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Smart Health Centers-Navigator Training

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Smart Health Centers-Navigator Training

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The Smart Health Centers project places trained health information specialists (Navigators) in traditional and non-traditional health facilities to assist patients in connecting to their own medical records and find reliable information about their own conditions. All Navigators are trained in the Smart Health Center Model using this training guide.

The Smart Health Centers project places trained health information specialists (Navigators) in traditional and non-traditional health facilities to assist patients in connecting to their own medical records and find reliable information about their own conditions. All Navigators are trained in the Smart Health Center Model using this training guide.

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Smart Health Centers-Navigator Training

  1. 1. 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
  2. 2. Acknowledgements We would like to thank Our Sponsors  The Smart Chicago Collaborative  The Chicago Community Trust  John D. and Catherine T. MacArthur Foundation  Otho S.A. Sprague Memorial Institute Smart Chicago Collaborative Alliance of Chicago, Community Health Services, L3C (Phase I) 2
  3. 3. Introduction The 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 patients/clients/consumers 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 “full users of electronic health record systems. 3
  4. 4. Authors Page Valerie 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 CEED@Chicago 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 B.S 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; Training/Development; 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 W/MBE 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
  5. 5. Table of Contents •Module 1 • Project Overview •Module 2 • Health Navigator Role •Module 3 • Basic Health Information and Security of Information •Module 4 • Basic Computer Skills •Module 5 • Health Information Technology and Personal Health Records •Module 6 • Patient Portals 5
  6. 6. Module 1: Project Overview Project Overview PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE 6
  7. 7. Module 1: Project Overview LEARNING OBJECTIVES Have a strong knowledge of the project, its goals and objectives Understand and identify partners & staff Understand the Health roles i.e.. supervisory role, staff, policies and procedures Understand information about sponsoring organization Participate in activities to reinforce learning 7
  8. 8. Module 1: Project Overview As 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 residents’ 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 “meaningful use” of electronic health information, such as healthcare patient portals and personal health records. 8
  9. 9. Module 1: Project Overview - Collaboration 9 Smart Collaborative of Chicago Community Trust City of Chicago Otho Sprague Foundation Smart Collaborative Site • Family Focus • Laurie Children Hospital • Acts of Faith • Lawrence Hall • CCHS • Health Leads of Chicago • Erie Health Center • Near North Health Center
  10. 10. 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
  11. 11. Module 1: Project Organizational Chart Smart Health Collaborative Other Sites Acts 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
  12. 12. •Health Navigators: – Are employees and/or volunteers at Community Health Centers (CHCs), churches, or Community Based Organizations (CBOs) – Are oriented on organizational polices, roles and responsibilities of facility or healthcare centers •Sites: – 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), etc. – Provide training on health care practices and/or chronic diseases, etc. 12 Module 1: Health Navigators & Project Sites
  13. 13. Module 1: Activity: Knowledge Test 13
  14. 14. Module 2: The Role of the Health Navigator PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE 14
  15. 15. 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
  16. 16. Module 2: Health Navigator Role New role Support (Technical Assistance) Perform demos using technology Hands-on for patients/clients Look up Quality Health Information Explain Personal Health Record Navigate Patient Portals 16
  17. 17. 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
  18. 18. 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
  19. 19. 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. http://www.bls.gov/soc/2010/soc211094.htm 19 Module 2: Health Navigator Role
  20. 20. 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)
  21. 21. 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)
  22. 22. 22 http://www.latitudelearning.com/ .
