1. Online Access: Communication Matters! Paul Tang, MD Chief Medical Information Officer Palo Alto Medical Foundation Sutter Health

2. Outline Patients’ information needsPatients’ information needs PAMFOnlinePAMFOnline Benefits and experiencesBenefits and experiences

3. Desired Online Services Online Users Harris Interactive, 2002

4. Online Patients Want Their Information Online Online survey of 1000 healthcare consumersOnline survey of 1000 healthcare consumers Want online option to traditional access:Want online option to traditional access: – 84% - electronic alerts (e.g., flu vaccine, HM) – 83% - lab test results – 80% - personalized information after an office visit – 69% - online charts to monitor chronic diseases – 43% - willing to select physician based on availability of Internet services Harris Interactive, 2000

5. Overview of PAMFOnline Creating a Online Healing Relationship

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7. Early Experience with PAMFOnline

8. PAMFOnline Enrollment

9. PAMFOnline Patients Age Distribution, General Release

10. PAMFOnline Tiered Service Model Basic servicesBasic services –Access to selected information from EMR –Custom-tailored health information –Appointment requests –Prescription renewals –Administrative communication Messaging services (60/yr)Messaging services ( $ 60/yr) –Clinical communication with physicians –Medical advice request

11. Quality and Efficiency Rx Renewal

12. Send request to MD via ID Mail Prescription Renewal Turn of the Century (circa 2000) Pharmacy faxes request to PAMF PAMF pharmacy enters request into pharm computer Prints request Return to MA Patient picks up Rx To MA inbox MA orders chart FAX or call Rx back to pharmacy Pharmacy calls pt MD approves/ denies req

13. MD/RN approves/ denies req Medication Renewal Through PAMFOnline

14. Patient-Specific Information Resources

15. Customizing Educational Material to the Patient PAMFOnline provides patients with access to their record including:PAMFOnline provides patients with access to their record including: –Diagnoses –Medications –Lab test results –Patient instructions Unfamiliar words or phrases can generate questions or concernsUnfamiliar words or phrases can generate questions or concerns

18. Patient and Physician Satisfaction

19. * Subscribers only PAMFOnline Patient Survey Valued Services

20. Physician PAMFOnline Survey “Are you satisfied with PAMFOnline?” Physicians with 100+ PAMFOnline patients

21. Critical Success Factor Integration with EMR Information from EMR availableInformation from EMR available Common workflow with messagesCommon workflow with messages –Messages automatically included in EMR –Lab release –Rx renewal EMR-level securityEMR-level security

22. Leadership Challenges EMR infrastructureEMR infrastructure –Leadership (vision and guts) –Capital –Expertise NHII (e.g., standards, laws, policies, identifiers)NHII (e.g., standards, laws, policies, identifiers) ReimbursementReimbursement –Conditions Established patientEstablished patient DocumentationDocumentation E&M guidelinesE&M guidelines

23. Summary Patient-centered, safe, continuous care is an expectation of 21 st century health carePatient-centered, safe, continuous care is an expectation of 21 st century health care Secure, online communication with patientsSecure, online communication with patients –Improves care –Convenient for patients –Streamlines workflow, increases efficiency –Increases patient satisfaction –Generates patient loyalty