Keith E Torkelson, MS
Technology
Patient Portal Study
Quality & Value - Audit Results
Report-01 - Also –
AVEY - Buster
Universal Care –
Brand New Day
Aerial - Cerecons’
Patient Portal Audit & Evaluation
By Mentalation
Solutions Group (MSG, 2016) & Keith E Torkelson, MS
|
|
|
|
|
|
|
Date Last Scored
|
Assessment
|
Calculation
|
Result
|
|
|
-
|
|
|
|
|
|
20160827-SAT
Items Scored = 13
|
Patient Portal Content Audit Score [PP-CAS]
|
2 PASS/13 Items X
100 =
|
15%
|
|
|
20160823-TU
Items Scored = 22
|
Patient Portal Quality Audit Score (Errors) [PP-QAS]
|
2 PASS/22 Items X
100 =
|
9%
|
|
|
|
|
|
|
|
20160827 - Patient Portal Audit Report Card (No Control
Available)
Screen Shot of Brand
New Day - Cerecons Dashboard (20160823-TU)
We here at Mentalation Solutions Group (MSG) have
performed both a 22-point Quality Audit and a 13-point Content Audit of our
program’s Patient Portal (Cerecons – Aerial).
We have no control patient portal for this study. We were limited to evaluating only our own
record (n=1). We found that out of a
sampling of four (4) members in our program, Brand New Day (BND), that only we
were referred to using the patient portal.
After thoroughly reviewing the content in our record we determined that
our record’s Patient Portal Content Audit Score (PP-CAS) as of 20160827 is 15
percent (%). After reviewing the
quality of our record we determined that our record’s Patient Portal Quality
Audit Score (PP-QAS) as of 20160823 is 9 percent (%). These values are incredibly terrible.
Follow Up Action Items
It is very likely that the errors
are split between programming and coder errors. We here at MSG would not recommend our portal content for a
Health Information Exchange (HIE). We
are sharing our findings with the Mental Health Services Act – Orange County –
Technological Needs Group (TAC) with the hope that it will help them avoid any
of the pitfalls we pointed out in this report.
We did find a puzzling glitch with entries under Physicians Recently
Visited. We have no recollection for
visiting four (4) of the practitioners listed.
Lastly, we offer Brand New Day (BND) portal administration the chance to
have us correct our own record. Due to
issues with confidentiality, which we have run across in the past, we know it
is unlikely we can correct any but our own Brand New Day – Cerecons patient
portal record.
Round-01 Documents – Provider Series-01-
|
|
Worksheet
|
Tech_Patient_Portal_Study_16090202_WS-01
|
|
|
Brief Appendix
|
Tech_Patient_Portal_Study_16080402_Append-Brief
|
|
|
My Medications - A First Impression – Screen
Shot
Figure – My Medications Screen Shot – Marked Up
Error Types – My Medications (3/22 of total errors found =
Audit Error Share)
|
-
|
|
|
|
#
|
Error Type
|
Example
|
Better if
|
|
|
-
|
|
|
|
1
|
Incorrect Value & Impossible Value
|
60000 for Quantity
|
60
|
|
2
|
Date Format
|
Oct 17 2015
|
20151017
|
|
3
|
Missing Header
|
Date Header Omitted
|
Included
|
|
|
|
|
|
|
Table – Medication Domain – Errors – Wrong and Impossible
Values
Metadata Specs - Range of Medication Data (2012-2016) Range
of Errors (2014-2016)
Likelihood of Getting the Medications’ Section (Domain)
Right
Due to the nature of both coding and programming errors: It
is likely these errors occur in other clients’ patient portal records. The chance that these errors can be
corrected is very small. We recommend
deletion and recoding with an improved coding quality framework in place.
(Level of Error(s) when extrapolated across all clients = Crash Worthy)
Outline
Pages Predicted for This Brief Report (25)
It is good that we here at MSG predicted a limit to our
brief report because at one point our brief report exceeded fifty (50)
pages. To keep this report brief we
separate our appendices PRN. For
example: Introduction – Brief [20160830-TU SEPARATED] & Seven Issues (No
PASSES) for Fleshing [SEPARATE].
