MyChart: A link between you and your provider

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Now that an electronic recordkeeping system is up and running well, Jefferson Healthcare is actively inviting patients to check out MyChart, a program that lets patients and providers communicate electronically.

MyChart is part of the new electronic medical records system called Epic, which was launched at Jefferson Healthcare in June 2013. Patients could have signed up for MyChart at that time. However, public hospital district officials did not promote or encourage the use of MyChart until recently, waiting until many of the initial bugs had been worked out.

“We did a soft rollout for the first six months and now we’re more confident with Epic,” said chief medical information officer R. Corey Asbell, who, because he is also a physician’s assistant, not only understands the electronic system, but also understands medical issues and lingo.

“MyChart is the user interface for patients to access the medical records system,” he said, adding that the goal is quite simply “to engage the patient in their care.”

As of Sept. 1, about 24 percent of all patients seen at Jefferson Healthcare clinics have signed up for MyChart. Twice as many have been given access codes, but have yet to actually sign up to communicate via MyChart.

There are plenty of things patients can accomplish through MyChart.

You can see if you have an appointment or make one, view most lab and test results, see past appointments and visit summaries, review your current medications and email questions to your provider.

As for refills, it is best to call your pharmacy first to see if you need a refill before asking for one through MyChart.

“Most people will think that’s everything,” Asbell said of all the things that MyChart can do.

What MyChart won’t give you is provider’s notes about how your hip replacement operation went, for example, nor will it give you the detailed clinical notes of your routine visit to your doctor. You also can’t receive billing information yet, but that is likely to happen in the future.

And there are a few lab results that it won’t give you.

“The list of labs that do not show up in MyChart is quite long, but still a very small percentage when you think about the thousands of labs that are orderable,” said Asbell.

There are reasons for some results not being made available.

A provider may need to discuss a diagnosis in person with a patient; for example, test results for sexually transmitted diseases (STDs) are not available through MyChart. Also, some test results are not visible because of technical limitations and an inability to interface between systems. You can’t see your X-rays at this point, but you can see the report on them, for instance.

KEEPING HEALTHY

What MyChart is focused on doing is keeping you in contact with your medical providers and keeping you engaged in your health, Asbell said.

While most providers praised the MyChart capabilities from the get-go, Asbell acknowledged that there were some providers who weren’t so thrilled with the idea of their patients having access to them via email.

“The person who was most fearful of this system now has the highest number of patients on MyChart,” Asbell said, adding that that particular doctor is quite happy with the system.

“She has eliminated inefficiencies, such as phone tag, which frees her up and her nurse up for more face-to-face time,” Asbell said.

Asbell noted that emails from patients do not go directly to physicians. Nurses are assigned to check emails daily and often can address patient questions without a doctor, he said. In those cases, it is clearly noted in the messages that it is the nurse responding, not the doctor, he said.

“It’s a whole new level of transparency” in patient-caregiver communication, Asbell said.

What the new communication tool also has meant is that there are occasions when a patient may misinterpret lab or test results.

“There’s a learning curve to this,” Asbell said.

It’s not uncommon, for example, to see the word “abnormal” on a test when fasting is involved. But if a patient sees that word on a test and doesn’t know that “abnormal” is actually OK, they might wonder if the provider has missed something when they haven’t, he said.

“You have to trust your provider’s interpretation and not the computer,” Asbell said. “Most people are content when they get a reassurance from their provider.”

“MyChart probably displays the most important 25 percent of information about a patient,” he said.

And the information the doctor enters into the system is instantly available.

One of the reasons MyChart, like Epic, is considered beneficial is because important medical information is available to other health care providers who have access to the Epic system. So if a local resident is hurt in Seattle, for example, hospitals there can electronically access important health care records and find out that patient has an allergy or a past surgery that could affect their immediate care. If that other hospital is not in the Epic system, the patient can pull up their own chart on either a smartphone or a tablet.

ACCESS CONCERNS

That instant access capability, which some might see as a plus, has raised concerns for others that medical records could be accessed inappropriately.

Asbell has heard this concern before, but believes it has been addressed. All inquiries into someone’s MyChart account leave a “footprint” on the electronic medical record (EMR) system and therefore can be tracked. Someone can’t just peek into someone’s record.

While patients can give loved ones permission to access their accounts – or give them the password to their accounts – up until last week, youths ages 12-17 could not sign up for MyChart.

As of Sept. 30, 2014, that has changed, Asbell said. He noted that it is a change Providence Health & Services – a health care system with locations throughout the Pacific Northwest, Alaska, California and Montana – is making systemwide.

AN ISSUE

Providence’s involvement in the MyChart effort has raised concerns because Providence is a not-for-profit Catholic health care ministry. Seattle’s Swedish Medical Center became affiliated with Providence after Jefferson Healthcare became affiliated with Swedish.

Jefferson Healthcare Commissioner Tony DeLeo noted at a recent board meeting that he was concerned that the image of a cross at the bottom of the MyChart page – Providence administers MyChart – may raise concerns for some who are worried that Providence could potentially interfere in care specifically related to reproductive health and end-of-life wishes.

TURKEY TIME

In the meantime, Asbell and others say that MyChart offers patients a way to connect with health care providers like never before and gives access to useful information.

Asbell even envisions a time when “e-visits” and video visits with providers could happen.

As for down-to-earth, real uses of MyChart, Asbell joked that if a patient wanted to prove how well he was doing, say, during Thanksgiving, he could whip out his cell phone and access MyChart to prove he has been losing weight and therefore good to go for eating that last piece of pie, with whipped cream, just for that one day.

The bottom line, he says, is that the patient is more engaged than ever in their health care.