  23. 23. Module 2: Soft Skills Self-paced web-based improvement in customer service listening, presentation, communication, diversity and empowerment courses. • Giving an Effective Presentation 2.5 hour(s) • Learn effective communication skills and audience-involvement techniques that can be used during presentations. • Communication Fundamentals 2 hour(s) • This online training course presents the essential skills needed to communicate effectively in the work environment. • Dealing with Diversity 1 hour(s) • This course discusses how to recognize and respect individual differences and describes some strategies that can be used to deal with diversity. • Listen for Understanding 1.5 hour(s) • This course is on Listening for Understanding. This online training course teaches communications and active listening skills. • Empowerment in the Workplace 1.75 hour(s) • 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. • Customer Service Excellence 1 hour(s) • This course outlines how to maintain excellence in customer service. • Facilitating Improvement 2 hour(s) • Learn to lead an audience to new ideas or understandings. 23
  24. 24. Module 2: Cultural Competencies When you hear the term “cultural competency “, what comes to mind? 24
  25. 25. 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
  26. 26. Module 2: Health Literacy Definition of Health Literacy The degree to which individuals have the capacity to obtain, process, and understand basic health information & services needed to make appropriate health decisions Healthy People 2010 26 Source: http://nnlm.gov/outreach/consumer/hlthlit.html Penny Glassman, former Technology Coordinator, National Network of Libraries of Medicine New England Region, Shrewsbury, MA
  27. 27. 27 Source: http://www.stvincentcharity.com/programs- services/centers-excellence/health-literacy/what-is.aspx
  28. 28. Module 2:Health Education Theory 28
  29. 29. Module 2: Health Education Theory Consumer Information Processing Model 29
  30. 30. Module 2: Health Education Theory – 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 –2) 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, http://msucares.com/health/health/appa1.htm ) 30
  31. 31. Module 2: Health Education Theory – Stages of Change 31
  32. 32. Module 2:The Generations Today’s workforce has 5 types of workers with differing styles. These workers include: ◦ The Builders/Mature/Silent ◦ The Boomers ◦ The X-ers ◦ The Net/ Millennials ◦ The iGen 32
  33. 33. Module 2:Generation Values VALUES IN… BUILDERS/MATURE/ SILENT BOOMERS XERS Net/ Millennial/iGen 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 100%Print Media (Books) 90%Print Media 10% Electronics 65% Electronics 35% Print Media 90% Electronics 10% Print Media 33
  34. 34. Module 2: Patient Engagement Introductions are important in patient engagement. Tone, body language and energy are important. Strategy and Tips for Introduction: •30 second intro •Initial impressions often sets the tone •Introduce yourself •Tone •Body language •Explain who you are •Explain why you are there •Include role of technology in healthcare •Include benefits to patients •Invite them to experience technology 34
  35. 35. Module 2: Patient Engagement Conducting 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
  36. 36. Module 2: Patient Feedback •Complete feedback form on all Encounters (manual) Spreadsheet. •Within a few months the feedback form will be electronic (Score card). •This information is important feedback to report to project leadership and measure program effectiveness. 36
  37. 37. Module 2: Patient Engagement Feedback Date Start time Age Range Gender Topics discussed Length of time with patient (approximate) Navigator notes/observations 37
  38. 38. Module 2: Patient Engagement Role Play 38
  39. 39. Module 3: Basic Health Information & Security of Health Information PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE 39
  40. 40. LEARNING OBJECTIVES 40 • Overview of the Affordable Care Act (ACA) • Overview the Health Insurance Portability & Accountability Act (HIPAA) • Personal Health Records (PHR) Privacy and Security Issues/Video • Overview of Government Insurance Marketplace & County Care • Tips for Creating Private and Secure User IDs and Passwords • Privacy & Security: Clearing Your Internet Browser Module 3: Basic Health Information & Security of Health Information
  41. 41. 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 won't 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
