In 2010, DuPage Medical Group (DMG) began its “MyChart journey,” as Karen Adamson puts it. This entailed the largest independent physician group in the greater Chicago area adopting an Epic patient portal that gives patients access to physicians, and vice versa, online.
“Our patients realized the advantages of communicating this way rather than on the phone, and our physicians and staff appreciated the efficiencies of communicating electronically with patients for test results, refills, and general medical questions,” says Adamson, DMG’s chief information officer. “It’s just a lot more convenient.”
Today, about 60 percent of DMG’s active patient population—more than four hundred thousand—are active on MyChart. It has been more popular in established practices, Adamson says; newer practices take a while to ramp up and get comfortable with the system.
MyChart has served as the foundation for several of the organization’s telemedicine initiatives, including e-visits and video visits. Video visits took a while to catch hold but have gone from being used once or twice a week to a current average of twenty-five. Most of the visits are for primary care conditions, but the organization has begun offering them for dietitians and other specialty services.
“The initial goal was to get the technology working and get patients to use the mobile app rather than home devices,” Adamson says. “My team has partnered with clinical operations management and physicians to make sure we have the appropriate buy-in. We’ve also worked closely with marketing, which has really done an incredible job of promotion using our website, Facebook, and radio.” Drivers on local expressways might also see a huge billboard touting the MyChart portal and video visits.
“When we started video visits, we assumed a younger demographic would be interested, but our latest data tells us that about half the video visits came from patients older than forty.”
Adamson and her team have also expanded patients’ self-scheduling options. Now, patients can schedule appointments on the DMG website or through MyChart 24/7. They can even self-schedule tests such as mammograms and heart scans. In early 2017, DMG was scheduling around 3,500 appointments a week through the platform, including an average of two hundred new patients. Adamson says that this has taken some pressure off the call center and allowed them to maintain the growth.
All of this innovation is being led by a combination of patient demand and by the organization’s push. “We have some patients looking for it, but in a lot of ways, we are ahead of the curve and patients are learning about these technologies from us,” Adamson says. “But there have been some surprises. When we started video visits, we assumed a younger demographic would be interested, but our latest data tells us that about half the video visits came from patients older than forty, and our most senior patient was eighty-four years old. We’ve been pleasantly surprised by that.”
The technology has been important in helping to harness the rapid growth DMG has seen of late, as the organization has acquired new practices and taken on more physicians. That’s placed a demand on IT infrastructure, including networks, phones, and application teams. To better manage the growth, Adamson has a project management office within the department to handle the entire acquisition process, from initial discovery all the way to classroom training for physicians and staff.
“We go through a lessons-learned process after each acquisition that allows us to improve the process of subsequent practices,” she says. “What we’ve heard from the new practices is that they feel the process was smooth and well-supported and that they’ve felt welcomed.”
On top of all that activity, Adamson’s department has completed ten data conversions in the past year. It’s a time-intensive process, involving mapping, validation, and testing. As a parallel, the team has an ongoing project to extract information needed from the legacy system to ensure retention of medical records. And there’s no end in sight to the telemedicine innovations, Adamson says, though there are longer-term goals.
“We see this becoming more of a standard delivery-of-care option,” she says. “The current challenge is that most of the payers don’t reimburse for it, so currently, we offer it as a retail service with a nominal fee the patient pays. Over time, I think this will become a covered benefit in plans. We want to get ahead of the curve, get tech in place, and create patient awareness and excitement.”