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Monday, July 15, 2002
> Stuck in the Patient Portal.

Patient portal... what to do and who to ask... that's the latest dilemma. In order to build the portal with a proper interface, questions need to be answered. In order for the questions to be answered, people need to be identified to be asking the questions of. Identifying the people likely requires understanding of the process and what might work into the natural course of things best. Questions such as the following are arising and possibly keeping development from moving forward:

Who has access to the portal?
Are there varying levels of access depending on who is accessing?
Which providers are given access?
Is the provider portal inter- or intranet based?
What is the process for assigning logins?
What support is provided and by whom?
What is the process for re-assigning lost passwords?
What is acceptable proof of identity to get re-assigned a lost password?
Are there legal implications to the decisions made surrounding any of these questions?

...and I'm certain there are plenty more. The real issue is identifying the who's and how's in getting questions such as these answered. Do we form a committee? If so, who resides on it? etc..... Perhaps this has already been thought out and a solution exists. If so, it's time to share those thoughts with Web Services (especially Michael Sheehan). Perhaps some of the Shared Care Plan Summit can be spent in discussion around this issue?

Here's some information Michael has shared about his vision of the portal will work:

Patient

Comes in from the Internet always

Initial registration will require staff process to validate

Patient will be linked to their Medical Manager number; LastWord Number if they have one; and any other clinic ID number used in the practice

Demographics that may be fairly detailed will be entered by the patient initially (assume that longer term there will be data moving between systems - lots of things to consider here)

This creates a Patient Portal that will evolve over time to include more and more patient specific information and eventually prompts

The patient will connect with a secure link connection and will see ONLY their information

For shared care plan - will be able to view, enter, and edit all information for them (we will need an audit trail)

Their will be education links that are specific to the patient's disease and in the longer term that will be segmented by things like learning style for the individual patient

Staff

Comes in from behind our firewall generally (this will be a good discussion to see how to handle staff - I assume that everyone will be on our network - something to confirm - Do we allow access to this over the Internet from home or if they are off-site for some reason)

Initial user name and password will need to be set up

Very limited user demographics entered

The security may evolve over time - initially I recommend that a staff member has access to the Shared Care Plan application and that they can access any patient that has a shared care plan - I really hope that we can keep this process simple

Staff person will need a look-up feature to access a patient and their care plan (audit trail on who they access)

Staff will be able to see the shared care plan in the same format as the patient

Staff can enter and edit information (audit trail)

> Dialogue Proposal.

My favorite piece of Bohm, et al's Proposal on Dialogue is the final paragraph:

"The spirit of Dialogue is one of free play, a sort of collective dance of the mind that, nevertheless, has immense power and reveals coherent purpose. Once begun it becomes continuing adventure that can open the way to significant and creative change."

With our community on the verge of significant and creative change in the delivery of healthcare through Pursuing Perfection, and the health care 'system' so desperately in need of that change, it is essential that we engage in Dialogue to get us past our habits of  repeating  what we are used to saying, and defending what we think we want, to be open to creating something new.  We need to explore our reactive thoughts, mistrust and fears together, and see whether they can be replaced with a new appreciation for our community partners' intent to do what is best for patients.
> Dialogue for Transformation.

Please see Marc's post, and do contact me if you would like to join our Dialogue Group.  Click on this link to view a short slide show which sets the stage for Dialogue.

Marc's Weblog. Notes from Marc Pierson before you read this proposal by David Bohm and others: This is proposal is kind of long and kind of technical and abstract. You may not like it or finish it. You may want to read at least the last section on dialogue in existing organizations. Dialogue itself is simple (if you join a group with some experience), immediately rewarding, and profoundly eye opening. You can read about it and/or just do it. In either case if you want to join our dialogue group in Whatcom County--if you are in healthcare or you are a patient or you are in a patient's support system--contact Lori Nichols (LNichols@hinet.org) for dates and times. The meetings are usually every other Wednesday from 1-3 PM. [WWPP]


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