You are a Vital Member of the My HealtheVet MHV Team

1. You are a Vital Member of the My HealtheVet (MHV) Team My HealtheVet Class #122

2. MHV Class #122 Faculty Southern Arizona VA Healthcare System Karen Hebda, EEO Manager, VISN & Facility MHV POC Michelle Levack, Asst. Chief HIMS & Privacy Officer Tom Vagedes, Clinical Applications Coordinator Fayetteville, North Carolina VA Medical Center Terri Admire, Patient Education Coordinator & MHV POC

3. 3 What is My HealtheVet (MHV)?

4. 4 Class Objectives Identify essential team members, their roles and responsibilities Understand the team concept, effectiveness, and endless possibilities Learn successful implementation strategies for current and future My HealtheVet functionality

5. 5 Main Objective Sell the Team Approach

6. 6 VISN 18 Team Includes facilities in Albuquerque, NM Amarillo, TX Big Spring, TX El Paso, TX Phoenix, AZ Prescott, AZ Tucson, AZ VISN 18: 1st place nationally for percentage of veteran population enrolled in MHV and for number of authenticated users

7. 7 VISN 18 Team Attribute Successes To: Monthly Phone Conference Setting Goals Tracking Goals Sharing Best Practices Brainstorming Combining Our Efforts

8. 8 VISN 18 Goals

9. 9 VISN 18 Team Graph showing progress toward Rx Refill in 2006

10. 10 VISN 18 Team Graph showing progress toward Rx Refill in 2007

11. 11 283-Bed Tertiary-Care Facility Affiliations with 85 academic institutions including University of Arizona Colleges of Medicine, Nursing & Pharmacy Includes: Blind Rehab Center Geriatrics & Rehab Center Research Facility Spinal Cord Injury Clinic

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15. 15 MHV Team Roles, Responsibilities and Best Practices MHV POC Keep current on all MHV info Recruit & train volunteers Gather statistical data Plan & chair monthly meetings Prepare & distribute meeting minutes Keep management informed Provide help to veterans as needed

16. 16 MHV Team Roles, Responsibilities and Best Practices IT POC Technical and subject matter expert for hardware & software needs MHV kiosk readiness and lockdown solution Installs updates Liason to IT Department for all MHV computer needs Role Administrator for MHV Admin Portal (originally assigned user roles)

17. 17 MHV Team Roles, Responsibilities and Best Practices Patient Nurse Educator Includes MHV training in all health classes Covers MHV in New Employee Orientation (NEO) Includes MHV topics in facility-wide education committee Participates in outreach to staff, volunteer and veteran organizations Arranged to get MHV In-Person Authentication (IPA) training video on the Instant Health Line, making it easily accessible throughout the facility

18. 18 MHV Team Roles, Responsibilities and Best Practices PERC Librarian Monitors both MHV kiosks and printers Assists veterans with registration, authentication, and troubleshooting Shows IPA video on Instant Health Line as needed Duplicates materials as needed Acts as MHV helpline for phone inquiries in absence of MHV POC

19. 19 MHV Team Roles, Responsibilities and Best Practices Pharmacist Acts as liaison to Pharmacy staff for all MHV related issues Placed MHV information in New Patient Handbook Encourages Online Refill as preferred method for refilling prescriptions (brochure, voice mail, window pick up, etc.) Instrumental in getting MHV kiosk near OP Pharmacy Conducts MHV training updates as needed during Pharmacy staff meetings Brings Pharmacy concerns to monthly MHV team meetings

20. 20 MHV Team Roles, Responsibilities and Best Practices TLC Pharmacy Tech Acts as liaison to TLC Pharmacy staff for all MHV related issues Troubleshoots website problems with patients who call the TLC line Works directly with MHV POC to assist patients with refill issues and questions Includes MHV printed updates to Pharmacy staff folders to keep everyone informed

21. 21 MHV Team Roles, Responsibilities and Best Practices Dietician Worked with MHV design team to test the food & activity journals Provides MHV updates to nutritional staff Provides training on MHV functionality for dieticians Encourages use of MHV with patients to track their diets Nutrition Week Activities

22. 22 MHV Team Roles, Responsibilities and Best Practices LPN, Geriatrics Worked with subcommittee to draft first implementation plan that was used as a national model Provides MHV updates to Geriatric Clinic staff Promotes MHV with all Geriatric Clinic patients & family members Had several articles published in the Retiree Newsletter at the local Air Force Base Provided MHV brochures for out-briefings on base

