Session _852 Successfully Implementing My HealtheVet on a

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Session _852 Successfully Implementing My HealtheVet on a Powered By Docstoc
					           Session # 852

 Successfully Implementing
My HealtheVet on a Shoestring
“string or cord used for lacing and fastening…”




Ref: www.freedictionary.com

                                                  2
     Ground Rules
• Please write any questions on the 3x5
  cards provided
• Room assistants will collect the cards and
  as time permits, we will attempt to respond
  to all questions
• If we run out of time, your questions and
  answers will be posted on the VeHU
  website


• Learn lots and have fun!!
                                            3
     Today‟s Objectives

• Learn how to build a successful
  My HealtheVet Team environment

• Learn how to create a supportive
  atmosphere for My HealtheVet

• Explore co$t effective implementation
  $trategie$

                                          4
      Our My HealtheVet POC Presenters

Marsha H. White, MLS, MHSE, CHES
Medical & Patient Health Librarian
Gainesville Florida




                                         5
Lisa Kendziora
Patient Advocate
Erie, Pennsylvania




                     6
Micki Wheaton, RN, MSN
Patient Health Education Coordinator
Ann Arbor, Michigan




Micki‟s great, great, great, great,
great, great, great Aunt Mable


                                       7
The North FL/South GA Veterans
        Health System
     Marsha White, MLS, MHSE,
              CHES
9
     Getting Started
• What to do first?
• Chief of Outpatient Pharmacy
  – primary motivator
• Rx Refill our main focus - at least in the
  beginning
• „On-hold‟ message about Rx Refill




                                               10
"Did you know that the VA now has
My HealtheVet, an internet site where you can
find reliable heath information, get news of
interest to veterans, and order your prescription
refill requests online? You can also check the
status of your refills and view your entire
prescription history right on your computer. Log
on to this site by visiting www.myhealth.va.gov.
Registering is quick and easy and ordering refills
takes just a few clicks of your mouse. Why not
give it a try today?"
                                                 11
         Our Approach: “Quasi-traditional”
•   Good morning to all -
•   I am trying to get a work team together to help the My HealtheVet program get off to a
    great start here at NF/SG Veterans Health System. The only real requirements to join
    our team are enthusiasm and a desire to help veterans use My HealtheVet to its full
    potential.
•   Initially, we would meet face-to-face several times to discuss a kickoff and publicity, but
    much of what we discuss can be done via email. You would be expected to help (or
    send people to help with the actual celebratory activities but, otherwise, time demands
    should be relatively minor.
•   I think you would be a definite asset to this team and hope you will join us.
•   Please let me know if you would like to be part of our My HealtheVet team.


•   Marsha



•   Marsha H. White, MLS, MHSE, CHES
•   Medical and Patient Health Librarian
•   Library Service (142D)
•   North Florida-South Georgia Veterans Health System
•   1601 SW Archer Rd.
•   Gainesville, FL 32608-1135                                                                    12
•   (352) 376-1611 ext. 6314
      Our Approach: “Quasi-traditional”
• Multidisciplinary      • Members:
  Work Team since          – Pharmacy
  2005                     – Social Work
• Met monthly at first     – Information
                             Management
• Now - ad hoc only
                           – Clinical Informatics
• Primary means of
                           – Voluntary Service
  communication:
                           – Nursing
  via Outlook              – Mental Health
  mailgroup                – Medicine



                                                    13
     Management Buy-In
• Our implementation plan
  – NF/SG VHS
  – VISN 8

• Presentations to leadership

• VISN 8 My HealtheVet team
  – VANTS calls
  – Giveaways and ideas


                                14
     Communication Strategies
• Presentations to staff @ meetings
• Tables and booths at:
  – Employee & veteran health fairs
  – Community health events
  – Veteran organization meetings
    • Local and Regional
• Articles in staff newsletters – the FlaG
• Articles in veteran newsletters


                                             15
Communication Strategies




                           16
17
Communication Strategies




                           18
     Our Successes
• Name Recognition
  – My HealtheVet is
    familiar
     • to most staff
     • to many of our
       patients
  – My name is familiar
     • as contact
     • as problem solver
  – Technique
     • Personal My
       HealtheVet business
       cards
     • Stamp with contact
       info

