Smart Health Centers-Navigator Training

Smart Health Centers Health Navigator
Training Handbook
Alliance of Chicago, Community Health Services, L3C
The Smart Chicago Collaborative
Chicago Community Trust
Otho S. A. Sprague Memorial Institute
Catherine T. MacArthur Foundation
PATIENT ENGAGEMENT
HOW TECHNOLOGY CAN BE USED FOR HEALTHCARE

Acknowledgements
We would like to thank
Our Sponsors
 The Smart Chicago Collaborative
 The Chicago Community Trust
 John D. and Catherine T. MacArthur Foundation
 Otho S.A. Sprague Memorial Institute
Smart Chicago Collaborative
Alliance of Chicago, Community Health Services, L3C (Phase I)
2

Introduction
The Smart Health Centers project (SHC) empowers underserved patients by bringing
the knowledge of technology and medical records to improve health outcomes
directly to the fingertips of community members.
Smart Health Centers increases confidence for those navigating the use of
technology by demonstrating its uses within Community Health Centers. SHC
provides accessible and user-friendly education in health and wellness solutions.
This training manual is designed to provide training and development to Health IT
Navigators. Their skills will be used to provide the necessary knowledge to
patients/clients/consumers of the Smart Health Center project.
The Smart Health Centers project offers an integrated approach to enhancing health
and wellness. SHC provides online access of health information to improve the
medical experience so that individuals may better understand and make well-
informed decisions about their health. Patients are ensured high-quality online
material, personalized, culturally-sensitive advice and access to their own electronic
records. SHC partners with community health centers to enhance public computing
resources, and ultimately, patients become “full users of electronic health record
systems.
3

Authors Page
Valerie Brown is a Masters in Public Health Candidate in Community Health Sciences
at the University of Illinois at Chicago. She has an earned certificate in Community
Public Health Practice from UIC. For several years she has worked with
CEED@Chicago in Health Literacy and Community Health Workers and two years on
a Patient Centered Care Collaborative to Improve Minority Health research project.
Valerie has an MBA and B.S Computer Information Systems from Keller Graduate
School of Management and DeVry University. Professional experience includes
Computer Networking and managing and operating IT helpdesks. She co-authored
this manual while working as an intern at CHITREC and Alliance of Chicago.
Diana Beasley is a consultant with Human Resources and Organizational
Development experience which includes: Program Design; Training/Development;
Human Resource Management; Organizational Management and Group Dynamics.
Ms. Beasley also has several years of experience in Management Consulting and
Coaching, Technical Assistance, Leadership Training and Project Management to
major corporations, nonprofit organizations and FQHC health centers. Ms. Beasley
has degrees in Psychology, Urban Studies and Business Administration, and a
certificate in Human Resources. She is Founder and Managing Consultant of
Management Synergistics Inc., a 14th year W/MBE management-consulting firm in
Chicago. Ms. Beasley is a native Chicagoan, maintains an active lifestyle, and has
many affiliations in several groups and associations.
4

Table of Contents
•Module 1
• Project Overview
•Module 2
• Health Navigator Role
•Module 3
• Basic Health Information and Security of Information
•Module 4
• Basic Computer Skills
•Module 5
• Health Information Technology and Personal Health Records
•Module 6
• Patient Portals
5

Module 1: Project Overview
Project Overview
PATIENT ENGAGEMENT
6

LEARNING OBJECTIVES
Have a strong knowledge of the project, its goals and objectives
Understand and identify partners & staff
Understand the Health roles i.e.. supervisory role, staff, policies
and procedures
Understand information about sponsoring organization
Participate in activities to reinforce learning
7

As the nation moves toward a 21st Century technology-based health
care system, providers, medical staff and patients must also.
The goals for the Smart Health Centers include:
◦ Expanding underserved residents’ access to online health and
wellness information
◦ Educating patients on how to access, adopt and maintain health
information for themselves and their families.
◦ Educating patients on how to identify trusted online health
information including a set of provider suggested web based
resources and tools.
◦ Helping consumers achieve “meaningful use” of electronic health
information, such as healthcare patient portals and personal health
records.
8

Module 1: Project Overview - Collaboration
9
Smart Collaborative of
Chicago Community Trust
City of Chicago
Otho Sprague Foundation
Smart Collaborative Site
• Family Focus
• Laurie Children Hospital
• Acts of Faith
• Lawrence Hall
• CCHS
• Health Leads of Chicago
• Erie Health Center
• Near North Health Center

Module 1: Project Perspective
The Smart Health Center model revolves around the information Navigator at
each site. The Navigator is part subject matter expert and part teacher. By
helping patients access their own health records online, they empower to
patients to take control of their own health. Navigators also help patients find
information online health information and support groups for chronic
illnesses. The wealth of information on the internet can enable residents to
make health better choices.
Some Smart Health Centers have computers available for public use for those
residents who may not have access to the Internet at home, along with 250
other sites throughout Chicago.
Behind the desk, patients who visit the clinic have their medical records
uploaded to a secure server that patients and doctors can access. Even if the
patient changes doctors or moves to a different city, the records can follow
the patient with no hassle.
10

Module 1: Project Organizational Chart
Smart Health
Collaborative
Other Sites
Acts of Faith
Erie Health Care Center
Near North Health Centers
Lawrence Hall
Health
Navigator
Health
Navigator
Health
Navigator
Family Focus
Center
Health
Navigator
Lurie Children
Hospital
Health
Navigator
11

•Health Navigators:
– Are employees and/or volunteers at Community Health Centers (CHCs), churches, or
Community Based Organizations (CBOs)
– Are oriented on organizational polices, roles and responsibilities of facility or
healthcare centers
•Sites:
– Provide training and development on other policies and procedures for the center
Including the Affordable Care Act (ACA) and the Health Insurance Portability and
Accountability Act (HIPAA), etc.
– Provide training on health care practices and/or chronic diseases, etc.
12
Module 1: Health Navigators & Project Sites