23. 23 MHV Team Roles, Responsibilities and Best Practices Physician Champion Encourages all providers to incorporate MHV in their practice Conducts outreach during Medical Staff Meetings Instrumental in getting MHV website info on Next Step of Care Form Has recruited patients to act as MHV volunteers Included MHV website info on Advanced Clinical Access Brochure

24. 24 MHV Team Roles, Responsibilities and Best Practices

25. 25 MHV Team Roles, Responsibilities and Best Practices Secretary to Associate Director

26. 26 MHV Team Roles, Responsibilities and Best Practices Administrative Officer Community Based Outreach Clinics (CBOC) Acts as liaison to all CBOC staff for MHV updates and issues Represents CBOC concerns during committee meetings Requests signage and other promotional materials as needed Identifies locations for MHV kiosks as new CBOC sites are activated Helped to workout the IPA procedure that was developed and ready for use as soon as the IPA process was implemented

27. 27 MHV Team Roles, Responsibilities and Best Practices Volunteers Work directly with veterans and families in the registration process (assisted over 200 w/registration in FY07) Help to troubleshoot problems brought to them by MHV users Call in overhead announcements when they are posted at the kiosk Outreach to patients in waiting areas to provide MHV brochures and information Donated used computer equipment for use in the MHV kiosk Developed ideas and methods for outreach to inpatients

28. 28 MHV Team Roles, Responsibilities and Best Practices The List Goes On- Consider Telephone Operators Eligibility/Enrollment Staff ROI/HIMS CPRS/Clinical Applications Coordinator (CAC) Medical Media Voluntary Service Staff Public Affairs Officer� Never turn anyone away� Invite anyone with an interest to join your team�

29. 29 SAVAHCS MHV Team Most Recent Additions Assistant Chief HIMS/ROI-Michelle Levack CPRS Team/CAC-Tom Vagedes

30. 30 Release of Information (ROI) Involvement Michelle Levack, Assistant Chief of HIMS Privacy Officer Training ROI Staff to Prepare for IPA National MHV Online Training Satellite Conferences Local Hands On Training All Involved ROI Staff Registered on MHV All ROI clerks were given a walk through on the MHV website, specifically the MHV portal. This walk through was conducted by Karen Hebda, the MHV POC. At the time of the walk through all ROI clerks were registered for the portal. The walk through was completed prior to the implementation of IPA.All ROI clerks were given a walk through on the MHV website, specifically the MHV portal. This walk through was conducted by Karen Hebda, the MHV POC. At the time of the walk through all ROI clerks were registered for the portal. The walk through was completed prior to the implementation of IPA.

31. 31 ROI Involvement Workload Planning Contingency Plan Use of other HIM staff members Transcription Program Support Assistant Coding Staff CBOC clerks Authentication capabilities Enrollment/Eligibility

32. 32 Tools Developed MHV Form 10-5345a Colored to differentiate between ROI and MHV Guidance through Email Locating users on portal Admin Portal issues Helpful hints from ROI staff

33. 33 Tools Developed Face to Face VISN Meeting Networking Delegation of subject matter experts Instant Health Line MHV video �My HealtheVet: Building Your Personal Health Record�

34. 34 IPA Implementation Test Patient Employee volunteer Slow Going Issues with the MHV administrative portal Slow, steady stream of veterans Troubleshooting via phone and email with VISN team members

35. 35 Outreach Efforts IPA Numbers for February 2007IPA Numbers for February 2007

36. 36 Current IPA Stats

37. 37 Outreach Efforts MHV Posters MHV website Located on patient records Mailings Pharmacy First party ROI requests

38. 38 Outreach Efforts Partnership with MOVE! Posters and Literature Patient Carnival Veterans Benefits Fair CBOC Benefits Fair

