RevolutionPHR Customer Advisory Draft FINAL 06.08 · / Page1/ June/8,2012/! RevolutionPHR! PuttingIt’IntoPractice’ / / / Overview! / RevolutionPHRis/a/power/patient/engagement

www.revolutionehr.com Page 1 June 8, 2012

RevolutionPHR

Putting It Into Practice

Overview RevolutionPHR is a power patient engagement tool that allows clinics that operate with RevolutionEHR to provide an EHR-‐tethered information sharing experience with their patients. This document will assist the RevolutionEHR customer with understanding the features of RevolutionPHR, and the necessary background information to configure RevolutionEHR to work closely with the patient’s pre-‐examination Interview feature. RevolutionPHR allows patients to have access to discrete pieces of information that is housed in RevolutionEHR:

• the patient’s basic demographics • the doctor’s basic practice information • appointments of the future and past, and access to clinical summaries • status of orders for eyeglasses and contact lenses • account status and access to billing statements for printing

The most dynamic offering of RevolutionPHR is within the Appointments section, where customers can Confirm appointments and take pre-‐examination Interviews that will automatically load into the patient record when the office visit is started. The Interview process will map patient answers to questions about eye and vision concerns, lifestyle, and vision correction needs directly into RevolutionEHR. As you review this document, you will see a wide variety of screenshots and explanations of their uses and capabilities that the Interview offers. This document will also assist the RevolutionEHR customer with the set-‐up of the Encounter Steps that will associate with the RevolutionPHR Interview. It will also demonstrate the many new components in RevolutionEHR that relate to data documentation from the Interview process.


Table of Contents Section 1: RevolutionPHR Overview pp. 3-‐9 Section 2: Interview Summary pp. 10-‐26 2a. HPI Mapping for Special Eye and Vision Issues Starts on pg. 12 2b. Documentation of Patient Case History, Expectations, Starts on pg. 21 and Needs Section 3: RevolutionEHR Enhancements for RevolutionPHR pp. 27-‐30 Section 4: Interview Mapping into RevolutionEHR pp. 31-‐46 4a. Interview Screens Related to Documentation of Starts on pg. 40 Special Patient Issues and Needs Section 5: Encounter Setup and Screen Edits pp. 47-‐52


Section 1: RevolutionPHR Overview This section will demonstrate the key areas of RevolutionPHR as seen after the patient has securely logged in to their PHR.

OVERVIEW SCREEN – Home page with summary of important information

ABOUT ME SCREEN – Review of key demographic information


DOCTOR SCREEN – Overview of the doctor’s practice and patient’s primary location

SPECIAL NOTES for Doctor page: The links for Map It! and Get Directions help support your practice by giving patients access to Google Map technology (see next to images.) In this fictitious environment, the practice address shows www.google.com but in your practice it will display your practice’s website address MAP IT! – When clicked, Google Maps will show practice location


GET DIRECTIONS – When clicked, Google Maps will show practice directions from patient’s home address to practice


APPOINTMENTS SCREEN – Summary of the upcoming appointment, and most recent and all historical visits

APPOINTMENTS SCREEN Action – After clicking “show all” for History, a list will be revealed; “hide all” will take away the history display


APPOINTMENTS SCREEN Action – By clicking “print summary” for any historical, signed encounter, patient may access a PDF of the visit’s clinical summary

ORDERS SCREEN – Displays current orders and status as noted in RevolutionEHR, and patient’s order history


ACCOUNT SCREEN – Summary of account, current and past invoices, and payments

SPECIAL NOTES for Account page: Various actions can be taken from the Account page. The print icon allows patients to print invoices and past bills. Current Invoices will display in a grid, and Billing History and Payment History will display the one most recent item by default, while the show all button will open all previous items in a grid (see next two images.) ACCOUNTS SCREEN Action – Click “show all” to see all Billing History Items


ACCOUNTS SCREEN Action – Click “show all” to see all Payment History Items

ACCOUNTS SCREEN Action – Click print icon to see Invoice as printable PDF


Section 2: Interview Summary This section will demonstrate the key actions and workflow of the patient pre-‐examination Interview. SPECIAL NOTES for Interview: The practice will need to have developed an office protocol for the patient to receive their secure login credentials, Username and Password, for this process to be available. Every action that is taken by the patient in the Interview will be available within RevolutionEHR in the Interview History component as well as within the screens of the encounter (once the encounter is started.)

