One of the most frustrating aspects of the healthcare system for patients right now is how difficult it is to understand the various players. Communication and transactions are complex and time-consuming because of the dispersed nature of the ecosystem. Consumers’ expectations are high in the healthcare sector due to the highly personalized and convenient experiences they’ve had in other sectors.

If you buy anything online and travel, you want a frictionless experience. Platforms for e-commerce are making every effort to improve the user experience. Since everything is tailored to your preferences, you no longer have to drive to the mall to do some shopping. Your order can be delivered in less than an hour with just a few clicks. E-commerce platforms use AI and behavioral information to forecast your interests and customize your purchasing experience. Consumerism in health is a simple way of saying that patients are actively engaged in their very own health and wellness.

Traditional healthcare providers still face a barrier in making investments in back-end infrastructure that would allow for a digital experience.

“Healthcare consumerism,” as medical practitioners call it, refers to individuals making decisions about their own health care. ‘Patient-centered care,’ as the word suggests, places patients at the center of the healthcare decision-making process. As healthcare expenses continue to grow, patients are seeking a similar experience to what they enjoy in other service industries, like banking or retail.

Uber and Lyft, two firms at the vanguard of the transportation revolution, are no exception. Because the way it portrays the journey from point A to point B, Uber has mastered the art of consumer marketing. You don’t have to wait in lines or worry about payments because they’ve taken care of everything. Can healthcare businesses aspire to make this transition by making the process frictionless – from booking appointments as simple as making an Uber reservation?

According to a Definitive Healthcare survey, Health care consumerism was a top trend in 2018 and projected to continue to define the industry’s future and maintain its long-term viability.

Creating a consumer experience that is connected

If you’re concerned about managing your health and wellness from home, wearable technology has become a significant part of your daily routine. In contrast, barely half of the healthcare professionals inquire about wearable tech data during appointments, although 57% of consumers believe this data would be useful in their healthcare discussions.

Consider the case where you use your banking app to make a purchase and the transaction goes through. So, the next step is to contact customer service or go to the bank to view the information. As soon as you pick up the phone, you expect the person on the other end to know exactly what you’re trying to say.

When a physician advises in-house therapy or diagnostic testing following a digital consultation, the patient expects the hospital to have that information and not burden them with a new process. But this is not what happens in many care settings. Can we change that?

Patients’ dissatisfaction can be remedied with a well-designed CRM system. Adopting digital capabilities, such as digital apps, the usage of AI, and wearables, in order to remain competitive and future-ready.

Traditional healthcare providers still face a barrier in making investments in back-end infrastructure that would allow for a digital experience. Good digital tools are helping to increase patient autonomy, leading to an increase in patient care, greater retention and adherence. The healthcare business will benefit financially from this initiative. Reduced healthcare expenses are directly correlated to greater patient empowerment. Though most large healthcare providers have launched mobile applications, businesses will need to add new features, such as integrating data from wearable gear into the app.

Mergers and Acquisitions in Digital Health

Digital health deal volume grew by more than 26% in 2021. A sign that healthcare organizations are looking to adopt digital health companies that offer eHealth, telemedicine, and wearable technologies to get a head start on innovation.

Healthcare organizations can also partner with retail chains and e-commerce websites similar to other companies that are partnering with other industries to market their services. The cost of these services is minimal, but they will have a significant impact on the quality of patient experience Personalization, omnichannel customer experience, and improving the physical channel experience all play a role in this.

Booking appointments online should be as simple and convenient for our patients as shopping or purchasing groceries is for the rest of us – patients do not appreciate waiting to meet healthcare needs, just as they do not like to wait to book a hotel, airline, or shop.

How do we do this? Start simple, remove friction in the most painful areas of patient accessing care. Here at the International medical center hospital, the hospital advocates for person-centric solutions. IMC Patients can book in-person appointments and cancel or reschedule them without contacting any hospital department first. You can do this via IMC’s internet site, WhatsApp, chatbot, and mobile app since these systems are meant to give you time flexibility. You can also find out about hospital departments and treatment providers. The IMC application’s guardian feature allows you to register and manage appointments for your family members. Diagnostic testing can also be scheduled. In addition, patients can schedule E-visits from the comfort of their homes. Patients residing outside of the city’s core could use an E- visit to reach IMC’s treatment providers.

