Private Sector Innovation and Policy Advancement
The implementation phase of policy making involves two components, (1) rulemaking and (2) operation of policies (Longest, 2010). According to Longest (2010), the success of any policy’s operational stage depends on two variables: (1) the design or construction of the policy and (2) characteristics of the organization including the capability of its managers. A critical element for an organization is to have leaders that are in alignment with the goals and objectives of the policy, if not, this could risk the success of the implementation. Leader’s main objectives in operationalizing the implementation phase of a policy include, strategizing, designing and leading.
Private Sector Organizations and Patient Portals
I will focus on the implementation of patient portals at the organization I work for- Yavapai Regional Medical Center, located in Prescott Arizona.
Yavapai Regional Medical Center (YRMC) is a full-service, not-for-profit community health system. YRMC is a state-of-the-art healthcare system with two acute care hospitals, a network of primary and specialty care clinics, outpatient health and wellness centers, cardiac diagnostic centers, and outpatient medical imaging centers. Together, YRMC’s network of services provides medical care and wellness resources to a geographic area encompassing 5,500 square miles and covering the communities of Prescott, Prescott Valley, Chino Valley, Dewey, Humboldt, Mayer, Paulden, Bagdad, Yarnell, Kirkland, Skull Valley, and Crown King. Yavapai Regional Medical Center, is locally owned and operated out of Prescott, Arizona. Yavapai Regional Medical Center (YRMC) strives to create an environment where people of YRMC work alongside patients and their families to provide peace of mind and peace of heart, as well as physical cure and comfort. YRMC has two main campuses, YRMC West (located in Prescott, AZ) and YRMC East (located in Prescott Valley, AZ). YRMC West, the original campus, has 134 inpatient beds, and YRMC East, which opened on May 15, 2006, has 72 inpatient beds.
Strategizing: In June 2012, YRMC went live with our electronic medical record (EMR) which comprised of 55 IT applications across the two acute care hospitals. One of YRMC’s goals for fiscal year 2012 was to attest for Meaningful Use Stage One. One of the set objectives to meet Meaningful Use Stage One was getting patients to sign up for the portal. This was part of the YRMC’s strategy in the timing of the implementation of the EHR.
My interviews of the professionals I conducted were: Randy Rahman, prior CIO of YRMC (he was CIO when YRMC went live with the EHR), and Tim Roberts, current CIO for YRMC. Their perspectives on the strategy for designing, implementing and sustaining the EHR were similar. Additionally, their concern about security and privacy regarding the patient portal was paramount. They both concurred that the integration of Health Information Technology and EHRs in healthcare was evolving and is a journey.
Leading and Designing: Prior to implementation of the EHR, we began working with our marketing department on the development and communication of the patient portal, which we named CareConnect. Through workflow analysis, we determined that the most important interface with patients regarding the portal occurs during the registration process. Therefore, we developed talking points for our registration staff and developed Care Connect brochures (see brochure below) for patients and their family members to take home for reference.
The Health Information Management (HIM) department conducted internal open house events where YRMC staff could register for a CareConnect account. Additionally, the HIM staff participated in local community events discussing the benefits of the patient portal in order to support the registration process with the public.
YRMC also developed a robust Public Relations (PR) campaign which included media releases, articles in local publications, with a heavy emphasis on EMR/Patient portal in community newsletters, annual reports, etc. A patient portal community was also established, which can be accessed on www.yrmc.org.
In order to support the registration conversation and PR campaign, we used print and radio advertising to extend our message into the community.
As both Mr. Rahman and Mr. Roberts indicated in their interviews, this is a journey, so we continue to support the patient portal with radio advertising as appropriate to keep the CareConnect brand in the public’s mind.
In June 2015, YRMC Physician Care (YRMC’s employeed physician practices) made the transition from Athena to Cerner EHR. This was also part of the strategy in obtaining “One Chart” for patients seen in the office practices. Again, we worked with our marketing department to communicate this change internally and externally. This included an entirely new campaign that was focused on internal communication/talking points, etc. (see brochure below).
Throughout this journey, we have monitored our progress on meeting the indicators for meaningful use. We have successfully attested for both Meaningful Use Stage 1 and Stage 2. This has required the organization to develop a council that oversees the process, a dedicated individual that monitors progress and an executive sponsor that provides leadership and guidance. Throughout this process, YRMC consistently worked together to create the empathetic environment necessary to meet the stated goals and objectives.
Serving as the executive sponsor for this initiative, I would concur with the comments by Mr. Rahman and Mr. Roberts; implementation of a policy is an evolving journey. The rules change, incentives change, and penalities are applied for not meeting the requirements. I would add one other comment, the reward for achieving success is extremely satisfying. Although the monetary reward was beneficial to the organizations bottom line, seeing the team who worked hard to meet the requirements beam with pride and take ownership, has been well worth the effort.
References
Longest, B.B. Jr. (2010). Health policymaking in the United States (5th ed.). Chicago, IL: Health Administration Press
Retrieved from: www. yrmc.org
Patient portals 