smart health centers-navigator training

117
Smart Health Centers Health Navigator Training Handbook Alliance of Chicago, Community Health Services, L3C The Smart Chicago Collaborative Chicago Community Trust Otho S. A. Sprague Memorial Institute Catherine T. MacArthur Foundation PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

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Page 1: Smart Health Centers-Navigator Training

Smart Health Centers Health Navigator Training Handbook

Alliance of Chicago Community Health Services L3C The Smart Chicago Collaborative Chicago Community TrustOtho S A Sprague Memorial InstituteCatherine T MacArthur Foundation

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

Acknowledgements

We would like to thank

Our Sponsors The Smart Chicago Collaborative

The Chicago Community Trust

John D and Catherine T MacArthur Foundation

Otho SA Sprague Memorial Institute

Smart Chicago Collaborative

Alliance of Chicago Community Health Services L3C (Phase I)

2

IntroductionThe Smart Health Centers project (SHC) empowers underserved patients by bringing the knowledge of technology and medical records to improve health outcomes directly to the fingertips of community members

Smart Health Centers increases confidence for those navigating the use of technology by demonstrating its uses within Community Health Centers SHC provides accessible and user-friendly education in health and wellness solutions

This training manual is designed to provide training and development to Health IT Navigators Their skills will be used to provide the necessary knowledge to patientsclientsconsumers of the Smart Health Center project

The Smart Health Centers project offers an integrated approach to enhancing health and wellness SHC provides online access of health information to improve the medical experience so that individuals may better understand and make well-informed decisions about their health Patients are ensured high-quality online material personalized culturally-sensitive advice and access to their own electronic records SHC partners with community health centers to enhance public computing resources and ultimately patients become ldquofull users of electronic health record systems

3

Authors PageValerie Brown is a Masters in Public Health Candidate in Community Health Sciences at the University of Illinois at Chicago She has an earned certificate in Community Public Health Practice from UIC For several years she has worked with CEEDChicago in Health Literacy and Community Health Workers and two years on a Patient Centered Care Collaborative to Improve Minority Health research project Valerie has an MBA and BS Computer Information Systems from Keller Graduate School of Management and DeVry University Professional experience includes Computer Networking and managing and operating IT helpdesks She co-authored this manual while working as an intern at CHITREC and Alliance of Chicago

Diana Beasley is a consultant with Human Resources and Organizational Development experience which includes Program Design TrainingDevelopment Human Resource Management Organizational Management and Group Dynamics Ms Beasley also has several years of experience in Management Consulting and Coaching Technical Assistance Leadership Training and Project Management to major corporations nonprofit organizations and FQHC health centers Ms Beasley has degrees in Psychology Urban Studies and Business Administration and a certificate in Human Resources She is Founder and Managing Consultant of Management Synergistics Inc a 14th year WMBE management-consulting firm in Chicago Ms Beasley is a native Chicagoan maintains an active lifestyle and has many affiliations in several groups and associations

4

Table of ContentsbullModule 1bull Project Overview

bullModule 2bull Health Navigator Role

bullModule 3bull Basic Health Information and Security of Information

bullModule 4bull Basic Computer Skills

bullModule 5bull Health Information Technology and Personal Health Records

bullModule 6bull Patient Portals

5

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 2: Smart Health Centers-Navigator Training

Acknowledgements

We would like to thank

Our Sponsors The Smart Chicago Collaborative

The Chicago Community Trust

John D and Catherine T MacArthur Foundation

Otho SA Sprague Memorial Institute

Smart Chicago Collaborative

Alliance of Chicago Community Health Services L3C (Phase I)

2

IntroductionThe Smart Health Centers project (SHC) empowers underserved patients by bringing the knowledge of technology and medical records to improve health outcomes directly to the fingertips of community members

Smart Health Centers increases confidence for those navigating the use of technology by demonstrating its uses within Community Health Centers SHC provides accessible and user-friendly education in health and wellness solutions

This training manual is designed to provide training and development to Health IT Navigators Their skills will be used to provide the necessary knowledge to patientsclientsconsumers of the Smart Health Center project

The Smart Health Centers project offers an integrated approach to enhancing health and wellness SHC provides online access of health information to improve the medical experience so that individuals may better understand and make well-informed decisions about their health Patients are ensured high-quality online material personalized culturally-sensitive advice and access to their own electronic records SHC partners with community health centers to enhance public computing resources and ultimately patients become ldquofull users of electronic health record systems

3

Authors PageValerie Brown is a Masters in Public Health Candidate in Community Health Sciences at the University of Illinois at Chicago She has an earned certificate in Community Public Health Practice from UIC For several years she has worked with CEEDChicago in Health Literacy and Community Health Workers and two years on a Patient Centered Care Collaborative to Improve Minority Health research project Valerie has an MBA and BS Computer Information Systems from Keller Graduate School of Management and DeVry University Professional experience includes Computer Networking and managing and operating IT helpdesks She co-authored this manual while working as an intern at CHITREC and Alliance of Chicago

Diana Beasley is a consultant with Human Resources and Organizational Development experience which includes Program Design TrainingDevelopment Human Resource Management Organizational Management and Group Dynamics Ms Beasley also has several years of experience in Management Consulting and Coaching Technical Assistance Leadership Training and Project Management to major corporations nonprofit organizations and FQHC health centers Ms Beasley has degrees in Psychology Urban Studies and Business Administration and a certificate in Human Resources She is Founder and Managing Consultant of Management Synergistics Inc a 14th year WMBE management-consulting firm in Chicago Ms Beasley is a native Chicagoan maintains an active lifestyle and has many affiliations in several groups and associations

4

Table of ContentsbullModule 1bull Project Overview

bullModule 2bull Health Navigator Role

bullModule 3bull Basic Health Information and Security of Information

bullModule 4bull Basic Computer Skills

bullModule 5bull Health Information Technology and Personal Health Records

bullModule 6bull Patient Portals

5

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 3: Smart Health Centers-Navigator Training

IntroductionThe Smart Health Centers project (SHC) empowers underserved patients by bringing the knowledge of technology and medical records to improve health outcomes directly to the fingertips of community members

Smart Health Centers increases confidence for those navigating the use of technology by demonstrating its uses within Community Health Centers SHC provides accessible and user-friendly education in health and wellness solutions

This training manual is designed to provide training and development to Health IT Navigators Their skills will be used to provide the necessary knowledge to patientsclientsconsumers of the Smart Health Center project

The Smart Health Centers project offers an integrated approach to enhancing health and wellness SHC provides online access of health information to improve the medical experience so that individuals may better understand and make well-informed decisions about their health Patients are ensured high-quality online material personalized culturally-sensitive advice and access to their own electronic records SHC partners with community health centers to enhance public computing resources and ultimately patients become ldquofull users of electronic health record systems