There is a lack of personalization in the healthcare industry, that means healthcare providers will have to catch up to the rest of society shortly. The company that is first to identify the customer, respond to their needs, and build long-term relationships will be ahead of the rest. In all elements of care delivery and engagement, a focus on wellness and prevention is essential. The patient is transformed into a customer with this level of customization.

Providers need to respond soon!

The post How Healthcare Consumerism can ready the industry for the next ten years appeared first on HealthTech Magazines.

The fiscal Year 2020 challenged and changed all of us. It changed the way we work, the ways we connect, and in some cases, the work we do. What has not changed is our drive and commitment to our patients, our community, and each other. The challenges of the COVID-19 pandemic have underscored the importance of our healthcare organizations’ values, and especially our commitment to human life and the centrality of the patient experience and outcomes in everything we do.

Our shared priority should be improving and delivery of integrated comprehensive care and safety for all our patients. Let’s challenge our energy and progress to shoot for delivering an exceptional patient experience.

Improving patient experience is not just the right thing to do; it is essential in today’s more consumer-driven healthcare ecosystem to remain competitive and profitable. I want everyone to view this not as just another challenge to get through, but as an opportunity to better meet your patient population’s changing needs and expectations to innovate and improve the patient experience. One essential component of this is empowering patients to own their healthcare records and more actively engage in their own healthcare or the healthcare of those for which they are caregivers. The importance of a centralized, single integrated system; an un-fragmented system over a wide range of specialties will increase this sense of ownership, efficiency, safety, comprehensive care, continuity of care, lower re-admission rates, and cost-effectiveness for our patients from the front door to the back end.  

The patient experience is critical and a crucial component of our ability to attract and retain patients. When patients form positive relationships and trust their physicians and our organizations, they become more engaged in their own care. Their compliance rate increases and they develop a stronger sense of loyalty to the institution. 

As a healthcare organization, how are we making sure our patients will have a positive experience? What does your organization’s reputation and the quality of care delivered mean to each of you? How will you play your part to deliver coordinated care that leads to better outcomes for your patients?

These are some of the measures that must be taken in order to foster a culture of patient-centered care at your organization; where patients and their families consistently experience quality, compassion, and partnership:

1.  Issues important to patients should be included in all quality initiatives.

2.  Evaluate provider efforts to integrate patient values and preferences into care delivery and discuss the various approaches to developing this crucial organizational competency.

3.  Encourage and support participation from all key stakeholders. We need to promote organization-wide engagement in patient-centered care initiatives. 

4.  Over time, set priorities in collaboration with leadership through integration of strategic priorities.

5. Facilitate communications and integration with other organizational priorities and see the shortcomings and what needs to be done to improve your organization.

6.  Spread and scale patient-centered care initiatives throughout your organization.

Understanding and working to improve the patient experience; which is the sum of all the touchpoints in the continuum of care, is critical. Enhancing patient experience positively impacts the organization: 

1.  Patients, their families and caregivers become more engaged in their own health outcomes.  

2.  Enhances the organizations’ revenue.  

3.  Improves the organizations’ reputation for one of a kind treatment center

Our shared priority should be improving and delivery of integrated comprehensive care and safety for all our patients. Let’s challenge our energy and progress to shoot for delivering an exceptional patient experience.

The post Patient-Centered Care Underscored in the time of Pandemic appeared first on HealthTech Magazines.

Austin Regional Clinic, in conjunction with health consulting firm MDH Consulting, has been working to improve communications with patients on specific messages, with the end goal of engaging more patients to keep up with their preventive health care screenings and the management of their chronic diseases. In this case, we have categorized patients based on their attitude and response to healthcare communications and then crafted specific colorectal screening reminder messages based on their perceived category, or “patient segment.”

Values-based communications

When health-related communications are oriented towards an individual’s value, more patients “get” why the information is relevant to them. Personalizing the content and messaging means that the message makes sense to the patient. This is the concept of values-based communications used by MDH and ARC to encourage patients to get their colon cancer screening and oft-avoided preventive health screening.

Patient segmentation

The connected era we live in has revealed more about people’s healthcare preferences. Cognitive research models can now be applied to healthcare to better understand and incorporate patients’ preferences, so we can assist them in improving the quality of care.

The outcome of this connectedness is to improve our insights into patients’ health status, preferences, and priorities. We are gaining a better understanding of what works and what doesn’t when it comes to sustaining health improvement initiatives.