                             19
Our Successes




                20
Our Successes

                • Ellen
                  – alternate POC for GV
                  – HELP Desk liaison
                  – Right hand assistant
                     • Registers patients
                     • Assists with IPA




                                            21
     Our Successes
• Effective use of leadership
  development programs
  – Stepping with PRIDE
  – Competency Development for Leaders in
    the Twenty-First Century (CDL)
• Groups are sponsored by Employee
  Education System (EES) and VISN
  workgroups
  – Varies by VISN


                                            22
My HealtheVet Tool Kit




                         23
2008 Stepping with PRIDE Team




                                24
     Our Successes
• Projects we’ve been involved with:
  – Clinical Champions
  – IPA Standard Operating Procedure (SOP)
  – Move-ember and other wellness events
  – Displays set up in high-traffic areas
  – Performance Improvement (PI) posters
    • Annual PI fair
• Posters for 2007 VeHU


                                             25
     Our Successes
• Annual CORE Competency
  – All employees must fulfill requirement
• This should ensure that all staff have
  basic My HealtheVet information
• Employees need to register themselves
• Employees will learn about IPA process
• Attendance at @ least one My
  HealtheVet presentation necessary


                                             26
          Our Successes
Competency             Competency             Competency Level   Validation Method
Indicator              Behavior

Basic Information      •Understand Purpose                       Ten Question Quiz
                       •Learn Web Address
                       •Describe Resources




Registration Process   •Enroll                                   Demonstration
                       •Explain IPA process                      Discussion

Updating Information   How to Update                             Demonstration
                       Personal                                  Discussion
                       Information/Use
                       Health
                       Journals/Create
                       Wallet Card
New Features           Describe New                              Attendance @
2008-2009              Functionalities                           Presentation



                                                                                     27
Our Successes




                28
      Sharing SharePoint
• Go to your              • Select „level of
  SharePoint site           permissions‟
• Go to „site settings‟      – Most likely this will be
                               „reader‟
• Then „manage users‟
                          • Click „next‟
• Click „add users‟
                          • Uncheck box if you
• Click on the address
                            don‟t want to send
  book
                            them an email
  – Locate names as you
    would in Outlook      • Leave it checked if
                            you do


                                                      29
     Our Challenges
• Lack of time - #1
  – POC is collateral duty
  – No time to track our accomplishments
  – Everyone is really busy! (work team
    members included)
• Too many things to do
• Not enough time to get everything done



                                           30
     Our Challenges
• How we cope –
  – Train a substitute or alternate POC
  – Hold formal meetings only when essential
  – Meet ad hoc
    •   Face to face only when essential
    •   Via Outlook or VANTS calls
    •   Via Outlook mailgroups
    •   People can read and respond when convenient
        to them



                                                  31
     Our Challenges
• Geography
  – #2 challenge
  – Our primary service area covers parts of 2
    states
  – Two hospitals, 2 OPCs, 6+ CBOCs
  – Some of our services in off-site locations




                                             32
     Our Challenges
• How we cope –
  – Outlook mailgroups
  – Weekly van service to CBOCs
  – Daily shuttles between hospitals in
    Gainesville and Lake City
  – Informal face-to-face site visits




                                          33
     Other Challenges
• My HealtheVet not a mandatory
  training requirement
  – Not essential unless required by Joint
    Commission
• No time slot for My HealtheVet in
  new employee orientation
  – Schedule too full




                                             34
    Other Challenges
• Not enough computers

• Resistance of some support staff

• Replacement of work team members




                                     35
     Our Future Plans


• Participate in FL and GA conventions
  for various veteran groups

• Reach out to OEF/OIF veterans

• Visit veteran assistance offices on local
  college campuses

                                          36
 MY HEALTHeVET

VA MEDICAL CENTER
ERIE, PENNSYLVANIA
       Facility Information
•   Community-Based Outpatient Clinics: 5
•   Number of Beds: 78
•   Number of Employees: 610
•   Number of Unique Patients FY07: 20,052




                                         38
     My HealtheVet Pilot from VISN


• To increase the number of patients
  registered and authenticated

• To increase awareness of My HealtheVet
  throughout medical center/CBOCs




                                           39
Goal



   To complete 1,000 additional
In-Person Authentications through
         My HealtheVet