3

Authors PageValerie Brown is a Masters in Public Health Candidate in Community Health Sciences at the University of Illinois at Chicago She has an earned certificate in Community Public Health Practice from UIC For several years she has worked with CEEDChicago in Health Literacy and Community Health Workers and two years on a Patient Centered Care Collaborative to Improve Minority Health research project Valerie has an MBA and BS Computer Information Systems from Keller Graduate School of Management and DeVry University Professional experience includes Computer Networking and managing and operating IT helpdesks She co-authored this manual while working as an intern at CHITREC and Alliance of Chicago

Diana Beasley is a consultant with Human Resources and Organizational Development experience which includes Program Design TrainingDevelopment Human Resource Management Organizational Management and Group Dynamics Ms Beasley also has several years of experience in Management Consulting and Coaching Technical Assistance Leadership Training and Project Management to major corporations nonprofit organizations and FQHC health centers Ms Beasley has degrees in Psychology Urban Studies and Business Administration and a certificate in Human Resources She is Founder and Managing Consultant of Management Synergistics Inc a 14th year WMBE management-consulting firm in Chicago Ms Beasley is a native Chicagoan maintains an active lifestyle and has many affiliations in several groups and associations

4

Table of ContentsbullModule 1bull Project Overview

bullModule 2bull Health Navigator Role

bullModule 3bull Basic Health Information and Security of Information

bullModule 4bull Basic Computer Skills

bullModule 5bull Health Information Technology and Personal Health Records

bullModule 6bull Patient Portals

5

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 4: Smart Health Centers-Navigator Training

Authors PageValerie Brown is a Masters in Public Health Candidate in Community Health Sciences at the University of Illinois at Chicago She has an earned certificate in Community Public Health Practice from UIC For several years she has worked with CEEDChicago in Health Literacy and Community Health Workers and two years on a Patient Centered Care Collaborative to Improve Minority Health research project Valerie has an MBA and BS Computer Information Systems from Keller Graduate School of Management and DeVry University Professional experience includes Computer Networking and managing and operating IT helpdesks She co-authored this manual while working as an intern at CHITREC and Alliance of Chicago

Diana Beasley is a consultant with Human Resources and Organizational Development experience which includes Program Design TrainingDevelopment Human Resource Management Organizational Management and Group Dynamics Ms Beasley also has several years of experience in Management Consulting and Coaching Technical Assistance Leadership Training and Project Management to major corporations nonprofit organizations and FQHC health centers Ms Beasley has degrees in Psychology Urban Studies and Business Administration and a certificate in Human Resources She is Founder and Managing Consultant of Management Synergistics Inc a 14th year WMBE management-consulting firm in Chicago Ms Beasley is a native Chicagoan maintains an active lifestyle and has many affiliations in several groups and associations

4

Table of ContentsbullModule 1bull Project Overview

bullModule 2bull Health Navigator Role

bullModule 3bull Basic Health Information and Security of Information

bullModule 4bull Basic Computer Skills

bullModule 5bull Health Information Technology and Personal Health Records

bullModule 6bull Patient Portals

5

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 5: Smart Health Centers-Navigator Training

Table of ContentsbullModule 1bull Project Overview

bullModule 2bull Health Navigator Role

bullModule 3bull Basic Health Information and Security of Information

bullModule 4bull Basic Computer Skills

bullModule 5bull Health Information Technology and Personal Health Records

bullModule 6bull Patient Portals

5

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 6: Smart Health Centers-Navigator Training

Module 1 Project OverviewProject Overview

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

6

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 7: Smart Health Centers-Navigator Training

Module 1 Project OverviewLEARNING OBJECTIVES

Have a strong knowledge of the project its goals and objectives

Understand and identify partners amp staff

Understand the Health roles ie supervisory role staff policies and procedures

Understand information about sponsoring organization

Participate in activities to reinforce learning

7

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 8: Smart Health Centers-Navigator Training

Module 1 Project OverviewAs the nation moves toward a 21st Century technology-based health care system providers medical staff and patients must also

The goals for the Smart Health Centers include

Expanding underserved residentsrsquo access to online health and wellness information

Educating patients on how to access adopt and maintain health information for themselves and their families

Educating patients on how to identify trusted online health information including a set of provider suggested web based resources and tools

Helping consumers achieve ldquomeaningful userdquo of electronic health information such as healthcare patient portals and personal health records

8

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 9: Smart Health Centers-Navigator Training

Module 1 Project Overview - Collaboration

9

Smart Collaborative of Chicago Community Trust

City of Chicago

Otho Sprague Foundation

Smart Collaborative Sitebull Family Focusbull Laurie Children Hospital bull Acts of Faithbull Lawrence Hallbull CCHSbull Health Leads of Chicagobull Erie Health Centerbull Near North Health Center

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 10: Smart Health Centers-Navigator Training

Module 1 Project Perspective

The Smart Health Center model revolves around the information Navigator at each site The Navigator is part subject matter expert and part teacher By helping patients access their own health records online they empower to patients to take control of their own health Navigators also help patients find information online health information and support groups for chronic illnesses The wealth of information on the internet can enable residents to make health better choices

Some Smart Health Centers have computers available for public use for those residents who may not have access to the Internet at home along with 250 other sites throughout Chicago

Behind the desk patients who visit the clinic have their medical records uploaded to a secure server that patients and doctors can access Even if the patient changes doctors or moves to a different city the records can follow the patient with no hassle

10

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 11: Smart Health Centers-Navigator Training

Module 1 Project Organizational Chart

Smart Health Collaborative

Other SitesActs of Faith

Erie Health Care Center

Near North Health Centers

Lawrence Hall

Health Navigator

Health Navigator

Health Navigator

Family Focus Center

Health Navigator

Lurie Children Hospital

Health Navigator

11

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 12: Smart Health Centers-Navigator Training

bullHealth Navigatorsndash Are employees andor volunteers at Community Health Centers (CHCs) churches or

Community Based Organizations (CBOs)ndash Are oriented on organizational polices roles and responsibilities of facility or

healthcare centers

bullSitesndash Provide training and development on other policies and procedures for the center Including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA) etcndash Provide training on health care practices andor chronic diseases etc

12

Module 1 Health Navigators amp Project Sites

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 13: Smart Health Centers-Navigator Training

Module 1 Activity Knowledge Test

13

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 14: Smart Health Centers-Navigator Training

Module 2 The Role of the Health Navigator

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

14

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 15: Smart Health Centers-Navigator Training

Module 2 Health Navigator Role

LEARNING OBJECTIVES

Identify the role and responsibilities of a Health Navigator

Identify the core competency skills of a Health Navigator

Recognize similarities in Community Health Workers and Health Navigators

Understand the role of Health Literacy in patient engagement

Understand the role of Cultural Competency in patient engagement

Recognize role of theory in delivering health education and its influence on health behavior

Discuss the influence of Generational perspectives

Activity Patient Engagement Role Play

Provide feedback on the patient engagement

15

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 16: Smart Health Centers-Navigator Training

Module 2 Health Navigator Role

New role

Support (Technical Assistance)