The Five Health Personalities

Based on proprietary research developed by PatientBond, MDH guided us on their values-based profiling capabilities to place individuals into five “health personality segments,” listed here from the most proactive to the most reactive:

• Self-achievers – “I take ownership of my health and I actively take steps to be healthy. I focus on achieving my goals and objectives. An illness is just another challenge to be overcome.”
  
  
• Balance seekers – “I am open to many ideas and options, as long as they make sense for me. I need context to understand ideas and recommendations.”
  
  
• Priority jugglers – “I worry more about my family’s health than my own. I am constantly on the go, juggling many responsibilities, so getting sick is not an option.”
  
  
• Direction takers – “I look to my physician and other healthcare providers for guidance and direction on what I need to do to take care of my health.”
  
  
• Willful endurers – “There are more important things in my life to focus on than improving my health. I live in the “here and now,” and I can handle whatever comes at me.”

Orienting on values means everyone gains a better understanding of how patients see the world. This means content and communications can be “transmitted on the frequency patients are already listening for,” by having a better grasp of “what people hear” as they engage with portals, programs, physicians, and nurses.

Looking for the “a-ha” moment

Using the right words may seem like a simple thing, but it’s remarkably effective when those words are found. When receiving messages geared toward their perceived segment, patients report more “a-ha” moments about things that have too often been confusing or mundane in the past; their health decisions become more precise and appropriate for them.

ARC’s goal was to determine if customized messages for specific patient segments would increase colon cancer screening rates compared to using a single message to all patients.

Response rate

ARC’s goal was to determine if customized messages for specific patient segments would increase colon cancer screening rates compared to using a single message to all patients. There were a total of 5,724 patients that were part of the study. One thousand six hundred twenty-nine patients received messages personalized for them and a control group of 1,662 of the patients received the same messaging that went out each year. The remaining patients received regular reminders but no additional communications.

When measuring the response rate per health personality segment, the patients in all segments who received the letters or emails with customized verbiage consistently responded at a higher rate than the control group. Overall, ARC increased email response rates from 27% to 39% and test completion rates increased 2% -5% depending on the segment, as demonstrated below.  

In conclusion

Engaging patients in their health and improving health outcomes is a continuous goal of population health. By better understanding how patients prefer to receive guidance – instead of just using a traditional, one-size-fits-all approach – we recognized and aligned with what our patients ultimately wanted to know: ‘Is this screening really relevant to me? And do I really need to do it now?’

Ultimately we confirmed that by using data and an understanding of human psychology, patients were more likely to respond to outreach efforts and make decisions about their health that could ultimately lead to living a longer and higher quality of life.

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Managing IT amidst a pandemic does not come without challenges to say the least. Leadership and management theories require thoughtful planning. But, in a crisis, planning and protocol go out the window! So what does a CIO do when the need to roll out IT solutions at light speed goes against every principle you have been driving home for years? Adapt, communicate, and motivate.

Introduction – What We Faced

Day one: COVID morning meeting:

Come up with IT solutions for: 1- Mobile hospital drive through testing center, 2 – MASH COVID treatment facility, 3 – Patient family communication, 4 – Transfer 150 Associates to work-at-home, 5-Deploy telemedicine solution for physician practices, 6 – tele-consult technology for inpatient virtual patient visits, and 7 – Data analytics dashboards for COVID daily stats… and the list goes on.

Day one: Afternoon IT team feedback:

“Boss, you’ve got to be kidding… that’s a pretty tall order!!!”
Spoiler: It all got done and with amazing speed, agility, accuracy, and effectiveness. Once the team got used to the fact that our usual planning cycle just crashed, we accomplished every task with great aplomb.

The Pandemic brought an unprecedented demand for our services overnight. Motivation is key to keeping your IT force driving home solutions during a crisis.

How We Adapted

When looking to adapt, turn to your nursing, and ex-military IT personnel. They are instrumental in getting past: “Hey, did our CIO just go haywire?” banter to: “OK, we need to pull this together now … here’s how we’re going to do it…” They also quickly get used to the fact that directives are less of a discussion (in a crisis) and more of a tacit “do now.” The chain of command is imperative in this situation when the “do now” versus “plan to have ready” initiatives all blur together.

