Helpdesk Calls Increasing Daily!

The volume of calls is increasing daily. I had to juggle 2 calls at once this afternoon.
One of the calls was a patient saying "Awesome! I feel privileged to be a part of this. I am so glad this is happening!".
I had to charge my headset to ensure proper ergonomics:-)

Great day at the Helpdesk!

Great way to use MyOSCAR

Great way to use MyOSCAR

Last week one of our staff, who is a patient at our Stonechurch Clinic sent me a myoscar message that she had received her flu shot at work. I copied her message, entered her Oscar EMR and added the flu shot to her prevention chart.

Everyone is happy-she didn’t have to call the clinic or come in to register her flu vaccine, and the clinic now has her recorded vaccine and will qualify for the bonus for that patient. A win-win for everyone

MyOSCAR Helpdesk Calls!

We have received more than a dozen calls on the MyOSCAR Helpdesk.

I am happy to say that the comments have been overwhelmingly positive!

I am looking forward to blogging more results!

MyOSCAR looking good!

Features of MyOSCAR are becoming more polished every day. Our amazing programming staff has been in high gear. Soon data from OSCAR will supplement the patient’s own entries.

Patients can now:

- set their blood pressure goals, enter their measures and track them on a graph

- set goals and track any health and wellness measures of their choice

- enter all their medications including supplements and over-the-counter, how and why they are taking them, and print a list

- complete a comprehensive survey of medication effects to facilitate a conversation with their health care professional

- read about common health conditions to understand treatment choices

The reports are starting to come in! We have users!

We can start to tell that people are authenticating their MyOSCAR accounts. It is quite exciting to see the growth in users.  It is happening slowly but we hope that as people come into the clinic for their regular visits or have time to call the Help Desk then they will sign up for the system. We can't tell who is signing on...that would contravene privacy but we can watch the numbers grow day by day!
The open information sessions only had a few people drop in because it was convenient since they were at the clinic already. No one RSVPed. We are not sure why people have not participated but possibly it could be that computer users would rather do everything on-line or over the phone.  We are re-evaluating the need for information sessions as we start to think about opening up MyOSCAR to the next clinic.

A New Website and Training Video

Letters are starting to go out. Patients visiting http://MyOSCAR.org will now be greeted by a much more professional looking web-site:

Moreover, if they click video they will be shown a very well made training video


Group meetings will start next week. Exciting!
David Chan

So what's in the envelope?

When the patient opens the envelope...
(1) The cover page with the patient's address showing on the window of the envelope. It also contains the MyOSCAR User Account Details.
(2) A four page (one large 2-sided paper folded in half) invitation letter written by the Medical Director of the clinic which provides information on:
     a) benefits of Personal Health Records
     b) new feature release dates
     c) levels of authentication
     d) dates for information sessions at the clinic
     e) the research study to evaluate MyOSCAR
(3) A two sided Authentication Form
(4) A three page Letter of Information & Consent - there is one for patients over 18 and another one for patients under 18
(5) A bright green additional reminder to ask the patient to sign the consent and send it in if he/she wants to participate in the evaluation study
(6) A colorful MyOSCAR Hotline prochure
(7) A stamped envelop

This makes for a very fat envelope!
This is all done by hand! Come meet the crew...

David Chan

2123 and counting...

That's the number of MyOSCAR accounts set up at the end of today since October 1! Invitation letters will be mailed out starting this Friday. We are expecting to invite over 4800 patients by the end of next week.
David Chan

Success but not without bumps along the road...

Yes we can print the letters but that turned out to be the easy part. The hard part has been trying to get people set up to access the Oscar chart in the clinic. There are rules....some we hadn't thought of such as staff also being patients, and the formality of adding new users, signing confidentiality agreements, the list goes on.
I have been trying to think of a way to describe the process and the best I can come up with is the domino effect. You are sure you can set up the dominoes to knock each other down by starting with the first one and adding one for each step of the way to the end one which is your goal. All 10 dominoes are in place, knock them down and only 2 fall over, you haven't thought of something and that domino is missing so the rest can fall. Now you add the new one, like the staff being a patient and now 4 fall over but something else has been missed and you have to fix that and add it to the line and knock them over again.
We have close to 8,000 patients to offer MyOscar accounts to between the 2 clinics so there is endless organization needed to get this mailed out. Looking ahead now we are worrying about how many patients might come to an information session. Our  biggest room only holds 80 people what if 200 come? So we had to add a RSVP to the letter and register patients for the information nights we have set up. How many will come? Stay tuned...

Success! Well, the first of hopefully many more to come...