Module 1: Activity: Knowledge Test
13

Module 2: The Role of the Health Navigator
PATIENT ENGAGEMENT
14

Module 2: Health Navigator Role
LEARNING OBJECTIVES
Identify the role and responsibilities of a Health Navigator
Identify the core competency skills of a Health Navigator
Recognize similarities in Community Health Workers and Health Navigators
Understand the role of Health Literacy in patient engagement
Understand the role of Cultural Competency in patient engagement
Recognize role of theory in delivering health education and its influence on
health behavior
Discuss the influence of Generational perspectives
Activity: Patient Engagement Role Play
Provide feedback on the patient engagement
15

New role
Support (Technical Assistance)
Perform demos using technology
Hands-on for patients/clients
Look up Quality Health Information
Explain Personal Health Record
Navigate Patient Portals
16

Module 2: Health Navigator
Responsibilities
Promoting the Smart Health Center to patients and stake holders.
Educate and demonstrate use of technology to patients.
Assist patients, care givers and family members - logins and navigation
of Smart Health Center technology.
Provide privacy and safety information for using technology for health.
Educate patients on benefits and usage of Personal Health Records.
Tracking feedback and information to understand patients needs in
using technology for health.
Collaborating with other team members to reduce barriers and
improve education of community members.
Building additional knowledge and improving skills through self-study,
webinars, virtual and in-person trainings and workshops.
17

Module 2: CHW and Health Navigator
COMMUNITY HEALTH WORKER (CHW)
Part of Health Care Team
Provides Outreach
ID Services and Referrals
Health Education
Specialized health knowledge (asthma,
diabetes, HIV)
Culturally appropriate care
HEALTH NAVIGATOR
Part of Health Care Team
Provides Outreach
ID Services and Referrals
Health Education
Specialized health knowledge (Health
Information Technology)
Culturally appropriate care
18

21-1094 Community Health Workers (Navigator)
Assist individuals and communities to adopt healthy behaviors.
Conduct outreach for medical personnel or health organizations to implement
programs in the community that promote, maintain, and improve individual and
community health.
May provide information on available resources, provide social support and
informal counseling, advocate for individuals and community health needs, and
provide services such as first aid and blood pressure screening.
May collect data to help identify community health needs. Excludes "Health
Educators" (21-1091).
Illustrative examples: Peer Health Promoter, Lay Health Advocate
Source: US Department of Labor, Bureau of Labor Statistics.
http://www.bls.gov/soc/2010/soc211094.htm
19

Module 2: Core Competencies
 Communication Skills
 Interpersonal Skills
 Knowledge base about the community health issues and
available services
 Service coordination
 Advocacy skills
 Teaching skills
 Organizational skills
 Privacy and Confidentiality
20
Source: (Berthold, Miller, Avila-Esparza, 2009, Foundations for Community Health Workers, p13)

Module 2: Soft Skills
Interpersonal warmth
Trustworthiness
Open-mindedness
Objectivity
Sensitivity
Competence
Commitment to social justice
Good psychological health
Self-awareness and understanding
Empathy
21
Source: (Berthold, Miller, Avila-Esparza, 2009, Foundations for Community Health Workers, p15)

22
http://www.latitudelearning.com/ .

Module 2: Soft Skills
Self-paced web-based improvement in customer service listening, presentation,
communication, diversity and empowerment courses.
• Giving an Effective Presentation 2.5 hour(s)
• Learn effective communication skills and audience-involvement techniques that can be used during presentations.
• Communication Fundamentals 2 hour(s)
• This online training course presents the essential skills needed to communicate effectively in the work environment.
• Dealing with Diversity 1 hour(s)
• This course discusses how to recognize and respect individual differences and describes some strategies that can be used to deal
with diversity.
• Listen for Understanding 1.5 hour(s)
• This course is on Listening for Understanding. This online training course teaches communications and active listening skills.
• Empowerment in the Workplace 1.75 hour(s)
• Online training to develop empowerment initiatives in the workplace. This online learning path outlines the benefits of
empowerment, and provides tools and techniques to help promote empowerment at all levels of the organization.
• Customer Service Excellence 1 hour(s)
• This course outlines how to maintain excellence in customer service.
• Facilitating Improvement 2 hour(s)
• Learn to lead an audience to new ideas or understandings.
23

Module 2: Cultural Competencies
When you hear the term “cultural competency “, what comes to mind?
24

Module 2: Cultural Competencies
Why is cultural competency important?
-People come from diverse backgrounds with many different kinds
of beliefs and practices
-We want to connect with others in a genuine way. We want to
show authenticity (realness), respect, true understanding and
build trust.
25

Module 2: Health Literacy
Definition of Health Literacy
The degree to which individuals have the capacity to obtain,
process, and understand basic health information & services
needed to make appropriate health decisions
Healthy People 2010
26
Source: http://nnlm.gov/outreach/consumer/hlthlit.html Penny
Glassman, former Technology Coordinator, National Network of
Libraries of Medicine New England Region, Shrewsbury, MA

27
Source: http://www.stvincentcharity.com/programs-
services/centers-excellence/health-literacy/what-is.aspx

Module 2:Health Education Theory
28

Module 2: Health Education Theory
Consumer Information Processing Model
29

Module 2: Health Education
Theory – Stages of Change
Precontemplation - the person is unaware of the behavior change and has no
intention to take action and has not seriously thought about change (step before
being introduced to HIT at the CHC –2) Contemplation - the person is seriously
thinking about a change (in the near future); (accepts HIT navigator invitation to
learn role of HIT in their health) 3) Preparation - the person is planning to take
action and is making final adjustments before changing behavior; (engaged
consumer asks questions and creates a logon) 4) Action - the person implements
some specific action (patient creates a PHR) 5) Maintenance - the person continues
with the desired action (continues to update PHR on their own with historical
information after initially created) 6) Termination - the person has zero temptation
to go back to former behavior and has 100% confidence in their new ability. (patient
works to build and maintain PHRs for mate, children and other family members)
Source: Health Education Models, http://msucares.com/health/health/appa1.htm )
30

