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Running head: FINAL TEACHING PLAN: PATIENT PORTAL

Final Teaching Plan: Patient Portal


Melinda L. Swander
University of Central Florida

FINAL TEACHING PLAN: PATIENT PORTAL

Final Teaching Plan: Patient Portal


Description/Context:
The Centers for Medicare and Medicaid (2014) have initiated an incentive program to
motivate providers to provide electronic health records to their patients. Electronic health
records can help a patient to become more involved, ease coordination with other providers, and
assist in approving their overall care. Nurses play a vital role in the healthcare team to ensure
patients are given the information on how to access their medical records. Without their support,
the patient will not be knowledgeable about how to obtain their records and the hospital will not
met their benchmarks set forth by the Medicare and Medicaid Electronic Health Records
Incentive Programs.

Intended Audience:
The audience for this teaching session is a group of 10 medical-surgical registered nurses
from a telemetry unit at an acute care community hospital. The experience of these nurses range
from 6 months to 12 years.

Teaching Plan:
To educate the staff on the importance of informing patients how to access their medical
records from the hospital as part of the Center for Medicare and Medicaid Electronic Health
Record Incentive Program.

FINAL TEACHING PLAN: PATIENT PORTAL

Goal:
The staff will be able to verbalize the steps to teaching a patient to access their medical
records through the patient portal access.

Objectives:
Following a 30 minute education session on the patient portal access, the nurse will be able to
1. Verbalize the rationale for the organization to comply with the Center for
Medicaid and Medicares meaningful use requirements for patient information
regarding their hospital stay (Knowledge).
2. Identify 3 out of the 8 types of patient information obtainable online regarding
their hospital stay (Comprehension).
3. Explain the 3-step process for a patient to gain access to their patient portal
access from home (Comprehension).
4. Demonstrate the required nursing documentation for patient portal access,
within the inpatient charting system (Application).

Teaching/Learning Strategies with Rationale:


The first objective I chose was from the knowledge domain, as this is a prerequisite for
all other levels within the cognitive domain (Bastable, 2014). I think its very important, when
educating, to ensure the student understands the why of what is being taught. I wanted the
student to understand why educating the patient about patient portal access was important to the
organization.

FINAL TEACHING PLAN: PATIENT PORTAL

Next, I chose a comprehension objective within the cognitive domain to ensure the
learner understood what the patient could benefit from having this patient portal access. As the
nurses will be educating their patients, I also wanted to verify they could explain to the patient
the correct sequence to gain access. This will ensure the nurse also has an accurate
understanding of how the patient accesses the patient portal from home.
Finally, as this is a Center for Medicare and Medicaid Electronic Health Record
Incentive Project, it is important that the nurses document this education appropriately within the
computer system (eHealth University: Center for Medicare & Medicaid Services, 2014). As we
all know this is a very important objective because if it wasn't documented, then it wasn't done.
The documentation supporting the education has been conducted is submitted electronically to
the government. We must meet our current benchmark, which is 50% of the defined patient
population, to receive the financial incentives.

Preparation:
Prior to the teaching session, I will provide each of the learners with background
information about the Center for Medicare and Medicaids Electronic Health Record Incentive
Program. In addition, I will also make available instructions on how to view a sample patient
portal via the hospitals website. Each nurse will be expected to review the materials and answer
a short quiz regarding the materials prior to attending the learning session. (See appendix A)

Obstacles:
As I implemented this teaching plan, I realized that I was competing with several other
equally as important initiatives that were being introduced house wide. These competing topics

FINAL TEACHING PLAN: PATIENT PORTAL

included clinical hourly rounding, AIDET (Acknowledge, introduce, duration, explanation, and
thank you) skills labs, and faxed patient reports from the emergency room. As our organization
is in the middle of a transition in ownership, I noticed first hand that the staff was saturated with
new information. Knowing the importance of staff compliance with educating their patients on
patient portal access, I was able to push through the barriers and proceed with the education. At
the completion of the learning activity, I allowed time for debriefing, realizing the importance of
giving the staff time to verbalize any issues or concerns with following this process (Billings &
Halstead, 2012).

Content Outline
I.

Lecture: Using a PowerPoint presentation (APPENDIX D), provide an introduction


and overview of patient portal
a. Review Pre-teaching activity quiz (APPENDIX A)
Rationale: Efficient way to share background information needed to gain support for
the education (Bastable, 2014).

II.

Demonstration: Demonstrate the steps the patient will take to access their electronic
health records via the patient portal access & document this in the medical record.
Rationale: This teaching approach appeals to the psychomotor domain and actively
engages the learner (Bastable, 2014).

III.

Return Demonstration/Role Playing: I split the group up into five groups of two. I
allowed each learner to verbalize the steps taken for a patient to access their medical
record via the patient portal access to their partner (patient). Then I had them switch

FINAL TEACHING PLAN: PATIENT PORTAL

roles. After completing the task I had them demonstrate how to accurately document
this task in the medical record. (evaluation tool: APPENDIX B)
Rationale: Gives the learner the opportunity to gain confidence with the skill and will
better retain it (Bastable, 2014).
IV.

Group Discussion/Critical Thinking: Debriefing of education and answer any


questions or concerns they may have regarding the teaching.
Rationale: Using this educational method encourages the participants to think about
questions or concerns with the education (Bastable, 2014).

Critical Thinking Approach:


At the conclusion of the return demonstration, I will allow time for group discussion. It
is during this time, where I find that learners will come up with what if scenarios. I will use
this time to help them critically think through the solutions to their questions by returning the
questioning to them. For example, what if the patient does not have an email address? I will
allow them to identify possible solutions, such as creating one, or using a trusted family
members email address. As Bastable (2014) concluded, information is becoming more and
more accessible and therefore the need to memorize is less important, but the need to critically
think is becoming more important.

