Surveys Results: Prior to Implementation and One Year Later

Based on results of the survey given to staff prior to training and launch of the program, the majority of respondents viewed the project positively. Once training was accomplished, there was an 8.5% increase in the overall excitement of site personnel with a correlating decrease in responses that leaned toward a "wait and see attitude".

Prior to training and launch of program there was a wide range of concerns; however, the majority dealt with how the program would affect each individual's job responsibilities, the technological support for the remoteness of patients and patient compliance. During the past year these areas have become more clearly defined. Most notably the technology used at first wasn't sufficient to ensure continuous monitoring. This area is one of the most critical and will vary greatly depending on population specific demographics; cell tower vs land line vs VOIP. Understanding patient and site technology capabilities prio to launch could ensure a smoother implementation.

Additional comments provided during the survey addressed the tech issues with suggestions including options that would allow patients to view results and offer healthcare support literature which might encourgage patients to better engage in their care.

Efficiency issues were also mentioned such as ensuring there is a streamlined interface between the Healthcare Records Management System (Epic) and the software used by RNs to input program information (Ideal Life). This would decrease the burden of recordkeeping placed on personnel.

Catching Up: Successes and Celebrations!

Patient participation grew from 67 patients in early December to 85 patients in mid-March for a total of 220-225 since the start of the program. Interpreters needed for certain demographics, this continues to be successfully managed as of December 18, 2014.

New per diem nurse hired for rural clinics to assist as back-up when primary RN is unavailable. This will ensure program continuity and reduce workload on primary RN. We continue to look for opportunities to support the local healthcare community as well as provide patients in rural areas with the monitoring care they need. To this end, we are researching possible partnerships with healthcare providers outside the Mosaic Medical arena.

 

Form Translation

Although progress has been made regarding the translation of written materials into Spanish, challenges persist.

The onsite translator at Mosaic Medical has created Spanish versions of the Inventory and Consent and Welcome letters.  However, the survey that measures the effects of the program on patient self-management ability, the PAM Scores questionnaire, was created by Insignia, and worded in such a way as to produce specific desired information.  Mosaic’s translator is unable to translate the questionnaire, as a direct interpretation would not yield the same meaning.  This form is available in Spanish by Insignia, but has not yet been made available to COTN.

PAM Scores

As per the HERSA grant which is funding the expansion of Telehealth into Central Oregon, patients are required to complete pre- and post- Patient Activation Measure scores.

One challenge with this process is that some patients are reluctant to complete the surveys.  Others fail to return their completed surveys.

A second hurdle has been sorting out how to keep track of the scores.  When COTN first launched Telehealth in Prineville in 2013, the process involved scanning the completed forms so that they were accessible electronically.  Once scanned, the forms were saved in in “other orders” – this was prior to there being a specific place in EPIC for the forms to call home.

Heading forward, the scores will be saved in the “referral” section in EPIC, and pre- and post- scores will be entered into an Excel Spreadsheet as they are collected.