                                    40
         Team
Lisa Kendziora, MHV Point of Contact/Patient Advocate
• Pat Akerly, NP, Clinical Applications Coordinator
• Elaine Chaffee, CBOC Business Manager
• Bob Feldman, Volunteer
• Christine Getsinger, Medical Records Administrator
• Sheryll Hardesty, Supervisor, Medical Records
     Technician
• Dave McLaughlin, Visual Information Specialist
• Kevin Sweeney, Information System




                                                        41
     Pilot Presentations

• PowerPoint to VISN 4
• Presentation to medical center leadership,
  supervisors, and support staff
• Presentation to VAVS, Service Officers,
  and Congressional Liaisons
• New Patient Orientation
• Shared Diabetes Classes
• MOVE Program
• New Employee Orientation
                                           42
      Communication Efforts
• Salute Your Health veteran newsletter
• SharePoint developed for employees
• Letter to all volunteers




                                          43
     Strategies / Initiatives


• Health fairs conducted at the CBOCs
• Fairs conducted at medical center
• Employee contest




                                        44
Health Fairs



         • Refreshments
         • Promotional
           items
         • Door prizes




                          45
         Signage Solution

                                Notice Me!
    Hey… I’m
   Over Here!!!
                                 Notice Me!


  Hey…
Notice Me!                   I’m Most
                            Important!
                            Bla bla bla



                                        46
     Marketing Strategies
6‟ Life-size posters placed throughout
  medical center and CBOCs




                                         47
     Marketing


• Tent cards




• Finger puppets


                   48
Marketing
                     • Mousepads
                 • Business Cards
        • Pharmacy Mailout Notices
           • Pre-Registration Kiosk




                                 49
     Employee Contest


• Conducted an all-employee contest:
  who was responsible for getting patients to
  register/authenticate the most veterans
  during a specified timeframe

• Winner received $100 canteen gift
  certificate


                                            50
     Workarounds


• Voluntary Service Assistance:
     - Funding for door prizes at CBOC
       health fairs
     - Funding for gas cards at medical
       center fairs
     - Funding for canteen gift certificates
       at medical center fairs

                                               51
     Logistics


• 2 PCs dedicated at the medical center
• 1 PC dedicated at each CBOC
• Designated employees at the medical
  center and CBOCs are authorized to
  authenticate on In-Person Authentication




                                             52
Communication Efforts


The NEED to talk directly to patients
     regarding My HealtheVet




                                        53
     Challenges / Barriers


• Collateral duty for team members

• Limited volunteers

• Staff support




                                     54
Statistics




             55
        VISN Growth

        Number of Patients Registered/Authenticated

•   November 13, 2007:      114          8th in VISN 4
•   February 26, 2008:      246          6th in VISN 4
•   March 22, 2008:         367          3rd in VISN 4
•   March 29, 2008:         434          2nd in VISN 4
•   April 5, 2008:          534          1st in VISN 4!
•   May 31, 2008:           662          1st in VISN 4

        Continue to remain in 1st place for VISN 4!!!

                                                          56
     Upcoming Initiatives


• Dedicated My HealtheVet phone line
• Plans are underway to install 5 additional
  PCs in various locations in the medical
  center
• Appointment reminder calls informing
  patients of My HealtheVet



                                               57
 Successfully Implementing
My HealtheVet on a Shoestring
  Micki Wheaton, MSN, RN
  Patient Health Education Coordinator
  My HealtheVet Point of Contact
     Successful Team Environment
               Be a Visionary
• Have a vision with the end goal in mind
  – Imagine all the possibilities
  – Envision the implications
  – Be realistic about limitations
  – Strive to be optimistic with the potential




                                                 59
    Successful Team Environment


• Share the vision




                                  60
    Setting Up a Team / Committee
 Team approach – Situational

    ●    Goal Sharing
         Formed a My HealtheVet team
         Diverse workforce
         Brainstorm
         Network


    ●    Incentive Award


                                       61
 Setting Up a Team / Goal Sharing

Team Approach – Situational

   Goal: Communicate and share the vision

   Goal: Increase staff awareness

   Goal: Devise a plan to educate and recruit
         patients




                                                62
Setting Up a Team / Goal Sharing




                               63
     Communicate and Share the Vision with Goal Sharing


• Develop tools & Marketing Strategies
  – To increase staff awareness and recruit
    patients
    • Referral/consultation Slips
         – Red Carpet
                                              PHE Referral Slip
    •   Friendly competition   Name/last 4 SS#:______________Date_____________
    •   Blitz‟s                Topic(s) to be reviewed (please check):

