Reference no: EM133949342

Use Case Example 1: Institution X has fully integrated PROs in its EHR and they have an active patient portal. During clinic visits, patients are encouraged to sign up for the patient portal and provided with a brochure that explains all the things that can be done with the portal including completion of questionnaires. On the portal itself, there is a video that will help patients learn how to navigate around the portal as needed. Appointment reminders, both electronic and print, notify patients if they have a questionnaire to complete prior to their appointment. Using this approach has enabled a significant percentage of patients to complete questionnaires asynchronously from appointments and/or prior to appointments, thus resulting in less disruption of workflows on the day of the clinic visit. Patients who choose this option rarely require specific training. Those who present for appointments without having completed an assigned questionnaire are presented with a tablet by the receptionist and they complete the questionnaire in the waiting area prior to being escorted to the exam room. Little training is required in use of the tablet. If assistance is needed, then a member of the care team (not the receptionist) will assist the patient. The EHR immediately scores the questionnaire and results are available for review by the provider or other care team members immediately.

Use Case Example 2: Institution Y has fully integrated PROs in its EHR, supporting collection of PRO data from patients via the patient portal, smart phones, and tablets at the time of the visit. Providers and staff have been trained how to "order" PROs either synchronous with an encounter or asynchronous via a message to the patient portal. Other providers have worked with the IT team to develop custom logic that will automatically attach a PRO to a visit or send out a PRO to a cohort of interest. Providers and staff have also been trained to know where to look in the EHR to find the results. This training has been done with a) small groups, b) one-on-one at the elbow support, c) peer-to-peer training, and d) the development of videos available on the organization's intranet. The core PRO team has a dashboard to monitor PRO completion rates and, where there are low rates, can supplement training to those groups or individuals to troubleshoot. Providers and staff have also been trained how to use documentation tools to more efficiently find results and share them with patients. PRO score interpretation is built into the results report and several PROs have associated triggers to drive alerts and best practice advice within the EHR. In one instance, such advice was not provided and resulted in a temporary influx of consults to a supporting service. The problem was immediately addressed by re-visiting the training and alerts to ensure they were providing optimal support to frontline teams.

1. Which would you recommend for use with your patients?

2. Sign up for the patient portal available through your own healthcare provider.

3. Describe the functions available.

4. Enter some real or fake health data. (Don't tell us the details.)

5. Which types of data would you likely share with a primary care provider or ED?

6. Which types of data would you likely want to find as an advanced practice nurse?

7. Is there any patient education material available in the portal? Where is it? If not there, what information would you want and where would you put it?