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By Sarah C. Threnhauser, MPA

For the most part, executives of health and human service organizations haven’t viewed electronic health records (EHR) as a tool for improving staff satisfaction or consumer engagement.

Most of the coverage about clinical professionals’ views of EHRs are pretty negative—see Survey: Ophthalmologists hold negative perceptions of EHRs, 92% of Nurses Dissatisfied with EHR Technology, Health IT, and Patient, Physician Satisfaction with EHR Systems Remains Low. And, even though consumer engagement is more important than ever to improve self-care and improve outcomes, consumers’ satisfaction with their ability to access their own health data is mixed. Recent surveys show that, in 2014, nearly 4 in 10 Americans were offered electronic access to their medical record—and only half of those individuals their record at least once within the year (see Trends In Consumer Access And Use Of Electronic Health Information). The research also shows that some vulnerable populations—especially Medicaid beneficiaries, low-income individuals, the uninsured, Spanish speakers, and family caregiver—are “health information-compromised.”

As health care becomes more information-intensive, the most vulnerable consumers risk poorer care access, potentially higher costs, and a greater burden of disease (see Right Place, Right Time: Health Information & Vulnerable Populations). What consumers want in health information is straightforward—easier access to clinical professionals, financial transparency, improved communication, and mobile-friendly formats. All of this presents a challenge for managers, who are trying to bridge the consumer information and engagement gap with EHRs they aren’t satisfied with (see Less Consumer Education Demands More Consumer Engagement and From Consumer Engagement To Consumer Activation).

But there are EHR deployment practices that can improve both staff satisfaction and consumer engagement. That was the message in The 2018 OPEN MINDS Management Best Practices Institute session, Increasing Client & Staff Engagement Through Creative Use Of Technology, featuring Matt Chamberlain, Chief Operating Officer, Welligent; Heather Rudolph, President, RCI; Gaston Nguyen, Ph.D., Director of Electronic Health Information Management Department, Pacific Clinics; and Yamile Arriola, Project Manager, Pacific Clinics. They identified five key criteria for data—accessible, actionable, timely, engaging, and reusable—to make this happen.

Accessible—Data must be available “on-demand”, when it is needed, regardless of consumer or staff location. Whether in the “office”, or in the field, consumers and staff need access to information in order to make decisions.

Actionable—The system must “interpret” the data and prompt staff and consumers to act. These reminders assure that consumers don’t need to be reminded about remaining engaged or that staff don’t forget important clinical information.

Timely—These “action insights” need to be delivered to consumers and staff at the right time, allowing quick response.

Engaging— EHRs have traditionally been designed to meet specific business needs and functional requirements. Platforms developed for staff and consumers must be easy to access, easy to use, and help to “interpret” information and prompt interaction and action. Some examples of engaging features in these platforms include mapping appointment location; online surveys; real-time access to health records; access to medication lists; access to educational materials; and enhanced communication between members of care teams and consumers and caregivers.

Reusable—To make the return on investment on any of these initiatives work, consumer and staff platforms need to be based on using existing EHR data, and factor in on-going labor costs associated with recruiting consumers and maintaining consumer involvement.

Pacific Clinics in Los Angeles is a great example of how to leverage EHR data for better consumer and staff engagement. They serve 22,500 consumers each year by providing mental health, substance use treatment, housing, and employment services, across four counties. Pacific Clinics recently launched an online consumer portal to allow consumers to have real-time access to their health care records, as well as medication lists, educational materials, appointment location mapping, and customer satisfaction surveys. To get consumers engaged and using the portal, they started by targeting a specific group for participation: consumers that were receiving medication services—with the goal of getting 5% of consumers to use their portals. Ms. Yamile explained, “Our support staff was trained at a central location to the point that they felt comfortable enough to go back to their own sites. Our department tracked the enrollment status because we wanted to make sure we were on track for the minimum five percent. Some hit up to 32%.”

Dr. Nguyen explained that with a project this size, the communication and support is critical, as is the buy in from staff throughout the organization. Educating the consumer and the staff is critical, as is the ability to customize the platform to make it as user-friendly as possible; e.g., what do you want the consumer to see, how will they enroll or disenroll, how will that be managed? Dr. Nguyen explained, “We had to change our intake process, with new agreements and consent forms. Decide how you will manage the workflow when things go wrong. We then thought about the promotion part. How we get it out to the consumers, and the training they need to use it. We spent months on the promotion part to get the excitement up about the coming tool.”

For more on building your own consumer engagement strategies and platforms, check out these resources from the OPEN MINDS Industry Library:

  1. Integration, Interoperability & Consumer Engagement
  2. Keys To Incorporating ‘Self-Determination’ Into Your Services
  3. Consumer Satisfaction, Consumer Engagement & Shared Decisionmaking
  4. How Do Consumers Pick A Provider? It’s Often Not Quality
  5. 7 Must-Have Qualities That Drive Employee Engagement – White Paper Released By OnShift
  6. 7 Must-Have Manager Qualities That Drive Employee Engagement
  7. Increasing Client & Staff Engagement Through Creative Use Of Technology
  8. Innovation Defined: ‘Useful, Actionable, Efficient’
  9. Tech-Enabled Intervention Reduces Adolescent Postdischarge Suicide Attempts
  10. UCSF Partners With Dignity Health On Digital Platform Designed For Frictionless Consumer Engagement

For more on this developing and important discussion on data management and access in the health care landscape, join us on October 23 at The 2018 OPEN MINDS Technology & Informatics Institute for the session, “The Challenges Of Data Management In A Digital World: An Executive Discussion On Security, Privacy, & Consumer Control.”

Editor’s Note: This article originally reported that Pacific Clinics serves 12,000 consumers each year. The article was updated on September 16, 2018 to report that the Pacific Clinics serves 22,500 consumers each year.

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