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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Resource Overview

Patient portals, sometimes also referred to as personal health record systems (PHR) are web-based portals commonly attached to electronic health record systems (EHRs). These patient-centered portals provide patients with the ability to login and review health information related to their care. Common patient portal services include ways in which to schedule appointments, send messages to their care providers, review test results and refill prescriptions.

Outside of the benefits to the patient, implementation of patient portals had come to the attention of healthcare providers due to the inclusion of Meaningful Use of objectives centered on the use of patient portals and electronic engagement with patients.  Stage 3 requirements are still being explored and the impact it will have on Health Centers is unknown. Therefore, it is a challenge for small practices and Health Centers to determine how to best derive value from Patient Portals and effectively implement them into their workflow.

The tools and articles posted below are meant to provide examples, templates and strategies that can assist Health Centers in understanding how patient portals can better engage their patients in self-management of their care, and after an initial investment in time and money can decrease the burden on their clinical and administrative staff.

Patient Portal Resources

Sample Information Blocking policies, procedures, and templates

Tools for Health Centers to Comply with Rules Prohibiting Information Blocking

Steps in using sample information blocking policies, procedures, and templates from HITEQ:

(available for download at the bottom of this page)

 

  1. Conduct Initial Information Blocking Risk Assessment (Appendix A) as part of the organizational record, and update annually thereafter.
  2. For any organizational practices that appear on the list of suspected practices for Information Blocking (Appendix A, Section VI)
    1. Record the exact practice and current workflow, and assess whether any of the 21st Century Cures Act ONC exceptions apply using Appendix D: Information Blocking Exceptions and other references. 
    2. For any practices that are reviewed where no exceptions apply, cannot be modified, and is/are necessary, document that the organization does not intend for the practice to result in information blocking.
  3. Develop/review policy/ procedure for reviewing/fulfilling requests for information.
    1. Ensure that process is non-discriminatory and expedient.
    2. Ensure that electronic and physical information requests are consistent in terms of consent, privacy, and legal requirements.
  4. Develop a process for documenting exceptions to requests
    1. Ensure that process aligns with the eight possible exceptions, noting that five allow for not fulfilling the request while the other three refer to procedures for fulfilling requests.
    2. Use other HITEQ information blocking process resources, including Appendix D: information blocking exceptions
  5. Implement documentation for exceptions on a case-by-case basis
  6. Develop a process for responding to requests, either where information will be shared and access maintained or where the request will not be fulfilled, and the reason needs to be communicated. 
  7. Review and adopt information blocking complaint procedures (Appendix E)
    1. Use Appendix G as a template for investigation workflow.
    2. Use Appendix H to document the investigation.
  8. Document complaints, incidents, and related responses and/ or actions
    1. Use Appendix F - Incidence Response Log to document this.

Download all of these documents below.

Disclaimer: Information blocking forms become part of the record and can be reviewed by OIG during an investigation. The HITEQ Center and related entities are not liable for any direct or indirect consequences resulting from information given herein and advises legal counsel review of these and all forms prior to use.

The HITEQ Center project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of awards totaling $779,625 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable suggestions and contributions from HITEQ Project collaborators.