Posts Tagged ‘self-management’

LVHN Portal Places Healthcare Control in Patients’ Hands, Liberates Staff

November 30th, 2017 by Patricia Donovan

patient portal rolloutConsumers accustomed to communicating, shopping, banking and booking travel online increasingly expect those same conveniences from their healthcare providers.

And as Lehigh Valley Health Network (LVHN) has learned, despite the myriad of benefits a patient portal offers, the most important reason to incorporate this interactive tool into a physician practice is because patients want it.

“As much as we emphasize the marketing aspect of [the portal], having a nice, functional technology that we get in other aspects of our life has really been an enabler,” notes Michael Sheinberg, M.D., medical director, medical informatics, Epic transformation at LVHN. Many LVHN patients found the portal on their own, independent of the tool’s formal introduction, he adds. “Patients really wanted this. Our patients want to be engaged, they want to have access, and they want to own their medical information.”

Dr. Sheinberg and Lindsay Altimare, director of operations for Lehigh Valley Physician Group at LVHN, walked through the rollout of the LVHN portal to its ambulatory care providers during Patient Portal Roll-Out Strategy: Activating and Engaging Patients in Self-Care and Population Health, a November 2017 webinar now available for rebroadcast.

The 2015 launch of LVHN’s patient portal and its continued user growth has earned it the distinction of being the fastest growing patient portal on the Epic® platform.

As Ms. Altimare explained, LVHN first launched its portal with limited functionality in February 2015 as part of the Epic electronic health record that had gone live two years earlier. But even given the portal’s limited feature set, LVHN quickly recognized the tool’s potential to enhance efficiency, education, communication and revenue outside of traditional doctor’s office visits.

At its providers’ request, however, LVHN first piloted the portal within 14 of its 160+ physician practices, using feedback from providers in the two-month trial to further tweak the portal before next rolling it out to its remaining clinicians, and finally to patients.

LVHN supported each rollout phase with targeted marketing and education materials.

Today, LVHN patients and staff embrace the functionality of the portal, which offers an experience similar to that of an online airline check-in. Via the portal, LVHN patients can self-schedule appointments, complete medical questionnaires and forms, even participate in select e-visits with physicians—all in the comfort and privacy of their own homes.

Not only are about 45 percent of LVHN’s 420,000 patients enrolled in the portal, but self-scheduling doubled in the first six months of use. Additionally, upon examining a segment of portal participants over 12 months, LVHN identified a steady rise in portal utilization for common tasks like medication renewals and medical history completion.

The portal “liberates our patients from the need to access our providers in the traditional way,” says Dr. Sheinberg. Appreciation of this freedom is reflected in improved patient experience scores, he adds.

“The portal is a patient satisfier, and certainly a staff satisfier, because it reduces patient ‘no-shows’ and liberates our staff from more manual processes, putting them in the hands of our patients.”

Remote Diabetes Monitoring: Magic is in the Phone Call, Not the Technology

January 8th, 2015 by Patricia Donovan

Using a blend of telehealth, access to electronic medical records, electronic communication with providers and direct communication with patients, nurse care managers with the New York City Health and Hospitals Corporation’s (NYCHHC) House Calls Telehealth Program significantly improved patient clinical outcomes and impacted healthcare costs for enrollees with diabetes. Here, Susan Lehrer, RN, BSN, CDE, associate executive director of the telehealth office for NYCHHC, shares some lessons learned from the eight-year-old program.

We can achieve really significant clinical and financial outcomes with available simple technology. I want to say ‘simple’ because this is not rocket science. It’s a glucometer that transmits over a modem, a blood pressure cuff that transmits the information of blood pressure via Bluetooth® to us that we see on a Web site within seconds.

That information is the first step, but providing the case management and communication back to providers is where the magic happens. Conducting effective patient interactions utilizing motivational interviewing can be done over the phone. We were all disbelievers in the beginning. “How can I do the same thing that I did face-to-face over the phone?” we asked ourselves.

You can’t do the same thing, but over time, you can achieve the same outcomes, as long as you have providers seeing the patients and patients keeping their appointments.