39. 39 Outreach Efforts to CBOCs This poster was created for mailing, e-mail, and display at all seven CBOC�s. The CBOC Administrative Officer, Alicia Miller, is a member of the MHV team and requested specific posters, mailings, and e-mail for the patients who receive care at the CBOC�s. Something similar was created for local implementation. Attention MyHealtheVet Users At Community Based Outreach Clinics Those who have been using MyHealtheVet for refilling prescriptions online and tracking their personal health information have been awaiting the capability of seeing the name of their prescription as well as the prescription number when they order refills online. You will also be able to view key portions of your Personal Health Record as they are released throughout 2007. In order to upgrade your MyHealtheVet account to allow this to take place, you will need to go through the In Person Authentication Process. You can streamline this process by doing the following from your home computer: Step 1: Log in to your account on MyHealtheVet (www.myhealth.va.gov) and be sure that you indicate that you are a VA patient (Personal Information Tab, Profile, and scroll down to Relationship to the VA-if the VA Patient box is not checked off, check it off and use the Save button at the bottom of the page) Step 2: Watch the MyHealtheVet Training Video (available on the website from the Home Page.� Go to the Quick Links on the right side of the Home Page. Select the link for In-Person Authentication, and then select the link for the MHV Orientation Video). Step 3: Print out the MyHealtheVet Participation Form (available on the website from the Home Page, following the instructions as in Step 2 and selecting the link for the MHV Participation Form).� Complete and sign this form.� Once you have done Steps 1-3, you can bring your signed form with a government issued photo ID (VA Card, Driver�s License, etc.) to your local VA Clinic. They will verify your identity and forward the Participation Form to Tucson for final processing. You can expect the verification to be completed within 7-10 days. If you experience any problems with any of the above steps, contact the MHV Coordinator in Tucson at 800-470-8262 Ext 4754. Anyone who has not yet registered on the website can do so by logging in to www.myhealth.va.gov.This poster was created for mailing, e-mail, and display at all seven CBOC�s. The CBOC Administrative Officer, Alicia Miller, is a member of the MHV team and requested specific posters, mailings, and e-mail for the patients who receive care at the CBOC�s. Something similar was created for local implementation. Attention MyHealtheVet Users At Community Based Outreach Clinics Those who have been using MyHealtheVet for refilling prescriptions online and tracking their personal health information have been awaiting the capability of seeing the name of their prescription as well as the prescription number when they order refills online. You will also be able to view key portions of your Personal Health Record as they are released throughout 2007. In order to upgrade your MyHealtheVet account to allow this to take place, you will need to go through the In Person Authentication Process. You can streamline this process by doing the following from your home computer: Step 1: Log in to your account on MyHealtheVet (www.myhealth.va.gov) and be sure that you indicate that you are a VA patient (Personal Information Tab, Profile, and scroll down to Relationship to the VA-if the VA Patient box is not checked off, check it off and use the Save button at the bottom of the page) Step 2: Watch the MyHealtheVet Training Video (available on the website from the Home Page.� Go to the Quick Links on the right side of the Home Page. Select the link for In-Person Authentication, and then select the link for the MHV Orientation Video). Step 3: Print out the MyHealtheVet Participation Form (available on the website from the Home Page, following the instructions as in Step 2 and selecting the link for the MHV Participation Form).� Complete and sign this form.� Once you have done Steps 1-3, you can bring your signed form with a government issued photo ID (VA Card, Driver�s License, etc.) to your local VA Clinic. They will verify your identity and forward the Participation Form to Tucson for final processing. You can expect the verification to be completed within 7-10 days. If you experience any problems with any of the above steps, contact the MHV Coordinator in Tucson at 800-470-8262 Ext 4754. Anyone who has not yet registered on the website can do so by logging in to www.myhealth.va.gov.

40. 40 Distance of CBOCs

41. 41 CBOC Implementation

42. 42 CBOC Implementation Teleconference to prepare for IPA Staff from all five CBOC�s MHV POC ROI Supervisor CBOC Supervisor CBOC Administrative Officer Kiosk Placement

43. 43 CBOC Implementation Is it working? Forms received inter-office mail Forms received through fax

44. 44 Employee Outreach New Employee Orientation Staff given a walk through of the portal Staff enrolled Mandatory Training VISN 18 Requirement SAVAHCS Requirement

45. 45 Employee Outreach Encourage Staff MHV Enrollment New Employee Orientation Prizes include: Gym Membership, Restaurant Gift Certificate, Select Parking Spot for One Month, Gift Certificate to the Canteen Store, Bowling Passes, Free Oil Change Obstacles Overcome Results of Efforts Significant increase in number of employees enrolled

46. 46 Employee Outreach Top 5 Facilities for Employee MHV Enrollment

47. 47 Employee Outreach VISN 18 Employee MHV Enrollment

48. 48 MHV Team Plans for the Future Clinical Applications Coordinator members can bring added value to the MHV Team as you prepare for the electronic personal health record

49. 49 Opportunities for CAC�s Education and Training of new staff Re -educating and -training current staff CPRS Orders and MHV Creation of templates with links to MHV Coordinate mobile computers for MHV Vista routines to track MHV data Support for new MHV features e.g. �Blended View of Medications� Align MHV goals and VHA goals e.g. Patient knowledge of their medications and reconciliation to document changes