Module 2: Health Education
Theory – Stages of Change
31

Module 2:The Generations
Today’s workforce has 5 types of workers with differing styles.
These workers include:
◦ The Builders/Mature/Silent
◦ The Boomers
◦ The X-ers
◦ The Net/ Millennials
◦ The iGen
32

Module 2:Generation Values
VALUES IN…
BUILDERS/MATURE/
SILENT BOOMERS XERS Net/ Millennial/iGen
MOTHER Homemaker Working Mother Single Mother Single Mother/ Father
FAMILY Close Family Dispersed Family Latchkey Kids Looser Family Structure
MARRIAGE Married Once Divorced/ Remarried Single Parent Undetermined
HAIR Short Hair Long Hair Any Style Hair Bleached/ Spiked
CLOTHES Formal Casual Bizarre Anything Goes
MUSIC Big Band/ Swing Rock 'n' Roll Alternative, Rap Very Diverse
MONEY Save It Now Buy It Now Want It Now Get It Now (online)
PURCHASING Purchase w/ Cash Purchase w/ credit card Struggling to Purchase Purchase Online
MARKETING Ford Marketing Concept GE Marketing Concept Ignored Market Interactive Global Market
HIGH-TECH Slide Rule Calculator Computer Internet
WORK STYLE Team Work Personal Fulfillment Tentative/ Divided Loyalty Networking
WAR Win a War Why a War? Watch A War Winless War
MORALS Puritan Ethics Sensual Cautious Tolerant
LEARNING
STYLES 100%Print Media (Books)
90%Print Media
10% Electronics
65% Electronics
35% Print Media
90% Electronics
10% Print Media
33

Module 2: Patient Engagement
Introductions are important in patient engagement. Tone, body language and
energy are important.
Strategy and Tips for Introduction:
•30 second intro
•Initial impressions often sets the tone
•Introduce yourself
•Tone
•Body language
•Explain who you are
•Explain why you are there
•Include role of technology in healthcare
•Include benefits to patients
•Invite them to experience technology
34

Module 2: Patient Engagement
Conducting Interviews and Demonstrations
1. Introduction, the interview and the end.
2. Conversational
3. Understanding the response techniques
4. Checking responses
5. Follow-up questions
6. Staying on track and getting back on track
7. Good Listening Skills
35

Module 2: Patient Feedback
•Complete feedback form on all Encounters (manual) Spreadsheet.
•Within a few months the feedback form will be electronic (Score
card).
•This information is important feedback to report to project
leadership and measure program effectiveness.
36

Module 2: Patient Engagement Feedback
Date Start time Age Range Gender Topics discussed
Length of time with patient
(approximate) Navigator notes/observations
37

Module 2: Patient Engagement Role Play
38

Module 3: Basic Health Information &
Security of Health Information
PATIENT ENGAGEMENT
39

LEARNING OBJECTIVES
40
• Overview of the Affordable Care Act (ACA)
• Overview the Health Insurance Portability & Accountability Act (HIPAA)
• Personal Health Records (PHR) Privacy and Security Issues/Video
• Overview of Government Insurance Marketplace & County Care
• Tips for Creating Private and Secure User IDs and Passwords
• Privacy & Security: Clearing Your Internet Browser
Module 3: Basic Health Information &
Security of Health Information

Module 3: Affordable Care Act
(ACA)
"Health care reform" refers to a federal law called the Affordable Care Act, passed in March 2010.
To most people, health care reform means:
New and better ways to get affordable health care coverage
More options for receiving quality medical care
As of January 1, 2014, citizens are required to have health insurance or pay a penalty.
The only people who won't have to buy health insurance or pay a penalty are:
Those with certain religious beliefs
Members of Native American tribes
Undocumented immigrants
Those who are in prison
Those whose income is below a certain level
 Those with pre-existing conditions
41

Module 3: HIPAA
HIPAA stands for the “Health Insurance Portability and
Accountability Act,” a federal law passed in 1996.
HIPAA imposes several requirements related to health insurance and
health records.
One aspect of HIPAA, known as the Privacy Rule, provides patients
with certain rights with respect to their health information, requires
that health care providers protect the privacy of health information,
and requires that those working for health care providers be trained
in policies and procedures related to maintaining privacy.
This aspect of HIPAA went into effect on April 14, 2003, and applies
to health information in any form, including: paper, electronic, and
verbal health information.
42

Module 3: HIPAA (continued)
Recently, the HIPAA Security Rule/HITECH Act went into
effect which requires that electronic health information
be maintained in a way that protects the availability,
integrity and confidentiality of these records.
Individuals who will work with electronic versions of
health information must also complete training on the
HIPAA Security Rule which is available on-line or
provided by their health care facility.
43

Module 3: HIPAA (continued)
What is “Protected Health Information”?
Comes from a health care provider or a health plan
Identifies an individual or
Could be used to identify an individual
Describes the health care, condition, or payments of an
individual
Describes the demographics of an individual
44

Module 3: PHR Privacy and
Security HIPAA features
Health Insurance Portability & Accountability Act (HIPAA) 1996.
Ensures portability of insurance coverage between jobs
Improves efficiency of health care transactions
Ensures security and privacy of health information
Covers electronic, written and spoken medical information
Grants consumers right to request copies and change info
Protects how medical information is used
Protects who has access
45

