August 26, 2024
For over 50 years, TrueCare has focused on improving the health of their communities by providing quality health care that is comprehensive, affordable, and culturally sensitive. Since opening their first health clinic in 1974, TrueCare has expanded into a network of 22 health centers and Women, Infant and Children (WIC) program locations, now serving approximately 65,000 patients annually.
As a Federally Qualified Health Center (FQHC) serving San Diego and Riverside Counties in Southern California, TrueCare’s patients often have limited digital literacy and access. With 17% uninsured, 94% falling below the 200% of the federal poverty line, and 40% preferring care in a language other than English, many patients did not finish high school or attend college and feel intimidated by technology.
To address these challenges, TrueCare used OCHIN Epic to implement a robust digital literacy plan, helping patients manage their care virtually.
“In today’s environment, a lot of the work that we do is virtual. We have virtual visits. We allow our patients to check in using MyChart, or to message their provider. So, we really need our patients to be able to understand this technology,” said Ana Ramon, director of patient access services at TrueCare. “[It] really is a right that all our patients should be able to have … to be partners in their health care.”
“Everyone deserves to have a positive, quality health care experience,” said Tracy Elmer, chief innovation officer at TrueCare. “By developing a robust program, we have been able to help equip patients with the skills needed to navigate digital health care platforms, enhancing their overall experience and providing a more equitable means for access.”
In addition to improving patient outcomes and reducing barriers to care, TrueCare aimed to enhance efficiencies and increase digital literacy among its staff. This approach was intended to create more opportunities for patient engagement, autonomy, and satisfaction, while also facilitating long-term cost savings.
Enhancing patient engagement and access
The patient engagement and digital literacy program bloomed from a partnership and alignment with the technology TrueCare had already been implementing. Their team prioritized the accessibility of MyChart and ensured that their patients could use its features.
“The reason this is so important is because it has a direct impact on our patients. It gives them the opportunity to take control and really be involved in their own health outcomes,” said Kelly Brown, director of clinical informatics at TrueCare.
“Imagine waking up in the middle of the night with a sick child, unsure of what to do,” she said. “The first thought might be, ‘Do I need to take off work tomorrow to see my provider?’ But with MyChart, you can message your care team, share what’s happening, and schedule an appointment for the next morning.”
Patients can complete pre check-in steps and submit questionnaires in MyChart, allowing them to rest easy knowing they’ve taken the initial steps for care. TrueCare has also simplified appointment scheduling with the help of MyChart support specialists and a hotline, helping patients overcome scheduling barriers—especially those who work long and irregular hours.
“There is a lot of demand for same-day appointments with providers, and if you are having to wait until the call center opens, there is a good chance you may not get an appointment. So, helping our patients become more [digitally] literate creates a level playing field for getting the care they deserve,” said Matthew Kosel, vice president of clinical informatics and enterprise analytics at TrueCare.
TrueCare also integrated self-scheduling options with OCHIN Epic on their website, providing easy access to QuickCare (same-day) appointments and COVID vaccines. Additionally, TrueCare collaborated with OCHIN’s preferred technology partner, Doximity, to enhance support for video visits. This ensures that patients can enjoy a high-quality health care experience wherever and whenever they need it.
“The smooth integration of telehealth options along with MyChart lowers barriers to access by meeting the patients where they are, when they need care,” Elmer said.
Bridging the digital divide
To empower patients, TrueCare appointed digital health ambassadors to offer MyChart and digital tech support. Informational materials with a QR code for easy access to the MyChart portal were placed in the clinics, and a created catalog of short videos are available on their website to facilitate easy access to information. A “Tech 101” course, tailored to older Spanish-speaking patients, taught essential digital skills and celebrated course completion with a graduation ceremony.
“When we are developing collateral or rolling out tools like MyChart or video visits, we have to keep in mind that—while we know these tools are extremely beneficial to patients’ health care in the long run—it will take a little more education and handholding to help them understand the importance and benefits,” Ramon said. “Finally, we need to encourage them to utilize these tools.”
The impact extends beyond health care and outcomes. Patients developed a strong sense of community, and as they became more comfortable with technology like Zoom, they could better connect with distant family members.
“That was a lovely byproduct of what we taught them,” Brown said. “It all builds into what we’re really looking for, which is high quality health services and overall better quality of care, reducing all those barriers. When you can make a difference in a patient’s life with simple things such as connecting with your family, it’s going to ripple through the care that they receive.”
TrueCare also emphasized staff education through monthly “MyChart Minute” in their staff training sessions. Each month, they focus on a different MyChart feature, so everyone develops a strong understanding of how the feature works and feels comfortable answering patient questions.
“We also really aim to ensure they have a voice,” Kosel said. “We strive to involve frontline staff—not just upper leadership—in what we do, so they feel like they can impact the programs, take pride in working here, and maintain connection with us.”
With OCHIN’s support, these initiatives have led to significant measurable impact:
TrueCare collaborated closely with OCHIN on each of these projects, ensuring all components were in place and that they worked well and were user-friendly. “That’s a partnership—our team and the OCHIN team working together to come up with the best options to make it as easy and as intuitive as possible,” Brown said.
“I think OCHIN has been a really good partner for us as we seek to be innovative,” Brown added. “The analysts and the leaders that we’ve worked with have been excellent partners, understanding our vision and how we want to operate as an organization for our community.”
Kosel agrees. “It was so nice to talk with people who understand the unique challenges that an FQHC faces,” he said. “It is also great that we didn’t have to build everything from scratch— a lot of the work had already been done, and we just worked towards implementation. It’s so nice that we’re not reinventing the wheel every time.”
Innovating into the future
Looking ahead, TrueCare aims to increase the percentage of patients who self-schedule by 5% by the end of 2024. They plan to achieve this through video modules, using OCHIN technology partner Artera to run campaigns encouraging self-scheduling, and an expansion of their “Tech 101” pilot program, which has received praise from their senior support group for Hispanic adults.
They also plan to expand direct scheduling for their services and are launching a new self-scheduling pilot for their older adult health center, with additional sites to follow each month. In addition, TrueCare aims to enhance their digital health ambassador program, MyChart Minute, and telehealth programs, and to expand their patient video catalog.
“For MyChart adoption, it's a number we watch very closely, and we expect to see growth,” Brown said. “But it's also about MyChart utilization. We’re analyzing which features within MyChart are being used by different patient demographics and backgrounds, and identifying who may need more support.”
TrueCare’s vision for greater innovation and impact extends beyond clinic level. They are currently exploring how to define MyChart engagement for their WIC program members.
“You really need to spend time, meet your patients where they are, and offer a variety of initiatives to help them understand, utilize, and embrace all of this technology,” Brown said. “We really want to make it equitable so that all of our patients, regardless of background or digital literacy, are empowered to use these tools just like anyone else.”
Learn more about the inaugural OCHIN Impact Award recipients and their success stories in this blog post and video.
