MHS IM/IT TRICARE TRICAREOnline Activity
MHS IM/IT Program www.TRICAREOnline.com TRICARE Management Activity Brief to: National Committee on Vital and Health Statistics (NCVHS) National Health Information Infrastructure (NHII) Workgroup 5 January 2005 LTC(P) David Williams, AN, USA Deputy Director, Information Management Chief, eHealth Requirements & Operational Architecture David.Williams@tma.osd.mil DRAFT - v 1.6
Agenda MHS IM/IT Program eHealth Operational Vision www.tricareonline.com – – Operational View Current Functional Overview – Providers – Clinical Desktop Beneficiaries – Personal Health Record Collaboration Activities – Web-Appointing Functional Vision TRICARE Management Activity User Feedback Conclusions DRAFT - v 1.6 - Hand Outs 2
www.tricareonline.com MHS IM/IT Program High-Level Operational View (OV-1) Secure Portal to MHS Resources and Services Health Content Repository : : : Managed Care Support Contractors : : : : Registration Network Providers Referrals/Consults Claims Version 5.0 Health Information Drug Information Drug-Drug Interaction Checker Composite Health Care System II Appointments Pharmacy Lab Data Radiology Data E-mail TRICARE Management Activity Defense Enrollment Eligibility Reporting System : : : : Enrollment Master Patient Index Other Health Insurance Eligibility Internet & Defense Information Systems Network Providers Personal Health Journal Accessible Health Journal Health Risk Assessment Disease Tracking Tools Deployed Forces Patients MTFs Federal / Purchased Care Managers Integrating New & Existing eHealth DRAFT - v 1.6 - Hand Outs Innovations 3
t en nt Co s n m i a tio Cl rma fo In Pre / Post urveys Deployment S rth o N d se t Ba en eb llm W ro En th al He MHS IM/IT Program MT FW ebp age s Current State O TR TRO So uth TRO West TRICARE Management Activity encing r e f n o C Virtual Pe r so Jo nal u H r n ea a l lth Pr o v id e r W e bpages Ac Pati cess to nt ent He e a em Record lth g na a gM n i n ar e L y ac rm fill a Heat lth Ph Re a e h h In TRICARE Tele On Pres formation Management A cript pp line Activity i o oin TOPP n s Na tin vy g Rou der HE i tine v AR Pro ail Req Tes A – A IP H ues t R nt e Em e i A R t t A E E Pa ecur H H e S y orc m F r l TRICA A sd.mi Air o . RE De e r a c i r t ntal . r e w I id nform rov ww ation TR Provider – P ail De ICARSecure Em nt nta E R Ph e lP m on a e e l I t t ati ro ire nfo rma i t gr rm cy En orm Access to CHCSII am e Directions to MTF Health Affairs atio f In n 4 DRAFT - v 1.6 - Hand Outs al w ne t Re ues ug eq R Sec u Acc re Pro ess v to C ider HCS Dr
t en nt Co TRO West Health Content MTF Webpages s nTRO North Claims m i la atio Web Based C Information m or Enrollment f In Pre / PPost Pre / ost urveys Deployment Surveys eployment S D TRO West th d se t Ba en eb llm W ro En th al He MHS IM/IT Program MT FW h MHS SecureNorteHealth Portal ebp age s RO T Operational Vision: TRO So u TRICARE Management Activity cing n TRO South e r e f n o Virtual Conferencing C Virtual Pe r so Jo nal u H r n ea a l lth Pr o v id e r W e bpages Pati Health Patient ent Hea Record R lth t e corAffairs n e Veterans d em g na a gM n i n ar e Learning Management L cy a Pharmacy l rm filPersonal Health a Refill h e h H t eath P R eal Journal Telehealth Infor TRICARE Provider Webpages Teleh O m n Pres a t Management A i l o i Heath Information Online n n cript pp TOPP Activity ions OPP oin e T N Prescriptions Appointing tin av g Rou yH erRoutine Test d i Navy E HEAR tine rov il Request AR T P R e equ s HIPAA IPAA H t––Provider ma R n est t Patient E e i A R at cure E www.tricare.osd.mil EA PSecure H H SecureAir Provider Force HEAR Email Drug Renewal e e S y Request orc F Access to CHCS rm l i T r R m i . I A d C ARE A TRICARE Dental are.os Denta c i r t . r e w I id n v l w ro f P o – w r Provider Provider e r id m v ro Information ation TR P Email Secure Email De ICARSecure Army HEAR nt E Retiree nt TRICARE Ph a e R l m on a e P Entitlement e l I t t ati DentalroProgram nfo rma i i r t e gr rm cy En Directions Information to MTF Access to CHCSII Pharmacy rm am e Directions to MTF Health Affairs atio o f In n 5 DRAFT - v 1.6 - Hand Outs Information al w ne t Re ues ug eq R Sec u Acc re Pro ess v to C ider HCS Dr .
