The Patient Portal:

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The Patient Portal Connecting Patients
Physicians Through Technology Ernie
Hood CIO/VP Group Health Cooperative Seattle,
Washington
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Agenda

• Group Health Cooperative Facts
• Why a Patient Portal? the Back-Story
• MyGroupHealth, Group Healths Patient Portal
• Results, Learnings Challenges
• Where to next?

www.ghc.org
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Group Health Facts

• Group Health is a consumer-governed, nonprofit
  health care system that coordinates care and
  coverage
• Offering a mix of Health Plan products including
  HMO, POS, PPO, HSA
• Serving 522,408 patients in Washington and
  Northern Idaho
• 867 Medical Staff supporting 25 medical offices
  and 1 hospital
• 39 Networked Hospitals
• 2.323 billion annual revenue
• Purpose To transform health care

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Why a Patient Portal?
Rash Guy
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Modern Healthcare ?
Professionals View
Planned care
Depression
Heart Disease
Acute reactive care
Diabetes
Tyranny of the Urgent
Smoking cessation
Immunizations
More, shorter office visits
Chronic pain
Cancer screening
Increased "productivity"
Asthma
Arthritis
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Patient-Centered Health Care
Patients/Members View
I get surprised and delighted by my health care
team on a regular basis when they anticipate my
needs
I have useful interactions with my health care
team whenever and however I need to.
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EMR Implementation Traditional
Physicians first.
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Group Healths EMR Implementation
Patients first!
Big Bang Messaging Results Review Problem
List Transcription Authentication
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MyGroupHealth Group Healths Patient Portal

• Vision
• To enable unparalleled access and transparency by
  connecting members, staff, community providers,
  purchasers, and brokers with Group Health and
  with one another at the right place and right
  time. 
• Goals/Objectives
• Achieve market differentiation. Create talk in
  the community.
• Bond members to Group Health.
• Leverage the Web in physician practices.
• Reduce transaction costs and improve customer
  satisfaction via "self service" online health
  plan transactions.
• Use secure web services to make Group Health
  convenient and accessible for all our
  customers.

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Connecting Value for the Patient
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The Patient Portal

• Online member services include

• Messaging between patients and their doctors
• Appointment requests/replies upcoming
  appointments list
• Lab/Test results and result graphing
• After-visit summaries
• Messaging between patients and Consulting Nurse
  service
• Immunization and allergy histories
• Prescription refills with free delivery
• 5,000 topics of health information from the
  Healthwise Knowledgebase, including a drug
  information database
• Certificates of Coverage
• Summaries of Benefits
• Provider Directory with biographies for GH
  doctors
• Customer Service email, membership card requests,
  etc.
• EOBs,
• Parental access to online medical records for
  children 0-12

• Powered by Epics MyChart

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Online Test Results Clinical Information
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Test Results Graphing
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Information Therapy (lx)

• Ix is effective, more affordable, and with less
  side effects than Rx
• The same information, from the exam room to the
  living room

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The Health Risk Assessment
Online member services include

• Personal information
• Lifestyle and health behavior
• Screening and risk assessment
• Chronic condition management
• Senior issues
• Pre-populate labs and blood pressure
• Links to Healthwise Knowledgebase articles
• At-a-glance summary table
• Highly customized report

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Health Profile
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Results Is it Working?

• Patient Portal
• As of April 30, 2007
• 133,506 active MyGroupHealth patients (32.5 of
  adult enrollees)
• Weekly activity April 23, 2007
• Daily Unique Visits gt 43,363
• Lab Results gt 42,163
• After Visit Summary gt 10,910
• RX Orders gt 7,937
• Secure Messaging gt 5,606
• Issues gt 5,420
• View Appt gt 2,970
• Appt Request gt 1,803
• Immunizations gt 1,405
• EOB gt 1,147
• Allergies gt 671

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Increasing Awareness Adoption
133,506 Enhanced Member Users as of 4/30/2007 or
32.5 of adult enrollees
Plus, more than 10,000 parents have access to
their childrens online medical records.
And, more than 56.2 of members using Group
Health medical centersuse the Enhanced Suite of
online services.
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Site User Satisfaction Survey
June 2006

• Mailed survey of users of MyGroupHealth for
  Members (similar to survey conducted in July 2002
  and August 2004.)
• Criteria for inclusion into the sample pool was
• - current enrollee
• - during 4/06, sent gt 1 secure message or
  placed gt 1 rx order or viewed gt 10 lab
  results or Healthwise pages
• - survey sent to a random sample of 2,000 people
  from this pool
• 3. Response rate of 41 with only one wave. (n
  814)
• 4. Demographics of the respondents are in line
  with the overall MyGroupHealth user population.
  Greatest population group responding is women age
  50-59.

