MyHealtheVet is poised to undergo a major redesign that will expand core features and further improve the way veterans access their personal health records and interact with healthcare providers.

Launched in 2003 by the Department of Veterans Affairs, the MyHealtheVet portal allows veterans to refill prescriptions online, access clinical notes from their medical teams, manage health care needs and communicate with VA healthcare providers via secure messaging.

Last year, VA officials migrated the portal to a public cloud hosted by Verizon Terremark to boost performance and scalability. VA systems have their own separate, special enclave in the Verizon Terremark cloud. The VA also has started to offer portal users access to electronic health records via mobile apps.

VA is looking to completely redesign the portal, improving core features, such as upgrading the ability for veterans to schedule VA appointments, adding dashboard views, and offering a more seamless customer experience across all platforms — desktop, mobile and in-facility kiosks.

The goal is to implement information technology systems to improve the patient or customer experience, said Kim Nazi, a senior analyst with the Department's Veterans and Consumer Health Informatics division.

"My focus for the last year has been to turn attention to engaging our healthcare professionals so as patients use this online portal capability, we do it in a way that is clinically integrated," she said.

Take secure messaging, for example. From an IT perspective, secure messaging is a communications platform, but the VA's interest is in using it to provide customers a better experience. Secure messaging lets patients stay in touch with physicians in between medical visits and, in turn, gives physicians a better understanding of the patient's overall needs, Nazi said.

More than a decade of enhancements

The VA was one of the first large health organizations to have an enterprise-wide electronic health record system. As a result, MyHealtheVet began as a pilot program in 1999. The vision was to develop a prototype for personal records that could serve as a model to provide veterans access to data from their health records and transactional services, Nazi said. Based on the success of that pilot, the VA launched the MyHealtheVet portal in 2003.

"When we evaluated the pilot, we found veterans really valued having access to their electronic health record data," Nazi said. VA had a very robust personal health record system that veterans could access to get their medical information. If they were tracking their blood pressures at home, they would have an easy way to keep track of their information and share it during their healthcare visits.

Over the years, the VA incrementally added different types of information from the VA e-health records, working in conjunction with clinical subject matter experts on the best way to present the information.

In 2010, the VA worked in collaboration with the Defense Department and the Centers for Medicare and Medicaid Services on the concept of the Blue Button. The Blue Button is a tool to make patient medical records easily available for patients to download and share with members of their healthcare team. Veterans using MyHealtheVet can create a single electronic file that can include all their available personal health information.

In January 2013, using Blue Button, the VA expanded the types of information that is available to veterans from electronic health records, including clinical notes from a patient's medical team, known as VA Notes.

"One of the research studies we completed really demonstrated that people who had accessed their clinical notes felt it improved their ability to understand their condition," Nazi said. It also better prepared them for clinical visits, made them feel more in control of healthcare, and helped them to better remember the plan for their care, she said.

Measuring success, eliciting feedback

Specific features in MyHealtheVet are available to veterans based on their account type – basic, advanced or premium. All users who have a basic account are able to view their self-entered information. A VA patient can upgrade an account to advanced or premium.

Since 2003, more than 3.2 million veterans have registered with MyHealtheVet. About 2.7 million of those registrants are VA patients. That is about a 48 percent penetration rate within the VA population, Nazi said. Currently, 1.8 million VA patients have premium accounts, about 33 percent of VA patients. A premium account requires a one-time authentication, which requires the veteran to visit a VA facility in person for verification.

VA has employed the American Customer Satisfaction Index since 2007 to track customer satisfaction levels. ACSI has been beneficial because it is an industry standard method for quantifying satisfaction, Nazi said. ACSI "enables us to track quantitatively benchmark with other organizations and monitor trends overtime," Nazi said. The tool also gives VA the capability to use custom, question sets approved by the Office of Management and Budget.

From the inception of the MyHealtheVet program, VA officials asked veterans what type of services are important to them, Nazi said. From that feedback, VA realized patients wanted to view VA appointments, communicate electronically with their health team, access information and be able to track delivery of prescriptions. MyHealtheVet has fulfilled those requests.

The MyHealtheVet team now has an agile method in place to work with VA researchers on the development of custom question sets. Within a month, the team can collect direct feedback from veteran user organizations that helps influence how the VA prioritizes and develops future features, Nazi said.

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