Module 3: Privacy & Security Issues
Video
46
HIPAA SECURITY RULE
http://www.youtube.com/watch?v=QWRn2r5R7ts&feature=plcp
YOUR HEALTH INFORMATION, YOUR RIGHTS
http://www.youtubHIPAA/watch?v=FKTHncn-5Vs&feature=plcp
Spanish
http://www.youtube.com/watch?v=moQvCt4styk&feature=plcp

Module 3: Privacy & Security
Virus software
Firewalls
Strong User id’s and passwords
Secure websites
Trusted emails and attachments
SSL certificates
Encryption
47

48
Module 3: Government
Insurance Marketplace.org

When deciding on a purchase as important as health insurance
coverage, you need to empower yourself with as much knowledge as
possible. Speaking with a licensed agent is always strongly
recommended. They can supply you with all the tools you need to make
an informed decision and make you aware of health insurance options
that you may not even know you have.
You've likely heard of PPOs and HMOs. These are groups of doctors,
hospitals and medical specialists who provide health care services to
members at a discount. Before choosing a specific provider network,
check out how large it is and if there are participating doctors and
hospitals close to where you live.
49
Module 3: Government
Insurance Marketplace.org

Since lawmakers have passed the Affordable Care Act, it’s gotten easier to shop for individual health care
insurance. Theoretically, all you need to do is visit your state’s Health Insurance Marketplace to compare plans,
get quotes and enroll in coverage. But selecting a personal health care plan does require a certain level of
contemplation – so make sure you take these factors into consideration when you’re shopping for health care
for an individual.
Outline Your Medical Needs for a Personal Health Care Plan
The first thing you should do when shopping for individual health care insurance is to identify your medical
needs. If you’re relatively young and healthy, your medical needs may be minimal. If you’re planning to start a
family, though, you may need maternity coverage. If you regularly take certain medications, or have a pre-
existing medical condition, you need to factor in everything you’ll need your health insurance to cover. Outline
your medical needs, and focus on those needs and costs when you’re comparing plans.
Create Your Budget for Individual Health Care Insurance
Figuring out a budget for health care for individual needs is relatively simple. Income, minus expenses, and a
portion of what’s left over should go to personal health care insurance. If your needs are minimal, a basic
personal health care plan with a lower cost is probably right for you. No need to overbuy. If your medical
needs are more complex, though, it’s worthwhile to pay more for individual health care insurance that will
cover all of your medical costs.
Walk Through Several Plans
Take the time to fully walk through what your life would be like with a certain personal health care plan. Do it
again with a different plan. With the passage of the Affordable Care Act, insurers are required to issue a
Summary of Benefits and Coverage, or SBC, that can help you understand coverage and compare scenarios
under different health care plans. Take the time to fully understand how each plan would fit with your lifestyle
and needs before you make your final decision and enroll in your new health care plan.
52
Module 3: Marketplace
Health Insurance

Module 3: Creating and Managing
User IDs and Passwords
For internet sites creating a unique User ID and password is normal. User
IDs and passwords help protect the confidentiality of accounts and enables
the website owner to verify identity. This will be known only to the patient
and/or a family member or trusted friend should you choose to share it. Be
careful who you share this information. Similar to your social security
number or identification card, be careful with who you share your
information.
It is not uncommon to have 5, 10, 20 or more sets of User ID and passwords
for different websites and software applications. Also some passwords
expire and may have to be changed often. A private and secure process to
manage all your User ID and passwords is helpful. Suggestions follow:
Do not write down User IDs and passwords on paper or in a book where
others can view it easily. Writing down passwords and locking the list up
somewhere is a good idea and secure.
Storing them electronically in a file that is password protected is a good
idea and often secure.
53

Module 3: Tips for Creating Secure
User IDs and Passwords
User IDs and Passwords help protect the confidentiality of accounts and enables verification of identity.
Follow these tips to create a good user ID and password:
Create a user ID that others can't guess but is easy for you to remember.
Use a combination of letters and numbers (e.g., pat1sten10 or walk2dogs).
Many sites will ask users to use an email address for the User ID.
Try not to use the same password for every User ID and Password combination.
Avoid using family or pet names, your birthday, your anniversary or your social security number. (It is
too easy for others to guess)
Use a word you can remember, but replace some of the letters with numbers
(e.g., s1cr1t)
Users will often be given a set of instructions on how to create the User ID and Password for different
sites like….
Your user ID must be 6–16 characters and can contain any character found on your computer's
keyboard except spaces. As an added security measure, your user ID and password cannot be the same.
54

Module 3: Internet Browser
As you browse the Internet,
everything viewed is saved to the
cache on the hard drive. Loading
from the cache helps everything
load faster since it is loaded from
the hard drive instead of from a
server in a different part of the
world. To conserve hard drive
space or keep your browsing
private you can clear or delete the
history (cache).
55

Module 3:
Clear Internet Browser
Microsoft Windows users running
Microsoft Internet Explorer 6 and
above can delete their history files
by clicking the "Tools" menu,
"Internet Options," and clicking
the "Delete Files" or "Delete"
button. Users also have the option
of automatically deleting files each
time the close the browser
window by clicking the
"Advanced" tab and checking
"Empty Temporary Internet Files
folder when browser is closed"
under the "Security" section.
56

Module 4: Basic Computer Skills
Basic Computer Module
PATIENT ENGAGEMENT
57

Module 4: Basic Computer Skills
58
LEARNING OBJECTIVES
• Learn Basic Housekeeping for Maintenance of Computer Area
• Start Up, Troubleshooting, Turn Off Computer
• Assess and Provide Basic Computer Skills to Patients/Clients
• Computer Hardware, Software, Using a Mouse, Access Internet Browser
• Navigating the Smart Health Center Landing Page
• How to find Quality “Reliable and Accurate Health Information”
• Sample Google Search Results for “Diabetes”

Module 4: Housekeeping – Daily
Maintenance of Computer Area
59
• NO FOOD or DRINKS in the computer lab.
• Turn cell phones to vibrate.
• Respect all users time.
• Respect the equipment.
• NO game playing.
• Not for children use.
• NO Personal emails or Websites.

