# Presentation: 334758

## Overcoming Obstacles in Implementing  My HealtheVet

## Problem:

- Boston was having difficulty cultivating interest in MHV
- Clinicians often felt they had too much to do already
- Veterans never heard of My Health_*e*_Vet (MHV) and had little to no understanding of how it could benefit them

## Our Goals:

- To become a leader in enrolling veterans and completing the In Person Authentication (IPA) as 1 of 6 test sites nationally.
- To get both staff and veterans to see My Health_*e*_Vet as an instrument that could have a positive impact on the patient/clinician relationship
- To demonstrate the potential for positive impact on patient outcomes

## Objectives:

- To educate clinicians about the tools within MHV
- To help clinicians view MHV as something that could make their job easier, not just another thing they had to do
- Assist staff in finding opportunities to incorporate MHV in what they were already doing

## Objectives (cont)

- Increase enrollment of Veterans in MHV and complete IPA process on all enrolled vets receiving their care thru the VA
- To help veterans see how using MHV can benefit them and assist them in navigating within MHV, becoming familiar with the various options within the site.
- Provide supportive resources for veterans to facilitate their use of MHV and decrease their frustration when an obstacle presents itself.

## Create a Multidisciplinary MHV Teamwith members from:

- Primary care
- Cardiac clinic
- Nursing Case Mgmt
- Nutrition
- Pharmacy
- Rehab Services
- Mental Health
- Surgical Services

- Voluntary Services
- ROI staff/HIMS
- Library Services
- Medical Media
- IRM
- QM Coordinator
- Employee Education
- Public Affairs

## Meetings

- Sent out agenda prior to meeting
- Kept meetings short (<1 hour)
- Met by conference call every week initially
- Brainstormed to gather information, then sifted thru and developed game plan
- Developed small achievable goals to build momentum

## Meetings (cont)

- Gave members assignments that coincided with their position; minimized time commitment but maximized participation
- Attended POC calls w/ Alex Hersh the 2nd Tuesday/Wednesday of every month and  VISN POC meetings to capture other facility’s ideas (don’t re-invent the wheel)
- Visited MHV product site and training site

## To bring clinicians on-board we:

- Offered short convenient classes either during staff meetings or at lunch time
- Sought to include MHV as part of the Annual Mandatory education
- Made hands-on sessions available where we showed the tour of MHV and “The Perfect Visit” and then had viewers create their own account.

## To bring clinicians on-board we (cont)

- Identified likely areas whose patients could benefit from currently available features in MHV
- Targeted those clinical areas to saturate, giving providers support and tools to promote MHV

## Move Program

- Assisted veterans  enrolled in the Move Program to create accounts.
- Participants were asked to keep food and activity journals which could be reviewed and suggestions made to modify the program for optimal results.
- Weights were entered and used to track progress.
- Research Health options were introduced.

## Primary Care Team

- Patients were encouraged to create their own MHV account. Providers encouraged to use E-script to direct their patients to:
- 		-Complete their medical history 	under “Track Health” and to enter 	weights, blood pressures and glucose 	levels between visits

## Primary Care (cont)

- 		-Complete the list of medications including herbal preps and over the counter medications and print out for next doctor’s visit (assists w/Medication Reconciliation process)
- 		- Utilize Food and Activity Journals as appropriate
- 		-Develop treatment goals
- 		-Research health topics

## Nurses:

- Examined the materials in “Research Health”, particularly under the Medical Library which includes interactive tutorials for patients to use.