Report Content Inventory (For Brief Report)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Confirmation Research Results
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Table - Report Content Inventory (For Brief Data Report –
TAC Version – 20160902-F)
|
-
|
|
|
|
##
|
Patient Portal
Element or Tab
|
Cerecons
Error - Test Outcomes
|
Note
Regarding Fail
|
|
|
|
|
|
|
01
|
My Info - Demographics
|
PASS
|
|
|
02
|
My Doctors
|
Fail
|
Unknown Doctors
|
|
03
|
My (Member) alerts
|
Fail
|
Alerts out of date by 2 years
|
|
04
|
Send an Email
Non-Emergency
|
20160701-20160730
Fail
|
Close effort after 2 attempts
Conclusion - Unsupported
|
|
05
|
My Links > Email
|
Fail
|
Tested Email Option
|
|
|
|
|
|
|
06
|
My Medications
|
Fail
|
Numerical Errors
Errors with dates
|
|
07
|
My Recent Allergies
|
Fail
|
|
|
08
|
My Visits
|
Fail
|
Not enough info to determine if I really saw all of them
listed
|
|
09
|
My Recent Labs
|
Fail
|
Incomplete
No Reference Ranges
|
|
10
|
My Recent Referrals
|
PASS
|
|
|
|
|
|
|
|
11
|
My Immunizations
|
Fail
|
Not reported yet I have had several of them
|
|
12
|
My Medication Reviews
|
Fail
|
We do it every 3 months – not reported
|
|
13
|
Assessments
|
Fail
|
Submitted - Yet
never reported
|
|
|
|
|
|
|
|
Content Audit Score
(CAS) =
|
2 PASS/13 Items Scored = 15%
|
It Fails on any grading curve
|
|
|
|
|
|
|
Also see: [PENDING]
Appendix Brief – Login Information
Appendix – Printing the Dashboard
|
|
|
|
|
|
|
Date Last Scored
|
Assessment
|
Calculation
|
Result
|
|
|
-
|
|
|
|
|
|
20160827-SAT
Items Scored = 13
|
Patient Portal Content Audit Score [PP-CAS]
|
2 PASS/13 Items X
100 =
|
15%
|
|
|
|
|
|
|
|
|
20160823-TU
Items Scored = 22
|
Patient Portal Quality Audit Score (Errors) [PP-QAS]
|
2 PASS/22 Items X
100 =
|
9%
|
|
|
|
|
|
|
|
Table - 20160827 Patient Portal Audits – Cumulative Report
Card - Patient Portal Audit Report Card (No Control Available)
Acronyms for Quality Audit (Brief)
|
-
|
|
|
AcroCode
|
AcroCode
|
Note
|
|
|
-
|
|
|
A-SEP
|
Addressed Separately
|
|
|
IFF
|
Issues For Fleshing
|
|
|
NAF
|
No Assessment Found
|
|
|
NAR
|
No Assessment Reported
|
|
|
|
-
|
|
|
Table – AcroCodes (MSG) for Patient Portal Quality Audits
Results (PP-QAR)
Scoring Method(s) – PASS/Fail
Basically, we use a PASS/Fail method to score the items in
both the content and quality assessments.
All items received a Fail unless as PASS is scored. As addressed earlier we have no true
Controls for this study. Blank scoring
forms are included in our brief appendix handouts. The total number of items for Content is thirteen (13), whereas
the total number of items for Quality is twenty-two (22).
The next couple of pages address
the Quality of our Patient Portal. Our
summary findings for Patient Portal Audit Scores Report (PP-ASR) were presented
in the table above. Below are the
details about our Patient Portal quality assessment. The tables include our Patient Portal Audit Data. After working on this formal study since
winter quarter of 2016: We now consider our organization (MSG) educated about
Patient Portals. There are two parts
(tables) for our Quality assessment.