Module 4: Start Up, Troubleshooting,
Turn off computer
60
• The first activity of each day will be to turn on the Smart Health Center computers.
• Equipment is to be powered off at the end of the day. When working with patients
the computer will be turned on and working.
• Laptops and tablets are stored in secure locked environment
• Troubleshooting is a regular and normal part of the Health Navigator job.
• Remaining calm when working with patients is very important.
• Initiate troubleshooting steps for hardware, software or internet problems included
in the handbook. If not resolved:
1) ask the patient to return at a time convenient to them
2) contact the center IT support
• The last activity of each day will be to exit all applications, turn off the Smart
Health Center computers and return laptops and tablets to their secure locked
locations

PURPOSE To assess patient/client’s comfort level with computers.
1. Do you own or have you used a computer before? Score = 0
2. Do you have a smart phone? Score = 2
3. Do you know the components of a computer? Score = 4
4. Do you know how to access the internet? Score = 6
5. Do you have an email account? 5. Score = 8
6. Have you used a computer mouse before? Score = 10
61
Module 4: Computer Knowledge

Module 4: Computer Assessment
PURPOSE: Share skills with Health Navigator, the higher the
score the more basic skills training is required.
LIMITED SKILLS USERS  Go to Slides Labeled
ID essential parts of computer mouse skills open
internet browser  Privacy & security navigate landing
page  find quality health information
MORE EXPERIENCED USERS  Go to Slides Labeled
Privacy & security navigate landing page  find quality
health information
62

Mod 4: More Experienced  Go to
Navigating SHC Landing Page (Slide 70)
EXPERIENCED COMPUTER USERS
An answer of ‘yes’ to either of these questions may indicate a person is
familiar with a computer. A patient comfortable using the computer can go
to the section “Privacy and Security”. As time permits, introducing
“Personal Health Records and Patient Portal” in the next sections can
motivate patients to return for more guidance on how technology can be
used to take charge of their health. Evidence shows patients who invest
time reviewing; organizing and keeping track of their medical records often
receive improved quality care and have good health outcomes.
Navigating Smart Health Center Landing Page  Finding Quality Health
Information.
63

Module 4: Limited Computer Skills
 Go to Slide #65
COMPUTER USERS WITH LIMITED SKILLS.
Patient encounter(s) where there is limited familiarity with a computer
may need review of basic information on the parts of a computer, using
a mouse and accessing the internet first. On average this is about the
amount of time available to spend with a patient in an initial session. As
time permits patients can be invited back to learn “How to create
Personal Health Records and Patient Portal”.
ID computer HDW / SFW  Using a mouse  Accessing the Internet
 Navigating Smart Health Center Landing Page  Finding Quality
Health Information
64

Module 4: Computer Hardware
65

Module 4: Computer Software
66

Module 4: Using a Mouse
USING A MOUSE - New or limited skilled computer users are known to take extra time to
acquire the skill of using a mouse. Placement of the mouse in the hand and pressing the
correct button requires time and patience.
Step 1. Relax your hand over the mouse with your index and middle fingers over the
two control buttons.
Step 2. You will use your index (i.e., pointing) figure to “click” on the mouse and make
your selections.
Step 3. Moving the whole mouse on the pad will move the arrow/cursor on the screen.
Basic procedures to practice these skills are included in the following links:
Two additional good websites for practicing mouse skills are Mousarobics
http://www.skyways.org/central/mouse/page1.html and Mouse Exercises
Source: Chris Rippel Central Kansas Library System Great Bend, Kansas
crippel@ckls.org http://www.skyways.org/central/mouse/page1.html
Source: Mouse exercises developed by Vic Laurie, Ewing Learning Center, for SeniorNet
http://www.seniornet.org/howto/mouseexercises/mousepractice.html
67

Module 4:
Opening An Internet Browser
An internet browser allows access the internet. Most common ones are
Microsoft Internet Explorer, Firefox and Google Chrome. Mac’s Safari is
popular as well; however they are not currently deployed in the Smart
Health Centers. Use Internet Explorer (or the browser of your choice).
You can open the browser by double-clicking on the ICON or going
through the "Start" menu to open up the Internet.
68

Module 4: Open an Internet Browser
An internet browser allows access the internet. Most
common are Microsoft Internet Explorer, FireFox and
Google Chrome. Mac Safari is popular as well,
however, Mac’s are not currently deployed in the
Smart Health Centers. The internet browser at the
Smart Health Center should always be open and
available. These computers automatically go to the
Smart Health Centers page,
www.smarthealthcenters.com
69
Use Internet Explorer (or the browser of your choice). Open the browser by
double-clicking on the ICON on the desktop or going through the "Start"
menu to open up the Internet. Common internet activities are searching for
general information and health information, researching a product or service,
buying a product or service, checking weather and news. If you know directly
where you want to go, you can enter the address
(www.smarthealthcenters.com ).

