FUSE Corps - Los Angeles, CA
Currently, the Los Angeles Department of Health Services (DHS) faces a critical lack of enrollment in their MyWellness Patient Portal, a free and secure website and mobile application that connects patients to their doctors and health information. To increase enrollment in the MyWellness patient portal by 50% by June of 2022, FUSE will develop and implement a robust strategic toolkit and quality improvement plan for DHS.
This fellowship project begins on October 25, 2021, and ends on October 23, 2022. The fellowship begins with a multi-day virtual orientation the week of October 25, 2021. The selected Executive Fellow will begin their first day of providing services to the host agency on November 1, 2021.
The Los Angeles Department of Health Services (DHS) is the second-largest municipal health system in the nation. Through its integrated system of 27 health centers and four hospitals - and an expanded network of community partner clinics – DHS annually provides direct care for over 700,000 unique patients, employs over 23,000 staff, and has an annual budget of over $6.2 billion. DHS primarily serves patients in the safety net, 80% of whom received public insurance through Medi-Cal. DHS staff work around the clock to care for patients regardless of their income, insurance status, if they are experiencing homelessness, disabled, or are non-English speakers.
In 2015, DHS implemented a new electronic health record (EHR), ORCHID, and built the MyWellness Patient Portal. The MyWellness Patient Portal is a free and secure website and mobile application designed to connect patients to their doctors and health information. Through MyWellness, patients can immediately view their doctor’s notes and lab results, renew prescriptions, self-schedule vaccine appointments, and view upcoming appointments. In 2016, all DHS providers had adopted the ORCHID system, enabling providers to have instant, secure access to patient health information from any DHS facility. And by 2017, patients were able to self-enroll in the MyWellness patient portal without an email invitation. These MyWellness patient portal tools provide better clinical efficiency, better care coordination, and improve patient care and safety.
Currently, DHS is working to connect as many patients as possible to primary care providers, with Medi-Cal members assigned (empaneled) to DHS automatically to promote health equity. While self-enrollment is an option in the MyWellness patient portal, many patients – especially these empaneled patients – need encouragement and assistance for enrollment due to known issues related to the digital divide and technology literacy. However, there is a lack of consistency in these staff-assisted enrollment procedures. And many patients find the process arduous or enrollment resource materials confusing – leading to a lack of critical enrollment in the MyWellness patient portal.
DHS is determined to increase enrollment in the MyWellness patient portal by 50% by June of 2022. In addition, DHS will be launching new tools like video visits and e-visits within ORCHID and MyWellness in November 2021. To support this work, DHS will partner with FUSE Corps to host an Executive Fellow for one year to develop and implement a robust strategic enrollment toolkit and quality improvement plan across the organization. The Executive Fellow will implement data-driven recommendations to optimize enrollment operations, further build out a suite of patient-centered resources and materials to target and enroll hard-to-reach empaneled patients. These efforts will ensure DHS will meet its goal and that primary care providers can support coordinated and continuous care to patients, especially as the Covid-19 pandemic persists.
PROJECT SUMMARY & POTENTIAL DELIVERABLES
The following provides a general overview of the proposed fellowship project. This summary and the potential deliverables will be collaboratively revisited by the host agency, the Executive Fellow, and FUSE staff during the first few months of the fellowship, after which a revised scope of work may be developed and agreed upon by the FUSE fellow and the host agency.
Starting in November 2021, the FUSE Executive Fellow will build from much of the internal information collected by assessing DHS’s patient portal enrollment processes. The Executive Fellow will utilize their initial listening tour to quickly build deep relationships with a wide range of critical stakeholders, including staff who participate directly and indirectly in client enrollment. The Executive Fellow will travel to the various clinics and hospitals within the DHS network to explore the site-based realities of enrollment operations. The assessment will detail how the various providers currently support portal enrollment, map workflows and pain points, review the effectiveness of current communication materials and messaging, and determine gaps. The Executive Fellow will also engage with patients to understand the user experience with portal enrollment processes and materials, identifying areas of effectiveness, perceived gaps, and accessibility issues. They will review current data on portal utilization, assessing how to integrate potential new data streams that capture user information more granularly. The Executive Fellow will then conduct national research on best practices and innovations around patient portal enrollment engagement processes and communications, evaluating local applicability.
In the next phase, the Executive Fellow will edit and improve a robust toolkit for increasing patient portal enrollment. This will include recommendations to optimize enrollment operations, such as systems-wide processes, training, and a framework/structure for patient engagement. The Executive Fellow will engage various staff groups in the design process of these recommendations to ensure staff buy-in for new procedures. They will also edit and improve a suite of patient-centered resources in conjunction with the DHS Communications Team. These materials will use various delivery mechanisms and leverage effective outreach strategies to target and enroll hard-to-reach or inactive patients. The Executive Fellow will also explore how to incorporate this toolkit into the adoption plan for DHS’s other virtual healthcare tools, with a specific focus on ensuring it is easy to access and utilize via existing systems (e.g. SharePoint).
The Executive Fellow will then initiate activities that are most urgent or considered low-hanging fruit. This will include establishing clear integration phases for the new procedures or processes, clear roles of stakeholders, shifts in workflows, timelines around milestones, and metrics for tracking progress. The Executive Fellow will provide tactical training to staff to support the rollout of the toolkit, starting with frontline staff in clinics. Once implementation is kicked off, they should spend a significant amount of time reviewing appropriate metrics, integrating new data sets, and tracking enrollment activities, conducting an ongoing improvement of the toolkit and tests of change. The Executive Fellow will utilize this data to improve and build on the Tableau patient enrollment dashboard. The dashboard will provide sample profiles on users and trends on enrollment, informing the Department’s future enrollment strategies and investments, especially in their attempts to enroll the broader empaneled or inactive patient population.
By October 2022, the Executive Fellow will have overseen critical stages of implementation, and the Department will have reached its stated goal. This will include the following:
FUSE Corps is an equal opportunity employer with a core value of incorporating diverse perspectives into our work at every level. We encourage candidates from all backgrounds to apply for this position.
FUSE Corps - Los Angeles, CA
Currently, the Los Angeles Department of Health Services (DHS) faces a critical lack of enrollment in their MyWellness Patient Portal, a free and secure website and mobile application that connects patients to…