  42. 42. Module 3: HIPAA HIPAA stands for the “Health Insurance Portability and Accountability Act,” 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
  43. 43. Module 3: HIPAA (continued) Recently, the HIPAA Security Rule/HITECH 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
  44. 44. Module 3: HIPAA (continued) What is “Protected Health Information”? 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
  45. 45. Module 3: PHR Privacy and Security HIPAA features Health Insurance Portability & 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
  46. 46. Module 3: Privacy & Security Issues Video 46 HIPAA SECURITY RULE http://www.youtube.com/watch?v=QWRn2r5R7ts&feature=plcp YOUR HEALTH INFORMATION, YOUR RIGHTS http://www.youtubHIPAA/watch?v=FKTHncn-5Vs&feature=plcp Spanish http://www.youtube.com/watch?v=moQvCt4styk&feature=plcp
  47. 47. Module 3: Privacy & Security Virus software Firewalls Strong User id’s and passwords Secure websites Trusted emails and attachments SSL certificates Encryption 47
  48. 48. 48 Module 3: Government Insurance Marketplace.org
  49. 49. 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. You've 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 Marketplace.org
  50. 50. Get Covered Illinois.gov 50
  51. 51. Get Covered Illinois.gov 51
  52. 52. Since lawmakers have passed the Affordable Care Act, it’s gotten easier to shop for individual health care insurance. Theoretically, all you need to do is visit your state’s 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 – so make sure you take these factors into consideration when you’re shopping for health care for an individual. Outline Your Medical Needs for a Personal Health Care Plan The first thing you should do when shopping for individual health care insurance is to identify your medical needs. If you’re relatively young and healthy, your medical needs may be minimal. If you’re 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 you’ll need your health insurance to cover. Outline your medical needs, and focus on those needs and costs when you’re comparing plans. Create Your Budget for Individual Health Care Insurance Figuring out a budget for health care for individual needs is relatively simple. Income, minus expenses, and a portion of what’s 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, it’s worthwhile to pay more for individual health care insurance that will cover all of your medical costs. Walk Through Several Plans Take 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: Marketplace Health Insurance
  53. 53. Module 3: Creating and Managing User IDs and Passwords For 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 and/or 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
  54. 54. Module 3: Tips for Creating Secure User IDs and Passwords User IDs and Passwords help protect the confidentiality of accounts and enables verification of identity. Follow these tips to create a good user ID and password: Create a user ID that others can't guess but is easy for you to remember. Use a combination of letters and numbers (e.g., 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 (e.g., s1cr1t) Users will often be given a set of instructions on how to create the User ID and Password for different sites like…. Your user ID must be 6–16 characters and can contain any character found on your computer's keyboard except spaces. As an added security measure, your user ID and password cannot be the same. 54
  55. 55. 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
  56. 56. Module 3: Clear Internet Browser Microsoft 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
  57. 57. Module 4: Basic Computer Skills Basic Computer Module PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE 57
  58. 58. Module 4: Basic Computer Skills 58 LEARNING OBJECTIVES • Learn Basic Housekeeping for Maintenance of Computer Area • Start Up, Troubleshooting, Turn Off Computer • Assess and Provide Basic Computer Skills to Patients/Clients • Computer Hardware, Software, Using a Mouse, Access Internet Browser • Navigating the Smart Health Center Landing Page • How to find Quality “Reliable and Accurate Health Information” • Sample Google Search Results for “Diabetes”
  59. 59. Module 4: Housekeeping – Daily Maintenance of Computer Area 59 • NO FOOD or DRINKS in the computer lab. • Turn cell phones to vibrate. • Respect all users time. • Respect the equipment. • NO game playing. • Not for children use. • NO Personal emails or Websites.
