Jerry and JoGale Ray, aka Mr. and Mrs. Santa Claus, get a smile from patient Caleb Sean Randolph, five months, during a visit to the pediatric clinics at Medical Center East last week.
photo by Anne Rayner
New Web tool unites patients, clinical teams
These days everything from the bank to the library to the IRS has a Web-based interface to improve customer access.
“Why not your doctor's office?” asks Jim N. Jirjis, M.D., assistant chief medical officer and director of the Adult Primary Care Center.
To answer that question, Vanderbilt University Medical Center has begun to give patients secure access via the Web to the electronic messaging function in StarPanel, Vanderbilt's innovative electronic medical records and clinical workflow application.
Physicians say the move is a prelude to major advances in patient education, disease management and clinic efficiency.
“This represents immediate improvement of communication with patients, with zero additional costs in the clinic and great potential for helping us guide patients to effective self-care,” said Jirjis, a clinician partner for development of StarPanel and electronic patient messaging. “It's this type of innovative support for quality outcomes that I believe distinguishes Vanderbilt from all other health care competitors.”
Dario A. Giuse, Ph.D., the expert who leads development of VUMC medical records applications, said he knows of no other medical center that has pursued this level of integration of patient messaging with the electronic medical record.
“Once we get patients to the site, the sky's the limit,” Jirjis said.
Highlights of the new system include:
• Based on diagnoses and other information in a patient's electronic medical record, the system can send targeted patient teaching materials automatically, and it can send automatic reminders to chronic disease patients who are due for testing.
• The tool will aid patient monitoring and gathering of outcomes data: clinics will be able to send out Web-based forms that patients will use to document blood pressure, postop recovery and quality of life; patients with diabetes will be able to plug in their home glucose monitors to send results directly to the medical record.
• For any patient who is a registered user, VMG subspecialty groups will be able to send electronic intake forms prior to the initial clinic visit.
• Patients will be able to submit updates to their medical history.
• Perhaps most frequently of all, patients will use the site for sending routine requests for prescription refills, clinic visits, and information about their non-emergent medical conditions.
“This will free phones for more complex and urgent matters,” Jirjis said. “With patient messages being triaged by the team in the clinic, only a fraction of patient requests may need physician attention.”
Developers stressed that messages from patients won't go directly to doctors' own StarPanel message baskets, but will go instead to the message baskets of nurses or other staff whom clinic managers and doctors designate to receive patient messages.
While StarPanel message baskets have long allowed secure intradepartmental communication of electronic patient information, the application hasn't previously allowed physicians to send patient information to colleagues in other Vanderbilt departments. As an aid to in-house referral and consultation, StarPanel interdepartmental messaging will roll out in anticipation of patient messaging.
“Doctors will love it,” Jirjis said. “This will allow clinicians who work together to share vital information more easily.” As with patient messaging, message baskets will be specially designated for incoming interdepartmental StarPanel messages.
StarPanel patient messaging has spread through a portion of the Adult Primary Care Center and will be available for use by other clinical services this year. The plan is to take it housewide by April, when a federal law will go into effect making it illegal for providers to put patients' personal health information into e-mail.
“We haven't encouraged the use of e-mail for patient messaging because it lacks secure patient privacy. This new Web tool provides our first real opportunity to promote secure electronic information exchange with patients,” Jirjis said.
When the rollout is complete, patients will be able to register online and will reach their Vanderbilt electronic message baskets through the My Health at Vanderbilt Web portal (myhealthatvanderbilt.com). The portal is already open to all patients for viewing their VUMC billing information, sending questions to the billing office, paying bills electronically and viewing their schedule of clinic visits.
“From a patient's perspective, compared with waiting on the phone to speak with the nurse or whomever, this is a much better use of my time,” said David M. Dilts, Ph.D., professor of Management of Technology in the Department of Electrical Engineering and Computer Science.
Dilts studies the development and adoption of technology, and it happens that he is among 160 patients now using Vanderbilt patient messaging. “I can send a message and go about my business, knowing that I'll be notified as soon as a response becomes available,” he said. “I also like the way the site allows me to keep track of correspondence with physicians and with the billing office.”
The patients, staff and faculty who helped develop and test the tool have agreed that, at least for the time being, it will not include automatic patient access to the entire electronic medical record. Also, the system will allow patients to send messages only to those Vanderbilt doctors whom they've seen recently or are scheduled to see in the future.