206 CIS: Secure Messaging Admin Functions

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206 CIS Secure Messaging Admin Functions

• Andy Knaster
• andrew.knaster_at_va.gov
• July 15, 2008

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Outline for SM Administration Session

• Introduction to Secure Messaging (SM)
• SM Purpose
• SM Roles
• Administrator Responsibilities
• Administrative Functions
• Reporting
• Questions

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Introduction to Secure Messaging

• SM is a system that will provide patients and
  providers with the ability to send non-urgent,
  non-emergency secure messages to the intended
  recipient.
• It will do this without the use of an e-mail
  system and the inherent risks of exposing
  confidential information that comes with e-mail.
  
• The intent of the system is to improve the
  provider-patient relationship by providing an
  electronic communications medium in addition to
  the telephone.

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SM Roles

• Veteran
• Provider
• Other Staff
• Administrator

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Veteran

• Must have
• Internet Access
• An My HealtheVet (MHV) account
• Be In-Person Authenticated (IPA)
• Show government approved ID
• Completed the 10-5345a-MHV form
• View the IPA Introduction Video
• Opted-in to SM

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Opting In Requirements

• Acknowledging several things
• SM is for non-urgent use
• The veteran must have been IPAd and have an MHV
  account
• Adherence to standards of conduct
• Turnaround time of three business days
• Any or all messages may become part of the
  patient record
• Remote notification specifications

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Provider

• Doctors
• Registered Nurses
• Nurse Practioners
• Physicians Assistants

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Other Staff

• Clinical Support Team
• Pharmacists
• Specialists
• Technicians
• Provider Triage
• Call center

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SM Administrators

• Various levels
• Nationwide
• VISN
• Facility
• Responsibilities
• Setting up triage groups
• Adding people to the system
• Identifying providers, clinical support team, and
  triage staff
• Running reports

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SM Administrator Responsibilities

• Administrative Functions
• Reporting

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Administrative Functions

• Create an SM Administrator Account
• Activate an SM Staff Member Account
• Administer an SM Triage Group
• Set Up Patient Blocking
• Configure Group Opt In Status

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Create an SM Administrator Account

• Who can create an SM Administrator account for a
  particular level of SM Administrator?
• Create an SM Administrator account

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Who Can Create a SM Administrator Account?
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Create an Administrator Account

• Administrator accounts are set up and maintained
  through the MHV administrative portal
• The national release is going to be a phased roll
  out
• SM National administration is going to take care
  of making sure that administrative portal access
  is provided as needed

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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Activate an SM Staff Member Account
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Administer an SM Triage Group

• What is an SM triage group?
• Triage staff
• Clinical team members
• Providers
• Grouped together to serve as the initial
  recipient of messages
• Actions
• Handle a message
• Assign a message

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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Administer an SM Triage Group
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Set Up Patient Blocking

• Why block a patient?
• Repeatedly using SM for non-routine
  communications
• Using offensive language or otherwise violating
  the terms and conditions
• If one person blocks a patient, that patient is
  blocked from all access

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Set Up Patient Blocking
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Configure Group Opt-In Status

• What is opting-in/opting-out?

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What is Opting-in/Opting-out?

• There are certain terms and conditions that
  participants in SM must abide by
• Opting in is the explicit agreement with those
  terms and conditions by the veteran
• It is the responsibility of the SM Administrator
  to ensure that each clinician that has been opted
  in has received and agreed to the terms and
  conditions of use of SM
• Opting out is the action of removing ones access
  to SM

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Differences in Opting-in/Opting-out

• Veterans
• By default, they are opted out
• Upon their first use of SM, they are presented
  with an opt-in screen
• They may opt out at any time without assistance
• Staff
• They need an administrator to opt them out

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Group Opting In/Out

• This is to allow the SM Administrator to opt in
  and opt out one or more users at a time
• In the clinical environment, the SM Administrator
  is the only one with the ability to perform opt
  ins and opt outs

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Group Opting In/Out
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Group Opting In/Out
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Group Opting In/Out
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Reporting

• The Importance of Reporting
• Reports Available to Administrators
• CSV Files

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The Importance of Reporting

• Measurement of Impact
• Improvement in patient care
• Reduction in phone calls and visits
• Assessment of Compliance
• How many messages are completed in the required
  timeframe
• Process Improvement
• Appropriate staffing of triage groups
• Understanding and reacting to trends

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What is a CSV File and Why Should I Care?

• The output of all the reports is a CSV file
• CSV stands for Comma Separated Values
• Plain text file
• Displays as an Excel spreadsheet if
• Internet Explorer is the browser
• Excel is installed on the system
• Can also be downloaded and read by
• MS Access
• MS Word

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CSV File

• "Messages by Provider","","","","",""
• "Date Range 07/01/2007 08/31/2007","Smallville
  VAMC","","","",""
• "Provider Name","Total Messages","Progress
  Notes","Read","Unread","Escalated"
• Patient, One Q.","44","13","26","5","0"
• Patient, Two","27","4","13","8","2
• Resulting Excel Spreadsheet

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Reports Available to Administrators

• Messages by Category
• Discovery Audit
• System Health Monitor
• Lists on Demand

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Messages by Category

• This report breaks down messages by categories
  determined by the use of predefined message forms
• At release time there will be 11 different
  predefined message forms

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Messages by Category
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Messages by Category
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Discovery Audit

• This report is used by request for HIM for
  discovery during litigation
• Because it contains the actual content of
  messages a special password must be used to
  access the report

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Discovery Audit
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System Health Monitor

• A report that regularly checks the operational
  status of the system
• This reports in real time and historically

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System Health Monitor
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System Health Monitor
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System Health Monitor
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Lists on Demand

• Numbers of Opted In
• Providers
• Clinical Team Members
• Triage Staff
• Veterans
• Escalated Messages

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Lists on Demand

• Message Counts
• Providers
• Clinical Team Members
• Triage Staff
• Veterans
• Total Messages
• Messages Saved as Progress Notes
• Messages Read
• Messages Unread

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Lists on Demand
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Lists on Demand
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Other Reports

• In addition to the reports previously mentioned,
  SM will be able to produce reports using
  Microsoft Reporting Server
• These can be designed without a revision to the
  application software
• They will typically be run on a scheduled basis
• The output is a CSV file like the other reports
• This is a very important feature because we will
  discover the need for more business metrics as we
  use the application

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Active Participant Report

• Count of participants that have received or sent
  a message during the reporting interval.
• Grouping VISN, facility
• Sub-grouping Clinician, Staff, and Patient
• Reporting interval Day, Week, Month, Year

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Response Turnaround Time Report

• The Secure Message table contains two timestamps.
  
• One is for the date and time the message was
  created.
• The second is the date and time the message was
  marked complete.
• The difference between those is the response
  time, the basis for this report.

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Response Turnaround Time Report

• Count of messages marked complete within three
  business days of origination.
• Grouping VISN
• Reporting interval Month and Year
• Grouping Facility
• Reporting interval Day, Week, Month, Year

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Response Turnaround Time Report

• Count of messages marked complete after more than
  three business days of origination.
• Grouping VISN
• Reporting interval Month and Year
• Grouping Facility
• Reporting interval Day, Week, Month, Year
• Response Time minimum, maximum, and average
• Grouping VISN
• Reporting interval Month and Year
• Grouping Facility
• Reporting interval Day, Week, Month, Year

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Training and Education

• A very conscious effort has been made to make SM
  Administrator functions user friendly
• However, we will have specific training and
  education materials available for SM
  Administrators

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Questions