Page 1 of 2 – Patient Portal
Quality Audit - Data
|
-
|
|
|
|
|
Item
#
|
Error Type
|
Description
|
Sample
Incidence
|
Correct
[PASSES]
|
|
|
-
|
|
|
|
|
|
|
|
|
|
|
01
|
1-Date
|
Format Quality &
Consistency
|
|
[A-SEP] - IFF
|
|
02
|
Activity Counter(s)
|
|
Absent
|
|
|
03
|
Anonymous Coders (QC)
|
|
Global
|
|
|
04
|
Assessments
|
Evaluated
|
NAF
|
|
|
05
|
Assessments
|
Reported
|
NAR
|
|
|
|
|
|
|
|
|
06
|
Client Input
|
Updating Fields
|
My Visits
|
|
|
07
|
Color
|
Duplication
|
Headers
|
|
|
08
|
Consistency
|
Across Fields
|
Dates
|
|
|
|
|
|
|
|
|
|
Scored = 9
(PP-AQS Sub-score) =
|
|
|
# - PASSES/Items
0/8
|
|
|
|
|
|
|
|
Table - Patient Portal Quality Audit Scores (PPA-QS-9 Item)
- Results – Last Scored: 20160823
Also see: [PENDING]
Appendix – Quality Audit Worksheet – 22 Item – Combined –
Page 1 of 1
Page 2 of 2 – Patient Portal Quality Audit - Data
|
|
|
|
|
|
Item
#
|
Error Type
|
Description
|
Sample
Incidence
|
Correct
[PASSES]
|
|
|
|
|
|
|
|
09
|
Data
|
Incomplete
|
My Recent Labs
My Immunizations
|
[A-SEP] - IFF
|
|
|
|
|
|
|
|
10
|
Data
|
Missing
|
My Recent Labs
|
|
|
11
|
Data
|
Not Up to Date
|
My Alerts
|
|
|
12
|
Demography
|
|
|
PASS
|
|
13
|
Detail
|
Lacking
|
My Visits
|
|
|
14
|
Errors
|
Copy & Paste
|
My Medications
|
|
|
|
|
|
|
|
|
15
|
Feature
|
Unsupported
|
My Links > Email
|
|
|
16
|
Feedback
|
Methods
|
WEAK
|
[A-SEP] - IFF
|
|
17
|
Formatting
|
|
All Over
|
|
|
18
|
Impossible
|
Entries
|
My Medications
|
|
|
19
|
Promotional & Facilities
|
|
POOR
|
[A-SEP] - IFF
|
|
|
|
|
|
|
|
20
|
Spelling
|
|
|
PASS
|
|
21
|
Use of Color
|
|
No Enhancement
|
|
|
22
|
Value
|
Incorrect
|
My Medications
|
|
|
|
-
|
|
|
|
|
|
Scored = 14
(PPA-QS Sub-score) =
|
|
|
# - PASSES/Items
2/14
|
|
|
|
|
|
|
|
Table - Patient Portal Quality Audit Scores (PPA-QS-9 Item)
- Results – Last Scored: 20160823
Also see: [PENDING]
Appendix – Quality Audit Worksheet – 22 Item –
Combined – Page 1 of 1
My Doctors Tab > Physicians Recently Visited (Concern
& Most Puzzling)
12 of 12 Entries
Captured > 8 = Correct > 4 Unknowns
-
|
|
|
Unknown Physician
|
Specialty
|
Name of Real Doctor
|
-
|
|
|
Carrie Wakai
|
Optometrist
|
Ann Inman and Boyce
|
Shubhangi Godbole
|
General Practice
|
Chester Mojica
|
Zulmira Chadwick
|
Lic Voc Nurse
|
Un-needed
No hits on Google
|
Angelita Beredo
|
Internal Medicine (Endocrinologist)
|
Un-needed
|
-
|
|
|
Table – My Doctors Tab – Physicians Recently Visited -
Unknown Doctors
Action Items - My Doctors Tab > Physicians Recently
Visited
-
|
|
Action Item
|
Progress
|
-
|
|
Check Internet for the Nature of Practitioners
|
Results on Next Page
|
Check “My Referrals” Tab in Patient Portal
|
No referrals approved for these four (4) practitioners
|
Review paper versions of referrals mailed to us
|
No referrals mailed to us
|
|
|
Solicit advice
|
|
Bring to the attention of Provider
|
|
Bring to the attention of CMS
|
|
|
|
My Doctors Tab > Physicians Recently Visited (Most
Puzzling)
Confirmation Research Results