MHS IM/IT Program MHS Secure eHealth Portal Operational Vision: TRO West Health Content MTF Webpages Claims TRO North Information Web Based Enrollment Pre / Post Deployment Surveys MHS Websites Service Portals Business Partners TRO South Virtual Conferencing Business Partners Open Portal TRICARE Management Activity Outside Agencies Patient Health Record Outside Agencies Open Portal MHS Websites Learning Management Service Portals Telehealth TRICARE Management Heath Information Activity Prescriptions Navy HEAR HIPAA www.tricare.osd.mil SecureAir Provider Force HEAR Access to CHCS Provider – Provider Secure Email TRICARE Retiree Entitlement Dental Program Information Directions to MTF Pharmacy Refill Personal Health Journal Provider Webpages Online TOPP Appointing Routine Test Request Patient – Provider Secure Email Drug Renewal Request TRICARE Dental Information Army HEAR Access to CHCSII DRAFT - v 1.6 - Hand Outs Health Affairs Pharmacy 6 Information
MHS Secure eHealth Portal Operational Vision: MHS IM/IT Program Health Resources TOL Help Web Based Enrollment Pre / Post Deployment Surveys TOL Business Partners Outside Agencies Open Portal MHS Websites Service Portals Telehealth Heath Information Prescriptions Navy HEAR SecureAir Provider Force HEAR Access to CHCS TRICARE Management Activity Virtual Conferencing Patient Health Record Patient Health Record Trusted Health Information Rx Checker Anatomy Explorer TOL Help Condition Explorer Kid’s Health & Games TOL Health Calculators Educational Resources Health Learning Resources Management Pharmacy Refill Personal Health Journal Provider Webpages Online TOPP Appointing Routine Test Request Patient – Provider Secure EmailDrug Renewal Request Provider – Provider Secure Email Army HEAR Access to CHCSII Directions to MTF DRAFT - v 1.6 - Hand Outs 7
MHS Secure eHealth Portal Operational Vision: MHS IM/IT Program TRICARE Management Activity Virtual Conferencing Web Based Enrollment Pre / Post Deployment Surveys Patient Health Record Business Partners Outside Agencies TOL Help TOL Open Portal MHS Websites Health Learning Resources Service Service Portals Portals Telehealth Web Based Telehealth Heath Information Enrollment HEAR Prescriptions Secure Portal Navy HEAR Access to CHCS I / II Telehealth Secure Provider Force HEAR ServiceAir Portals Access to CHCSWeb Based Enrollment Secure Portal Management Pharmacy Refill Personal Health Journal Provider Webpages Online TOPP Appointing Routine Test Request Pharmacy Patient – Provider Refill Secure EmailDrug Renewal Request PHR Learning Provider Management – Provider Secure Email Learning Management HEAR PHR Directions to MTF Pharmacy Refill Access to CHCS I / II Service Portals DRAFT - v 1.6 - Hand Outs Access to CHCSII Army HEAR 8
MHS Secure eHealth Portal Operational Vision: MHS IM/IT Program Pre / Post Deployment Surveys Outside Agencies Business Partners TOL Help TOL Open Portal MTFMHS Pages Websites Heath Information HEAR Prescriptions Web Based Enrollment Health Resources Service Portals Online Appointing Telehealth TOL Access to CHCS I / II Facility Pages TOL Learning Provider Management – Provider Secure Email Provider Pages PHR Secure Messaging Secure Messaging Routine Bene Services Directions to MTF Pharmacy Refill Bene Online Services Appointing Personal Health Journal Provider Webpages Test Request Provider Pages Patient – Provider Drug Renewal Online Secure Email Facility Pages Appointing Request Secure Portal Service Portals TRICARE Management Activity DRAFT - v 1.6 - Hand Outs 9
MHS Secure eHealth Portal Operational Vision: MHS IM/IT Program Outside Agencies TRICARE Management Activity www.tricareonline.com Is the Single Secure MHS Web Portal for eHealth and Telemedicine Initiatives Business Partners TOL Help TOL Open Portal MHS Websites Web Based Enrollment Health Resources Service Portals Telehealth Online Appointing HEAR Secure Portal Bene Services Secure Messaging TOL Access to CHCS I / II Provider Pages Service Portals Facility Pages Learning Management PHR Pharmacy Refill DRAFT - v 1.6 - Hand Outs 10
