1. Experience with Patient Portal at Duke University Scott V. Joy, MD, FACP Medical Director The Colorado Health Foundation P/SL Medical Center Associate Professor of Medicine University of Colorado School of Medicine

2. Part 1: Initiation

3. OBJECTIVES OF PROGRAM/INTERVENTION (Start date July 2007) To develop and test the feasibility of an online portal to allow patients access to view their unedited lab results and radiology reports. To create educational materials and communication strategies to notify patients of the existence and use of the online portal. To measure the usage of this new technology by patients and the provider perception of the impact of the portal on their clinical responsibilities. Abstract Presented 2008 Society of General Internal Medicine Annual Session

4. Description of Project/Intervention. Patients who had laboratory or radiology studies performed were able to review their unedited results and reports 7 days after the reports were created. Patients were introduced to and educated about the portal by the following methods. Written instructions given to patients at appointment check-in. Providers to patient communication during office visit Patients received f/u e-mail after visit inviting them to access the portal and to create a secure account to view their test results.

5. Healthview Accountholder Demographic Information as of Dec 2007 Female61% Male39% Under 18:6% 18 through 3424% 35 through 4930% 50 through 6429% 65 and over11%

7. Part 2: Maintenance

8. Patient Viewing of Normal and Abnormal Laboratory and Radiology Results Using the Portal Weekly report developed for practice Listed patients who had portal accounts and who had recent normal or abnormal lab and radiology reports available for viewing During a 3 week period in 2009, data reviewed to evaluate the percentage of portal patients who viewed all, some, or none of their results Total of 590 patients 8 Abstract Presentation, Society of General Internal Medicine Annual Session, 2010

9. Patient’s Viewing of Portal Results 9

10. Results Reviewed by Patients 10 *18% of results not viewed were abnormal

11. Part 3: Enhancements

12. Health Risk Assessment Questionnaire Project Pre-visit clinical input by the patient via the Healthview Portal

13. 13 Health Risk Assessments through March 2011 Footnote : Completed HRAs are for Duke Select and Duke Basic members.

14. The health risk questionnaire is part of the online check-in process for qualified appointments.

16. Family History Grid

17. Exercise Questions

18. Tobacco Use

19. Alcohol Consumption

20. Health Goals The patient can select up to 3 goals to discuss at their visit. The readiness scale gives an indication of the patient’s willingness to change.

21. Report Display in eBrowser

22. 22 Completion Times for HRA Questionnaire as part of Portal Online Check-in Abstract presented at Society of General Internal Medicine 2012 Annual Session

23. Questions Answered and Percentage of Responses for each Category Category% of patients who completed Exercise100% Tobacco Use100% Alcohol Consumption100% Personal Health Goals84% Family History72% 23

24. Family History Report Family History% responded T2DM32% Stroke18% Depression15% Alcoholism12% Heart Attack10% Colon Cancer7% Breast Cancer4% Prostate Cancer1% 24

25. Personal Health Goals Health GoalNumber of responses (n=109) Get the right amount of exercise41 Reach a healthy weight41 Improve my cholesterol24 Eat a healthy diet24 Stay in good health22 Feel better and have more energy19 Control my blood pressure16 Reduce stress in my life15 Get my blood sugar to my target8 Reach a better balance in my life6 Learn more about my health5 Stop smoking or tobacco use3 25