APPOINTMENT SCREEN – Click “take interview” button to launch the Interview process for that particular Upcoming Appointment

RevolutionEHR Action – New five-‐ball system will display a Yellow ball (second down on left) to denote that the Interview for this appointment has not been done

RevolutionEHR Action – Green ball denotes Interview has been started but not yet completed


WELCOME – Initial page of Interview to provide context to the patient

PATIENT RFV – Patient’s explanation of reason for upcoming visit; displays last encounter date and doctor of record from RevolutionEHR

PATIENT RFV – Main Reason dropdown reduces need for typing


PATIENT RFV – Completed data will be delivered into RevolutionEHR Patient RFV text box as editable text

RevolutionEHR Action – Patient RFV display of data entered in Interview

2a. HPI Mapping for Special Eye and Vision Issues SPECIAL NOTES about Interview progress: After documenting the Patient RFV, the Interview will ask the patient to provide detailed information for any condition or concern that is present: *Eye Conditions: a list of general eye diagnoses, and any ICD-‐9 diagnosis item in RevolutionEHR will automatically display to the patient as a condition about which more information is needed *Eye Concerns: a list of general eye concerns based upon the patient’s viewpoint *Vision Concerns: a list of visual concerns that the patient may be experiencing For each of the items answered YES, a special pop-‐up interview box will appear that will ultimately log patient responses that will be populated into the HPI screen of RevolutionEHR.


EYE CONDITIONS – General eye conditions that have been diagnosed; any YES that is pre-‐populated is identifying diagnoses that are in RevolutionEHR for that patient

EYE CONDITIONS – Patient may manually toggle YES/NO to any or all other items


EYE CONDITIONS Action (e.g. Glaucoma = YES) – HPI pop-‐up questions will be displayed

EYE CONDITIONS Action (e.g. Glaucoma = YES) – All patient answers will be directly mapped into HPI


EYE CONDITIONS Action (e.g. Diabetes = YES) – HPI pop-‐up questions will be displayed for any YES (e.g. Diabetes questions)


EYE CONDITIONS Action (e.g. Diabetes = YES) – All patient answers will be directly mapped into HPI


EYE CONDITIONS Action (e.g. Dry Eye = YES) – HPI pop-‐up questions will be displayed for any YES (e.g. Diabetes questions)


EYE CONDITIONS Action (e.g. Dry Eye = YES) – All patient answers will be directly mapped into HPI


EYE CONCERNS – General eye concerns that the patient may be experiencing

EYE CONCERNS Action (e.g. Tearing = YES) – All patient answers will be directly mapped into HPI


VISION CONCERNS – General vision concerns that the patient may be experiencing


VISION CONCERNS Action (e.g. Double Vision = YES) – All patient answers will be directly mapped into HPI

2b. Documentation of Patient Case History, Expectations, and Needs SPECIAL NOTES about Interview progress: After documenting the HPI-‐related information for eye conditions, eye concerns, and vision concerns, the remainder of the Interview aims to document more information for the patient case history, as well as allowing the patient to state their expectations and any special needs. Six total screens are available for your use. The answers to these questions will be available in the encounter, and any pertinent positives will be contained in a new “Review” popup that is accessible during the encounter and also from the Appointment Details section of the Schedule Module.


CURRENT CORRECTIVE LENSES – Patient observations about their vision

COMPUTER DEMANDS – Questions related to computer vision actions


VISION PERFORMANCE AND OUTDOOR DEMANDS – Identifying issues with vision performance and special circumstances with outdoor demands


EYEGLASS DESIRES – Specific patient requests and needs for eyeglasses

PLAN TO PURCHASE – Patient statement of specific purchases to be made


INTERESTS IN SERVICES OR PRODUCTS – Possible opportunities for new actions


THANK YOU – Final page of Interview to provide context to the patient and a checklist of action items to be completed prior to the examination

RevolutionPHR Action – Green checkmark denotes Interview completed

RevolutionEHR Action – Green checkmark denotes Interview completed


Section 3: RevolutionEHR Enhancements for RevolutionPHR This section will demonstrate the key additions to RevolutionEHR that are necessary for maximized value via use of RevolutionPHR.