Technology enables us to give the feedback at the moment that the patient needs it. If somebody’s blood sugar is 58, and they don’t feel very well, calling them at that moment, which we do every day, prevents them from overcorrecting. Eventually, they learn how to treat their hypoglycemia. Giving that immediate feedback to a patient is where the dramatic clinical outcomes occur. Patients can learn self-management with very targeted interventions and support.

To recap, it’s not about the technology, because the data comes to us every day, but it’s the magic that happens in the phone call back to the patient.

remote diabetes management
Susan Lehrer RN, BSN, CDE is the Associate Executive Director for the House Calls Telehealth program for the New York City Health and Hospitals Corporation. Ms. Lehrer joined HHC in 2006 to design and implement the Telehealth program to provide expert care management for Diabetics with poor control.

Source: Diabetic Telehealth Monitoring: The Impact of Real-Time Data on High-Risk Patients (webinar available for replay)

WellCare Works Community ‘Front Lines’ to Close Social Care Gaps for Dual Eligibles

October 10th, 2013 by Patricia Donovan

Healthcare is local — and therefore, care needs to be local and community-based, says WellCare Health Plan.

The mission behind WellCare’s HealthConnections model is simple: when you do something good for the community, you do something good for your members — and vice versa.

This philosophy is also rooted in fact: according to joint research by the Robert Wood Johnson Foundation and the University of Wisconsin School of Public Health, 80 percent of what affects health outcomes occurs outside doctors’ offices.

That’s why so much of the work done by WellCare Health Plan, a managed care organization (MCO) that serves only government programs, is devoted to connecting its members with sorely needed community-based services — a healthy mix of public health and social support. Its team of advocates works the front lines of the community, pooling resources with a common goal — the reopening a local food bank, for example.

HealthConnections even labors to sustain the services when necessary, with a combination of grants and community support, explained Pamme Taylor, WellCare’s vice president of advocacy and community-based programs, during an October 2013 webinar on Closing Care Gaps and Engaging Dually Eligible Members in Self-Management.

The HealthConnections model, with an interdisciplinary care team as its foundation, is not a traditional MCO approach, she continues. HealthConnections kicks off its arrival in a new area with a hard look at community data, cataloging need and available services. The resulting database is accessible by WellCare caseworkers, who match the services to the vulnerable populations it serves, including the dually eligible (individuals qualifying for both Medicaid and Medicare).

Equipped with both the individual’s electronic medical record and a social services record, the caseworkers have a global view of their members’ health and social needs.

The HealthConnections model started in Kentucky in November 2011 with a baseline of about 2,500 entities. By the time the pilot ended in 2012, the robust social services database contained almost 14,000 unique agencies representing about 200,00 programs and services across the region — most of which are owned by minorities, women or the disabled. Approximately three-quarters of the compiled services are federally funded, which leaves the system financially vulnerable, Ms. Taylor noted.

HealthConnections identified and filled more than 175 specific gaps, and launched more than 10 community-based health initiatives.

To illustrate how HealthConnections helps to close socially based care gaps, Ms. Taylor used the example of a typical family of six living in rural United States:

Mom and dad both now work two part-time jobs. In 2008, dad was an executive at a company but lost his job because of the economic crisis. To make ends meet, they’re now working two part-time jobs. Living with them in 1,100 square feet are three children and a grandmother. The daughter is 19 years old and pregnant for the second time. The two twin boys, ten years old, are very enthusiastic children; one is developmentally delayed and the other one has emotional outbursts. The grandmother just recently moved in with the family, and she has been diagnosed with diabetes and has been noncompliant with her treatment. She also has early onset dementia.

HealthConnections was able to connect everyone in this family to various social service supports, but there were still gaps, she notes. For example, looking at the daughter alone, HealthConnections put social supports in place to ensure the young woman had a healthy pregnancy and delivery. The assistance didn’t end there. “She also hadn’t graduated high school, so we helped connect her to a program where she got her GED. She is now fully employed and she’s considering college,” Ms. Taylor said.

During the webinar, Ms. Taylor also described the five key roles of the community health worker and addressed the challenges of identifying and communicating with dual eligibles.

Pamme Taylor talks more about WellCare’s “healthcare is local” philosophy in this HealthSounds podcast.