    •   Flyers                 •www.myhealth.va.gov (web site)
                               •Other:
    •   E-mail alerts          Clinician signature:____________________________
    •   Prizes „teasers‟

                                 Please take this slip to the PHE Library (C122F)

                                 Open Monday thru Friday 9:00 a.m. - 3:00 p.m.
                                                                           64
   Communicate and Share the Vision with Goal Sharing

Devise a plan to educate and recruit patients
  • Walk-ins
  • Requests
  • Donated books
  • Hospital Admission Packs
  • Patient Education Resource Guide
  • New Employee Orientation
  • Patient Education Newsletter
  • Computer Classes


                                                        65
     Communicate and Share the Vision with Goal Sharing


• Barker




                                                          66
     Communicate and Share the Vision with Goal Sharing


• Results of Using Incentives

                        •    Implemented: Increased volunteer 'veteran' assistance in PHE
                             library for 1:1 personalized service with MHV registration
                             continued. Inservice of the clerks in clinic areas to enhance
                             referrals. Plus all strategies continued listed below.



                    •       Implemented: Table with MHV poster & flyers and veteran "Barker"
                            promoting site; "free gift" of imprinted pens; personalized service.
                            Increased referrals. Inservice professional staff. Including all below
                            items



                        •    Implemented: MHV Poster in Preceptor room; circulated flyers;
                             business cards with MHV web site; posted 'Top 200 Cities', goal-
                             sharing team; consultation slips; "Free radios and/or books"; All
                             voluntary and library staff trained and committed to MHV project;
                             Including all below listed items.


                    •       Implemented: "free books" located outside of library; flyers on MHV
                            posted on bulletin boards and for library patrons


                                                                                                 67
 Communicate and Share the Vision with Incentive Award




Incentive Award
  –   Team formed
  –   Diverse workforce
  –   Brainstorm Reasons for Improvement
  –   Assumptions
  –   Action Plan
  –   Implementation
  –   Track Progress
  –   Report Findings



                                                    68
      Communicate and Share the Vision with Incentive Award


Reason for Improvement:
   Volume of calls related to prescription refills
   Access to care
   Case manager follow up
   Veteran anecdotal reports


Assumptions:
    An improvement in operational effectiveness, cost
    effectiveness and enhanced customer satisfaction
    can be realized by encouraging veterans to register
    for My HealtheVet and enroll in the prescription refill
    functionality.
                                                              69
          Communicate and Share the Vision with Incentive Award


Actions
•   Formed interdisciplinary team: Nursing, Pharmacy, Patient Advocate
     – Promoted time spent now would yield positive outcomes
     – Developed action plans

•   Increased awareness of Rx refill functionality
     – Face to face meetings/Inservicing
     – Communicate/Advertise
     – Develop stand alone tools
     – Posters, flyers, bulletin board

•   Developed scripting and tracking tools
     – Phone calls, Walk-ins, patient complaints

•   Increased accessibility of My HealtheVet Rx refill information
     – „Take-Away‟ brochures/literature
     – Referrals to PHE library
     – Phone follow up or mail outs
                                                                         70
                                                               Communicate and Share the Vision with Incentive Award


  Track Progress

Pharmacy trended data on the number of patients per week
   that were utilizing My HealtheVet for prescription refills.
                                                                         Patients Utilizing MHV for
                                                                               Prescription
                                                                               Refills / Week
  Patients / Week




                    250
                    200
                    150
                    100
                     50
                      0
                          9/7/2005




                                                                          1/7/2006

                                                                                     2/7/2006
                                                                                                3/7/2006

                                                                                                           4/7/2006

                                                                                                                      5/7/2006

                                                                                                                                 6/7/2006

                                                                                                                                            7/7/2006

                                                                                                                                                       8/7/2006

                                                                                                                                                                  9/7/2006
                                     10/7/2005

                                                 11/7/2005

                                                             12/7/2005




                                                                                                                                                                             10/7/2006

                                                                                                                                                                                         11/7/2006




                                                                                                             Date                                                                                                                                            MHV Prescription Refills / Week