Mod 4: Navigating the Smart
Health Centers - Landing Page
70

Mod 4: Navigating the Smart Health
Centers Landing Page
71
http://smart-health-
centers.smartchicagoapps.org/

72
Health Centers Landing Page

Adult Health
www.familydoctor.org
www.cdc.gov
www.Northwesternhospitallearningcenter.org
Pediatric Health
www.Healthychildren.org
www.Familydoctor.org
www.Kidshealth.org
Teen Health
www.bedsider.org
www.youngwomenshealth.org
www.advocatesforyouth.org
www.sexedlibrary.org
Nutrition
www.clocc.net
www.cspinet.org/smartmouth/index1.html
www.choosemyplate.gov
www.womenshealth.gov/bodyworks
www.healthyfoodshealthymoves.org/about-
us.html
Physical Activity
www.clocc.net
www.startwalkingnow.org (English only)
www.bam.gov/sub_physicalactivity – for kids
(English only)
www.win.niddk.nih.gov/publications/index.htm#
public
73

Women's Health
www.womenshealth.gov
www.Familydoctor.org
Chronic Disease
Diabetes – www.diabetes.org
Heart Disease – www.heart.org
Cancer – www.cancer.org
www.cdc.gov/DiseasesConditions
www.win.niddk.nih.gov/publications/index
.htm#public
Prenatal/Pregnancy/Breastfeeding
www.babyfriendlyusa.org
www.acog.org
www.womenshealth.gov/pregnancy
www.lalecheleague.org
Oral Health
www.healthyteeth.org
74

Nutrition
www.clocc.net
www.cspinet.org/smartmouth/index1.html
www.choosemyplate.gov
www.womenshealth.gov/bodyworks
www.healthyfoodshealthymoves.org/about
-us.html
Physical Activity
www.clocc.net
www.startwalkingnow.org (English only)
www.bam.gov/sub_physicalactivity – for
kids (English only)
www.win.niddk.nih.gov/publications/index.
htm#public
Stop Smoking
www.cancer.org/Healthy/StayAwayfromTob
acco/GuidetoQuittingSmoking/index
www.smokefree.gov
HIV/AIDS
www.medicinenet.com/human_immunode
ficiency_virus_hiv_aids
Community Resources
http://weconnectchicago.org/
75

Module 4: Finding Quality
Health Information
FINDING QUALITY HEALTH INFORMATION
The providers, nurse, health center administrators, pharmacists,
dentists, and ophthalmologists at your location have carefully selected
web health information sites that are trusted, reliable and great sources
of information for you and your family.
Your Community Health Center or our sponsors do not have any
financial or personal interests in these websites. The content is solely
the property of the vendor. Please check with your provider for further
discussion about articles and topics that appear on these websites.
Read the information carefully to increase your health care knowledge.
Remember to check with your provider before changing any treatment
plans.
76

(Regular Internet Search)
When looking up health information, use the suggested
Quality Information Checklist to find reliable, accurate health information.
Yes No
_____ _____ √ Can you read and understand the website?
_____ _____ √ Is the purpose of the website clear?
_____ _____ √ Is the website easy to use?
_____ _____ √ Is the website written by an organization or person you can trust?
_____ _____ √ Is the information biased in anyway?
_____ _____ √ Has the website been updated recently?
______ ____ √ Is the information correct and error-free?
Source: River Valley Healthy Communities Coalition, Rumford, Maine, Who Can You Trust? http://www.rvhcc.org/pdf/HIL_Sourcebook.pdf
77
Module 4: Finding Reliable and
Accurate Health Information -Checklist

For an activity let’s try to identify good and poor sources of reliable information on the internet. A
popular search topic is normally a population or health topic. Examples follow
Population or Community Type…Men, Women, Teens, Children, Seniors
By topic…Diabetes, Heart Disease, High Blood Pressure
Go to google (www.google.com) and type in “diabetes” as search criteria.
1. What were the first two or three websites that appeared?
Measure the first two or three websites with the suggested Quality Information Checklist. Share your
findings.
2. What were the next two or three websites that appeared?
findings.
3. What were the next group of three websites that appeared?
findings.
78
Module 4: Finding Reliable and
Accurate Health Information

Mod 4: Google Search for “Diabetes"
79

80
Mod 4: Activity - Accurate Health Information

Module 5: Health Information
Technology and Personal Health Records
81

LEARNING OBJECTIVES
•Recognize Health Information Technology (HIT) terms and acronyms
•Identify HIT at the Federal, State and Local Level
•Understand the similarities and differences in Electronic Medical
Records (EMRs), Electronic Health Records (EHRs) and Personal Health
Records (PHRs)
•Name the benefits of PHRs for Patients and Providers
•Recognize common contents and elements of PHR systems
•Identify Privacy and Security PHR issues
•Create a PHR
82
Module 5: Health Information
Technology and Personal Health Records

Module 5: Introduction
Utilizing the latest technology at the
Smart Health Centers, the Health
Navigator will invite patients to learn
how creating PHRs can help them take
charge of their health, receive efficient
care and track all their health care
encounters through their entire health
care spectrum. Patients will be able to
share this information with providers to
help them coordinate their care
efficiently, help providers gain a timely
and current view of their health status
and help them develop the most
accurate diagnosis and treatment plan.
83

Mod 5: Introduction to Health
Information Technology (HIT)
84

Mod 5: Introduction to Health
Information Technology (HIT)
HIT is the use of electronic hardware, software and technologies
used to manage and share patient information electronically,
rather than through paper records.
Health IT is designed to improve patient safety, health care
quality, efficiency and data collection and decrease health
care costs.
85

Mod 5: HIT Federal Governance
86
The Office of the National Coordinator for Health Information Technology (ONC)
is at the forefront of the administration’s health IT efforts and is a resource to the
entire health system to support the adoption of health information technology
and the promotion of nationwide health information exchange to improve health
care. ONC is organizationally located within the Office of the Secretary for the
U.S. Department of Health and Human Services (HHS). ONC is the principal
Federal entity charged with coordination of nationwide efforts to implement and
use the most advanced health information technology and the electronic
exchange of health information.
Source:
http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200

Module 5: HIT
State and Local Governance
87
In Illinois at the state and local level the entity for overseeing HIT planning,
implementation, maintenance and sustainability is the Illinois Office of Health
Information Technology (OHIT). They have the responsibility for building the Illinois
Health Information Exchange (ILHIE) secure state electronic network that will be used
to share the personal health information for patients and consumers among health
care providers in Illinois.
Source: http://www2.illinois.gov/gov/HIE/Pages/OHIT.aspx
Illinois Office of Health Information Technology

