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NORC

NORC. Prashila Dullabh, MD July 18, 2013. Consumer Empowerment Workgroup : Evaluating Patients Role in Providing Feedback to Improve the Quality of Information in the Medical Record. ONC-Funded Study. Funded under ONC’s Consumer e-Health Program Goals of the study

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  1. NORC Prashila Dullabh, MD July 18, 2013 Consumer Empowerment Workgroup : Evaluating Patients Role in Providing Feedback to Improve the Quality of Information in the Medical Record

  2. ONC-Funded Study • Funded under ONC’s Consumer e-Health Program • Goals of the study • Illustrate current approaches to patient feedback, comparing approaches in health care to other fields • Assess responses to the need for patient engagement in efforts to improve data quality in EHRs, identifying any shortcomings in current practices and recommend responsive action • Pilot test a patient feedback process Important progress is being made…. Keeping EHRs Error-Free: the Value of Patient Engagement

  3. Background Insert Presentation Title and Any Confidentiality Information

  4. Patients interested in accuracy of their records Markle Foundation survey finds 87% of respondents would use a PHR to “check for errors or mistakes in their health records” (Markle Survey: The Public Expects Benefits from Health IT, December 2010) Keeping EHRs Error-Free: the Value of Patient Engagement

  5. Patient portals are being used to gather patient feedback Survey of eight patient portals (2010) • Beth Israel Deaconess Medical Center • Children’s Hospital Boston • Geisinger Health System • Kaiser Permanente • NorthShore University Health System • Palo Alto Medical Foundation • Partners HealthCare • Veterans Health Administration Encourage: Acknowledge potential for issues and recommend patient contact their provider Facilitate: Build on encouragement to provide online mechanisms accept patient input: Keeping EHRs Error-Free: the Value of Patient Engagement

  6. Geisinger Pilot Study Insert Presentation Title and Any Confidentiality Information

  7. Goals and Research Questions • and

  8. Overview of Geisinger Pilot • Started November 2011 • Inclusion criteria: • Patient has at least one chronic condition (e.g. asthma, hypertension, diabetes, COPD,CHF) • Patient is a user of the MyGeisinger portal • Patients with upcoming appointments invited to complete a medication feedback form prior to their office visit • 2 clinics included in the original pilot • As of June 2012: • Total of 1500 patients received the form,

  9. Key Findings Insert Presentation Title and Any Confidentiality Information

  10. Patient Engagement • Many patients liked the opportunity to provide feedback outside of office visits, and preferred the form to calling • Many patients felt the form helped them to prepare for their visit and be more informed about their medications • Providers report the form has improved patient engagement and information-sharing “I take 30 or so meds. I probably wouldn’t be able to list all of them on my own. The form helps me remember to take all of my meds and request refills.” - Participating patient “It’s amazing to see the response we’ve received and the details patients have provided so far. They are very thorough. I had an elderly male patient who went through the survey completely. I assumed that a family member helped him complete the form, but then I talked to him and found out that he did it all by himself.” - Participating pharmacist

  11. Patients are Eager to Provide Feedback • Patient response ~30% exceeded expectations Insert Presentation Title and Any Confidentiality Information

  12. Patients are Eager to Provide Feedback On average patient requested at least 2 changes per submitted form Insert Presentation Title and Any Confidentiality Information

  13. Patients Can Provide Accurate Feedback • Subsample Analysis of 116 patients • In 56% (68/121) of cases pharmacists accepted patient requests for changes Insert Presentation Title and Any Confidentiality Information

  14. A Supportive Online Environment Important for patient feedback MyGeisinger Usage Rates Annualized for 2012 Insert Presentation Title and Any Confidentiality Information

  15. Policy Implications Proposed measure for Meaningful Use Stage 3: “SGRP 204D: Provide patientswiththeabilitytorequestanamendmenttotheirrecordonline(e.g., offer corrections, additions, orupdatestotherecord) through VDTinanobviousmanner.” • Geisinger pilot results support • Provide outpatients the ability to request updates to their record online (e.g., offer corrections, additions, or updates to the record) for medications through VDT using structured forms • Measures: ~30% of patients responded to an offer to update. ~85% of those were processed within 4 business days • Patient portal survey support • Medication allergies, Immunizations, and Demographics • Other promising areas for patient sourced data • Smoking Status, Advance Directives, Family Health History Keeping EHRs Error-Free: the Value of Patient Engagement

  16. In Conclusion • Patients can be effectively engaged to provide accurate and reliable feedback • There are effective strategies to gather and process patient feedback • The pilot serves as a test case for collaborative processes that can be employed to improve data quality of EHRs Insert Presentation Title and Any Confidentiality Information

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