IPA: Moving Toward a Paperless Release of Information ROI

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IPAMoving Toward a Paperless Release of
Information (ROI)

• Presented by
• Amarah Hicks, RHIA
• Chief HIMS Denver VAMC
• Marjorie Poulin, RHIT, CIPP
• Chief HIMS Privacy Officer, My HealtheVet POC
  Togus VAMC

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Ground Rules

• Please write questions on the 3X5 cards provided
• Room assistants will collect the cards and we
  will attempt to respond as time permits to all
  questions
• If we run out of time your questions and answers
  will be posted on the VeHU website

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Class Description

• This HIMS/My HealtheVet co-sponsored session will
  use both audio-visual aids and role-playing to
  demonstrate how In-Person Authentication and
  Personal Health Record (PHR) extracts will allow
  for paperless Release of Information for
  laboratory results.

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Learning Objectives

• At the end of this presentation, attendees will
  have an understanding of
• Understand In-Person Authentication (IPA) process
  and its relationship to ROI Policies and
  Procedures.
• Identify current and planned PHR extracts which
  will be available to the veteran after they have
  completed the IPA process.

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My HealtheVet Administrative Portal

• Overview of In-Person Authentication (IPA)
• Overview of My HealtheVet Administrative Portal
• https//admin.myhealth.va.gov

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In-Person Authentication (IPA)

• VHA Handbook 1907.02 provides guidance on the IPA
  process
• IPA is performed by individuals who have been
  granted access to the MHV Administrative Portal
  in the role of authenticator.

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In-Person Authentication (IPA)

• IPA is the first step in allowing My HealtheVet
  veteran users to access selected portions of
  their online personal health record
• Essentially, this is the heavy proofing
  required to verify a persons identity
• Ensures that access to a veterans individual
  health information is granted only to the
  individual to whom the information pertains
• Every veteran requesting initial access must be
  verified or authenticated

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In-Person Authentication (IPA)

• Training?
• HIM Chief or PO is responsible for training ROI
  or other staff assigned to do IPA
• Who performs IPA?
• ROI Clerks
• Administrative Staff at CBOCs
• Volunteers
• Purpose?
• To assure that the correct veteran is given
  access to the right information

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In-Person Authentication (IPA)

• Requires validation or heavy proofing
• Must be a registered My HealtheVet user
• Show one form of government ID or VIC card
• View MHV Orientation Video ( available on MHV
  website)
• Read Sign MHV Participation Form (10-5345a-MHV)

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In-Person Authentication (IPA)

• Note only required initially, and once
  authenticated, the veteran has access to all
  information released via MHV.
• The IPA process may be performed at any facility,
  regardless of whether the Veteran is a patient at
  that facility.

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Administrative Portal

• Administration Portal offers resources and
  services for implementation of the Personal
  Health Record (PHR)
• This portal has the following portlets
• Manage User Roles (MUR)
• In-Person Authentication (IPA)
• Hold for Review

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IPA Portlet

• The IPA portlet allows Authenticators to
• Look up MHV users
• Save user information from a partial
  authentication session to be completed at a later
  date
• Retrieve user data from MHV
• Record prerequisite training and sign-off
  criteria
• Record that the authentication process is
  complete for a user
• Check for authentication status of a user
• Remove authentication designation from a user

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Administrative Portal Home
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Administrative Portal
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Search MHV Users
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Search MHV Users - Error
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Search Results
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Authenticate User
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Authenticate User - Error
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Delay Authentication
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Successful Delay Authentication
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Mistakes?

• What happens if a mistake is made during the
  authentication process?
• The process must be terminated and started again

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Termination Authentication
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Verify Termination
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Successful Termination
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Removal

• What if youre unable to authenticate?
• If ROI or assigned staff is a Veteran, they
  cannot authenticate themselves
• Can you remove an authentication?
• Only in rare circumstances
• Must provide a reason for removal in admin portal

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Remove Authentication
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Verify Authentication Removal
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Successful Removal
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Batch Authentication - Search for Users
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Remember to Log Out !!!
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Possible Error Messages
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In-Person Authentication

• There are currently about 75,000 IPAd users.
• Allows for veterans to see prescription names,
  lab data, and appointment data.
• In the future it will allow for an additional 21
  extracts as well as allow them to participate in
  Secure Messaging.

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• Now we are going to demonstrate how MHV and IPA
  process will impact release of information (ROI).

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ROI Process Before IPA

• Veteran must complete ROI form or submit a
  request in writing
• ROI clerk must review photo id or verify the
  veterans signature
• ROI clerk reviews the request to assure it is
  HIPAA compliant
• ROI clerk enters the request into the ROI
  software

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ROI Process Before IPA

• ROI clerk must locate information requested in
  CPRS or paper chart
• ROI clerk completes the request in ROI software
• ROI clerk creates prints a cover letter
• ROI clerk must verify address on request
• ROI clerk mails the request to veteran

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ROI Current Process

• ROI clerk often has to call the veteran to
  clarify request or if request is not valid
• Veteran or requestor may not receive completed
  request
• Duplicate Requests
• Veterans sometimes request the same information
  multiple times.
• Receive phone calls from veterans to check on
  status of requests

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ROI Current Process

• Request must be completed within 20 work days
• Privacy concerns
• ROI clerk has to ensure information is sent to
  the correct location
• ROI clerk has to assure that information is not
  misfiled in the electronic or paper chart
• Minimum necessary standard
• Disclosure restrictions, if applicable

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Scenario 1 Walk-in

• OIF/OEF Veteran comes into the ROI office to
  request a copy of her lab results.

