Health Informatics and Quality Course e SignUp and

Health Informatics and Quality Course e. Sign-Up and e. Check-In Nivedita (Neve) Chang POIS Project Coordinator Physician Organization Information Services Mythili Raghunath Senior Project Manager PO Practice Solutions & Strategic Outreach

Health Informatics and Quality Course Agenda q q q e. Sign-Up and e. Check-In Functionality Front Desk/Administrative Staff Workflow Clinical Staff Workflow Roll Out Plan Q&A 2

Health Informatics and Quality Course ESIGN-UP & ECHECK-IN 3

Health Informatics and Quality Course Overview e. Sign-Up to solicit My. Chart sign-up e. Check-In to complete prearrival info Arrival at the practice 4

Health Informatics and Quality Course e. Sign-Up – How it works • Email to all patients above 18 years of age who have appointments in the next 14 days who do not have an active My. Chart (Weill Cornell Connect) account – Recent change was made to require e-mail or exception reason during check-in • Links the patient to our standard self-sign up page (Lexus. Nexus) – Why are we doing this? • Increase My. Chart adoption for future initiatives 5

Health Informatics and Quality Course e. Sign-Up 6

Health Informatics and Quality Course e. Check-In – What is e. Check-In? • Patients can update certain information the day before their appointment in My. Chart in one screen – Why are we doing this? • Expedite some of the check-in process 7

Health Informatics and Quality Course e. Check-In – How it works • Patient gets an e-mail tickler 1 Day before appointment to complete pre-arrival information Mark Dinkin, MD 01/17/18 10: 00 AM 8

Health Informatics and Quality Course e. Check-In Completes pre-arrival information, including: • • • Verify Demographics Verify Insurance Review Medical Information: • Medications • Allergies • Problem List Make Payments Signs Documents • AOB • HIPAA • Non-Par Consent Note: Demographics, Insurance, and Medical Information is skipped if previously confirmed in past 30 days. Documents will not appear if they have been collected and are not expired. 9

Health Informatics and Quality Course Demographics Patients can either verify existing demographics is correct or edit the information. Edits immediately update directly into the patient’s Epic chart. 10

Health Informatics and Quality Course Insurance Patients can verify Active Insurance Coverages. If they add a new insurance, the coverage will be seen on the IFS for the practice to review and also goes into the Registration workqueue. 11

Health Informatics and Quality Course Medications Patients can Add/Remove Medications. Changes will be queued up for the provider under the ‘Reconcile Outside Information Activity’. 12

Health Informatics and Quality Course Medications Note: Patients can manage their pharmacy preferences from this page, which will file directly in to the patient’s chart. 13

Health Informatics and Quality Course Allergies/Problem List Patients can Add/Remove Allergies and Problem List. Changes will be queued up for the provider under the ‘Reconcile Outside Information Activity’. 14

Health Informatics and Quality Course Payments Patients can choose to pay their outstanding balance payments. 15

Health Informatics and Quality Course Documents Patients can choose to e-sign the HIPAA, AOB and Non Par consents. 16

Health Informatics and Quality Course e. Check-In Complete Once the patient completes the whole process, they will get a notification. 17

Health Informatics and Quality Course Future Functionality • “Welcome”: Ability to arrive at a tablet/kiosk using a bar code. 18

Health Informatics and Quality Course Summary e. Sign-up email 14 days before appt. e. Check-In email 1 day before appt. Demographics, Insurance Meds, Allergies, Problem List, Pharmacy Payments HIPAA, AOB, Non-Par forms signed e. Checked-In & Ready for Arrival 19

Health Informatics and Quality Course My. Chart e. Check-In Demo • In-system demo: e. Check-in workflow in My. Chart 20

Health Informatics and Quality Course STAFF WORKFLOWS 21

Health Informatics and Quality Course Front Desk Training Goals Before Visit ü Collect and verify patient emails (email field + email opt-out is a hard stop in Epic) ü Encourage My. Chart sign-up and usage of e. Check-In ü Ensure Registration WQs are clean to ensure errors are minimized ü Reconcile any new insurance changes 22