Perform demos using technology

Hands-on for patientsclients

Look up Quality Health Information

Explain Personal Health Record

Navigate Patient Portals

16

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 17: Smart Health Centers-Navigator Training

Module 2 Health Navigator Responsibilities

Promoting the Smart Health Center to patients and stake holders

Educate and demonstrate use of technology to patients

Assist patients care givers and family members - logins and navigation of Smart Health Center technology

Provide privacy and safety information for using technology for health

Educate patients on benefits and usage of Personal Health Records

Tracking feedback and information to understand patients needs in using technology for health

Collaborating with other team members to reduce barriers and improve education of community members

Building additional knowledge and improving skills through self-study webinars virtual and in-person trainings and workshops

17

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 18: Smart Health Centers-Navigator Training

Module 2 CHW and Health Navigator

COMMUNITY HEALTH WORKER (CHW)

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (asthma diabetes HIV)

Culturally appropriate care

HEALTH NAVIGATOR

Part of Health Care Team

Provides Outreach

ID Services and Referrals

Health Education

Specialized health knowledge (Health Information Technology)

Culturally appropriate care

18

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 19: Smart Health Centers-Navigator Training

21-1094 Community Health Workers (Navigator)

Assist individuals and communities to adopt healthy behaviors

Conduct outreach for medical personnel or health organizations to implement programs in the community that promote maintain and improve individual and community health

May provide information on available resources provide social support and informal counseling advocate for individuals and community health needs and provide services such as first aid and blood pressure screening

May collect data to help identify community health needs Excludes Health Educators (21-1091)

Illustrative examples Peer Health Promoter Lay Health Advocate

Source US Department of Labor Bureau of Labor Statistics

httpwwwblsgovsoc2010soc211094htm

19

Module 2 Health Navigator Role

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 20: Smart Health Centers-Navigator Training

Module 2 Core Competencies

Communication Skills

Interpersonal Skills

Knowledge base about the community health issues and available services

Service coordination

Advocacy skills

Teaching skills

Organizational skills

Privacy and Confidentiality

20

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p13)

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 21: Smart Health Centers-Navigator Training

Module 2 Soft Skills

Interpersonal warmth

Trustworthiness

Open-mindedness

Objectivity

Sensitivity

Competence

Commitment to social justice

Good psychological health

Self-awareness and understanding

Empathy

21

Source (Berthold Miller Avila-Esparza 2009 Foundations for Community Health Workers p15)

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 22: Smart Health Centers-Navigator Training

22httpwwwlatitudelearningcom

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 23: Smart Health Centers-Navigator Training

Module 2 LMS To Increase Soft Skills

Module 2 Soft SkillsSelf-paced web-based improvement in customer service listening presentation communication diversity and empowerment courses

bull Giving an Effective Presentation 25 hour(s)

bull Learn effective communication skills and audience-involvement techniques that can be used during presentations

bull Communication Fundamentals 2 hour(s)

bull This online training course presents the essential skills needed to communicate effectively in the work environment

bull Dealing with Diversity 1 hour(s)

bull This course discusses how to recognize and respect individual differences and describes some strategies that can be used to dealwith diversity

bull Listen for Understanding 15 hour(s)

bull This course is on Listening for Understanding This online training course teaches communications and active listening skills

bull Empowerment in the Workplace 175 hour(s)

bull Online training to develop empowerment initiatives in the workplace This online learning path outlines the benefits of empowerment and provides tools and techniques to help promote empowerment at all levels of the organization

bull Customer Service Excellence 1 hour(s)

bull This course outlines how to maintain excellence in customer service

bull Facilitating Improvement 2 hour(s)

bull Learn to lead an audience to new ideas or understandings

23

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 24: Smart Health Centers-Navigator Training

Module 2 Cultural CompetenciesWhen you hear the term ldquocultural competency ldquo what comes to mind

24

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 25: Smart Health Centers-Navigator Training

Module 2 Cultural Competencies

Why is cultural competency important

-People come from diverse backgrounds with many different kinds of beliefs and practices

-We want to connect with others in a genuine way We want to show authenticity (realness) respect true understanding and build trust

25

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 26: Smart Health Centers-Navigator Training

Module 2 Health Literacy

Definition of Health Literacy

The degree to which individuals have the capacity to obtain process and understand basic health information amp services needed to make appropriate health decisions

Healthy People 2010

26

Source httpnnlmgovoutreachconsumerhlthlithtml Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 27: Smart Health Centers-Navigator Training

27

Source httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 28: Smart Health Centers-Navigator Training

Module 2Health Education Theory

28

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 29: Smart Health Centers-Navigator Training

Module 2 Health Education TheoryConsumer Information Processing Model

29

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 30: Smart Health Centers-Navigator Training

Module 2 Health Education Theory ndash Stages of Change

Precontemplation - the person is unaware of the behavior change and has no intention to take action and has not seriously thought about change (step before being introduced to HIT at the CHC ndash2) Contemplation - the person is seriously thinking about a change (in the near future) (accepts HIT navigator invitation to learn role of HIT in their health) 3) Preparation - the person is planning to take action and is making final adjustments before changing behavior (engaged consumer asks questions and creates a logon) 4) Action - the person implements some specific action (patient creates a PHR) 5) Maintenance - the person continues with the desired action (continues to update PHR on their own with historical information after initially created) 6) Termination - the person has zero temptation to go back to former behavior and has 100 confidence in their new ability (patient works to build and maintain PHRs for mate children and other family members)

Source Health Education Models httpmsucarescomhealthhealthappa1htm )

30

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 31: Smart Health Centers-Navigator Training

Module 2 Health Education Theory ndash Stages of Change

31

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 32: Smart Health Centers-Navigator Training

Module 2The GenerationsTodayrsquos workforce has 5 types of workers with differing styles These workers include

The BuildersMatureSilent

The Boomers

The X-ers

The Net Millennials

The iGen

32

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 33: Smart Health Centers-Navigator Training

Module 2Generation ValuesVALUES INhellip

BUILDERSMATURESILENT BOOMERS XERS Net MillennialiGen

MOTHER Homemaker Working Mother Single Mother Single Mother Father

FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure

MARRIAGE Married Once Divorced Remarried Single Parent Undetermined

HAIR Short Hair Long Hair Any Style Hair Bleached Spiked

CLOTHES Formal Casual Bizarre Anything Goes

MUSIC Big Band Swing Rock n Roll Alternative Rap Very Diverse

MONEY Save It Now Buy It Now Want It Now Get It Now (online)

PURCHASING Purchase w Cash Purchase w credit card Struggling to Purchase Purchase Online

MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market

HIGH-TECH Slide Rule Calculator Computer Internet

WORK STYLE Team Work Personal Fulfillment Tentative Divided Loyalty Networking

WAR Win a War Why a War Watch A War Winless War

MORALS Puritan Ethics Sensual Cautious Tolerant

LEARNING STYLES 100Print Media (Books)