                                                                                                                                                                                                     Prescriptions / Week   700
                                                                                                                                                                                                                            600
                                                                                                                                                                                                                            500
                                                                                                                                                                                                                            400
                                                                                                                                                                                                                            300
                                                                                                                                                                                                                            200
                                                                                                                                                                                                                            100

                             And trended the number of                                                                                                                                                                        0
                                                                                                                                                                                                                                  9/7/2005




                                                                                                                                                                                                                                                                                 1/7/2006

                                                                                                                                                                                                                                                                                            2/7/2006
                                                                                                                                                                                                                                                                                                       3/7/2006

                                                                                                                                                                                                                                                                                                                  4/7/2006
                                                                                                                                                                                                                                                                                                                             5/7/2006
                                                                                                                                                                                                                                                                                                                                        6/7/2006
                                                                                                                                                                                                                                                                                                                                                   7/7/2006

                                                                                                                                                                                                                                                                                                                                                              8/7/2006

                                                                                                                                                                                                                                                                                                                                                                         9/7/2006
                                                                                                                                                                                                                                             10/7/2005

                                                                                                                                                                                                                                                         11/7/2005

                                                                                                                                                                                                                                                                     12/7/2005




                                                                                                                                                                                                                                                                                                                                                                                    10/7/2006

                                                                                                                                                                                                                                                                                                                                                                                                11/7/2006
                             prescriptions per week.
                                                                                                                                                                                                                                                                                                                    Date                                                                                    71
    Communicate and Share the Vision with Incentive Award




             Findings/Outcome

Facility registrations to My HealtheVet increased
incrementally by 51% during this time period,
moving VISN 11 from a national placement of
11th, to 7th in number of new registrants, to
My HealtheVet.



                                                       72
    Communicate and Share the Vision with Incentive Award

VISN 11 also moved to the top 5 in the nation
for number of prescriptions refilled through
My HealtheVet.




                                                       73
        Communicate and Share the Vision with Incentive Award

• Improved operational effectiveness
      • Phone calls r/t Rx refills decreased
      • Enhanced communication
      • Access to care

• Cost effective:
      • Stock-piling and/or wastage decreased
      • Processing only those medication refills needing refilled
      • Co-pay for only those medications needing refilled

• Enhanced customer satisfaction AEB:
      • Testimonials from veterans
          – Felt more in control and pleased with ability to self-
            manage.
          – Stock-piling decreased and/or eliminated.
          – Co-pay for only those meds that they actually use and/or
            need.
          – Report more knowledgeable about their medications
                                                                    74
     Successfully Implementing My HealtheVet on a Shoestring


Obstacles?

             Overcome obstacles by viewing them as
             opportunities.




            Use technology that is available.
            Find resources already being utilized that you
            can tag My HealtheVet information on to or make your own.
            Take part in events that are already scheduled.
            Dialogue/network with others and learn their success stories.

                                                                       75
     Successfully Implementing My HealtheVet on a Shoestring


• Celebrating Your Success
• Communicate and celebrate team success
  – Party: for meeting and exceeding expectations
  – Recognition: Write up in employee
    newspaper, facility, VISN reports and/or
    national recognition
  – Pictures of team on bulletin board
• Encourage vested veterans to come back
  for classes – bring others
• Consider strategies for replication
• External networking

                                                               76
Communicate and Share the Vision with Effortless Advertising




                                                           77
Communicate and Share the Vision with Effortless Advertising




                                                           78
Communicate and Share the Vision with Effortless Advertising




                                                           79
        Communicate and Share the Vision with Effortless Advertising




    Four page tabloid
placed in key traffic areas




                                                                   80
Communicate and Share the Vision




                                   81
Successfully Implementing
My HealtheVet on A Shoestring




                                82
Successfully Implementing
My HealtheVet on A Shoestring




        Questions?

                                83
Successfully Implementing My HealtheVet on a Shoestring


                 Session #852

                Today’s Presenters:

         Marsha White – marsha.white2@va.gov
         Lisa Kendziora – lisa.kendziora@va.gov
         Micki Wheaton – micki.wheaton@va.gov
         Susan Haidary – susan.haidary2@va.gov

    Please feel free to contact any of today’s presenters
                    if you have questions.




                                                            84

				
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