50. 50 New Staff Education & Training CPRS is the current health care record Clinical and Administrative staff training Expand awareness of busy staff Concept of a unified health record CPRS and MHV comprise the future record Many opportunities to educate and train Promote the goals of MHV Assist MHV enrollment Train-the-trainer model Staff learn and then train others

51. 51 New Staff Education & Training Current Opportunities Staff are trained to use the Computerized Patient Record System (CPRS) Training includes veteran�s access to the health record through My HealtheVet My HealtheVet as a personal health record Computer link to a portal of valuable information The Veteran as Active Participant in their care

52. 52 Staff Education & Training Future Opportunities Staff education as MHV advances Veteran access expands with new functions and information, e.g. �Blended View� of Medications Immunizations Progress Notes Vital Signs

53. 53 CPRS Orders & MHV Patients are thinking about their health when discharged Discharge Instructions are given to every patient when discharged Discharge Orders were modified to include a MHV reminder to the patient Nurses are also encouraged to promote MHV with these patients

54. 54 Discharge Order Reminder

55. 55 Templates and MHV Add the MHV link to templates Providers: Use templates in progress notes Can easily review the MHV page Can promote MHV Can describe MHV in the visit Can demonstrate ease of access

56. 56 Templates and MHV

57. 57 Assist With Computer Availability Volunteer with a mobile computer workstation presenting MHV to a patient A bit of humor: In the notes of the MHV committee Ms Hebda transcribed that we were using computers to outreach MHV to inpatient veterans; this resulted in a misunderstanding that generated 14 email messagesA bit of humor: In the notes of the MHV committee Ms Hebda transcribed that we were using computers to outreach MHV to inpatient veterans; this resulted in a misunderstanding that generated 14 email messages

58. 58 VistA Routines and MHV Data VistA Reports can be used to track MHV progress Tracking Rx Refill Progress Support for VISN Goals

59. 59 Select Refill Request Source Local Menu Option: ? 1 My HealtheVet Refill Requests by Month/Day 2 Refill Requests via Pharmacy Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text. Select Refill Request Source Local Menu Option: 1 My HealtheVet Refill Requests by Month/Day * Previous selection: DATE PROCESSED from Jun 1,2006 to Jun 22,2006@24:00 START WITH DATE PROCESSED: Jun 1,2006// (JUN 01, 2006) GO TO DATE PROCESSED: Jun 22,2006// (JUN 22, 2006) DEVICE:

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61. 61 OUTPUT FROM WHAT FILE: PRESCRIPTION// SORT BY: REFILL//���� (multiple) REFILL SUB-FIELD: 'RELEASED DATE/TIME//�� START WITH RELEASED DATE/TIME: Jun 1,2006//�� (JUN 01, 2006) GO TO RELEASED DATE/TIME: Jun 22,2006//�� (JUN 22, 2006) � WITHIN RELEASED DATE/TIME, SORT BY: REFILL//���� (multiple) � REFILL SUB-FIELD: +MONTH(RELEASED DATE/TIME);"";C1;S � Replace �� By 'RELEASED DATE', do you mean REFILL 'RELEASED DATE/TIME'? Yes//�� (Yes) � START WITH MONTH(RELEASED DATE/TIME): FIRST// ��� WITHIN MONTH(RELEASED DATE/TIME), SORT BY: REFILL//���� (multiple) ��� REFILL SUB-FIELD: +NUMDATE(RELEASED DATE/TIME);"";C11 � Replace �� By 'RELEASED DATE', do you mean REFILL 'RELEASED DATE/TIME'? Yes//�� (Yes) ��� START WITH NUMDATE(RELEASED DATE/TIME): FIRST// ����� WITHIN NUMDATE(RELEASED DATE/TIME), SORT BY: FIRST PRINT FIELD: REFILL//���� (multiple) � FIRST PRINT REFILL SUB-FIELD: !RELEASED DATE/TIME;# REFILLS"

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63. 63 Support for New MHV Features

64. 64 Align MHV Goals and VHA Goals E.g. Patient knowledge of their medications Medication Reconciliation to document changes

65. 65 Team Concept Works

66. 66 Fayetteville VA Medical CenterFayetteville, North Carolina

67. 67 Fayetteville VA Medical Center Part of VISN 6

68. 68 Veterans Served by the Fayetteville VAMC Clinical Core Level III Facility 90 general medical, surgical and mental health beds 69 beds in long-term care unit 21 counties served including 2 counties in South Carolina 2 community-based outpatient clinics

69. 69 Additional Resources Veterans requiring specialized services are referred to the Durham VAMC, or other VISN 6 VA facilities. VA/DoD agreement between Womack Army Hospital, Pope Air Force Base and Fayetteville VAMC to augment health care delivery. Affiliations with Campbell University School of Pharmacy, University of North Carolina Schools of Medicine, Dentistry and Pharmacy.