## Pharmacy

- Check to see when medications can be refilled by mail-order option
- Reorder medications
- Enter list of medications obtained from other resources including over the counter meds, vitamins and herbal preps and medications from non-VA health care providers
- Use “Contact Us” to report any problems

## To facilitate the use of MHV by Veterans, we:

- Developed a MHV Center in the lobby of each of our 3 campuses which is easily accessible, highly visible and could provide for privacy and confidentiality of patient’s information
- Improved signage and banners to provide direction
- Sent out flyers with appointment reminders

## To facilitate the use of MHV by Veterans, we: (cont)

- Used volunteers to “Man” our MHV desk who can walk the veteran through the process of creating an account or assist them with features of the program.
- 		-Forged relationships with the local high school to bring in students needing to complete mandatory community service requirements
- 		-Worked with local colleges to develop a “job description” for their work study program

## We made ourselves visible at every event possible! 

- MHV “Open Houses”
- 	Veterans/Memorial
- 	   Day
- Nursing Orientation
- Nursing Equipment  Day
- Holiday Parties

- Veteran Employees Luncheon
- Local Council on Aging
- Women's Health VISN Seminar
- Red Sox Opening Day  Party

## We made ourselves visible (Cont)

- Joined Hospital Committees which would help promote MHV
- 		-The Latest Generation committee which focuses on the needs of our newest veterans unique needs to access care
- 		-Patient Family Health Education
- Put announcements on our electric moving message boards
- Sent flyers in appointment letters
- Placed flyers in all waiting rooms in Lucite wall holders
- All flyers and signage bears the MHV logo

## To support our Veterans and Improve Communications:

- We added a phone number for veterans to call with questions specific to MHV that appears on all flyers
- Created an email account
- Sent out monthly e-letters
- Suggested features for them to explore
- Provided veterans with another way to trouble shoot issues that arise in using MHV

## Our climb to success....

## My Favorite Success Story:

- 		Mr X sat in his wheelchair, hooked up to his oxygen tank, waiting to be picked up after his doctor’s appointment. After watching me assist several veterans in creating MHV accounts, he asked me what I was doing. I explained and then offered to assist him in creating an account.

## 		Mr X shared that he was 90 yo Navy veteran and had served his country aboard a ship in the Pacific as a communications officer. He currently had a computer for his grandson’s use but had not used it himself.
		Because of Parkinson's Disease, he had trouble using the mouse, so I made him a list of keyboard commands to minimize his dependence on the mouse. Keyboarding was somewhat familiar to him from his work in the Navy.
		At Christmas, I received a card from him thanking me for helping him with learning to use My HealtheVet.

- 		Because of Parkinson's Disease, he had trouble using the mouse, so I made him a list of keyboard commands to minimize his dependence on the mouse. Keyboarding was somewhat familiar to him from his work in the Navy.
- 		At Christmas, I received a card from him thanking me for helping him with learning to use My Health_*e*_Vet.

## 		He has celebrated his 91st birthday and now orders his groceries on line, enjoyed doing his own Christmas shopping on line, no longer depending on his daughter, and thanks to his grandson, has learned about “chat rooms” where he made a connection with a ship mate he said he had not heard from in 50 years!
		Using the computer has given him a sense of independency that he had lost as his aging body betrayed him. And to think it all started with MHV! 

- 		Using the computer has given him a sense of independency that he had lost as his aging body betrayed him. And to think it all started with MHV!

## In review, did we meet our goals?

- 	Goal #1
- 	To become a leader in enrolling veterans and completing the In Person Authentication as 1 of 6 test sites nationally.
- 	*In the past 9 months, we rose from 51st place to 2nd place with enrollment into MHV and number of veterans completing the IPA process.

## 	Goal #2
	To get both staff and veterans to see My HealtheVet as an instrument that could have a positive impact on the patient/clinician relationship

	*Our team has built a working collaboration between clinicians and our veteran population. Patient Satisfaction remains high.

- 	To get both staff and veterans to see My Health_*e*_Vet as an instrument that could have a positive impact on the patient/clinician relationship
- 	*Our team has built a working collaboration between clinicians and our veteran population. Patient Satisfaction remains high.

## 	Goal #3
	To demonstrate the potential for positive impact on patient outcomes

	*It is too soon to draw any conclusions with this as many of the features that may impact this have not yet been released.

- 	To demonstrate the potential for positive impact on patient outcomes
- 	*It is too soon to draw any conclusions with this as many of the features that may impact this have not yet been released.