SHOW MORE – New addition of the “Interview History component to see all Interviews

INTERVIEW HISTORY – Grid listing of Interviews and associated encounters; can be printed

SPECIAL NOTE for Interview History: The Interview responses provided by the patient in RevolutionPHR can be seen in PDF format and by double-‐clicking the interview to open the PDF. It can be printed from there, although there is limited value to a printed version.


CHANGES TO WORKFLOW STEPS – 1. A new Workflow Step called “Interview” is now available. It comes in two versions, the longer “Interview-‐Comprehensive” and the shorter “Interview – Basic”, the view on the left is the comprehensive; 2. The History step will ideally have the RFV and HPI steps removed so these two screens will be in the Interview; the view on the right shows the new list of History screens


REVIEW BUTTON, ENCOUNTER – Every Encounter header bar now has an additional “lookup” icon on the far left, called “Review” which provides the user with a view of all data entered into the Interview which may be of value to users to see at a glance.

REVIEW HYPERLINK, SCHEDULE – The Schedule’s Appointment Details box now has an additional item called Encounter where a hyperlink called “Review” is available which provides the same capability as the Review Button in the Encounter


REVIEW POPUP – The Review popup will display key pieces of information including RFVs, Insurances, Numbers of Rxs, Service Codes (with Dxs), and any pertinent positive Interview items that are populated into the Encounter from the Interview


Section 4: Interview Mapping into RevolutionEHR This section will demonstrate the mapping of data from the Interview to RevolutionEHR. Each screen in the RevolutionPHR Interview has a matching screen in RevolutionEHR. SPECIAL NOTES for Interview mapping: The new Interview screens have been built as tests (like IOP or VA tests, with the matching buttons on the top) so they can be edited in the future. Also please be aware that the only screens that have items that will lead to HPI pop-‐ups, and when transitioning from one of those screens to the next one by use of the NEXT button, a slight delay will occur as the next screen will be seen and thereafter the HPI Wizard for any necessary YES selections will pop up. Data will not pre-‐fill the Interview screens in RevolutionEHR until that screen is accessed by the user. The data can be reviewed and will be saved upon use of NEXT or PREVIOUS, or navigating to a different screen in the Workflow Steps. PATIENT RFV – Data entered in Interview will populate the RFV box as editable text

PATIENT RFV – Close up of the Patient RFV data


EYE CONDITIONS – Interview answers populated (NOTE – positive responses outlined in dark blue, will be vetted next by HPI Wizard popups)

SPECIAL NOTE for all RevolutionPHR Interview screens: Clicking the “Test Normal” button, second from right, will cause all answers to be populated with the response of NO.


HPI POPUP (e.g. Glaucoma = YES) – Interview answers populated

GENERATE HPI BUTTON

SPECIAL NOTE for RevolutionEHR HPI Wizard Popups: After reviewing and editing the data within the popup, the necessary action to push that data into the HPI Grid is to click the “Generate HPI” button


HPI POPUP (e.g. Diabetes = YES) – Interview answers populated

IGNORE REMAINING (HPIs) BUTTONS – Provides a shortcut past HPI data from the Interview entirely (Ignore Remaining) or from the current HPI displayed (Ignore Current)

SPECIAL NOTE for RevolutionEHR HPI Wizard Popups: If HPI popup data is entered from the RevolutionPHR Interview or by a RevolutionEHR user, and that data can be ignored entirely or for the displayed HPI. Once HPI Interview data is ignored, it cannot be repopulated.


HPI POPUP (e.g. Dry Eye = YES) – Interview answers populated


EYE CONCERNS – Interview answers populated (NOTE – positive responses outlined in dark blue, will be vetted next by HPI Wizard popups)


HPI POPUP (e.g. Tearing = YES) – Interview answers populated


VISION CONCERNS – Interview answers populated (NOTE – positive responses outlined in dark blue, will be vetted next by HPI Wizard popups)


HPI POPUP (e.g. Double Vision = YES) – Interview answers populated


HPI GRID – Interview answers populated by “Generate HPI” button

SPECIAL NOTES for RevolutionEHR HPI Grid: All HPI data populated in the HPI Wizard popups will be displayed in this grid, including pertinent negative responses. Any data group can be edited as has been available in the past. 4a. Interview Screens Related to Documentation of Special Patient Issues and Needs The remaining Interview screens provide documentation of the patient’s expectations, issues, and any special needs. In this first iteration of the RevolutionPHR Interview and the RevolutionEHR equivalent screens do not allow practices to edit or eliminate questions that they would prefer to not have on their screens SPECIAL NOTES about special documentation screens: The answers to these questions that are pertinent positives will be contained in a new “Review” popup that is accessible during the encounter and also from the Appointment Details section of the Schedule Module.