The addresses were taken from the Patient Portal
Research All Unknowns on WWW (Changed strategy)
Search Patient Portal for Details
Doctor Carrie Wakai - Optometry
Address: 3756 Santa
Rosalia Dr #100 - Los Angeles, Ca 90008
Tel: (323) 294-7517 - Fax: (323) 294-9219
Doctor Angelita Beredo - Internal Medicine
Address: 301 N
Prarie Ave #301 - Inglewood, Ca 90301
Tel: Note Listed > Fax: Note Listed
Doctor Zulmira Chadwick - Lic Voc Nurse
Address: 5455 Garden
Grove Blvd 5th Fl - Westminster, Ca 92683
Tel: Note Listed > Fax: Note Listed
ORIGIN: Hebrew
Doctor Shubhangi Godbole - General Practice
Address: 12675 La
Mirada Blvd #200 - La Mirada, Ca 90638
Tel: Note Listed > Fax: Note Listed
Origin: Indian: Religion: Hindu
Search for Referrals in Patient Portal
Date Range = 20160801 – 20130626 Total Referrals Recorded as
of 20160825-TH: = 32
None of the Providers in Question have Referrals associated
with them
Shortfall of Patient Portal
No method to bring up invoices (bills) with appropriate
level of detail.
With regards to the
mystery providers: What would you do?
-
-
-
-
-
1-Syntax for Dates - Format Quality &Consistency
Out of all of our findings we find date formatting and
placement our highest priority suggestion
We here at MSG fractionate our some Issue For Fleshing
(IFF). We have referenced material
about common data coding protocols. The
programmers for our Patient Portal do not appear to have referenced the same
data coding standards (specifications).
They would better be served by standardizing their formats and data
definitions. The programming errors
lead to problems with sorting fields such as Medication Dates.
Variation in Date Formats as they Appear
|
|
|
Patient Portal Domain
|
Date Format
|
Sort Issues
|
-
|
|
|
My Medications
|
Oct 17 2012
|
|
My Visits
|
05/02/12
|
|
My Recent Labs
|
12/29/2015
|
|
My Alerts
|
2014
|
|
My Recent Referrals
|
08/01/2016
|
|
-
|
|
|
Table – Samples of Dates Formats Used in Our Patient Portal
Record
Variation in Formatting (Summary)
This whole Patient Portal package needs to be bounced back
to the programmers.
The Biggest Issues
Once again, we here at MSG find: Date Format Issues –
Global: As one of the most serious problems with our client’s Patient
Portal. This utility suffers wrong and
inconsistent date formatting. This will
lead to sorting problems. This will
lead to Health Information Exchange errors.
This placement of dates in a list (database) is generally the most left
most field. We recommend the following
date formatting.
YYYY-MM-DD or
YYYY/MM/DD or
YYYY MM DD or
YYYYMMDD
Bank of America Model for Date Formats [20160901=TH: Last
Minute]
Date in Left Most Field
No Text in Date – Text in Description
Miscellaneous Lose Ends
Discussion Items (For Next Report)
Email Utility
Coders
Data Feeds & Sources
The Feedback Challenge
Summary & Recommendations (Fixes and Solutions)
“We here at MSG have some ideas about what to do next in
getting BND’s Patient Portal “right”.
End of Patient
Portal
Results Up Front
Report (RUF-R)
Divided
MSG (2016-2017)