MHS IM/IT Program – – – – – Personal Health Record Online Primary Care and Self-Referral Specialty Appointing TRICARE Benefits Links 18M Pages of Trusted Health Content Information Micromedex Consumer Drug Catalogue Online Drug Interaction Checker Non-Beneficiary Functionality: – – – – TRICARE Management Activity Beneficiary Functionality: – Current MHS eHealth Functional Overview (Viewed Through TOL) Provider Read-Only Pre and Post Deployment Health Assessments Non-Availability Statement (NAS) PCM Batch Reassignment i-learning / Web-Based Training Platform Functionality: – MHS Secure Portal (HIPAA Compliant) DRAFT - v 1.6 - Hand Outs 11
MHS IM/IT Program TRICARE Management Activity DRAFT - v 1.6 - Hand Outs 12
MHS IM/IT Program TRICARE Management Activity DRAFT - v 1.6 - Hand Outs 13
MHS IM/IT Program TRICARE Management Activity DRAFT - v 1.6 - Hand Outs 14
www.tricareonline.com MHS IM/IT Program TRICARE Management Activity User Statistics: – TOL – Total Number Registered Users: 220,000 PHR Patient Health Record User Feedback Total Number Registered Users: 6,600 New Users Added in 2004: 3,800 Average Number Unique Users per Month: 1,000 Popular Features: – HealthQuotient (Risk Assessment Profile) Profile of Health Issues That May Affect User or Family Members – Detailed – Secure – Anonymous Anonymity and Security Allow User to be More Open Than They Might be with Their Own Physician DRAFT - v 1.6 - Hand Outs 15
MHS IM/IT Program www.tricareonline.com TOL Appointment Trends 2002 through 2004 TRICARE Management Activity TOL Appointing Continues to Grow TO L Appointm ents 60,000 50,000 40,000 Increased 2X in CY 03 Increase 3X in CY 04 No Show Rates Lowered with TOL Appointing Sheppard AFB Achieved & Maintains 10% PCM Appointing via TOL 50,231 30,000 20,000 10,000 8,985 14,850 0 2002 2003 Calendar Year DRAFT - v 1.6 - Hand Outs 2004 16
MHS IM/IT Program Percent of "No Shows" 10% 9% www.tricareonline.com Comparison of TOL and Other “No-Show” Rates November, 2004 MHS MHS wide wide “No-Show” “No-Show” Rate Dropped Rate Dropped from from 7.5% to 4.4% 7.5% to 4.4% Army Army “No-Shows” “No-Shows” Dropped Dropped from from 8.4% to 6.9% 8.4% to 6.9% TRICARE Management Activity Navy Navy “No-Shows” “No-Shows” Dropped Dropped from from 7.8% to 5.0% 7.8% to 5.0% 8% Air Air Force Force “No-Shows” “No-Shows” Dropped from Dropped from 5.8% 5.8% to 3.7% to 3.7% 7% 6% 5% 4% 3% 2% 1% 0% MHS “No Show” Rate AF Total of TOL Booked Appts That Were “No Show” Total of TOL Booked Appts ARMY “No Show” Rate DRAFT - v 1.6 - Hand Outs NAVY Total of Appts Booked By Other That Were “No Show” Total of Appts Booked by Other Than TOL 17
www.tricareonline.com Functional Vision: MHS IM/IT Program TRICARE Management Activity Beneficiaries – One Stop Shopping for: – Clinical – Fully Integrated Personal Health Record Patient – Provider Secure Messaging Drug Renewals / Refills Provider Directed Web-Based Education – Info Rx Health Content Tools & Calculators Administrative MTF & Clinic Pages Provider Information Access to MCSC Web Pages MTF Appointing / Appointment Reminders Patient – Admin Secure Messaging TRICARE – Entitlement Information – Online Enrollment DRAFT - v 1.6 - Hand Outs 18
MHS IM/IT Program www.tricareonline.com Functional Vision TRICARE Management Activity Providers – Role-Based Virtual Desktop Access to All MHS Applications and Services: – Single Sign On (SSO) to Clinical Applications (Client Server & Web Applications) Context Management Enhances Patient Safety – Same Patient, Same Data – Secure Messaging – – – – Provider – Provider Provider – Patient Trusted Medical Reference Resources Telehealth Portal Provider Directed Web-Based Education – Info Rx Administrative Functions DRAFT - v 1.6 - Hand Outs 19