We have successfully set up the first batch of MyOSCAR accounts! After getting all the involved providers signed into MyOSCAR and added their MyOSCAR ID to their OSCAR accounts, and IT setting up a color printer, Linda and I crossed our fingers and proceeded to generate MyOSCAR accounts for the list of patients the participating doctor has confirmed.

The process turned out to be quite painless:
1. Search for the patient
2. Click "Register for MyOSCAR" for this patient
3. The following screen comes up which has all the required information pre-filled

4. Click "Submit"
5. The following confirmation letter is printed

6. Voila! Add the welcome letter and stuff them in an envelope with a window and Bob is your uncle!

We hope to mass produce this next week and get at least a couple of hundreds of patients set up. Will let you know!

David Chan

How will we know if we are successful?

The OSCAR Investigator Group is looking forward to gathering the information needed to answer that question! We have a great team of evaluators from a variety of backgrounds including health services research, family medicine, health informatics, pharmacy, and management. We are planning to look at the implementation of MyOSCAR from many points of view including the patient, provider and clinic perspectives. Our aim is to test the adoption, feasibility and usefulness of MyOSCAR including how connecting with the family practice clinic helps to improve primary health care. We are busy developing our own collaborative working relationships across our team since some of us have not worked with each other before. That in itself is a side reward of the project. A good evaluation will also mean working closely with the implementation and programming teams so that we can make sure we are all on the same page and not working at cross purposes. Our first meetings have been great and even though things are fast moving and there are a million details to work out we can already tell that there are a great bunch of very enthusiatic health care providers and clinic staff who are working hard to make the project a success. I am sure we will come across some road blocks but hopefully the team that has been assembled will handle the challenges with grace and figure out how to turn lemons into lemonade!
Lisa Dolovich

We are ready to start!

The meetings continued... There are considerable concerns that the secure communication between patients and the clinic is too cumbersome to set up and the workflow of managing these incoming messages must be customizable to each clinic environment. Patients must be aware, and must sign the consent to make sure expectations are clear (see http://myoscar.org/consent). We gave ourselves extra time until November 15, 2011 to make modification to the secure messaging system to better meet the needs of the participating clinics. When MyOSCAR is rolled out this Friday, patients won't be permitted to receive any clinic record or secure messaging until they are authenticated (proving who they say they are) by clinic staff. We will provide many different methods to make it easier for patients to do so.

So before we send out patient's invitation and their account information, these are the steps we have to follow:

1. Set up MyOSCAR accounts for all the participating providers and the research assistant. In order for these providers to use their existing EMR (OSCAR) to make transactions with the patient's MyOSCAR accounts they have to add their own MyOSCAR account ID's in their OSCAR account. The newly hired clinical liason person will be meeting each of these providers one on one to walk them through.

2. A list of active patients have been created and participating providers have scanned through the list to make sure all the patients are in fact active. We discovered in this process that a few (not that many) patients have in fact already left the practice. There is a delay between when a patient leaves a practice to when the government sends us the acknowledgement that the patient has been de-rostered.

3. Students have been hired to create MyOSCAR accounts for patients of the participating practices. It is estimated that it will take about 2-5 minutes for each account to be created, an individualized invitation letter to be printed and the letter along with the consent information be folded and inserted into an envelope. We are playing it safe to create these accounts one by one instead of batch. I think in the future we should be able to do this in a batch mode.

I think we are ready... fingers crossed!

David Chan

Getting going

Talking with the physicians who are participating has generated some questions but also lots of enthusiasm for the project. One of the clinics has now reviewed their practices and made sure all the patients are active, so far there are nearly 5000 patients to be contacted. The other clinic will be ready by next week so stay tuned for the final numbers of patients being offered email contact with their health care team.  

The beginning of an adventure

I have never written a blog before but better late than never!

So the impetus of writing this blog is to chronicle the start of an exciting eHealth project. My clinic, along with several other clinics will be offering some of our patients their very own Personal Health Record. I hope our experience will help many others to do the same. I do believe this will ultimately transform the way we do "business" - to provide health care to our patients.

The technology group and the implementation group have been meeting for weeks to plan this. Our start date was set for September 15, 2011 - today!!  One of the first things I learned was that things don't always work out the way I want - the project is delayed! We are still waiting for the final contract from the funding agency so the most realistic start date is now October 1, 2011. That's still a very ambitious date.

Later I will write about the people who are involved in this project and what role they play.

Already I heard over the grapevine that there is a general anxiety among the clinic staff. How will this new service affect the way we provide care? Will it add more work or will it make our work easier? Will patients really want to participate? We'll see.
David Chan