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Members like it
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Would you recommend the online messaging service
to another member?
They want others to have it!
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In the members words
I must tell you I was more than leery about
Group Health when the company I work for decided
to go that route, but after my first visit,I was
greatly impressed with your staff and the
information and care given me. After over thirty
years of trying to find a good medical
institution, I'm glad I came to GHC. But the
clincher is your online service, It blew me away,
all I can say is it's about time someone let the
average person take a peek into their medical
history, which until now was viewed as taboo by
most Drs. I feel most relaxed sittin' in my
"jammies" finding out in plain english what's
going on with my health. Your staff deserves a
big "atta boy" for this service, I just wish I
hadn't waited so long to give you a try. Yours
truly, K.A.. P.S. Keep up the great work.
Source Email to the webmaster from a verified
user of MyGroupHealth, 11/3/2004, 136am.
(emphasis added)
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In the customers words
...I was surprised to learn that Group Health is
so far ahead of other services. We've had
individual practitioners since arriving in WA, 4
yrs ago. When we transferred in GHC, we assumed
this was standard. We love ordering meds online.
I've emailed my doc's many times. We use the
online services to full advantage. Well
done! Source GH member at CRM Association of
the Northwest, 1/20/2005 I would just like to
Thank you for this web site. I can't begin to
tell you how many times I have used it for
information on the medications I take. I realize
it is not to be used in the place of a Physician,
but this sure helps when you have a question, and
when I visit my Doctor, I have something to bring
to them to ask and talk about...give me knowledge
on diseases and medications. Not to mention a lot
of other information. Again, Thank you so much
for all you do! Keep up that great work. Source
Email to the webmaster from a verified user
6/25/2005. Here is the point. I cannot find a
way to access my pending labs. If the data is out
there, can you point me towards it? If it is not
out there, can we add it to the system? Source
Email to the webmaster, 2005.
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Members report 94.5 satisfaction!
How satisfied are you with the following
services?
94.2
94.5
93.8
93.7
90.6
40.8
45.5
79.8
75.7
72.9
Satisfied
53.7
Very satisfied
48.2
79.9
67.1
63.3
49.1
41.9
35.2
2004 survey
Rx Refills
Secure Email
Appt Requests
Healthwise Knowledgebase
Lab/Test Results
MyGH Overall
After-Visit Summary
five point scale 5 Very Satisfied
Source MyGroupHealth for Members User
Satisfaction Survey June 2006. n 814.
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Patients Report Convenience Secure Email
Replaces Some Visits Phone Calls
Members report 94.5 satisfaction!
How would you have contacted your health care
team ifsecure email were not available? (n
646)
Phone the clinic to
6.7
discuss health
10.8
concern
Schedule a clinic
appointment
56.0
Schedule a phone
appointment
26.5
Would not have
contacted health
care team
Source MyGroupHealth for Members User
Satisfaction Survey June 2006. n 814
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Patients Report Convenience Secure Email
Replaces Some Visits Phone Calls
Patients Report Convenience while enhancing
in-person visits.
Members report 94.5 satisfaction!
How would you rate the value of secure email in
enhancing your visits to your health care team?
(n 666)
0.3
4.4
10.4
52.0
33.0
Source MyGroupHealth for Members User
Satisfaction Survey June 2006. n 814
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Patients Report Convenience Secure Email
Replaces Some Visits Phone Calls
Members report 94.5 satisfaction!
Patient Recommendations
Would you recommend MyGroupHealth to a friend or
colleague? (n 799)
Source MyGroupHealth for Members User
Satisfaction Survey June 2006. n 814
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What We Have Learned

• Choose the patient as the primary focus. It
  makes all the difference.
• Health Information Technology is foundational to
  other, higher-order aspirations safety,
  evidenced-based medicine, and real
  patient-provider shared decision making and yes,
  Customer Service!
• Physician leadership is crucial to the success of
  the effort. They are the face of the organization
  to the customer.
• The value of thinking about process, technology
  and people simultaneously.

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Challenges

• Connecting the Community
• Incomplete Electronic Records
• Privacy Laws
• Regulatory Requirements

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Where to next?
The Integrated Care Plan

• Personal Information
• I am deaf in my left ear. Share anything with my
  son, but not my daughter-in-law
• Life Goals
• I want to climb Mount Rainer with my grandson
• Medical Problem List
• Current or active problems
• Medical Past History
• Members Action Plan
• Self-managed goals (I will walk 30 minutes every
  day at lunch)
• Medications
• Medications and doses of what the patient is
  actually taking presented in ways that make
  sense.
• My Health Log
• A place to track BP, weight, exercise, etc
• Advanced Directive
• Treatment Plan
• Target Outcomes

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Through Technology

• We can Combine
• an Electronic Medical Record
• a Patient Portal
• an Online Health Risk Assessment and
• an integrated electronic Care Plan

Creating a powerful tool for effectively engaging
consumers in their own care.
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