the dynamic of the patient-clinician interaction by removing this mundane task, but also affects the cost structure. Less people are dedicated to tasks such as data entry, which are error prone, automatable, and time consuming to the patient when they show up onsite.”
And by doing this, says Ben Bau, vice president of software development at Vecna, not only is New Mexico Orthopaedics stepping out and meeting meaningful use criteria, but by having these types of functionalities added on to the registration process, the organization is also able to take special advantage of meaningful use by reducing underlying costs and improving patient experiences, rather than just hitting a bunch of check boxes. In a way, this solution is similar to using a boarding pass at airport for express check-in, he says.
As hospitals prepare for the incoming 25 million people who are expected to have health insurance by 2016, providing patient self-service technologies for data collection and administrative tasks prior to speaking with the doctor will become an industry-wide trend, although many patient care organizations are still lacking when it comes to deploying these strategies, says Jones. “There is a huge trend to getting the patient to have some skin in the game, and self service will play a big part of that. In order for patients to make educated decisions on their treatment, they have to have access to their information. Patient self-service is really that answer, and it’s why meaningful use is demanding the 5 percent.”
It’s incredibly hard for physicians to control what patients do outside of the practice, but one can see the importance the Centers for Medicare & Medicaid Services (CMS) is placing on it, he continues. “I have read that this is the year of the web portal, as we move into Stage 2. We saw the same thing with the huge jump of EHR adoption from 2011-2013; we will see the same when it comes to web portal adoption,” James predicts.
And when it comes down to it, patients are demanding access to their personal health information—and not surprisingly, reports say that approximately 90 percent of patients want to utilize technology to access and manage their health data. “We have many patients asking for us to send them their medical records electronically, and believe it or not, patients are becoming really savvy in that regard,” says Jones. “Just like we are seeing in the financial industry, patient self-service is a big piece to the future of healthcare.”
But not every patient is ready for this transition, Jones admits. “We see it split in the middle, and it’s really a lot about age. Our older demographic patients require a heck of a lot more education on taking advantage of these technologies for one, but there is also more reluctance from that demographic to use them. Of course, the exact opposite is true from our younger generation.” That could be changing, though, he says. “What better of a sampling of people than in an airport? How many elderly people are pulling out an iPad? Even my grandmother knows how to FaceTime right now. People, of all ages, are adapting to technology far faster than I ever would have imagined.”