CURRENT CORRECTIVE LENSES – Patient observations about their vision

COMPUTER DEMANDS – Questions related to computer vision actions


VISION PERFORMANCE AND OUTDOOR DEMANDS – Identifying issues with vision performance and special circumstances with outdoor demands

EYEGLASS DESIRES – Specific patient requests and needs for eyeglasses


PLAN TO PURCHASE – Patient statement of specific purchases to be made

INTERESTS IN SERVICES OR PRODUCTS – Possible opportunities for new actions


REVIEW POPUP – The Review popup now displays key pieces of information including all pertinent positive Interview items that were populated into the Encounter from the Interview


REVIEW POPUP Action – Click the green plus (+) button to create an Encounter Checkout Task for any item that needs to be addressed at the conclusion of the visit

REVIEW POPUP Closeup – Action buttons include the green plus (+) button to create Checkout Tasks, and the red minus (-‐) button to eliminate items from the Review list that do not need any attention


REVIEW POPUP Closed – After an encounter has been completed, the Review popup shows the summary of the data and will always be available for access

REVIEW POPUP Close-‐up – Summary of pertinent items that may assist particular staff or the doctor with providing special advice to the patient based upon defined needs


Section 5: Encounter Set-‐up and Screen Edits RevolutionEHR must be configured to accept data that has been submitted by the patient in the RevolutionPHR Interview. The key changes include adding the appropriate Interview Workflow Steps to desired Encounters, and modifying the screens in the History step. For an encounter that will use an Interview step, users must change the appropriate “History” part of that encounter. Note that for those History steps, the screens for RFV and HPI will need to be removed from the History step because they will be part of the new “Interview” step that includes the eye and vision questionnaire screens. INTERVIEW SCREENS – Recommended Interview screens listed in Administration


INTERVIEW STEPS – Note the Interview – Basic and Interview – Comprehensive Steps that should be inserted into the appropriate short and comprehensive encounters

SPECIAL NOTE about Interview Steps: Do not insert the PHR – Basic Interview or PHR – Comprehensive Interview Steps into any RevolutionEHR encounters. Those must be shown within the Workflow Steps Listing because they are utilized by RevolutionPHR.


HISTORY STEP -‐ SCREEN EDIT STEP 1 – Open any History screen that you have within encounters to which you will associate an Interview; Edit the History screen by removing the RFV screen by clicking the red minus (-‐) button


HISTORY STEP -‐ SCREEN EDIT STEP 2 – Then further Edit the History screen by removing the HPI screen by clicking the red minus (-‐) button


HISTORY STEP -‐ SCREEN EDITS COMPLETED – Save the new version of the History Step without RFV and HPI; Repeat this process for any History steps that have been created by the practice for various encounters

SPECIAL NOTE about newly revised History step and use of new Interview step: RevolutionEHR-‐related patient workflow will be greatly enhanced when patients complete the RevolutionPHR Interview prior to their visit. Even encounters that have no pre-‐completed Interview should be more completely and efficiently documented with the new Interview screens in RevolutionEHR. When practices implement the use of the Interview step, the technicians and doctors will be able to focus on simply reviewing the Interview data and will be able to simply complete the few History step screens to finish the complete patient case history.


ENCOUNTER SETUP – For any encounter where patients will be invited to perform a RevolutionPHR Interview, the encounter template must be edited by adding either Interview Step into the encounter AHEAD of the newly redefined History Step.

Documents

RevolutionPHR Customer Advisory Draft FINAL 06.08 · / Page1/ June/8,2012/! RevolutionPHR! PuttingIt’IntoPractice’ / / / Overview! / RevolutionPHRis/a/power/patient/engagement