  60. 60. Module 4: Start Up, Troubleshooting, Turn off computer 60 • The first activity of each day will be to turn on the Smart Health Center computers. • Equipment is to be powered off at the end of the day. When working with patients the computer will be turned on and working. • Laptops and tablets are stored in secure locked environment • Troubleshooting is a regular and normal part of the Health Navigator job. • Remaining calm when working with patients is very important. • Initiate troubleshooting steps for hardware, software or internet problems included in the handbook. If not resolved: 1) ask the patient to return at a time convenient to them 2) contact the center IT support • 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
  61. 61. PURPOSE To assess patient/client’s 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
  62. 62. Module 4: Computer Assessment PURPOSE: 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 computer mouse skills open internet browser  Privacy & security navigate landing page  find quality health information MORE EXPERIENCED USERS  Go to Slides Labeled Privacy & security navigate landing page  find quality health information 62
  63. 63. Mod 4: More Experienced  Go to Navigating SHC Landing Page (Slide 70) EXPERIENCED COMPUTER USERS An answer of ‘yes’ 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 “Privacy and Security”. As time permits, introducing “Personal Health Records and Patient Portal” 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
  64. 64. 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 “How to create Personal Health Records and Patient Portal”. ID computer HDW / SFW  Using a mouse  Accessing the Internet  Navigating Smart Health Center Landing Page  Finding Quality Health Information 64
  65. 65. Module 4: Computer Hardware 65
  66. 66. Module 4: Computer Software 66
  67. 67. Module 4: Using a Mouse USING 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 (i.e., pointing) figure to “click” on the mouse and make your selections. Step 3. Moving the whole mouse on the pad will move the arrow/cursor on the screen. Basic procedures to practice these skills are included in the following links: Two additional good websites for practicing mouse skills are Mousarobics http://www.skyways.org/central/mouse/page1.html and Mouse Exercises Source: Chris Rippel Central Kansas Library System Great Bend, Kansas crippel@ckls.org http://www.skyways.org/central/mouse/page1.html Source: Mouse exercises developed by Vic Laurie, Ewing Learning Center, for SeniorNet http://www.seniornet.org/howto/mouseexercises/mousepractice.html 67
  68. 68. Module 4: Opening An Internet Browser An internet browser allows access the internet. Most common ones are Microsoft Internet Explorer, Firefox and Google Chrome. Mac’s 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
  69. 69. 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, Mac’s 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, www.smarthealthcenters.com 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 (www.smarthealthcenters.com ).
  70. 70. Mod 4: Navigating the Smart Health Centers - Landing Page 70
  71. 71. Mod 4: Navigating the Smart Health Centers Landing Page 71 http://smart-health- centers.smartchicagoapps.org/
  72. 72. 72 Mod 4: Navigating the Smart Health Centers Landing Page
  73. 73. Mod 4: Navigating the Smart Health Centers Landing Page Adult Health www.familydoctor.org www.cdc.gov www.Northwesternhospitallearningcenter.org Pediatric Health www.Healthychildren.org www.Familydoctor.org www.Kidshealth.org Teen Health www.bedsider.org www.youngwomenshealth.org www.advocatesforyouth.org www.sexedlibrary.org Nutrition www.clocc.net www.cspinet.org/smartmouth/index1.html www.choosemyplate.gov www.womenshealth.gov/bodyworks www.healthyfoodshealthymoves.org/about- us.html Physical Activity www.clocc.net www.startwalkingnow.org (English only) www.bam.gov/sub_physicalactivity – for kids (English only) www.win.niddk.nih.gov/publications/index.htm# public 73
  74. 74. Women's Health www.womenshealth.gov www.Familydoctor.org Chronic Disease Diabetes – www.diabetes.org Heart Disease – www.heart.org Cancer – www.cancer.org www.cdc.gov/DiseasesConditions www.win.niddk.nih.gov/publications/index .htm#public Prenatal/Pregnancy/Breastfeeding www.babyfriendlyusa.org www.acog.org www.womenshealth.gov/pregnancy www.lalecheleague.org Oral Health www.healthyteeth.org 74 Mod 4: Navigating the Smart Health Centers Landing Page
  75. 75. Mod 4: Navigating the Smart Health Centers Landing Page Nutrition www.clocc.net www.cspinet.org/smartmouth/index1.html www.choosemyplate.gov www.womenshealth.gov/bodyworks www.healthyfoodshealthymoves.org/about -us.html Physical Activity www.clocc.net www.startwalkingnow.org (English only) www.bam.gov/sub_physicalactivity – for kids (English only) www.win.niddk.nih.gov/publications/index. htm#public Stop Smoking www.cancer.org/Healthy/StayAwayfromTob acco/GuidetoQuittingSmoking/index www.smokefree.gov HIV/AIDS www.medicinenet.com/human_immunode ficiency_virus_hiv_aids Community Resources http://weconnectchicago.org/ 75