90Print Media 10 Electronics

65 Electronics35 Print Media

90 Electronics10 Print Media

33

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 34: Smart Health Centers-Navigator Training

Module 2 Patient Engagement

Introductions are important in patient engagement Tone body language and energy are important

Strategy and Tips for Introduction

bull30 second intro

bull Initial impressions often sets the tone

bull Introduce yourself

bullTone

bullBody language

bullExplain who you are

bullExplain why you are there

bull Include role of technology in healthcare

bull Include benefits to patients

bull Invite them to experience technology

34

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 35: Smart Health Centers-Navigator Training

Module 2 Patient EngagementConducting Interviews and Demonstrations

1 Introduction the interview and the end

2 Conversational

3 Understanding the response techniques

4 Checking responses

5 Follow-up questions

6 Staying on track and getting back on track

7 Good Listening Skills

35

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 36: Smart Health Centers-Navigator Training

Module 2 Patient Feedback

bullComplete feedback form on all Encounters (manual) Spreadsheet

bullWithin a few months the feedback form will be electronic (Score card)

bullThis information is important feedback to report to project leadership and measure program effectiveness

36

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 37: Smart Health Centers-Navigator Training

Module 2 Patient Engagement Feedback

Date Start time Age Range Gender Topics discussed

Length of time with patient

(approximate) Navigator notesobservations

37

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 38: Smart Health Centers-Navigator Training

Module 2 Patient Engagement Role Play

38

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 39: Smart Health Centers-Navigator Training

Module 3 Basic Health Information amp Security of Health Information

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

39

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 40: Smart Health Centers-Navigator Training

LEARNING OBJECTIVES

40

bull Overview of the Affordable Care Act (ACA)

bull Overview the Health Insurance Portability amp Accountability Act (HIPAA)

bull Personal Health Records (PHR) Privacy and Security IssuesVideo

bull Overview of Government Insurance Marketplace amp County Care

bull Tips for Creating Private and Secure User IDs and Passwords

bull Privacy amp Security Clearing Your Internet Browser

Module 3 Basic Health Information amp Security of Health Information

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 41: Smart Health Centers-Navigator Training

Module 3 Affordable Care Act (ACA)

Health care reform refers to a federal law called the Affordable Care Act passed in March 2010

To most people health care reform means

New and better ways to get affordable health care coverage

More options for receiving quality medical care

As of January 1 2014 citizens are required to have health insurance or pay a penalty

The only people who wont have to buy health insurance or pay a penalty are

Those with certain religious beliefs

Members of Native American tribes

Undocumented immigrants

Those who are in prison

Those whose income is below a certain level

Those with pre-existing conditions

41

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 42: Smart Health Centers-Navigator Training

Module 3 HIPAA

HIPAA stands for the ldquoHealth Insurance Portability and Accountability Actrdquo a federal law passed in 1996

HIPAA imposes several requirements related to health insurance and health records

One aspect of HIPAA known as the Privacy Rule provides patients with certain rights with respect to their health information requires that health care providers protect the privacy of health information and requires that those working for health care providers be trained in policies and procedures related to maintaining privacy

This aspect of HIPAA went into effect on April 14 2003 and applies to health information in any form including paper electronic and verbal health information

42

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 43: Smart Health Centers-Navigator Training

Module 3 HIPAA (continued)Recently the HIPAA Security RuleHITECH Act went into effect which requires that electronic health information be maintained in a way that protects the availability integrity and confidentiality of these records

Individuals who will work with electronic versions of health information must also complete training on the HIPAA Security Rule which is available on-line or provided by their health care facility

43

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 44: Smart Health Centers-Navigator Training

Module 3 HIPAA (continued)What is ldquoProtected Health Informationrdquo

Comes from a health care provider or a health plan

Identifies an individual or

Could be used to identify an individual

Describes the health care condition or payments of an individual

Describes the demographics of an individual

44

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 45: Smart Health Centers-Navigator Training

Module 3 PHR Privacy and Security HIPAA features

Health Insurance Portability amp Accountability Act (HIPAA) 1996

Ensures portability of insurance coverage between jobs

Improves efficiency of health care transactions

Ensures security and privacy of health information

Covers electronic written and spoken medical information

Grants consumers right to request copies and change info

Protects how medical information is used

Protects who has access

45

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 46: Smart Health Centers-Navigator Training

Module 3 Privacy amp Security Issues Video

46

HIPAA SECURITY RULEhttpwwwyoutubecomwatchv=QWRn2r5R7tsampfeature=plcp

YOUR HEALTH INFORMATION YOUR RIGHTShttpwwwyoutubHIPAAwatchv=FKTHncn-5Vsampfeature=plcpSpanish httpwwwyoutubecomwatchv=moQvCt4stykampfeature=plcp

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 47: Smart Health Centers-Navigator Training

Module 3 Privacy amp Security

Virus software

Firewalls

Strong User idrsquos and passwords

Secure websites

Trusted emails and attachments

SSL certificates

Encryption

47

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 48: Smart Health Centers-Navigator Training

48

Module 3 Government Insurance Marketplaceorg

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 49: Smart Health Centers-Navigator Training

When deciding on a purchase as important as health insurance coverage you need to empower yourself with as much knowledge as possible Speaking with a licensed agent is always strongly recommended They can supply you with all the tools you need to make an informed decision and make you aware of health insurance options that you may not even know you have

Youve likely heard of PPOs and HMOs These are groups of doctors hospitals and medical specialists who provide health care services to members at a discount Before choosing a specific provider network check out how large it is and if there are participating doctors and hospitals close to where you live

49

Module 3 Government Insurance Marketplaceorg

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 50: Smart Health Centers-Navigator Training

Get Covered Illinoisgov

50

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 51: Smart Health Centers-Navigator Training

Get Covered Illinoisgov

51

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 52: Smart Health Centers-Navigator Training

Since lawmakers have passed the Affordable Care Act itrsquos gotten easier to shop for individual health care insurance Theoretically all you need to do is visit your statersquos Health Insurance Marketplace to compare plans get quotes and enroll in coverage But selecting a personal health care plan does require a certain level of contemplation ndash so make sure you take these factors into consideration when yoursquore shopping for health care for an individual

Outline Your Medical Needs for a Personal Health Care PlanThe first thing you should do when shopping for individual health care insurance is to identify your medical needs If yoursquore relatively young and healthy your medical needs may be minimal If yoursquore planning to start a family though you may need maternity coverage If you regularly take certain medications or have a pre-existing medical condition you need to factor in everything yoursquoll need your health insurance to cover Outline your medical needs and focus on those needs and costs when yoursquore comparing plans

Create Your Budget for Individual Health Care InsuranceFiguring out a budget for health care for individual needs is relatively simple Income minus expenses and a portion of whatrsquos left over should go to personal health care insurance If your needs are minimal a basic personal health care plan with a lower cost is probably right for you No need to overbuy If your medical needs are more complex though itrsquos worthwhile to pay more for individual health care insurance that will cover all of your medical costs