Make sure you confer with your CIO colleagues as much as possible. Ask them what they are doing every day? How are they managing? What new technologies did they deploy, and what partners helped them the most. Review what you glean every day and assess how you can interject these ideas to solve problems. Float concepts that you discovered and let your team run with them, redesign them, and make them fit your organization. Moreover, make sure you fish for ideas from everyone. Leaders must draw on every creative thinker on the team. With no planning cycle, unprecedented demand for services, and constrained resources, CIOs face a daunting challenge brought on by the pandemic: Solving complex problems quickly, pragmatically, and effectively. Consequently, we let every trial balloon fly. We are always open to new concepts but even more so at the core of this battle. All thoughts and ideas have credence during an emergency. I can assure you that every member of your team wants to do a great job and even more so in a crisis. They also want to put their own stamp on it and make it fit for the organization they know and love.

“If you think you are too small to make a difference, you have never been in bed with a mosquito.1”

Communication is Key

It is impossible to over-communicate in this situation. Our CTO started a daily Zoom conference call that was attended by everyone in the department – religiously. This kind of communication is critical to update the team on all that is going on in IT, in the hospital and health system. Reporting critical stats on the hospital, community, region, and the national situation helps illuminate the current state and what might be coming our way. This daily debriefing was the key to success — especially in the early stages. It also served as an inherent motivating force – helping the team take ownership for their contribution and feel more in control of their world. When the team develops an active ownership role, they look past the problem for the answer. Consequently, IT leaders must communicate continuously and define and then redefine how actions will align with the desired outcome – safer patient care.

Motivation Doesn’t Cost a Thing

Moral of the story: Collaboration occurs naturally when all stakeholders share a common objective. In this situation, there was/is a clear objective: Do everything possible to help frontline caregivers safely and efficiently care for our community. The Pandemic brought an unprecedented demand for our services overnight. Motivation is key to keeping your IT force driving home solutions during a crisis. Pizza donations to the team get old, but the gesture is always welcomed. Many thanks to all of our partners who made sure we were all well fed during these trying days. Sharing real stories is better than anything you can buy to help your team see the result of their hard work. For example, a family was not able to visit their loved one in the last stages of life. However, they were thankful they could say goodbye with the televisit capability provided by the IT team. Stories describe how meaningful and important our work is and answer inevitable doubts of “Am I making a difference?…”

What I “Re-Learned”

I inherently knew all of this, but dealing with this Pandemic strongly reinforced how many natural and insightful leaders already existed in my sphere of responsibility. No ONE person can provide all of the leadership necessary during a major crisis. Additionally, this one is very different. With social distancing, we needed to find other ways to be present, visible, and accessible to our teams. Therefore, we also needed to delegate traditional leadership acts throughout the entire chain-of-command. Good leaders know how to do this and aren’t threatened by empowering team members to make tactical decisions on the frontline. You need to do everything in your power to encourage and inspire people, at every level; to act as if leadership is everyone’s responsibility – because it is! Some say politicians never waste the opportunity in a crisis to shape and implement policy. CIOs should also take these opportunities to develop new leaders in their organizations. Never let a crisis encumber your ability to LEAD.

The post IT Leadership amidst a Crisis – Lessons from the Pandemic appeared first on HealthTech Magazines.

When everyone does better, everyone does better. There are so many polarizing views of the concept of “free” in the United States today, it becomes nearly impossible to unpack in one article. What most people can agree on, despite disagreements on how to operationalize, is the idea that when people have what they need to succeed, society is elevated. Although it seems that few can agree on how universal healthcare could be implemented in a country like the United States, it’s fair to say that most recognize that a healthier population leads to more productive and peaceful society.

Why not close the gap and provide all patients with better access and connectivity?

While dissecting the opportunities and pitfalls of the Medicare-for-all concept could be a riveting way to start the week, it may make more sense to take a step back and look for other, possibly more basic options to help keep the masses healthy (or at least, healthier.)

Universal internet access may sound like a luxury in a world where Wi-Fi is used for just as many non-necessities (hello Buzzfeed quizzes) as it is for necessities. It’s nearly impossible and totally impractical to try and differentiate what internet use is considered necessary versus superfluous, and it’s not in anyone’s best interest to start policing search histories for the average Joe. But it could very well be worth our while, as a society, to supply the entire population with reliable, highspeed, free internet.  When it comes to making incremental changes in how consumers engage in their healthcare and receive information, consistent, quality Wi-Fi access could drastically change how patients take care of themselves.