70. 70 MHV Promotion Strategy

71. 71 Organize A Task Force Form a multidisciplinary team. Involve administration.

72. 72 Implementing My HealtheVet Take a critical look at your facility and the resources available.

73. 73 Location, Location, Location Where are your MHV computers located? Do you have an appropriate space with equipment to view MHV instructional DVD�s?

74. 74 Challenges Space Staffing Time Management Budget

75. 75 Getting the Word Out With Limited Funds Signs Handouts Newsletters Emails Bulk mailings Telephone Trees Health Fairs VSO Events

76. 76 The Most Effective Approach for Implementing IPA/PHR Fayetteville�s IPA/PHR Plan is MHV Contest #6 Winner of the Above and Beyond the Call of Duty Award from My HealtheVet (November 14, 2006)

77. 77 Registration Process Veteran presents to HAS desk in Basement Outpatient Area and requests IPA for My HealtheVet Veteran is registered as MHV user and has viewed the IPA orientation video on the website Veteran will be given registration slip and will be directed to the ROI Window on the first floor from 8am-12noon and 1pm-4pm, Monday thru Friday

78. 78 Registration Process Veteran is not registered as MHV user Veteran will be escorted by a trained volunteer to the MHV computer in the Eagle Clinic waiting area to register for MHV and view the IPA orientation video on the website Veteran will then be given registration slip and will be directed to the ROI Window on the first floor

79. 79 Registration Process More than one veteran presenting for IPA at the same time will be escorted by a trained volunteer to room 119 in the Bravo Clinic to view the IPA orientation video as a group from 8am-12noon Any veterans in the group who have not registered for MHV will have to register for MHV on the computer in the Eagle Clinic waiting area Veterans will then be directed to the ROI window on the first floor

80. 80 Registration Process Veterans who present to the HAS desk for IPA after 12 noon and have either not registered for MHV or who need to view the IPA video, will be sent to Voluntary Service for assistance

81. 81 Final Registration Step Veteran who has completed prerequisites will present to the ROI window for IPA Veteran will provide one form of government-issued photo ID such as VIC card or driver�s license Veteran will sign participation form ROI staff will validate the veteran and match the veteran�s information with the Master Patient Index (MPI) ROI staff will initiate a record review

82. 82 Training Create dialog sheets for HAS staff to use so that they will know where to direct the veterans Create registration slips to give to veterans so that when they present to the ROI window the staff will know that they have completed the prerequisites for IPA Train volunteers to use MHV and the process for IPA Designate a Champion in each clinic and on each ward who has been trained to use MHV and knows the IPA process

83. 83 Communications Increase awareness of My HealtheVet 1. Continue to give MHV pamphlet to all veterans attending classes 2. Continue to present MHV as part of the New Patient Orientation Clinic 3. Continue to include MHV pamphlet in the admission packet 4. Veterans presenting in ambulatory care, pharmacy and lab areas will receive MHV materials 5. Veterans visiting the veterans benefits coordinator will receive MHV materials

84. 84 Uh, Oh! Problems With The Plan Retreat, take a second look, modify, be flexible. Turn around, renew, revitalize, go forward!

85. 85 SUCCESS!!! Don�t you love it when a good plan comes together?

86. 86 It�s Easy To Get Harried Computer problems Equipment failures Staffing issues Veterans questions Lack of time And on, and on��

87. 87 Slow and Steady Wins the Race Stay focused Follow your plan Be flexible Keep your eyes on the goal We�re rooting for you!!!

88. 88 Contact Information At Southern AZ VA Health Care System (VISN18) Karen Hebda, MHV POC, EEO Manager karen.hebda@va.gov Michelle Levack, Asst. Chief HIMS michelle.levack@va.gov Tom Vagedes, Clinical Apps Coordinator ronald.vagedes@va.gov At Fayetteville VA Medical Center (VISN 6) Terri Admire, MHV POC, Pt. Education Coordinator terri.admire@va.gov