Module 5: HIT Video
88
http://www.healthit.gov/patients-families/multimedia
Brochure: http://www.healthit.gov/sites/default/files/consumerfactsheetfinal.pdf

Module 5: Paper Medical Records
now Electronic Medical Records
Personal health information in a patient medical chart includes identifying information (name,
date of birth, gender, ethnicity), demographics, insurance, emergency information, provider
information, allergies, medical conditions, medication, tests, labs and more. This information is
being converted from a paper chart to various electronic versions of the record, namely an
EMR, EHR or PHR.
EMR - Electronic Medical Record EHR - Electronic Health Record PHR – Personal Health Record
89

Module 5: Types of Medical Records
90
Electronic Medical Record Electronic Health Record Personal Health Record
SIMILARITIES
An electronic record of
health-related information on
an individual that can be
created, gathered, managed,
and consulted by authorized
clinicians and staff within one
health care organization.
An electronic record of health-
related information on an
individual that conforms to
nationally recognized
interoperability standards and that
can be created, managed, and
consulted by authorized clinicians
and staff across more than one
health care organization.
An electronic record of
health-related information on
an individual that conforms to
nationally recognized
interoperability standards and
that can be drawn from
multiple sources while being
managed, shared, and
controlled by the individual.
DIFFERENCES
MANANGED BY
created, gathered, managed,
and consulted by authorized
clinicians and staff
created, managed, and consulted
by authorized clinicians and staff
managed, shared, and
controlled by the individual.
DIFFERENCES
NUMBER OF
ORGANIZATIONS
INVOLVED
within one health care
organization
across more than one health care
organization.
can be drawn from multiple
sources

Mod 5: Personal Health Records –
PHRs
Tool that gives patients the opportunity to collect, store, track and share
important, up-to-date information about the health encounters for
themselves or someone under their care.
The patient controls and grants access to only those they trust.
PHRs were once paper based repository systems and are now stored on
computers, available online and are web-based.
Some are free and some are available for a fee.
They are available online by third party vendors.
Privacy and Security requires consumers to select trustworthy, reliable
systems.
91

Module 5: Benefits of PHR•Track health information from multiple providers in different systems in one convenient location.
•The patient creates, manages and controls PHR and content
•The patient controls who has access to the personal health information
•Information is quickly and easily accessible for sharing with hospitals, providers and other health care
stakeholders on the spot
•The patient can correct information, keep it accurate and up-to-date anytime
•Information is always accessible nights, weekends, holidays as long as the Internet is up
•A history of test results, lab reports and immunization records are available.
• This can eliminate duplicated tests.
•Medication errors can be reduced when a provider has up-to-date current information on medications
and allergies
•Participating in this type of self management empowers patients to take charge of their health
92
http://www.youtube.com/watch?v=jQJVceBNXFY
AHIMA. What a PHR Can Do For You.

Module 5: Privacy and Security
Issues of PHRs
Protecting personal health information
Patient responsibility and tips
◦ Read user agreements and policies
◦ Understand who has access to your information such as vendor staff, their
partners, and if they share information with anyone
◦ Practice basic security measures - strong passwords, share only with
authorized contacts, use trusted secure sites
3rd party vendors who sponsor PHR systems are NOT
HIPAA covered entities
93

Module 5: Activity – Creating a PHR
94
How it works. HealthVault lets you gather, store, use, and share health information for
you and your family, putting you in control of your health information.

Mod 5: Activity--Creating a PHR
95

Mod 5: Activity – Creating a PHR
96

97

98

99
Mod 5: Activity Creating a PHR

Module 6: Patient Portal
PATIENT ENGAGEMENT
100

LEARNING OBJECTIVES
• Define Patient Portal
• Describe the Similarities and Differences in Medical
Records and Patient Portals
• Define the Benefits of Patient Portals
• Recognize How it Works
101

“ a patient portal is the starting point for a patient to find
information, set appointments, review lab results and/or view
general health information on a physician or hospital Web site.”
HIMSS definition http://www.himss.org/digital_office/20071127_DigitalOffice.htm
102

Module 6 : Patient Portal:
How it Works
Patient Portal systems vary. Each organization has the ability to design personal processes
Step 1: Register by requesting or receiving a PIN, User ID and/or password from your health
care provider
Step 2: Access the online web address location on the Internet
Step 3: Enter information at the field upon request. Information can include PIN or access
code, name, date of birth, userid and password
Step 4: Answer any questions for creating security questions and answers.
Step 5: Read, review and accept or decline any terms and conditions such as
consent form governing the conditions for the patient portal usage,
policy for responding to communication from the patient,
the policy for communicating with any partners or other external organizations,
 how email communication is handled and
 security and confidentiality policies
103

Mod 6: Similarities & Differences of
Medical Records and Patient Portals
DEFINITION:
From the HIMSS definition a patient portal is the starting point for a patient to find information, set appointments, review
lab results and/or view general health information on a physician or hospital Web site (or Electronic Health Record)
SIMILARITIES:
The Patient Portal is one view, usually a limited view of the patient’s health care sponsored EMR. It is the same (similar)
data from the EMR which the provider, health care center or hospital owns and manages.
DIFFERENCES:
It is not affiliated with the Personal Health Record which the patient owns and manages. The same information can be
contained in other records.
It is up to the patient to obtain the information from the provider.
It is up to the patient to get the information into the PHR.
It is up to the patient to share personal health information that the provider does not have.
It is not a total full access view to the health care sponsored EMR or EHR.
104

Module 6: Benefits of Patient
Portals for Patients and Providers
Patients can schedule appointments, check appointment schedules or
request an appointment at their convenience.
Patients can examine and pay their statements
Patient and Provider secure communication
Allows a patient to request a prescription refill
Patients receive reminders and other notifications securely
Patients can complete and update medical record information and
forms at their convenience.
105