  76. 76. Module 4: Finding Quality Health Information FINDING 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
  77. 77. (Regular Internet Search) When looking up health information, use the suggested Quality Information Checklist to find reliable, accurate health information. Yes No _____ _____ √ Can you read and understand the website? _____ _____ √ Is the purpose of the website clear? _____ _____ √ Is the website easy to use? _____ _____ √ Is the website written by an organization or person you can trust? _____ _____ √ Is the information biased in anyway? _____ _____ √ Has the website been updated recently? ______ ____ √ Is the information correct and error-free? Source: River Valley Healthy Communities Coalition, Rumford, Maine, Who Can You Trust? http://www.rvhcc.org/pdf/HIL_Sourcebook.pdf 77 Module 4: Finding Reliable and Accurate Health Information -Checklist
  78. 78. For an activity let’s 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 Type…Men, Women, Teens, Children, Seniors By topic…Diabetes, Heart Disease, High Blood Pressure Go to google (www.google.com) and type in “diabetes” 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
  79. 79. Mod 4: Google Search for “Diabetes" 79
  80. 80. 80 Mod 4: Activity - Accurate Health Information
  81. 81. Module 5: Health Information Technology and Personal Health Records 81
  82. 82. LEARNING OBJECTIVES •Recognize Health Information Technology (HIT) terms and acronyms •Identify HIT at the Federal, State and Local Level •Understand the similarities and differences in Electronic Medical Records (EMRs), Electronic Health Records (EHRs) and Personal Health Records (PHRs) •Name the benefits of PHRs for Patients and Providers •Recognize common contents and elements of PHR systems •Identify Privacy and Security PHR issues •Create a PHR 82 Module 5: Health Information Technology and Personal Health Records
  83. 83. Module 5: Introduction Utilizing the latest technology at the Smart Health Centers, the Health Navigator will invite patients to learn how creating PHRs can help them take charge of their health, receive efficient care and track all their health care encounters through their entire health care spectrum. Patients will be able to share this information with providers to help them coordinate their care efficiently, help providers gain a timely and current view of their health status and help them develop the most accurate diagnosis and treatment plan. 83
  84. 84. Mod 5: Introduction to Health Information Technology (HIT) 84
  85. 85. 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
  86. 86. Mod 5: HIT Federal Governance 86 The Office of the National Coordinator for Health Information Technology (ONC) is at the forefront of the administration’s 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 U.S. 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: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200
  87. 87. Module 5: HIT State 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: http://www2.illinois.gov/gov/HIE/Pages/OHIT.aspx Illinois Office of Health Information Technology
  88. 88. Module 5: HIT Video 88 http://www.healthit.gov/patients-families/multimedia Brochure: http://www.healthit.gov/sites/default/files/consumerfactsheetfinal.pdf
  89. 89. 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 – Personal Health Record 89
  90. 90. 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
  91. 91. Mod 5: Personal Health Records – PHRs 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
  92. 92. Module 5: Benefits of PHR•Track health information from multiple providers in different systems in one convenient location. •The patient creates, manages and controls PHR and content •The patient controls who has access to the personal health information •Information is quickly and easily accessible for sharing with hospitals, providers and other health care stakeholders on the spot •The patient can correct information, keep it accurate and up-to-date anytime •Information is always accessible nights, weekends, holidays as long as the Internet is up •A history of test results, lab reports and immunization records are available. • This can eliminate duplicated tests. •Medication errors can be reduced when a provider has up-to-date current information on medications and allergies •Participating in this type of self management empowers patients to take charge of their health 92 http://www.youtube.com/watch?v=jQJVceBNXFY AHIMA. What a PHR Can Do For You.
  93. 93. 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
  94. 94. Module 5: Activity – 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.