Health Informatics and Quality Course Front Desk Training Goals During Check-in ü Patient must still be “Arrived” in Epic ü Identify and positively affirm patients who have completed e. Check-In o “Thank you for verifying your information online through e. Check-in. To complete the check-in process, please complete additional forms [and other steps]” ü Check for pending insurance reconciliation or skipped steps (documents and payments), before completing remaining check-in steps ü Continue to encourage sign-up and usage of My. Chart, highlighting features such as e. Check-In and Online Scheduling. Marketing brochures will be available Ø Consider having an “Express Lane” for e. Check-In patients 23

Health Informatics and Quality Course Front Desk Training Goals During Check-in Note that e. Check-In steps do not need to be repeated at the practice, to avoid discouraging patients from using the functionality. o Patient can choose to skip payments and document signing o Review any duplicate information collected in patient forms o Pay attention to e. Check-In Status if patient has multiple appointments in your department. Currently, the status updates for only one appointment 24

Health Informatics and Quality Course My. Chart Status - DAR • Column on the DAR (“Patient My. Chart Status“) indicates if a patient is active on My. Chart Meaning behind My. Chart Status: 1. Active - Patient is active 2. Inactive - Patient is inactive 3. Pending - An activation code was generated for the patient but they have not used it 4. Code Exp - An activation code was generated for the patient and has expired. A new code must be generated. 25

Health Informatics and Quality Course My. Chart Status - DAR • If the patient is not active, print My. Chart code and sign-up instructions by clicking on “WCC code” on the toolbar 26

Health Informatics and Quality Course e. Check-In Status - DAR • New column on the DAR (“WCMC e. Check-In Status”) will indicate if a patient has completed e. Check-in Meaning behind e. Check-In Status: 1. Completed – Patient completed the entire e. Check-In workflow* 2. In Progress – Patient started the e. Check-In workflow but did not complete the entire process. 3. Blank – Either the patient is not eligible for e. Check-In or they are eligible, but have not logged into My. Chart. *If patient has multiple appointments, status will only update for one 27

Health Informatics and Quality Course Insurance Reconciliation • If patients change insurance, a warning will appear during check-in and an item will appear in the Reg. work-queue item prompting to review coverages on the Interactive Face Sheet • New coverages must be reconciled on the patient’s Interactive Face Sheet 28

Health Informatics and Quality Course Check-in Steps – New Patient e. Check-in patients: 1. Verify e. Check-In complete on DAR 2. 3. 4. 5. Check insurance or skipped steps* Scan Insurance Card Referrals Patient Forms (New Patient forms, Medical Questionnaire, Auths. , Financial Agreement, etc. ). 6. Copay – if collected at check-in 7. Arrive patient in Epic *Patients Regular patients: 1. 2. 3. 4. 5. Verify no e. Check-In on DAR Encourage use of e. Check-in Demographics Insurance Sign AOB, HIPAA, Non Par consent 6. Scan Insurance Card 7. Referrals 8. Patient Forms (New Patient forms, Medical Questionnaire, Auths. , Financial Agreement, etc. ). 9. Copay – if collected at check-in 10. Arrive patient in Epic can skip payments and document signing 29

Health Informatics and Quality Course Check-in Steps – Established Patient e. Check-in patients: Regular patients: 2. 3. 4. 5. 6. Patient Forms – if applicable 7. Copay – if collected at check-in 8. Arrive patient in Epic 1. Verify e. Check-In complete on DAR Check insurance or skipped steps* Patient Forms – if applicable Copay – if collected at check-in Arrive patient in Epic *Patients 1. 2. 3. 4. 5. Verify no e. Check-In on DAR Encourage use of e. Check-in Demographics Insurance Sign AOB, HIPAA, Non Par consent can skip payments and document signing 30

Health Informatics and Quality Course e. Check-In Reports • Notification on the DAR Column name: WCMC e. Check-In Status • Reports will be available to administrators in Epic Reporting Workbench Ø e. Check-In My. Chart Self Sign. Up Summary: high-level Ø e. Check-In My. Chart Self Sign. Up Detail: patient-level 31

Health Informatics and Quality Course Clinical Staff Training Goals • Identify My. Chart active patients. Continue to advocate for usage of My. Chart, highlighting features such as checking lab results and messaging with providers • Understand how and where to reconcile medical information that a patient enters in My. Chart • Medications • Allergies • Problem list 32

Health Informatics and Quality Course My. Chart Status - MPS • “My. Chart – WCC” column indicates if patient is active on My. Chart 33

