By Raj Tolelti (Originally written for AEHIT News Volume 1, No. 2)
As we evolve from fee-for-service to value-based healthcare, providers and payers will need to do everything they can to increase the frequency and quality of their interactions with patients across the continuum of care. That will require substantial investments in digital patient engagement solutions to automate many inefficient processes and proactively manage population health.
However, most of today’s patient engagement solutions – legacy health portals and point solutions – haven’t improved the patient experience. A recent survey showed that nearly three-quarters of consumers said they have had a healthcare experience that was worse or no better with providers and payers during the past two years.
By every measure, most portals and point solutions don’t provide the sophisticated digital user experience of consumer applications in the banking or retail industries, where automation has resulted in greater customer satisfaction. For one thing, portals put the burden on the patient or member to register and log in to a different system for each provider or payer – not exactly a positive user experience. It’s no wonder that only about 5 to 8 percent of patients actually access the typical portal.
If portals aren’t the answer, then what is? In my view, we need to make five fundamental paradigm shifts in the way that patients engage with their providers. These changes will enable our industry to move the needle substantially on improving the patient experience, outcomes, quality measures and population health, while reducing costs.
Consumer-centric design. In today’s on-demand, self-service economy, consumers expect to get service when and where they want it from Amazon, Uber and other businesses. Healthcare should be no different, providing a consumer-grade technology experiences and meeting patients and their families where they are and in the manner in which they want to interact, rather than expecting them to come to the technology.
When patients go to an emergency department, for example, they should know approximately how long the wait times will be and when their room will be available. By capturing the necessary information from back-end systems, we can send an automated text message or email notification containing that information directly to a patient’s or family member’s mobile phone. In the process, these push notifications can increase engagement rates to 60-80 percent.
Unified patient experience. Today’s tactical solutions will need to be replaced by unified platforms that meet both providers’ and patients’ needs. These platform solutions will need to incorporate comprehensive patient engagement functionality, including self-service appointment scheduling, mobile check-in, reminders, surveys, gaps in care outreach tools, care coordination, notifications and referral management.
Just as banks and retailers have done for years, payers and providers must offer a sophisticated mobile-first user experience for their members and patients. Consumers expect a consistent, personalized experience and convenient access to solutions via their smartphone, tablet and SMS (Short Message Service) alerts.
Re-engineered processes. To make healthcare more efficient, we will need to rethink the way we have always done business and adopt new processes adapted to a value-based payment model focused on efficiency, quality and outcomes.
For example, when patients arrive at their primary care physician’s office for their annual physical, they are usually given a clipboard with HIPAA forms and health assessments to fill out in the waiting room. Then, in the exam room, the physician assistant (PA) will typically go through the assessment and key in the patient’s answers into the EMR.
What if instead, we sent the health assessments to patients’ cellphones and they could complete and submit them before they enter the exam room or, better yet, prior to the appointment? Now the visit is much more efficient because the patient has already self-reported this baseline information into the system, streamlining the process, eliminating unnecessary paperwork and manual keying in of the information by the PA.
Another real-life example: A child was going in for surgery and the parent who needed to sign the consent form authorizing the procedure was working remotely on an oil rig. In a situation like this, that would typically mean faxing a form to the parent to review, sign and fax back to the hospital or outpatient surgery center. There’s a better way. The hospital or surgical center can use patient-engagement solutions to push a text message to the parent’s mobile phone with a link to the electronic form that can be signed and submitted immediately. This method eliminates the delay and friction associated with paper-based processes, while increasing patients’ and their families’ satisfaction with their healthcare providers.
Support for proactive care management. In the fee-for-service world of often reactive patient care, interactions between physicians and patients typically occur in healthcare settings for 15 to 20 minutes at a time (or less) – or during a two-to-three-day hospital stay. Between these single-event touchpoints, there is typically minimal or no communication between patients and providers.
By definition, value-based healthcare will require far more interactions with patients, a more proactive approach to managing patients’ healthcare, and a longer, ongoing care management life cycle. In an already overburdened healthcare system, providers will need to depend on digital technologies and automated solutions to meet these new needs.
In addition, by providing patients with a way to receive personalized content throughout their entire care journey, push web and native mobile-first technologies can result in up to 70 percent of patients viewing and valuing the care plan versus the 5 percent who may see it today on a legacy portal.
From nice-to-have to mission-critical. When patients become the center of care plan management, supported by push-based digital technologies, we can see dramatic improvements in both Meaningful Use and quality measures. For example, appointment adherence can increase by up to 50 percent, while medication adherence levels can improve by 10 percent or more.
Providers can ensure more patients get the care they need by sending reminder notifications to schedule a post-discharge appointment, an annual physical or an overdue colonoscopy. As a result, healthcare organizations can close gaps in care, reduce hospital readmissions, and improve performance on quality measures such as HEDIS (the Health Effectiveness Data and Information Set), PQRS (the Physician Quality Reporting System) and Medicare Star in pay-for-value models like the Medicare Access and Children’s Health Insurance Program Reauthorization Act.
As they transition from being mostly check-the-box to mission-critical applications, patient-engagement solutions will develop into unified, mobile-first enterprise platforms for achieving broader business goals and quality measures focused on promoting healthy populations, managing quality and reducing costs