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• ROI Clerk
• Can I help you?
• Are you enrolled in My Healthe Vet?
• Well, first you must be authenticated.

• Veteran
• Yes, I had labs drawn today and I would like to
  request a copy.
• Yes, but I didnt know I could see my lab
  results.
• How do I do that?

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• ROI Clerk
• Have you viewed the orientation video?
• Yes. Now youll need to complete the 10-5345a
  MHV form and provide photo identification.
• Alright, thats all you needed to do. Now I can
  grant you access to view your labs and scheduled
  appointments online.
• No, your labs will be available after a 7 day
  delay.
• This allows time for the test to be processed,
  entered into your electronic medical record and
  reviewed by your provider.

• Veteran
• Is that the one with Bo Derek?
• Heres my ID. (Vet completes form)
• Will my labs be available immediately for me to
  view?
• Why do I have wait 7 days to see the results?
• Will someone call me to let me know my results
  are ready?

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• ROI Clerk
• No one will call you to notify you when the
  results are ready for viewing. Youll need to
  remember to check online around 7 days after the
  test was taken.
• Currently you can only view lab results and
  appointments. But sometime in the near future
  you will be able to view other parts of your
  record and also send secure messages to your
  provider.
• My pleasure. If you have any questions, please
  contact the ROI office for assistance. Have a
  great day, and thank you for your service.
• .

• Veteran
• Wow, this is great! Now I dont have to come
  into the ROI office every time I need copies of
  my labs. I can simply check online and see them.
• What will else will I be able to access online?
• Fantastic. This is amazing. It is going to save
  me so much time, and it will help me monitor my
  health care more closely! Thank you for your
  help.

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Lets Recap

• ROI process before IPA
• Vet must submit every request in writing
• ROI clerk must review, evaluate, and process each
  request in ROI software
• Request must be printed and mailed to veteran

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Lets Recap

• ROI process after IPA
• Veteran completes IPA requirements
• ROI clerk verifies completion of all requirements
• ROI clerk grants veteran access to online
  personal health record (PHR)
• Veteran now has 24/7 access to PHR

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Benefits to Online PHR

• Allows for veterans to access their lab results
  and appointments at their convenience
• Allows veteran to easily share lab results with
  non-VA providers
• Encourages veterans to become more involved in
  their healthcare
• Eliminates the need for ROI to provide results to
  veterans
• Decrease the number of ROI requests

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Is Your Facility Prepared for IPA?

• Determine best place to
• View the Video
• Sign the form
• Increase flow of veterans
• Display handouts/promotional materials

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Is Your Facility Prepared for IPA?

• Education and Training for ROI clerks
• Learn about My HealtheVet
• Complete all training provided about IPA
• Review and understand IPA Handbook
• Understand 7 day hold, initial sensitive record
  review and need for quarterly record reviews.
• Be Proactive Seek out
• My HealtheVet POC or My HealtheVet Team

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Best Practices

• Have combined ROI into the File Room allowing for
  8 additional staff to assist with the My
  HealtheVet processing.
• Provided face to face training of all CBOC staff
  to process My HealtheVet IPA applications.
• Get Help! Volunteers, etc.
• Received a grant from Americorp for a full time
  person for one year to assist with My HealtheVet
  training through Volunteer Services.

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Best Practices

• When veterans present in ROI for a request,
  encourage them to take advantage of My HealtheVet
  for future requests
• Encourage other frontline staff to promote
• CBOC IPA implementation guide available
• Contact the veteran to inform that the IPA was
  successfully completed and thank them for
  registering.

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Best Practices

• Have dedicated space for veterans to register
  view the video
• Display promotional material in prominent
  locations throughout facility
• Encourage veterans to let other veterans know of
  the process and who to contact.

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Whats Coming Next?

• FY08
• View Appointments
• Chemistry/Hematology Lab Results
• Secure Messaging
• Wellness Reminders
• CPRS Flag Notification

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Whats Coming Next?

• FY09
• Personal Health Record Extracts
• Admissions
• Discharge Summary
• Allergies
• Co-Pay Balances
• Cytology, Microbiology, Microscopy, Pathology,
  Radiology
• Demographics
• ECG
• Immunizations
• Problem List
• Vitals
• Progress Notes
• Family Health History
• And more.

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CONTACT INFORMATION

• If you would like additional information on
  anything covered in today's class please contact
  us.
• Amarah Hicks
• [phone] X2259
• Marjorie Poulin
• [phone]

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Questions /Comments? ? ?