Health Informatics and Quality Course Medication Reconciliation • Medical Information gets reconciled in the same workflow as any clinical information received from outside organizations. This workflow has been in production for several years. 1. Patient reports information in My. Chart 2. Alert appears during encounter 3. Clinical staff reconciles – adds or discards information 34

Health Informatics and Quality Course Medication Reconciliation 1. Patient reports information in My. Chart 35

Health Informatics and Quality Course Medication Reconciliation 2. Alert appears within encounter 36

Health Informatics and Quality Course Medication Reconciliation 3. Reconcile information within “Outside of Local Medical Record” section. Add or Discard needed information 37

Health Informatics and Quality Course FAQs • Do the patients receive push notifications on their My. Chart app for e. Check. In reminders? o Yes, but the patient must have Push Notifications turned on for the My. Chart app. • If the patient has multiple appointments on the same day, will they receive an e-mail tickler for each appointment? o The patient will only receive 1 e-mail tickler per run (per day). • Can forms be sent via e. Check-In? Can you pay copay? o Currently, this functionality is not available. 38

Health Informatics and Quality Course FAQs • Do patients still see Insurances screen in e. Check-In, if this information has been verified by RTE 7 days prior to their visit? o If the patient has not verified their insurance information in the past 30 days via My. Chart, s/he will see the Insurance step within e. Check-In, which will list all of their current coverages. • Will the Health Information Exchange form be included in e. Check-in? o No. Currently e. Check-in only supports AOB, HIPAA, and Non-Par consent at this time. 39

Health Informatics and Quality Course FAQs • What workqueue shows the coverage updates made by the patient via e. Check-In? o Missing Registration Workqueue • What workqueue rule in Missing Reg Items do I filter by to only see any coverage updates made by the patient via e. Check-In? o WCMC INSURANCE UPDATE FROM MYCHART COVERAGE DISCOVERY [355976] 40

Health Informatics and Quality Course FAQs • During check-in, does the front desk staff still need to click on ‘Verify Patient’ on the checklist to produce the green check mark, even if the patient completes e. Check-In? o Yes. e. Check-In only indicates whether the patient has verified their information. The staff still needs to ensure that all checklist items are verified and have a green check mark before arriving the patient. • How does the outstanding balance get distributed? Can patients choose which department they want the payment to go to? o If the patients pay in full, the outstanding balance goes to oldest first. The patients cannot choose which departments to pay from within the e. Check-In workflow, but they can do so from the ‘Billing Account Summary’ page in My. Chart. 41

Health Informatics and Quality Course FAQs • Can patients select COBRA or self-pay under insurances? o The Insurance screen allows to select from a list of top payors, including “Other. ” There is no option for self-pay. Patients must speak with the front desk for this. 42

Health Informatics and Quality Course FAQs • Can patients enter a term date when removing insurances? o Patients are not prompted to enter a term date, but they can enter any additional information in the comments. Staff must review any patient submitted information as part of the reconciliation process. 43

Health Informatics and Quality Course FAQs • Can children complete e. Check-In? o Parents who are setup as proxies can complete e. Check-In for children aged 0 -11. Children aged 12 and older can complete e. Check-In. • Can patients upload an image with their insurance card? o Patient cannot scan insurance cards through e. Check-In, but in My. Chart they can send a secure message to their provider with attachments. They can send a message to any providers with whom they have had an in-person visit in the past three years. • Can patients enter a member ID under insurances? o Yes they can enter a member ID but the field is optional. 44

Health Informatics and Quality Course FAQs • Do patients need a code for e. Sign-Up? When does the code expire? o e. Sign-Up does not require entering an activation code. It only asks for identity verification questions. But if the patient has difficulty with the questions or wishes to bypass them, the practice can provide the activation code for them to enter. My. Chart codes expire after 45 days. • Can patients complete e. Check-In on the same day as their appointment? o Yes. Patients can complete e. Check-In right up until their appointment time. Once staff arrives the patient, they can no longer e. Check-In. 45

Health Informatics and Quality Course Q&A Neve Chang nik 2004@med. cornell. edu POIS Project Coordinator Physician Organization Information Services Mythili Raghunath myr 2002@med. cornell. edu Senior Project Manager PO Practice Solutions & Strategic Outreach 46