12.0 Patient Web Portal (PCP)

Please be advised that some videos will contain both PCP and Specialist content.
Video Time: 06:56

Applicable to PCPs and specialists. Patient web portal is a system that supports two-way, secure, compliant communication between the practice and the patient. For capabilities pertaining to patient’s use of portal, practice unit staff must be trained in and have implemented this capability, and patients must be able to use it currently.

12.1

Available vendor options for purchasing and implementing a patient web portal system have been evaluated

PCP and Specialist Guidelines:

  1. Assessment of vendor options may be conducted by PO or Practice Unit.

12.2

PO or Practice Unit has assessed liability and safety issues involved in maintaining a patient web portal at any level and developed policies that allow for a safe and efficient exchange of information

PCP and Specialist Guidelines:

  1. Safety issues may include prohibiting electronic communication for emergency situations, etc.
  2. All messages exchanged must be secure and HIPAA compliant.
  3. Attestation of PO is acceptable

12.3

Ability for patients to request appointments electronically is activated and available to all patients

PCP and Specialist Guidelines:

  1. Practice will schedule patients and notify them of their appointment time

12.4

Ability for patients to log and/or graph results of self-administered tests (e.g., daily blood glucose levels) is activated and available to all patients

PCP and Specialist Guidelines:

  1. Option should be available to patients, recognizing that not all patients will choose to use these tools.

12.5

Providers are automatically alerted by system regarding self-reported patient data that indicates a potential health issue

PCP and Specialist Guidelines:

  1. “Flags” may be set using customized parameters for individuals based on their care needs.

12.6

Ability for patients to participate in E-visits is activated and available to all patients

PCP and Specialist Guidelines:

  1. POs and/or Practice Units have developed and implemented protocol for responding to patient messages/requests for e-visits in a consistent and timely manner (e.g., a triage system), using structured online tools.
  2. Please refer to the AAFP guidelines for e-visits for more information.

12.7

Providers are using patient portal to send automated care reminders, health education materials, links to community resources, educational websites and self-management materials to patients electronically

PCP and Specialist Guidelines:

  1. At least 4 out of the 5 types of communications must be occurring
  2. Information must be actively transmitted to patients (not merely available on website)

12.8

Patient portal system includes capability for patient to create personal health record, and is activated and available to all patients

PCP and Specialist Guidelines:

  1. Content of personal health record may be defined by PO/Practice Unit, within context of patient portal system.

12.9

Ability for patients to review test results electronically is activated and available to all patients

12.10

Ability for patients to request prescription renewals electronically is activated and available to all patients

12.11

Ability for patients to graph and analyze results of self-administered tests for selfmanagement support purposes is activated and available to all patients

PCP and Specialist Guidelines:

  1. Option should be available to patients, recognizing that not all patients will choose to use these tools

12.12

Ability for patients to have access to view registries and/or electronic medical records online that contain patient personal health information that has been reviewed and released by the provider and/or practice is activated and available to all patients

12.13

Ability for patients to schedule appointments electronically through an interactive calendar is activated and available to all patients

PCP and Specialist Guidelines:

  1. Patients should have the ability to see currently available appointments and insert themselves in to the schedule of the practice. Time slot is then reserved for patient.
    1. May be subject to final confirmation by practice

Patients have access to a web portal enabling patients to access medical information and to have electronic communication with providers

PGIP - Physician Group Incentive Program

An innovative incentive program through BCBSM that brings together physician organizations from across Michigan, to encourage information sharing about various aspects of health care. Program participants, including both primary care physicians and specialists, collaborate on initiatives designed to improve the health care system in the state.

PO - Physician Organization

An organization that partners with physicians or is a group of physicians that works with health plans on contracts and other mutual interests (i.e. incentive programs, transition programs, etc.) of their organization.

PHO - Physician Hospital Organization

An organization that partners with physicians and hospitals in order to obtain payer contracts and to further mutual interests (i.e. incentive programs, transition programs, etc.) within integrated delivery systems.

MPP - Physician Partners

An organization that is 50% owned by physicians and 50% owned by the Health System to negotiate payer contracts, assist with health plan enrollment, and provide guidance and support in mutual interests that promote evidence based care and overall well being of their customers "the patient".

SRD - Self Reporting Data

Twice a year (summer and winter) BCBSM requires PO/PHO to conduct assessments for PGIP participating offices which include review of office demographic information, office technology and PCMH initiative implantation within the office. This data is linked to PCMH nomination, PCMH designations and PGIP incentive monies.

PU - Practice Unit

The identification of a practice within the PGIP program.

PCMH Nomination

An office in PCMH nomination status is requesting review by BCBSM for PCMH Designation. An office can be nominated through their PGIP participating PO/PHO during the BCBSM Winter SRD submission.

Denominator

Total number of "current" patients in the practice.

Numerator

Total number of patients in the denominator with whom conversations have been held and partnerships established at any point in the past

4P or Pay for Performance

Claim payments based on quality and utilization scoring determined by the health plan. (Quality based payment structure)