Walk Through Several PlansTake the time to fully walk through what your life would be like with a certain personal health care plan Do it again with a different plan With the passage of the Affordable Care Act insurers are required to issue a Summary of Benefits and Coverage or SBC that can help you understand coverage and compare scenarios under different health care plans Take the time to fully understand how each plan would fit with your lifestyle and needs before you make your final decision and enroll in your new health care plan

52

Module 3 MarketplaceHealth Insurance

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 53: Smart Health Centers-Navigator Training

Module 3 Creating and Managing User IDs and PasswordsFor internet sites creating a unique User ID and password is normal User IDs and passwords help protect the confidentiality of accounts and enables the website owner to verify identity This will be known only to the patient andor a family member or trusted friend should you choose to share it Be careful who you share this information Similar to your social security number or identification card be careful with who you share your information

It is not uncommon to have 5 10 20 or more sets of User ID and passwords for different websites and software applications Also some passwords expire and may have to be changed often A private and secure process to manage all your User ID and passwords is helpful Suggestions follow

Do not write down User IDs and passwords on paper or in a book where others can view it easily Writing down passwords and locking the list up somewhere is a good idea and secure

Storing them electronically in a file that is password protected is a good idea and often secure

53

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 54: Smart Health Centers-Navigator Training

Module 3 Tips for Creating Secure User IDs and PasswordsUser IDs and Passwords help protect the confidentiality of accounts and enables verification of identityFollow these tips to create a good user ID and password

Create a user ID that others cant guess but is easy for you to remember

Use a combination of letters and numbers (eg pat1sten10 or walk2dogs)

Many sites will ask users to use an email address for the User ID

Try not to use the same password for every User ID and Password combination

Avoid using family or pet names your birthday your anniversary or your social security number (It is too easy for others to guess)

Use a word you can remember but replace some of the letters with numbers(eg s1cr1t)

Users will often be given a set of instructions on how to create the User ID and Password for different sites likehellip

Your user ID must be 6ndash16 characters and can contain any character found on your computers keyboard except spaces As an added security measure your user ID and password cannot be the same

54

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 55: Smart Health Centers-Navigator Training

Module 3 Internet Browser

As you browse the Internet everything viewed is saved to the cache on the hard drive Loading from the cache helps everything load faster since it is loaded from the hard drive instead of from a server in a different part of the world To conserve hard drive space or keep your browsing private you can clear or delete the history (cache)

55

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 56: Smart Health Centers-Navigator Training

Module 3 Clear Internet BrowserMicrosoft Windows users running Microsoft Internet Explorer 6 and above can delete their history files by clicking the Tools menu Internet Options and clicking the Delete Files or Delete button Users also have the option of automatically deleting files each time the close the browser window by clicking the Advanced tab and checking Empty Temporary Internet Files folder when browser is closed under the Security section

56

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 57: Smart Health Centers-Navigator Training

Module 4 Basic Computer Skills

Basic Computer Module

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

57

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 58: Smart Health Centers-Navigator Training

Module 4 Basic Computer Skills

58

LEARNING OBJECTIVES

bull Learn Basic Housekeeping for Maintenance of Computer Area

bull Start Up Troubleshooting Turn Off Computer

bull Assess and Provide Basic Computer Skills to PatientsClients

bull Computer Hardware Software Using a Mouse Access Internet Browser

bull Navigating the Smart Health Center Landing Page

bull How to find Quality ldquoReliable and Accurate Health Informationrdquo

bull Sample Google Search Results for ldquoDiabetesrdquo

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 59: Smart Health Centers-Navigator Training

Module 4 Housekeeping ndash Daily Maintenance of Computer Area

59

bull NO FOOD or DRINKS in the computer lab bull Turn cell phones to vibratebull Respect all users time bull Respect the equipmentbull NO game playingbull Not for children usebull NO Personal emails or Websites

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 60: Smart Health Centers-Navigator Training

Module 4 Start Up Troubleshooting Turn off computer

60

bull The first activity of each day will be to turn on the Smart Health Center computers bull Equipment is to be powered off at the end of the day When working with patients

the computer will be turned on and working bull Laptops and tablets are stored in secure locked environment

bull Troubleshooting is a regular and normal part of the Health Navigator job bull Remaining calm when working with patients is very important bull Initiate troubleshooting steps for hardware software or internet problems included

in the handbook If not resolved1) ask the patient to return at a time convenient to them 2) contact the center IT support

bull The last activity of each day will be to exit all applications turn off the Smart Health Center computers and return laptops and tablets to their secure locked locations

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 61: Smart Health Centers-Navigator Training

PURPOSE To assess patientclientrsquos comfort level with computers

1 Do you own or have you used a computer before Score = 0

2 Do you have a smart phone Score = 2

3 Do you know the components of a computer Score = 4

4 Do you know how to access the internet Score = 6

5 Do you have an email account 5 Score = 8

6 Have you used a computer mouse before Score = 10

61

Module 4 Computer Knowledge

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 62: Smart Health Centers-Navigator Training

Module 4 Computer AssessmentPURPOSE Share skills with Health Navigator the higher the score the more basic skills training is required

LIMITED SKILLS USERS Go to Slides Labeled

ID essential parts of computermouse skills open internet browser Privacy amp security navigate landing page find quality health information

MORE EXPERIENCED USERS Go to Slides Labeled

Privacy amp security navigate landing page find quality health information

62

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 63: Smart Health Centers-Navigator Training

Mod 4 More Experienced Go to Navigating SHC Landing Page (Slide 70)

EXPERIENCED COMPUTER USERS

An answer of lsquoyesrsquo to either of these questions may indicate a person is familiar with a computer A patient comfortable using the computer can go to the section ldquoPrivacy and Securityrdquo As time permits introducing ldquoPersonal Health Records and Patient Portalrdquo in the next sections can motivate patients to return for more guidance on how technology can be used to take charge of their health Evidence shows patients who invest time reviewing organizing and keeping track of their medical records often receive improved quality care and have good health outcomes

Navigating Smart Health Center Landing Page Finding Quality Health Information

63

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 64: Smart Health Centers-Navigator Training

Module 4 Limited Computer Skills Go to Slide 65

COMPUTER USERS WITH LIMITED SKILLS

Patient encounter(s) where there is limited familiarity with a computer may need review of basic information on the parts of a computer using a mouse and accessing the internet first On average this is about the amount of time available to spend with a patient in an initial session As time permits patients can be invited back to learn ldquoHow to create Personal Health Records and Patient Portalrdquo

ID computer HDW SFW Using a mouse Accessing the Internet Navigating Smart Health Center Landing Page Finding Quality Health Information

64

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 65: Smart Health Centers-Navigator Training

Module 4 Computer Hardware

65

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 66: Smart Health Centers-Navigator Training

Module 4 Computer Software

66

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 67: Smart Health Centers-Navigator Training

