Project Mars | Outpatient Practice Redesign microCONSULTS Iteration 2 Experiment Update March 2014

2013 MFMER

Iteration 1: Recap

Previous Experimentation Combining all experimentation, we completed a total of 27 microCONSULTS

The average length was 9 min 15 sec.

Greater Efficiency and Access Each microCONSULT was evaluated to understand what slot type it would have filled if it had been a referred consult (e.g. new, established, return)

Matching the slot times in each department and subtracting the microCONSULT time, we saved a total of 1035 appointment minutes or 17.25 total appointment hours for 27 microCONSULTS.

Access and Satisfaction For each microCONSULT we also looked at the approximate availability of the referred to department or specialty.

Overall we saved patients a total of 118 days on their itinerary, averaging 4 days across all patients.

Patients ranked this interaction 6.2 out of 7, the average ranking for initiating providers was 6.1, the average ranking for receiving providers was 5.7

2013 MFMER

Iteration 1: Recap

2013 MFMER

Experiment Goals / Design Questions Specific design questions related to overall value / strategies and overall workflow include:

Strategy and Value 1. How does this interaction either differ or complement similar types of services, such as eConsults,

traditional curbsides, AskMayoExpert? 2. What is the value of the video and patient participation? 3. How does the microCONSULT provide value and a positive experience for the requesting

providers, responding providers, and patients? Which patients and conditions benefit most?

Workflow Integration 1. Using the microCONSULT prototype, can providers successfully identify, initiate, and execute a

microCONSULT with another provider? 2. What format and workflow is most appropriate for scheduled and real-time microCONSULTS? 3. Does the presence algorithm successfully identify provider availability, or white space, in our

clinical schedule?

Iteration 2 Experimentation: Design Questions and Effort

2013 MFMER

Experiment Planning: Recruiting Update

Recruited Partners: The list below represents our previous experiment partners and new participants. New groups include the ones shown in bold. GIM will be messaged to by Dr. Fleming. CV by Dr. Brozovich.

Current partners include:

GIM with Breast Clinic (14) Nephrology (1) CV (21) GI (6) Dermatology (6) Neurology (6) Endocrinology (5) Urology (1)

Orthopedic Surgery (2) Sleep Medicine (5) General Surgery (8) Radiology (4)

2013 MFMER

Prototype: The prototype went through the following steps related to the design and functionality:

User and technology requirements were defined from Iteration 1

We worked with a UI designer to map out screens on paper (wireframes)

We invited key Iteration 1 partners to review the wireframes for usability and experience as well as preliminary understanding of AME possibilities

Investigation of MSS and ROMS data to create the presence algorithm

IT resources built the iPad and iPhone application incorporating the ability to order a scheduled microCONSULT and conduct one real-time

Experiment Planning: Prototype

2013 MFMER

Metrics: A full metrics plan has been developed that includes: Baseline for requesting and responding providers to understand value, experience and

integration into workflows. Survey questions after each completed microCONSULT for requesting and responding

providers as well as the patient; delivered via the application to understand value, experience and integration into workflows.

Debrief and exit interviews with selected providers and patients conducted through qualitative interviewing / conversations.

Calendar review to identify how many internally referred consults are scheduled on responding providers calendars and how many could be microCONSULTS.

Application logging to understand logistics related to how many completed, length, ratio of pre-scheduled to unscheduled; type of search, presence algorithm performance, number of canceled, and when they occur.

Metrics plan developed by: CFI team, eHealth, Systems and Procedures, OAM, and CSHCD

Experiment Planning: Metrics

2013 MFMER

Training and Support: A training plan was developed that includes: Prior to drop-in training providers will have the application loaded; ESAs will support Invitation and participation in an 30 minute session where: Introduction to the concept of a microCONSULT through a graphic story Important logistics and workflow Review of functionality through mock-scenario Practice with one another to find a specialist Troubleshooting tips and tricks

Provide training collateral including a user guide and a laminated support and troubleshooting card.

On-going support through CFI availability to help participants use the application and identify future microCONSULTS. Contacts available through the application by email and pager access.

Training plan and materials reviewed by Resource Training and Development (RTD) and 2 practice sessions conducted by RTD and Electronic Support Assistants with CFI.

Experiment Planning: Training and Support

Demand and Capacity Analysis

A look at historical data to better understand number of internal referrals from GIM and between specialties. Simulation of analysis including beta-presence algorithm to determine potential capacity to accommodate the microCONSULT offering.

Experiment Planning: Schedule and Roll-out

March 3-April 10, 2014 Partner drop-in session 30 min Provide educational sessions to train recruited providers on the prototype and experiment. April 9-May 30, 2014 Experimentation Rolling launch. Complete both real-time and scheduled microCONSULTS with partners. July, 2014 Analysis and Findings Present findings from experimentation to Mars leadership and experiment partners.

Slide Number 1Slide Number 2Slide Number 3Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10