  95. 95. Mod 5: Activity--Creating a PHR 95
  96. 96. Mod 5: Activity – Creating a PHR 96
  97. 97. Mod 5: Activity – Creating a PHR 97
  98. 98. Mod 5: Activity – Creating a PHR 98
  99. 99. 99 Mod 5: Activity Creating a PHR
  100. 100. Module 6: Patient Portal PATIENT ENGAGEMENT HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE 100
  101. 101. LEARNING OBJECTIVES • Define Patient Portal • Describe the Similarities and Differences in Medical Records and Patient Portals • Define the Benefits of Patient Portals • Recognize How it Works 101 Module 6: Patient Portal
  102. 102. Module 6: Patient Portal “ a patient portal is the starting point for a patient to find information, set appointments, review lab results and/or view general health information on a physician or hospital Web site.” HIMSS definition http://www.himss.org/digital_office/20071127_DigitalOffice.htm 102
  103. 103. 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 and/or 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 usage, policy 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
  104. 104. Mod 6: Similarities & 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 and/or 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 patient’s 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
  105. 105. 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
  106. 106. 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
  107. 107. 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
  108. 108. 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.
  109. 109. 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.
  110. 110. Mod 6: Patient Portal DEMONSTRATION: Sample Community & Patient Activities on the Portal Sample Community content Sample Patient Activities on the portal: ◦ View Medical Record Summaries ◦ Refill a Prescription ◦ Fill out forms & sign them ◦ Use home monitoring forms ◦ Get directions to your office 110
  111. 111. 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.
  112. 112. Module 6: Most Common Elements of Patient Portals Home page of the patient portal 112
  113. 113. Mod 6: Most Common Elements of Patient Portals 113 Viewing portions of the medical record chart summary includes: • conditions, medications • immunizations, allergies • test results and past history
  114. 114. 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
  115. 115. QUESTIONS & ANSWERS Thank you! ◦ Diana Beasley (Management Synergistics Inc and CCT): ◦ synergy033@aol.com 115
  116. 116. REFERENCES Berthold, Miller & Avila-Esparza. (2009). The Role of CHWs. Foundations for Community Health Workers (1st ed). (p.13). 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 http://www.bls.gov/soc/2010/soc211094.htm Berthold, Miller & Avila-Esparza. (2009). The Role of CHWs. Foundations for Community Health Workers (1st ed). (p.15). 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 ( http://www.latitudelearning.com/ ) American Medical Association. Cultural Competency definition. Retrieved August 2, 2012 from www.csh.umn.edu/Modules/culture/comp/cp01.html Cultural Competence: Photo google images commonwealthfund.org National Network of Libraries of Medicine (2012) Definition Health Literacy. Retrieved August 10, 2012 from http://nnlm.gov/outreach/consumer/hlthlit.html (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 http://www.stvincentcharity.com/programs-services/centers-excellence/health-literacy/what-is.aspx Kelly Mc Quillen & Connie Davis. BC Health Literacy Prototype - Patients as Partners in Primary Health Care. Health Literacy Umbrella (p. 36) Retrieved August 10, 2012 from http://www.phabc.org/userfiles/image/McQuillen.pdf, 116
  117. 117. REFERENCES Stoney Brook University School of Medicine. Transtheoretical Model (Stages of Change) Photo Retrieved August 20, 2012 from http://medicine.stonybrookmedicine.edu/colorectalcancer/ModuleII/transtheoretical_model Domain Uniform Resource Locator (suffix) Retrieved June 20, 2012 from http://www.domainregister.com/comorg.html Robin A. Cohen, PhD & Patricia F. Adams. (July 21, 2011) Use of the Internet for Health Information: United States, 2009. Retrieved July 5, 2012 from http://www.cdc.gov/nchs/data/databriefs/db66.htm River Valley Healthy Communities Coalition. (2009) Rumford, Maine. Who Can You Trust? Health Information and the Internet. Retrieved June 15, 2012 from http://www.rvhcc.org/pdf/HIL_Sourcebook.pdf The Office of the National Coordinator for Health Information Technology. (2012). ONC definition. Retrieved July 12, 2012 from http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200 Illinois Office of Health Information Technology (OHIT). ILHIE definition. . Retrieved July 12, 2012 from http://www2.illinois.gov/gov/HIE/Pages/OHIT.aspx) Patient Portal Himss definition http://www.himss.org/digital_office/20071127_DigitalOffice.htm 117

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