Outcome Evaluation:
I will evaluate the learner by return demonstration. See APPENDIX B. In order for the
learner to successfully complete the education, they will meet each of the return demonstration
key steps.

FINAL TEACHING PLAN: PATIENT PORTAL

Teaching Implementation:
I successfully completed the education on 2 groups of 10 nurses on the medicaltelemetry unit at my facility in the beginning of October. I felt the education went extremely
well and I believe the staff not only understood how to complete the objectives, but understood
why it was important for the patient and the hospital. The first session took a little longer than
expected due to the class size. I wanted to ensure that I was able to evaluate each learner
demonstrate the proper education for the patient. The time I allotted for the debriefing and group
discussion at the end was a little longer than needed, so I was able to end the session within the
30 minute period. A three-item survey was provided to the participants following the education
session to evaluate and offer recommendations on how to improve the education. (See
APPENDIX C). All participants responded agree or strongly agreed to all three questions. No
additional feedback was provided on any surveys.

Teaching Effectiveness Assessment Plan:


Based on the electronic audits performed on all discharge documentation, we were able to
decrease the number of patients that failed to receive education regarding the patient portal prior
to discharge. Before the education we were averaging 10 delinquencies a week and after the
education we actually went three weeks without failing to document patient portal access
education. In approximately the last seven weeks, none of the nurses who attended the education
sessions have had patients they have discharged show up on that list! If I had to do the teaching
over again, I would ensure to include pool nurses. Many of the nurses who failed to document
properly were nurses from other departments, or pool staff that failed to receive the education.

FINAL TEACHING PLAN: PATIENT PORTAL


Now the next challenge will be meeting the next benchmarks set forth by the Center for
Medicare and Medicaid Services Electronic Health Record Incentive Program to have a certain
percentage of patients actually access their patient portal after discharge (Center for Medicare
and Medicaid Services (2014).

FINAL TEACHING PLAN: PATIENT PORTAL

References
Bastable, S. B. (2014). Nurse as educator: Principles of teaching and learning for nursing
practice (4th ed.). Burlington, MA: Jones & Bartlett .
Billings, M. D., & Halstead, J. A. (2012). Teaching in nursing (4th ed.). Saint Louis, MO:
Elsevier-Saunders.
EHealth University: Center for Medicare & Medicaid Services (2014, April). An Introduction to:
Medicaid EHR incentive program for eligible professionals. Retrieved September 25,
2014, from http://www.cms.gov/eHalth/downloads/eHealthU_IntroMedicaidEHREPs.pdf
Munroe Regional Medical Center (2014). Welcome to your patient portal: My health home.
Retrieved November 25, 2014, from http://www.munroeregional.com/patients-andvisitors/my-health-home-patient-portal.aspx
Center for Medicare and Medicaid Services (2014, August). Patient electronic access tip sheet.
Retrieved November 21, 2014, from http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/Downloads/PatientElecAccTipsheet_0618
2014-.pdf

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Appendix A- Pre-Teaching Activity

Access with My Health Home Patient Portal


In compliance with The Medicare & Medicaid Electronic Health Records Incentive
Program, Munroe is providing patients with access to their Personal Health Records (PHR).
Providing patients with access to their medical records will help them to become more involved
with their care, share their medical records with their next care provider, and ultimately help
improve their overall care. If the patient provides an e-mail address upon registration, or prior to
discharge, then he or she will receive an e-mail invitation after discharge to log into Patient
Portal from Munroes website.

Key Points

While not an entire Medical Record, the patient can now view and edit specific
clinical/personal data posted from Munroe such as:

Lab results

Medications

Radiology Reports

Vital signs

Immunization records

Hospital data from Horizon Clinicals are aggregated and then posted to RelayHealth.

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Patient education will be provided under the tab My Health Home in the patient
information folder given to each patient on admission.

The data resides on a secure cloud making it accessible to both patients and Providers.

After reviewing the sample portal access pages on the Munroe Regional Medical Centers
Home Page, please answer the following questions about the Patient Portal.

1. What is the Purpose of The Center for Medicare and Medicaids Electronic Health
Records Incentive Program?
_____________________________________________________________________
_____________________________________________________________________
2. How does the patient gain access to their medical records from home?
_____________________________________________________________________
3. Where Can I find patient information regarding the patient portal access?
_____________________________________________________________________
_____________________________________________________________________

Please bring this questionnaire to your learning session for discussion

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APPENDIX B: Return Demonstration Evaluation Tool


Key Steps
Patient is educated about the patient portal using the approved
marketing tool in the patient folder
If patient consents, patients email address is sent to admitting on
designated face sheet via fax # 7394
Verbalize to the patient they will get an invitation to access their
medical records via Relay Health within 24 hours after discharge
Instruct the patient that once they receive the invitation, click on the
link to register with Relay Health
Inform the patient that within 72 hours after discharge, they will be
able to access their electronic health record from home.
The Nurse will then access the Electronic Medical Record of the
Patient and document this education under Disposition
Charting/Electronic Health Record

Met

Not Met

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Appendix C: Teaching Evaluation

Please answer the following questions and provide additional comments. Your feedback will be
used to improve this education session in the future.

1. Objectives of the course were met? Please circle your answers below:
Strongly agree

Agree

Disagree

Strongly Disagree

2. Course was well organized? Please circle your answers below:


Strongly agree

Agree

Disagree

Strongly disagree

3. The teaching activities facilitated my learning? Please circle your answer below:
Strongly agree

Agree

Disagree

Strongly disagree

Comment:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Thank you for your feedback!

FINAL TEACHING PLAN: PATIENT PORTAL


Appendix D: PowerPoint Presentation

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