Issues of Patient Portals
Healthcare facilities have securely designed systems that protect
the EMR from the portion patients are able to access
Healthcare facilities have in place
◦ User agreements and policies explaining protections
◦ Secure logon protection and authentications
◦ Limited permissions for who has access to your information
Patients have responsibilities
◦ Practice basic security measures - strong passwords, share only with
authorized contacts, use trusted secure sites
106

Issues of Patient Portals
All messages sent between Providers and Patients are sent by secure
messaging. Secure messaging is the secure and protected transmission
of information between patients and their providers, including
clinicians and their support staff.
Traditional email messaging is not performed.
HIPAA continues to impose rules and regulations that improve and
protect patients privacy and security in health information exchange
HIPAA requires special security authentications for anyone accessing
EMR systems remotely
HIPAA requires tracking of personnel, dates and times to EMRs
107

Module 6: Patient Portal Overview
Patient Portal is a database-
driven software application
that allows you to build an
interactive secure patient
Web site.
The patient portal is
integrated with your existing
clinic health record systems
so that your patients can
access select parts of their
medical information.

From the portal, patients can
complete secure online forms
that are integrated with the
EMR.
Patients can also view their
secure messages from your
practice.

Mod 6: Patient Portal DEMONSTRATION: Sample
Community & Patient Activities on the Portal
Sample Community content
Sample Patient Activities on the portal:
◦ View Medical Record Summaries
◦ Refill a Prescription
◦ Fill out forms & sign them
◦ Use home monitoring forms
◦ Get directions to your office
110

Mod 6: Patient Portal Attach Chart Summary
Chart Summary includes
demographics and
structured clinical data such
as problems, meds, allergies.
Can be attached as text or in
CCR (Continuity of Care
Record) or CCD (Continuity
of Care Document)
structured data format.

Module 6: Most Common Elements
of Patient Portals
Home page of the patient portal
112

Mod 6: Most Common Elements of
Patient Portals
113
Viewing portions of the medical
record chart summary includes:
• conditions, medications
• immunizations, allergies
• test results and past history

Module 6: Most Common Elements
of Patient Portals
Sending or reviewing messages from provider
Request refills on prescriptions
Scheduling or cancelling appointments
Bill pay and statement viewing
114

QUESTIONS & ANSWERS
Thank you!
◦ Diana Beasley (Management Synergistics Inc and CCT):
◦ synergy033@aol.com
115

REFERENCES
Berthold, Miller & Avila-Esparza. (2009). The Role of CHWs. Foundations for Community Health Workers (1st
ed). (p.13). San Francisco, CA: Jossey-Bass.
US Department of Labor, Bureau of Labor Statistics. ( 2010, March 11). Standard Occupational Classification -
21-1094 Community Health Workers. Retrieved from http://www.bls.gov/soc/2010/soc211094.htm
Berthold, Miller & Avila-Esparza. (2009). The Role of CHWs. Foundations for Community Health Workers (1st
ed). (p.15). San Francisco, CA: Jossey-Bass.
Latitude Learning is a Learning Management System site that offers self-paced training courses in
communication, customer service, diversity and more ( http://www.latitudelearning.com/ )
American Medical Association. Cultural Competency definition. Retrieved August 2, 2012 from
www.csh.umn.edu/Modules/culture/comp/cp01.html
Cultural Competence: Photo google images commonwealthfund.org
National Network of Libraries of Medicine (2012) Definition Health Literacy. Retrieved August 10, 2012 from
http://nnlm.gov/outreach/consumer/hlthlit.html (excerpt article originally produced by Penny Glassman,
former Technology Coordinator, National Network of Libraries of Medicine New England Region, Shrewsbury,
MA)
Saint Vincent Charity Medical Center. (2012) 5 Steps to Better Health Literacy (2012) Retrieved August 10, 2012
from http://www.stvincentcharity.com/programs-services/centers-excellence/health-literacy/what-is.aspx
Kelly Mc Quillen & Connie Davis. BC Health Literacy Prototype - Patients as Partners in Primary Health Care.
Health Literacy Umbrella (p. 36) Retrieved August 10, 2012 from
http://www.phabc.org/userfiles/image/McQuillen.pdf,
116

REFERENCES
Stoney Brook University School of Medicine. Transtheoretical Model (Stages of Change) Photo
Retrieved August 20, 2012 from
http://medicine.stonybrookmedicine.edu/colorectalcancer/ModuleII/transtheoretical_model
Domain Uniform Resource Locator (suffix) Retrieved June 20, 2012 from
http://www.domainregister.com/comorg.html
Robin A. Cohen, PhD & Patricia F. Adams. (July 21, 2011) Use of the Internet for Health
Information: United States, 2009. Retrieved July 5, 2012 from
http://www.cdc.gov/nchs/data/databriefs/db66.htm
River Valley Healthy Communities Coalition. (2009) Rumford, Maine. Who Can You Trust? Health
Information and the Internet. Retrieved June 15, 2012 from
http://www.rvhcc.org/pdf/HIL_Sourcebook.pdf
The Office of the National Coordinator for Health Information Technology. (2012). ONC
definition. Retrieved July 12, 2012 from
http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc/1200
Illinois Office of Health Information Technology (OHIT). ILHIE definition. . Retrieved July 12, 2012
from http://www2.illinois.gov/gov/HIE/Pages/OHIT.aspx)
Patient Portal Himss definition http://www.himss.org/digital_office/20071127_DigitalOffice.htm
117

Smart Health Centers-Navigator Training

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Smart Health Centers-Navigator Training

Similar to Smart Health Centers-Navigator Training (20)

More from Smart Chicago Collaborative

More from Smart Chicago Collaborative (20)

Recently uploaded

Recently uploaded (20)

Smart Health Centers-Navigator Training