Module 4 Using a MouseUSING A MOUSE - New or limited skilled computer users are known to take extra time to acquire the skill of using a mouse Placement of the mouse in the hand and pressing the correct button requires time and patience

Step 1 Relax your hand over the mouse with your index and middle fingers over the two control buttons

Step 2 You will use your index (ie pointing) figure to ldquoclickrdquo on the mouse and make your selections

Step 3 Moving the whole mouse on the pad will move the arrowcursor on the screen

Basic procedures to practice these skills are included in the following links

Two additional good websites for practicing mouse skills are Mousarobicshttpwwwskywaysorgcentralmousepage1html and Mouse Exercises

Source Chris Rippel Central Kansas Library System Great Bend Kansas crippelcklsorg httpwwwskywaysorgcentralmousepage1html

Source Mouse exercises developed by Vic Laurie Ewing Learning Center for SeniorNet httpwwwseniornetorghowtomouseexercisesmousepracticehtml

67

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 68: Smart Health Centers-Navigator Training

Module 4 Opening An Internet Browser

An internet browser allows access the internet Most common ones are Microsoft Internet Explorer Firefox and Google Chrome Macrsquos Safari is popular as well however they are not currently deployed in the Smart Health Centers Use Internet Explorer (or the browser of your choice) You can open the browser by double-clicking on the ICON or going through the Start menu to open up the Internet

68

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 69: Smart Health Centers-Navigator Training

Module 4 Open an Internet Browser

An internet browser allows access the internet Most common are Microsoft Internet Explorer FireFox and Google Chrome Mac Safari is popular as well however Macrsquos are not currently deployed in the Smart Health Centers The internet browser at the Smart Health Center should always be open and available These computers automatically go to the Smart Health Centers page wwwsmarthealthcenterscom

69

Use Internet Explorer (or the browser of your choice) Open the browser by double-clicking on the ICON on the desktop or going through the Start menu to open up the Internet Common internet activities are searching for general information and health information researching a product or service buying a product or service checking weather and news If you know directly where you want to go you can enter the address

(wwwsmarthealthcenterscom )

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 70: Smart Health Centers-Navigator Training

Mod 4 Navigating the Smart Health Centers - Landing Page

70

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 71: Smart Health Centers-Navigator Training

Mod 4 Navigating the Smart Health Centers Landing Page

71

httpsmart-health-centerssmartchicagoappsorg

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 72: Smart Health Centers-Navigator Training

72

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 73: Smart Health Centers-Navigator Training

Mod 4 Navigating the Smart Health Centers Landing PageAdult Health

wwwfamilydoctororg

wwwcdcgov

wwwNorthwesternhospitallearningcenterorg

Pediatric Health

wwwHealthychildrenorg

wwwFamilydoctororg

wwwKidshealthorg

Teen Health

wwwbedsiderorg

wwwyoungwomenshealthorg

wwwadvocatesforyouthorg

wwwsexedlibraryorg

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

73

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 74: Smart Health Centers-Navigator Training

Womens Health

wwwwomenshealthgov

wwwFamilydoctororg

Chronic Disease

Diabetes ndash wwwdiabetesorg

Heart Disease ndash wwwheartorg

Cancer ndash wwwcancerorg

wwwcdcgovDiseasesConditions

wwwwinniddknihgovpublicationsindex

htmpublic

PrenatalPregnancyBreastfeeding

wwwbabyfriendlyusaorg

wwwacogorg

wwwwomenshealthgovpregnancy

wwwlalecheleagueorg

Oral Health

wwwhealthyteethorg

74

Mod 4 Navigating the Smart Health Centers Landing Page

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 75: Smart Health Centers-Navigator Training

Mod 4 Navigating the Smart Health Centers Landing Page

Nutrition

wwwcloccnet

wwwcspinetorgsmartmouthindex1html

wwwchoosemyplategov

wwwwomenshealthgovbodyworks

wwwhealthyfoodshealthymovesorgabout-ushtml

Physical Activity

wwwcloccnet

wwwstartwalkingnoworg (English only)

wwwbamgovsub_physicalactivity ndash for kids (English only)

wwwwinniddknihgovpublicationsindexhtmpublic

Stop Smoking

wwwcancerorgHealthyStayAwayfromTobaccoGuidetoQuittingSmokingindex

wwwsmokefreegov

HIVAIDS

wwwmedicinenetcomhuman_immunodeficiency_virus_hiv_aids

Community Resources

httpweconnectchicagoorg

75

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 76: Smart Health Centers-Navigator Training

Module 4 Finding Quality Health InformationFINDING QUALITY HEALTH INFORMATION

The providers nurse health center administrators pharmacists dentists and ophthalmologists at your location have carefully selected web health information sites that are trusted reliable and great sources of information for you and your family

Your Community Health Center or our sponsors do not have any financial or personal interests in these websites The content is solely the property of the vendor Please check with your provider for further discussion about articles and topics that appear on these websites Read the information carefully to increase your health care knowledge Remember to check with your provider before changing any treatment plans

76

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 77: Smart Health Centers-Navigator Training

(Regular Internet Search)

When looking up health information use the suggested

Quality Information Checklist to find reliable accurate health information

Yes No

_____ _____ radic Can you read and understand the website

_____ _____ radic Is the purpose of the website clear

_____ _____ radic Is the website easy to use

_____ _____ radic Is the website written by an organization or person you can trust

_____ _____ radic Is the information biased in anyway

_____ _____ radic Has the website been updated recently

______ ____ radic Is the information correct and error-free

Source River Valley Healthy Communities Coalition Rumford Maine Who Can You Trust httpwwwrvhccorgpdfHIL_Sourcebookpdf

77

Module 4 Finding Reliable and Accurate Health Information -Checklist

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 78: Smart Health Centers-Navigator Training

For an activity letrsquos try to identify good and poor sources of reliable information on the internet A popular search topic is normally a population or health topic Examples follow

Population or Community TypehellipMen Women Teens Children Seniors

By topichellipDiabetes Heart Disease High Blood Pressure

Go to google (wwwgooglecom) and type in ldquodiabetesrdquo as search criteria

1 What were the first two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

2 What were the next two or three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

3 What were the next group of three websites that appeared

Measure the first two or three websites with the suggested Quality Information Checklist Share your findings

78

Module 4 Finding Reliable and Accurate Health Information

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 79: Smart Health Centers-Navigator Training

Mod 4 Google Search for ldquoDiabetes

79

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 80: Smart Health Centers-Navigator Training

80

Mod 4 Activity - Accurate Health Information

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 81: Smart Health Centers-Navigator Training

Module 5 Health Information Technology and Personal Health Records

81

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 82: Smart Health Centers-Navigator Training