Healthcare professionals do not typically encourage patient-Googling of their healthcare conditions. But suppose for a moment that all patients could easily access to information about their conditions? If a provider suggested a specific educational website and the patient could actually engage in learning? Or patients could consistently access medical rideshares without worrying about data usage or connectivity problems? The potential for empowering all patients through quick information channels could be industry-changing. Skeptics might be inclined to assume that those who can’t afford basic internet likely can’t afford the devices needed for internet services, but we all know that’s not the case. Many communities and states have programs to offset the costs associated with smartphones, so even the most vulnerable patients are getting more connected each day. Why not close the gap and provide all patients with better access and connectivity?

If patients knew that they would always have reliable connectivity to send messages, participate in virtual care, and access condition-related information, there could be a measurable increase in patient engagement and accountability. The old saying that knowledge is power very much applies in this idea; when patients are empowered through information, they can be partners in their care. While it can be daunting to add yet another line item to a city budget, universal internet access could decrease overutilization, particularly of emergency services, by helping patients stay connected to their healthcare providers and treatment plans.

Of course, many places offer free Wi-Fi such as libraries and coffee shops. And yet we know that patients who have mobility limitations, transportation problems, or other barriers, in general, may not be able to physically go to a place to connect to Wi-Fi. Allowing everyone to connect to the internet can make this very large world feel a little smaller and more cohesive.

In 2016, the United Nations declared that universal internet access is a basic human right as it affords a person the ability to communicate and express themselves. While global internet access may be many years away, the United States can help lead the charge. The USA can provide all of its citizens with this human right without spending inordinate amounts of time worrying (more so judging) how people might abuse this right. The missteps of a few should not dictate the rights of so many vulnerable people who could benefit from universal internet access.

The internet has changed the world in ways that previous generations could not even fathom. While universal healthcare or universal post-secondary education may be long way off, it seems that the idea of universal access to the same information is a lighter lift that could benefit the masses.

Note: The views expressed in this article are that of the author and do not represent Evolent Health.

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As healthcare continues to rapidly evolve and patients and families increasingly expect to interact with their healthcare providers in the same manner as they interact with their airlines or e-commerce vendors, healthcare providers face a unique challenge in accommodating this expectation.  There are many reasons why the nature of healthcare makes embracing consumerism particularly daunting but the mere fact that it may be daunting does not mean that it isn’t critical.  Prospective patients expect it to be easy to make appointments and receive updates on their care through mobile apps and other electronic mechanisms and, if they don’t feel that a healthcare provider has been able to make their experience frictionless, they won’t hesitate to seek out an alternate provider.  If this occurs too frequently, you can see how the ongoing drain of prospective customers could adversely affect the ongoing business prospects of the healthcare provider.

New ways of improving communication with patients while they are on-site are bubbling to the surface including being able to be more transparent about wait times and finding out particular needs that a patient has to make their experience more enjoyable.

Tough or not, all providers have to jump into the consumerism pond, and consumerism is truly the primary focus of the healthcare world in 2019.  Providers are attempting to offer on-line booking capability for patients, in much the same way that one might anticipate booking a seat on an airplane.  But, consider some aspects of this process that makes this much trickier than booking an airplane seat.  A provider will need to be very confident that (1) the patient will actually show up for the appointment and (2) that they will be paid for the services that are rendered to the patient when they arrive.  This requires thorough insurance data capture and validation with an understanding of what insurance will pay and what the patient’s financial responsibility will be.  Also – and this is especially true for specialty practices – many health insurance payors require prior authorization before they will pay for certain services and oftentimes, a lot of clinical documents need to be exchanged for the insurance to approve the visit or procedure.  This document exchange is often a very cumbersome process involving many different parties: the patient, the referring physician, the insurance company, and others, and can be extremely frustrating.  A consumerist approach to healthcare attempts to mitigate these hassles, and current technology trends are taking steps to more effectively address these built-in obstacles and help meet or exceed prospective patient’s expectations.

