Hello, I'm David Douglas and I'm going to talk about Secure Messaging.
I'm a psychiatrist at the Portland, Oregon VA and the co-chair of the My HealtheVet clinical
advisory board.
So My HealtheVet is a personal health record, you probably know that the personal health
record or a PHR is a web based set of tools that allow patients to coordinate their health
information.
And to really see the transformative effects of My HealtheVet you can just look at the
utilization statistics on this page.
84 million visits, over 2 million registered users, 37 million prescription refills and
over 600 thousand Veterans using Secure Messaging.
Now these utilization statistics can be compared to those of other personal health records.
And a big one was Google Health.
You know global internet brand launched a personal health record and it was decommissioned.
And if you look at the postmortem that followed why Google Health was shut down, it actually
describes the inverse of what VA has done right.
And so it turns out from the Google Health experience, that patients don't really want
to transcribe 30 years of their own outside medical records, they want the health care
organization to serve up the medical records to them.
They want a PHR that's going to add value by giving them access to information, allowing
them to do things electronically that previously required them to go to the hospital or the
clinic.
So this leads me to the PHR Triumvirate, that's my own term.
These are the three things that a PHR should offer and if does offer it will attract patients.
Number one is Self-Service Transactions, and prescription refill is a good example.
There's a good reason why we have 37 million prescription refills it's because patients
want to do things for themselves that they used to have to go the hospital for or make
a phone call.
They want access to their data it's the data that the healthcare organization has on them
and finally they want electronic communication and that's Secure Messaging.
So Secure Messaging is a secure electronic communication medium between 600,000+ veterans
and their VA healthcare team.
It's the approved means of electronic communication with veterans and it's a key component of
virtual care.
So it's all about connections, we've talked about connections and relationships.
Secure Messaging is an improved efficient way for veterans to contact us and just today
in the back of the room while we were talking I got to secure message from a patient and
without leaving this auditorium, that Veteran now has an eye appointment that he asked me
to arrange for him through secure messaging.
So it was great and a very timely example.
I swear that I didn't set that up.
So again you think about the triumvirate self-service transactions accessed information and also
communication with the healthcare team that's what's allowed My HealtheVet to achieve the
utilizations statistics that a global Internet brand like Google couldn't do.
The appeal of secure messaging overlaps with the appeal of email.
It's durable if the veteran can't remember exactly what was in it; they can go back and
read it again.
It's legible, it's not handwritten information and it's sufficient.
It's an a asynchronous communication medium for the veteran where they can send me a secure
message, go off about his business, I get it an hour later, I can respond to him when
I have time.
The two parties don't have to be connected the way they are on a phone call.
So Secure Messaging is new but it's really just the latest chapter of a three decade
story of how the VA has continuously used information technology to reinvent itself
and improve the way we deliver care to our veterans and many people in this room know
this story but I love to recount it.
In the 80s we automated hospital processes like pharmacy and laboratory.
We got our first taste of how technology and process reengineering and the use of data
would lead to improve quality outcomes.
In the 90s we built an electronic medical record CPRS.
We deployed it across the largest centrally directed healthcare organization in the country.
Every VA medical center in the country was using the electronic medical record and that
really set the stage for dramatic, really stunning gains in the quality of care in the
VA.
It was described in Best Care Anywhere and again in a sequel to that book a big improvements
in quality, safety, cost efficiency and patient satisfaction and up to that point we'd really
focused of most of our technological efforts on our own providers, on our own healthcare
organizations, well the time is now to focus technology on our patients and that really
was the segue into consumer informatics and the growth of Secure Messaging.
So the idea of consumer informatics exists outside the VA and there've been some very
impressive goals that have been sent by visionary leaders.
There's Eric Dishmon the Chief Innovation Officer for Intel and he's calling for 50%
of Americans to be receiving virtual care by 2020.
And on the right we have our own visionary leader Dr. Petzel, he wants 50% of veterans
to be getting virtual care by 2014.
And now this isn't just a case of our visionary leader can beat up there visionary leader
although I know he probably could.
This is all about setting a strategy for the VA so that the maximum number of our veterans
can take advantage of this technology and achieve the transformative goals that will
improve their healthcare.
So what does virtual care look like?
It looks like this.
An empty waiting room on the left and a veteran at her home, on the right, with her laptop
computer communicating with her doctor.
We're tracking virtual care modality here's some recent statistics on how we're proceeding
towards that 50% goal that we want to hit by the end of next year and you can see that
Secure Messaging is accounting for about two thirds of that activity.
We're going to try to keep growing the program to hit the 50% goal just as Dr. Petzel wants
us to.
So secure messaging its 21st-century medicine.
It continues that the story of using process reengineering data and technology.
It improves the lives of our patients and I'm going to stop now and show a brief video
that will allow couple of our veterans to tell you what Secure Messaging means to them.
VIDEO: Dr David Douglas: We need to use technology
to reach out to patients so that they have access to information decision-support and
the ability to communicate with us using technology Narrator: Dr. David Douglas is a pioneer and
advocate in bringing insecure messaging to the VA community.
Dr. David Dougals: In the old days your interaction with the patient was limited to the time of
the scheduled appointment maybe to a phone call.
Now that we have secure messaging, I can communicate with my patients 24 x 7 anytime of the day
or week that they contact me or I need to contact them, we have the ability to communicate.
Narrator: Devin Naszbaum, a veteran of the war in Iraq, describes how Secure Messaging
works for him.
Devin: I really like using secure messaging because I can do it whenever and wherever
from my Smartphone.
If I'm walking down the street, if I'm in a coffee shop, if its 2 o'clock in the morning
and I have thought or a question about my health or medications or almost anything,
I can message my doctor right then and there.
I don't have to wait for 8 to 5 Monday to Friday to make a phone call.
Devin: So how are things going?
Dr David Douglas: Very good.
I'm still very grateful you taught me how to use your messaging on my mobile phone
(Laughs) Devin: when I do see the doctor and I've already
talked to him about Secure Messaging or we've already exchanged messages on Secure Messaging
we can kind of put that issue aside and talk about the current issue that I've showed up
at his office for or whatever checkup we are doing
Narrator: The service is available to all Veterans.
From Devin who grew up with the internet, to Veterans who served before the electronic
age like Vietnam veteran Larry Ubl.
Larry: When I first met Dr. Douglas and he introduced me to this program and asked me
if I wanted to be a part of it, I said "well yeah, I know I'm not high-tech type of person.
I'm kind of old-school" I still like that but I found that really easy for the Secure
Messaging and it's been great for me as far as being able to contact Dr. Douglas during
some times when I just needed to talk to somebody.
Dr. David Douglas: Stay in touch through Secure Messaging
Larry: You bet, thanks Devin: what the process of Secure Messaging
can do for the patient is that it just takes a lot of stress out of having to leave their
home maybe if they are disabled or don't like being out or its hard to get to the VA through
buses or taxis or something like that having to arrange a ride, it makes it a lot easier
to interact with your doctor wherever and whenever from your home or from your Smartphone
Narrator: There are over 500,000 Vets using My HealtheVet to communicate with their doctors.
Dr. Douglas's goal is to have all Veterans using the program
Dr. David Douglas: To veterans and also to my physician colleagues I would say jump in
the water's fine you'll be very happy that you did.
Secure Messaging is a huge improvement over 20th-century communication medium.
It's more efficient for us; it's more efficient for the patient they'll make you do a much
better job of providing care for our Veterans.