LEARNING OBJECTIVES

bullRecognize Health Information Technology (HIT) terms and acronyms

bullIdentify HIT at the Federal State and Local Level

bullUnderstand the similarities and differences in Electronic Medical Records (EMRs) Electronic Health Records (EHRs) and Personal Health Records (PHRs)

bullName the benefits of PHRs for Patients and Providers

bullRecognize common contents and elements of PHR systems

bullIdentify Privacy and Security PHR issues

bullCreate a PHR

82

Module 5 Health Information Technology and Personal Health Records

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 83: Smart Health Centers-Navigator Training

Module 5 Introduction

Utilizing the latest technology at theSmart Health Centers the HealthNavigator will invite patients to learnhow creating PHRs can help them takecharge of their health receive efficientcare and track all their health careencounters through their entire healthcare spectrum Patients will be able toshare this information with providers tohelp them coordinate their careefficiently help providers gain a timelyand current view of their health statusand help them develop the mostaccurate diagnosis and treatment plan

83

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 84: Smart Health Centers-Navigator Training

Mod 5 Introduction to Health Information Technology (HIT)

84

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 85: Smart Health Centers-Navigator Training

Mod 5 Introduction to Health Information Technology (HIT)

HIT is the use of electronic hardware software and technologies used to manage and share patient information electronically rather than through paper records

Health IT is designed to improve patient safety health care quality efficiency and data collection and decrease health care costs

85

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 86: Smart Health Centers-Navigator Training

Mod 5 HIT Federal Governance

86

The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administrationrsquos health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care ONC is organizationally located within the Office of the Secretary for the US Department of Health and Human Services (HHS) ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information

Source httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 87: Smart Health Centers-Navigator Training

Module 5 HITState and Local Governance

87

In Illinois at the state and local level the entity for overseeing HIT planning implementation maintenance and sustainability is the Illinois Office of Health Information Technology (OHIT) They have the responsibility for building the Illinois Health Information Exchange (ILHIE) secure state electronic network that will be used to share the personal health information for patients and consumers among health care providers in Illinois

Source httpwww2illinoisgovgovHIEPagesOHITaspx

Illinois Office of Health Information Technology

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 88: Smart Health Centers-Navigator Training

Module 5 HIT Video

88

httpwwwhealthitgovpatients-familiesmultimedia

Brochure httpwwwhealthitgovsitesdefaultfilesconsumerfactsheetfinalpdf

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 89: Smart Health Centers-Navigator Training

Module 5 Paper Medical Records now Electronic Medical Records

Personal health information in a patient medical chart includes identifying information (name date of birth gender ethnicity) demographics insurance emergency information provider information allergies medical conditions medication tests labs and more This information is being converted from a paper chart to various electronic versions of the record namely an EMR EHR or PHR

EMR - Electronic Medical Record EHR - Electronic Health Record PHR ndash Personal Health Record

89

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 90: Smart Health Centers-Navigator Training

Module 5 Types of Medical Records

90

Electronic Medical Record Electronic Health Record Personal Health Record

SIMILARITIES

An electronic record of

health-related information on

an individual that can be

created gathered managed

and consulted by authorized

clinicians and staff within one

health care organization

An electronic record of health-

related information on an

individual that conforms to

nationally recognized

interoperability standards and that

can be created managed and

consulted by authorized clinicians

and staff across more than one

health care organization

An electronic record of

health-related information on

an individual that conforms to

nationally recognized

interoperability standards and

that can be drawn from

multiple sources while being

managed shared and

controlled by the individual

DIFFERENCES

MANANGED BY

created gathered managed

and consulted by authorized

clinicians and staff

created managed and consulted

by authorized clinicians and staff

managed shared and

controlled by the individual

DIFFERENCES

NUMBER OF

ORGANIZATIONS

INVOLVED

within one health care

organization

across more than one health care

organization

can be drawn from multiple

sources

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 91: Smart Health Centers-Navigator Training

Mod 5 Personal Health Records ndashPHRs

Tool that gives patients the opportunity to collect store track and share important up-to-date information about the health encounters for themselves or someone under their care

The patient controls and grants access to only those they trust

PHRs were once paper based repository systems and are now stored on computers available online and are web-based

Some are free and some are available for a fee

They are available online by third party vendors

Privacy and Security requires consumers to select trustworthy reliable systems

91

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 92: Smart Health Centers-Navigator Training

Module 5 Benefits of PHRbullTrack health information from multiple providers in different systems in one convenient location

bullThe patient creates manages and controls PHR and content

bullThe patient controls who has access to the personal health information

bull Information is quickly and easily accessible for sharing with hospitals providers and other health care stakeholders on the spot

bullThe patient can correct information keep it accurate and up-to-date anytime

bull Information is always accessible nights weekends holidays as long as the Internet is up

bullA history of test results lab reports and immunization records are available

bull This can eliminate duplicated tests

bullMedication errors can be reduced when a provider has up-to-date current information on medications and allergies

bullParticipating in this type of self management empowers patients to take charge of their health

92

httpwwwyoutubecomwatchv=jQJVceBNXFYAHIMA What a PHR Can Do For You

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 93: Smart Health Centers-Navigator Training

Module 5 Privacy and Security Issues of PHRs

Protecting personal health information

Patient responsibility and tips Read user agreements and policies

Understand who has access to your information such as vendor staff their partners and if they share information with anyone

Practice basic security measures - strong passwords share only with authorized contacts use trusted secure sites

3rd party vendors who sponsor PHR systems are NOT HIPAA covered entities

93

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 94: Smart Health Centers-Navigator Training

Module 5 Activity ndash Creating a PHR

94

How it works HealthVault lets you gather store use and share health information for you and your family putting you in control of your health information

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 95: Smart Health Centers-Navigator Training

Mod 5 Activity--Creating a PHR

95

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 96: Smart Health Centers-Navigator Training

Mod 5 Activity ndash Creating a PHR

96

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 97: Smart Health Centers-Navigator Training

Mod 5 Activity ndash Creating a PHR

97

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 98: Smart Health Centers-Navigator Training

Mod 5 Activity ndash Creating a PHR

98

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 99: Smart Health Centers-Navigator Training

99

Mod 5 Activity Creating a PHR

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 100: Smart Health Centers-Navigator Training

Module 6 Patient Portal

PATIENT ENGAGEMENTHOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

100

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 101: Smart Health Centers-Navigator Training

LEARNING OBJECTIVES

bull Define Patient Portal

bull Describe the Similarities and Differences in Medical Records and Patient Portals

bull Define the Benefits of Patient Portals

bull Recognize How it Works

101

Module 6 Patient Portal

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 102: Smart Health Centers-Navigator Training

Module 6 Patient Portal

ldquo a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web siterdquo

HIMSS definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

102

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 103: Smart Health Centers-Navigator Training

Module 6 Patient Portal How it Works

Patient Portal systems vary Each organization has the ability to design personal processes

Step 1 Register by requesting or receiving a PIN User ID andor password from your health care provider

Step 2 Access the online web address location on the Internet

Step 3 Enter information at the field upon request Information can include PIN or access code name date of birth userid and password