To make this process as frictionless as possible, many healthcare providers are leveraging “patient portals” or mobile apps as their point of interaction with patients. These tools are getting increasingly better at making the patient-provider interaction smoother and providing a much-improved capacity for exchanging critical data and documents. Most patient portals allow patients to request medication refills with a few taps or clicks, pay outstanding balances securely, and communicate with their healthcare care team about non-emergent issues on time. There is a great value to that and patients have been shown to appreciate it. The improvement in the mobile experience has taken things to the next level and it allows a patient to interact with the healthcare provider through a device that they have become increasingly used to using for many of their everyday tasks – their cell phone.

In this new paradigm, providers not only benefit by having patients be able to communicate with them, but they benefit by being able to communicate with their patients. If a patient is coming in for a procedure, communicating with them electronically about what they need to do before the procedure or what time they need to arrive is efficient for all parties involved. Providers can also share news about new programs pertinent to a patient’s condition and facilitate a lot of information capture quickly and easily through electronic health questionnaires, the modern-day digital equivalent of the clipboard documents that patients typically have to fill out when they arrive for an appointment.

Behind the scenes, the patient experience is being enhanced by improvements in how important clinical data is shared between different providers. Electronic “continuity of care documents” (CCDs) are becoming the norm. These documents are generated at the end of each encounter and may be electronically sent to another provider of care or to a “health information exchange” (HIE), who would be able to share this with any provider who participates in the HIE. Also, a new technology called FHIR (“Fast Healthcare Interoperability Resources”) is making it easier to share data across many digital platforms through APIs (“application programming interfaces”). The recently released Apple Health Record is a great example of this new wave of “interoperability” of electronic health records; in essence, allowing patients to carry the preponderance of their health history in their pockets on a secure app on their cell phones.

New changes are afoot at many providers when the patient arrives. The patient may be able to receive directions on their phone to the parking area and a map of the facility when they arrive, including how to access amenities such as the cafeteria or gift shop. New ways of improving communication with patients while they are on-site are bubbling to the surface including being able to be more transparent about wait times and finding out particular needs that a patient has to make their experience more enjoyable. And, while technology is helping play a role, providers are focusing on non-technology-based things such as providing water for patients, offering them a blanket if they are cold, and configuring patient exam rooms to maximize the quality of the interaction between physician and patient.

So it’s a very busy time as it relates to enhancing the patient experience. These new technologies, coupled with a reinvigorated emphasis on patient needs and ease of interaction are coming into their own and having an appreciable effect on the totality of the patient experience.

The post How Healthcare is Taking the First Steps to Embrace Consumerism? appeared first on HealthTech Magazines.

By Christina Perez, Network Operations, ACO & CIO, Tenet Healthcare

In healthcare, when one thinks Patients and IT, we think Apps for fitness, calorie counting, and patient education tips but for many physicians they think Patient Portal. Physicians due to regulations have had many communications to their patient population to access and use their patient portal through the Electronic Health Records (EHRs). Physicians themselves are overwhelmed with all the IT healthcare acronyms: HIE, PPDX, HIT, then to be able to translate what is needed by regulation into communications for their patients to understand. Physicians are supposed to communicate to the patient their diagnosis, not regulations of IT use, is that why less than 50% of patients use patient portals or is it a patient learning curve. Physicians have reported the use of the patient portal messaging system as patients have asked for lab results, prescription refills, needed to follow up appointments via the patient portal. The patient portal has eased physician’s workflow as providers just click and route the needed request to the appropriate place to fulfill the patient’s request. As physicians at one time were reluctant to use EHRs, it is becoming wider spread as it is being understood that what once took five minutes to place a prescription order over the phone can now be done with a click of a button. EHR use was regulated in 2014 and the lag of use from physicians and their staff has also delayed the process in patient engagement in healthcare IT use, we have to admit there is a learning curve. Facebook launched in 2004 and a decade later it was expected to have the healthcare industry who is trained in medicine to be efficient not just to use but to also to teach health IT at 50% of our clinical population or face a penalty. Patient IT use could have been possible with templated communications that physicians can send to patients. EHRs have the capability to integrate with many applications to track a person’s fitness task and calories, yet it is still seldomly done. In chart reviews, through the EHR, it is seen that patients have written logs scanned into their charts and less of the actual application integration of patient captured data.

Physicians are supposed to communicate to the patient their diagnosis, not regulations of IT use, is that why less than 50% of patients use patient portals or is it a patient learning curve.

