Veteran Service Organization ‘Officers Day’December 3, 2010

MyHealtheVet

Features of MyHealtheVet Personal Information (contacts, providers, etc.) Personal Family and Military Health History Personal Health Summary Health e-Logs (blood pressure, weight, etc.) Medications (over the counter drugs, herbals, etc.) Allergies and Immunizations Medical Events Food and Activity Journals Online VA Prescription Refills, VA Prescription

History My Complete Medications (printable summary) Wallet Health Information Card Calendar Trusted Health Education Information Self-Assessment Tools, Wellness Reminders Mental Health Resources (including online

courses) Secure Messaging (currently at 8 VA sites)

MyHealtheVetPersonal Health Record

3-Tier Access ModelVisitorsRegistrantsIn Person

Authentication (IPA) veterans

“The laying on of hands will increasingly include the pressing of keys. This emerging model will improve the practice of medicine but will also bring new challenges.”

-JH Stone

Communications between physicians and patients in the era of e-medicine. New England Journal of Medicine, 2007

Complementary Tools EHR & PHR

Comprehensive record

At all care sitesDecision supportClinical remindersPatient Safety

VA ElectronicHealth Record

(EHR)

MyHealtheVet Personal Health

Record (PHR)

Secure web-based portalPatient & family centeredInformation and servicesMultiple levels of accessIncreasing offerings over

time

Internet Use in the U.S. - 200874% of adults in U.S.87% ages 18-29; 72% ages 50-6441% age 65 and older64% living in rural areas77% white, 64% black, 58%

Hispanic57% if < $30,000 per year

Pew Internet & American Life Project www.pewinternet.org

Our veterans and their families are increasingly online and engaged in their own health and

care.

MyHealtheVet Use (Feb. 2010)956,500 Registered

179,427 AuthenticatedRequires In-Person AuthenticationRequired to use Secure Messaging

Over 14 million RX refills processedAveraging 111,000 refills weekly in 2010

Authenticated Users Can:Refill PrescriptionsView MedicationsResearch Health InformationGet Wellness RemindersTrack and Graph Veteran MetricsUse Health JournalsUse Self-AssessmentSee Wellness CalendarAccess e-benefits

Manage Medications

Track Health Data

1. Hypertension2. Influenza Vaccine3. Pneumococcal Vaccine4. Colorectal Cancer Screening5. Lipid Measurement6. LDL Target7. Body Mass Index (BMI)>25.08. Diabetes Foot Exam9. Diabetes Hemoglobin A1C10. Diabetes Retinal Exam11. Mammography Screening12. Cervical Cancer Screening

MyHealtheVet Web Survey96% login from home1 out of 2 login monthly1 out of 4 login weekly or more3 out of 4 login for Rx refills64% would like to securely email their

provider

American Customer Satisfaction Survey (ASCI)

October 2007 – October 2009

Appointments

Viewing Appointments via MyHealtheVet

Appointment Summary DisplayVeteran view of their VA AppointmentsVeteran view of their VA Appointments

VA Appointment Detail DisplayVeteran view of a VA Appointment DetailVeteran view of a VA Appointment Detail

VA Appointment Display in Health Calendar

Click on calendar appointment to view details

Click on calendar appointment to view details

Appointment Email RemindersVeteran may

chose to have email reminders sent two weeks prior to appointment

Reminder is sent to email address on file in the veterans MHV account

Appointment Request through Secure MessagingMyHealtheVet is introducing Secure Messaging as a means

for the patient to electronically communicate with their participating provider.

Templates are available to allow the patient to request an appointment through Secure Messaging

Veteran-Provider Interaction with

MyHealtheVet Secure Messaging

US Army veteran Devin Nuszbaum

David M. Douglas, MD

Dreaded Phone Tree

Portland 1DID x 51495

(pm: Dayton 51850Voicemail Access

1: Direct Transfer

Start

0: Operator

Pharmacy CSSX 50810

(pm: Dayton 51850)

5. Scheduling AgentsDID & x 53494

(after 8-4:30: VM message)

PC SalemDID x 51499

(pm: Dayton 51850)

East Portland 1DID x 51007

(pm: Dayton 51850)PC North Coast x 52593

(pm: Dayton 51850)

PC BendDID x 51494

(pm: Dayton 51850)

East Portland 4DID x 51010

(pm: Dayton 51850)

East Portland 2DID x 51008

(pm: Dayton 51850)

East Portland 3DID x 51009

(pm: Dayton 51850)

Portland 2DID x 51497

(pm: Dayton 51850)

Portland 3DID x 51496

(pm: Dayton 51850)

Portland 4DID x 51498

(pm: Dayton 51850)

Vancouver 1x 31665

(pm: Dayton 51850)

Vancouver 2x 31901

(pm: Dayton 51850)

PC East Portlandx 50960

(pm: Dayton 51850)

34

21

MPC Vancouverx 50970

(pm: Dayton 51850)

12

MPC Portlandx 50960

(pm: Dayton 51850)

1234

6: Primary Carex 50980

123456

7: Specialty Clinicsx 50820

(pm: Dayton 51850)

3: Enrollment/Eligibility

DID x 55069(pm: voicemail)

PDX VA Phone Tree – v1.0 rev 2.1.08

Incorrect entry YYYYY

12

9

star

Main Greeting53651

all others

0123456

2008 QWEST phone book numbers grossly incorrectEligibility and Information

503-273-5289

9

AudioInquiryAppt Reminders

for 45 days

AudioCarePharmacy options

12

9

Order Refills

Check on the Status of Refills

Request a Renewal

Currently AudioCare appt pressing 9 goes to 50950

chg to 53494. At times this also cycles back to Audiocare 55201!

12

4. AudioCare Automated Services

DID x 55201

AudioCare Application

2: DirectoryXXXXX

7

8

Primary CarePt’s directed to call team

extension via DID line0

4

Themes

· Patient and caller self management· Simple, clear menus· Pleasant, calm, consistent voice· Fail safe loops for incorrect actions – no dead

ends for caller

How long do I have to listen to this music???

I am out of refills. Now what?

Hmm, maybe Secure Messaging?

“Doc I am out of refills”

Meanwhile back at the clinic…

De-Identified Notification

Same Username and Password

The Secure Message

The Doctor Replies

The Veterans De-Identified Notification

“No problem, your Rx is on the way.”

Questions?