Step 4 Answer any questions for creating security questions and answers

Step 5 Read review and accept or decline any terms and conditions such as consent form governing the conditions for the patient portal usagepolicy for responding to communication from the patient the policy for communicating with any partners or other external organizations how email communication is handled and security and confidentiality policies

103

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 104: Smart Health Centers-Navigator Training

Mod 6 Similarities amp Differences of Medical Records and Patient Portals

DEFINITION

From the HIMSS definition a patient portal is the starting point for a patient to find information set appointments review lab results andor view general health information on a physician or hospital Web site (or Electronic Health Record)

SIMILARITIES

The Patient Portal is one view usually a limited view of the patientrsquos health care sponsored EMR It is the same (similar) data from the EMR which the provider health care center or hospital owns and manages

DIFFERENCES

It is not affiliated with the Personal Health Record which the patient owns and manages The same information can be contained in other records

It is up to the patient to obtain the information from the provider

It is up to the patient to get the information into the PHR

It is up to the patient to share personal health information that the provider does not have

It is not a total full access view to the health care sponsored EMR or EHR

104

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 105: Smart Health Centers-Navigator Training

Module 6 Benefits of Patient Portals for Patients and Providers

Patients can schedule appointments check appointment schedules or request an appointment at their convenience

Patients can examine and pay their statements

Patient and Provider secure communication

Allows a patient to request a prescription refill

Patients receive reminders and other notifications securely

Patients can complete and update medical record information and forms at their convenience

105

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 106: Smart Health Centers-Navigator Training

Module 6 Privacy and Security Issues of Patient Portals

Healthcare facilities have securely designed systems that protect the EMR from the portion patients are able to access

Healthcare facilities have in place User agreements and policies explaining protections

Secure logon protection and authentications

Limited permissions for who has access to your information

Patients have responsibilities Practice basic security measures - strong passwords share only with

authorized contacts use trusted secure sites

106

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 107: Smart Health Centers-Navigator Training

Module 6 Privacy and Security Issues of Patient Portals

All messages sent between Providers and Patients are sent by secure messaging Secure messaging is the secure and protected transmission of information between patients and their providers including clinicians and their support staff

Traditional email messaging is not performed

HIPAA continues to impose rules and regulations that improve and protect patients privacy and security in health information exchange

HIPAA requires special security authentications for anyone accessing EMR systems remotely

HIPAA requires tracking of personnel dates and times to EMRs

107

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 108: Smart Health Centers-Navigator Training

Module 6 Patient Portal Overview

Patient Portal is a database-driven software application that allows you to build an interactive secure patient Web site

The patient portal is integrated with your existing clinic health record systems so that your patients can access select parts of their medical information

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 109: Smart Health Centers-Navigator Training

Module 6 Patient Portal

From the portal patients can complete secure online forms that are integrated with the EMR

Patients can also view their secure messages from your practice

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 110: Smart Health Centers-Navigator Training

Mod 6 Patient Portal DEMONSTRATION Sample Community amp Patient Activities on the Portal

Sample Community content

Sample Patient Activities on the portal View Medical Record Summaries

Refill a Prescription

Fill out forms amp sign them

Use home monitoring forms

Get directions to your office

110

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 111: Smart Health Centers-Navigator Training

Mod 6 Patient Portal Attach Chart Summary

Chart Summary includes demographics and structured clinical data such as problems meds allergies

Can be attached as text or in CCR (Continuity of Care Record) or CCD (Continuity of Care Document) structured data format

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 112: Smart Health Centers-Navigator Training

Module 6 Most Common Elements of Patient Portals

Home page of the patient portal

112

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 113: Smart Health Centers-Navigator Training

Mod 6 Most Common Elements of Patient Portals

113

Viewing portions of the medical record chart summary includesbull conditions medicationsbull immunizations allergies bull test results and past history

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 114: Smart Health Centers-Navigator Training

Module 6 Most Common Elements of Patient Portals

Sending or reviewing messages from provider

Request refills on prescriptions

Scheduling or cancelling appointments

Bill pay and statement viewing

114

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 115: Smart Health Centers-Navigator Training

QUESTIONS amp ANSWERS

Thank you

Diana Beasley (Management Synergistics Inc and CCT)

synergy033aolcom

115

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 116: Smart Health Centers-Navigator Training

REFERENCESBerthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p13) San Francisco CA Jossey-Bass

US Department of Labor Bureau of Labor Statistics ( 2010 March 11) Standard Occupational Classification -21-1094 Community Health Workers Retrieved from httpwwwblsgovsoc2010soc211094htm

Berthold Miller amp Avila-Esparza (2009) The Role of CHWs Foundations for Community Health Workers (1st

ed) (p15) San Francisco CA Jossey-Bass

Latitude Learning is a Learning Management System site that offers self-paced training courses in communication customer service diversity and more ( httpwwwlatitudelearningcom )

American Medical Association Cultural Competency definition Retrieved August 2 2012 from wwwcshumneduModulesculturecompcp01html

Cultural Competence Photo google images commonwealthfundorg

National Network of Libraries of Medicine (2012) Definition Health Literacy Retrieved August 10 2012 from httpnnlmgovoutreachconsumerhlthlithtml (excerpt article originally produced by Penny Glassman former Technology Coordinator National Network of Libraries of Medicine New England Region Shrewsbury MA)

Saint Vincent Charity Medical Center (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10 2012 from httpwwwstvincentcharitycomprograms-servicescenters-excellencehealth-literacywhat-isaspx

Kelly Mc Quillen amp Connie Davis BC Health Literacy Prototype - Patients as Partners in Primary Health Care Health Literacy Umbrella (p 36) Retrieved August 10 2012 from httpwwwphabcorguserfilesimageMcQuillenpdf

116

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117

Page 117: Smart Health Centers-Navigator Training

REFERENCES

Stoney Brook University School of Medicine Transtheoretical Model (Stages of Change) Photo Retrieved August 20 2012 from httpmedicinestonybrookmedicineeducolorectalcancerModuleIItranstheoretical_model

Domain Uniform Resource Locator (suffix) Retrieved June 20 2012 from httpwwwdomainregistercomcomorghtml

Robin A Cohen PhD amp Patricia F Adams (July 21 2011) Use of the Internet for Health Information United States 2009 Retrieved July 5 2012 from httpwwwcdcgovnchsdatadatabriefsdb66htm

River Valley Healthy Communities Coalition (2009) Rumford Maine Who Can You Trust Health Information and the Internet Retrieved June 15 2012 from httpwwwrvhccorgpdfHIL_Sourcebookpdf

The Office of the National Coordinator for Health Information Technology (2012) ONC definition Retrieved July 12 2012 from httphealthithhsgovportalserverptcommunityhealthit_hhs_gov__onc1200

Illinois Office of Health Information Technology (OHIT) ILHIE definition Retrieved July 12 2012 from httpwww2illinoisgovgovHIEPagesOHITaspx)

Patient Portal Himss definition httpwwwhimssorgdigital_office20071127_DigitalOfficehtm

117