It’s Not About The Box Improving Care at Group Health with People, Process and Technology

September 29, 2006

Which dot-phrase for meds?

Filed under: Electronic Chart,Medications — admin @ 6:06 am
Dot Med Phrases

Smartlinks that reference medications in our Epic system

I am cleaning out some items that I intended to share here. Attached is a document describing all of the current medication related smart-links. There are quite a few, based on the various requests we’ve received over the years. Feel free to use them as you see fit in your charting.


September 28, 2006

Satisfaction with MyGroupHealth shows impressive gains

Filed under: MyGroupHealth — admin @ 10:47 am
Satisfaction Slide Bank 1006

Slides showing data from most recent satisfaction survey, MyGroupHealth

Yesterday, I posted a survey from the Harris organization that showed national data regarding use of personal health records. The numbers are incredibly low across the nation, estimated at 1-3 %.

Today, I am sharing Group Health’s latest satisfaction survey of MyGroupHealth users. By “users,” we found patients who sent at least 1 secure e-mail, viewed 10 lab result or Healthwise pages, or placed 1 pharmacy online order. The response rate was 40.7 % out of 2000 surveys mailed, in June, 2006. Results are compared to a nearly identical survey performed in 2004.

The results are impressive.

  1. There are big gains in satisfaction with lab results on line – almost 10 % in the “Extremely satisfied” category. 67 % of users are “Extremely satisfied” with secure e-mail, a number that I think even folks at the Disney Corporation would respect.
  2. Group Health members continue to state that MyGroupHealth services impacts their health plan decision. Numbers which I have from 2002 in a national sample showed that 55 % of Americans said there would be a significant impact on the decision based on availability for online services. Our survey shows that number to be around 73 %. Also interesting from this question is the fact that even less people said that MyGroupHealth was not a factor for them in 2006 compared to 2004.
  3. Responses to the question, “what would you have done if e-mail/refills was not available?” are essentially unchanged between 2004 and 2006.
  4. There is a notable increase in the perception that secure e-mail adds value to in person visits. This is especially supportive of the work that many of you are doing in pre-visit secure e-mail.

I have been stimulated to compile this data for presentation recently, because I am heading to a roundtable on the “integrated personal health record” hosted by Kaiser Permanente, the Robert Wood Johnson Foundation and American Medical Informatics Association. The topic for discussion will be the intersection of the personal health record and the electronic health record, with an invitation-only guest list that includes Group Health, Intel, Kaiser Permanente, Geisinger, Epic Systems, National Health Service (UK), and Sutter Health, among others.

I will post updates from the roundtable to this blog. I think the experience of Group Health staff shapes the future of health care every day, and this should be an interesting forum to see what we can learn and teach.

September 27, 2006

Harris Poll : Few patients have access to the future

Filed under: e-health news — admin @ 5:28 am

Emily Hull, our manager of the EpicCare team, sent me this link to a newly released Harris Poll.

In it, a startling number of patients indicate that they have access to the resources that our patients do. They also indicate that they will be more likely to choose physicians who have access to these services. I think it’s hard sometime to apply data like that to our care system on the one hand. On the other hand, we’ve shown increases in member retention associated with MyGroupHealth. All good news.

September 26, 2006

Epic Users Group 2006 – A Rookies Tale

Filed under: User Group — admin @ 4:48 pm

 As a relative newcomer to UGM and with only one meeting under my belt, there was an overwhelming amount to learn, some to teach and even more to be proud of.  It took no time to see that Group Health is leading the way in areas of patient and parental access to health records, after visit summaries, transparency in on-line results reporting and clinical decision support.  Our commitment to quality and desire to measureand report it to providers are all ahead of the curve.  There were many meetings where I heard myself to say, ‘hey, we do that already’.

Harvard Vanguards’ work on population management tools for Diabetes was interesting. They were able to create a ‘dashboard’ for following their ‘at risk’ population and they built a multidisciplinary care model.  There used many care strategies that we can use as we roll our HEDIS work. Most of the population tracking tools lived outside the Epic environment. They were able to obtain excellent results with this model. Think of the success’s when the dashboard is in Epic.

There was interesting work on ‘partial dictations’ in Epic, combining both Smart Phrases and Smart Sets with limited dictations. This could save out group on dictation costs by weaving smaller dictated notes into standard templates.

Kaiser Permanente Colorado did some very good work on their HealthConnect member focused communications and built a toolkit for providers to help improve the quality of messaging patients and articulating complex or anxiety promoting health issues. We can bring this work to our own chart etiquette group to promote excellent e-communication.

Our Advance Directives project was validated thanks to direct meetings with Epic software folks.  It has always struck us that there was no elegant and simple approach to handling end of life issues in Epic.  Our suspicions were correct, there is no answer hidden deep in Epic dungeons. The good news is we have built a simple and elegant way of handling these that will be rolled out in the next few months. The use of Media Manager, a small program that may help us capture and organize all scanned documents may be of great utility to our group.

As we move toward our next upgrade with its myriad enhancements, it was both growth promoting and exciting to see how much Group Health has done in such a short time.


Secure messaging value

Filed under: MyGroupHealth,Quality / Affordability — admin @ 6:37 am

I received the following e-mail message from Randy Ideker, PA-C, Associate Medical Director for Primary Care, and received permission to share it here. To me it represents the idea that our clinicians and clinician leaders are seeing secure e-mail and being the visionaries, in the way that works best for their patients.

Whenever I talk to other medical groups and organizations, they typically ask, “how do we get our clinicians to do secure e-mail/release labs/do AVS’s.” I think the subtext of that question is, “How do we get our clinicians to be like you (Group Health)?” This is a nice enough thing ask, but I like to respond that they shouldn’t copy what we do, they should copy how we think: patient at the center, clinicians seeing the impact to the patient, clinicians doing what they do best with the tools available. Clinicians are the experts. Thanks to Randy and all of you for doing what you do best.

Hello everyone
Thank you for Qing this up in my brain again. There have been a few organizations attempting to assign RVUs to these visits with marginal success.

We do lead the World in E-medicine and we are making it up as we go. We that deliver care have been and continue to make, really pretty extradinary, advances in how we use SMing in managing our pts.

Physician usage ranges from less than 3% to 51% of f/f visits to manage a panel. We are starting to see REAL gains in quality and access using MyGH. I also think that we are getting to where Epic and MyGH is Really improving efficiency and quality of physician life. [I am not blowing smoke because I hear it in my rounds in 11 medical centers]. Ask Eugene Ocampo and Steve Burrows in EVT and Chris Byarky in Renton for their experience.

I will Q up another study and I want you, as the experts, to tell me what questions I should ask of clinicians to give us all meaningful information.

Pls forward this to your brain trust clinicians for suggestions.
Thank you in advance for your work on this study and thank you for all you do everyday.
Take care
Randy I

Randall Ideker PA-C
Medical Center Chief Everett
Assistant Medical Director
Primary Care North

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