MHS IM/IT Program TRICARE Management Activity DoD / VA – “Unity of Purpose” / “Unity of Effort” – – – Leveraging Requirements and Best Practices Achieving Common Look & Feel Unifying Health Content Offerings www.tricareonline.com Collaboration Activities: Collaboration with National Library of Medicine Conemaugh Health Systems – 12 Month Congressional Project to Validate eHealth Requirements and User Needs Most Used Features Ease of Use Features Desired in an “Ideal World” DRAFT - v 1.6 - Hand Outs 20
MHS IM/IT Program – PHR Is A Valuable Tool Online Appointing Continues To Grow DoD is Looking Forward: – Beneficiaries – Web-Based Clinical Desktop Patient – Provider / Provider – Provider Secure Messaging Collaboration Continues – – – Fully Integrated PHR Patient – Provider Secure Messaging Providers TRICARE Management Activity www.tricareonline.com Is the MHS One-Stop Shop for Online Healthcare Information & Services – Conclusions DoD / VA National Library of Medicine Industry DoD Beneficiaries Demand It DRAFT - v 1.6 - Hand Outs 21
MHS IM/IT Program TRICARE Management Activity Backup Slides DRAFT - v 1.6 - Hand Outs 22
MHS IM/IT Program www.tricareonline.com Portal Functional Concept Username & Password / CAC or PIN Service Portals TRICARE Management Activity Username & Password / CAC or PIN Authenticated ID Verification of ID (Authentication) Verification of ID Common Services: (Authentication) Single Sign On Context Management DMDC AuthorizationUser Rights and Privileges Web Applications DRAFT - v 1.6 - Hand Outs Authenticated ID AuthorizationUser Rights and Privileges Client Server Applications 23
MHS IM/IT Program www.tricareonline.com MHS PCM Appointment Snapshot For the Month of November 2004 TRICARE TRICARE Management Management Activity Activity Type of PCM Appts On CHCS Who Can Book Air Force Army Navy "As Is" MHS "Optimized" MHS “ ” Appt Clinic 49,637 113,904 52,772 216,313 165,228 “ ” WEA Appt Clinic 3,078 2,210 4,627 9,915 0 Appt Clinic Contractor 180,655 192,780 173,186 546,621 0 WEA Appt Clinic Contractor TOL 109,558 112,155 106,961 328,674 936,295 32% 27% 32% 30% 85% % of Available WEA Appts / All PCM Appts - Indicates Appointments That Can NOT Be Viewed On TOL The TRICARE Operations Center (TOC) is the source for all CHCS appointment data. “WEA” Web Enabled Appointment is a CHCS code that allows appointment to be viewed on TOL “ ” CHCS appointment type bookable only by the Clinic Total Appointments Available Per Booking Method: Clinic – 1,101,523 Phone – 875,295 TOL – 328,674 DRAFT - v 1.6 - Hand Outs 24
MHS IM/IT Program eHealth Collaboration Appointing Centers of Excellence TRICARE Management Activity Services Establishing Online Appointing Centers of Excellence (2 per Service) – Implement Best Business Practices to: – Maximize Appointment Access via TOL Educate MTF Staff and Local Beneficiary Populations Monitor and Report Progress to Stakeholders Centers of Excellence: Army - POC: MAJ Daniel Jetton – Dewitt Army Community Hospital, Ft Belvoir VA – Womack Army Medical Center, Ft Bragg, NC Air Force - POC: Maj Mark Meersman – U.S. Air Force Academy, CO – 71st Medical Group, Vance AFB, OK Navy - POC: CAPT Christine Boltz – National Naval Medical Center Bethesda, MD – Naval Medical Center Portsmouth, VA DRAFT - v 1.6 - Hand Outs 25
TRICARE Retiree Dental Program Secure Provider Access to CHCS www.tricare.osd.milAir Force HEAR Entitlement InformationDirections to MTF HIPAA Provider - Provider Secure Email Learning Management Pharmacy RefillPersonal Health Journal Provider Webpages TOPP TRICARE Management Activity. DRAFT - v 1.6 - Hand Outs 7 MHS IM/IT
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