It is almost 2020, yet in healthcare, there are still paper charts, clinics are not fully electronic and what should be sharable data is still not. The reality of patient IT use is still far from reality, but I do have great hopes that when my kids grow up, they will finally be able to access their whole chart as needed, for a Netflix monthly fee of course. I am not even sure if in the next 10 years we will move forward with IT use for patients unless regulations are mandated. When regulations were labeled meaningful use it was benchmarked that all clinics require 50% of their patients to access the patient portal and 5% use the system and send messages to communicate, now the regulation says at least 1 patients should be able of portal use. Having capability may not be enough for full patient participation to be able to create patient engagement. The healthcare industry can move forward and make use of the data collected more efficiently, but first, it has to start with the providers directing patients to access IT tools and education. Patient Medical Center Home is one model where healthcare physicians and staff are leading the way for patient engagement and they are measured by it. Clinicians are the main promoters of patient engagement of any healthcare IT tool. The healthcare industry wants to believe that patients are engaged in IT, but until programs become easier to access, appear user-friendly, and communications on how to access patient tools and education we still have a long road ahead of use. The healthcare industry has EHR webinars for clinic use but lack on webinars directed to patients for patient use. As EHR companies evolve, it will be more than just physician-focused but patient-centered as well.

The healthcare industry has EHR webinars for clinic use but lack on webinars directed to patients for patient use.

To truly promote strategies that are attainable for patient engagement of tools and education, we must turn to the physicians as the patient’s trust and listen to their physician.  Physicians can turn to their EHR Company to learn more about integration with IT applications and to be able to create a webinar tailored just for patients on IT use.

The post IT Strategies Promoting Patient Engagement Tools and Education appeared first on HealthTech Magazines.

In 2012, Children’s Health^SM faced two significant environmental changes that held the potential to impact provider workflow vis-a-vis additional documentation requirements. And if these changes were not handled well, they could result in a significant negative impact to provider efficiency, clinical communication, and revenue capture. With the possible financial impact being in the millions, we needed to “fuel up” for these changes. What were they?

• Texas was moving to Prospective Payment System (PPS) for Medicaid inpatients Sept. 1, 2013
• Roll out of the International Classification of Diseases Version 10 on Oct. 1, 2015

Being an organization that seeks to leverage the power of technology tools to improve care delivery and outcomes, we thought this challenge represented a perfect opportunity to draw on the collaborative spirit of our team members, to develop processes that would enable us to meet the requirements of PPS and ICD-10, and employ the robust technology tools we have deployed across our organization.

This initiative resulted in Children’s Health in Dallas rolling out a Clinical Documentation Integrity Program that was fueled by a combination of technology, data analytics, and process changes that ultimately helped us increase overall case mix index (without additional employees), improved clinical communication, and streamlined provider documentation.

People and Process:

We assembled a multidisciplinary workgroup comprised of physicians, advance practice nurses, nutrition, coders and clinical documentation integrity specialists. The work effort began with the team defining the problem and conducting an extensive literature review. Our plan was to begin the process with our Gastrointestinal division and then expand the project to all departments. As such, we secured a physician champion from the gastrointestinal division and sought participation from disciplines to serve as subject matter experts. The clinical documentation integrity specialist facilitated the meetings, pulled the information together and wrote/managed the multiple drafts. Then the document was socialized, which enabled us to receive valuable feedback. The socialization process included meeting with providers one-on-one, department meetings, case studies, posters, and lunch-and-learn engagement. This resulted in extensive changes to the document, which was then triangulated against literature review to ensure we were maintaining a solid scientific base. With the vetting process being tied to scientific evidence, we were able to accomplish and sustain the culture change necessary to gain adoption.  The Health Information Management (HIM) team served as the leadership force in the project, with the IT team supporting the “power pack” behind the solution that was embedded in the workflow.

The Power Behind the Program (Technology)

Children’s Health used its electronic medical record (EMR) and clinical decision support tools to support this initiative. The EMR tools used included the clinical documentation integrity application, template redesign, and reporting tools. The clinical decision support tools included computer assisted coding, APR-DRG enhancer, and auto-generated queries. Clinical communication was improved with the increased capture of co-morbid conditions, and provider documentation was streamlined to improve efficiency without the need for additional full-time employees (FTEs) for the effort. Implementation of the EMR allowed us to shift staff that had previously performed other roles into clinical documentation integrity (CDI) positions. There were also additional benefits to case management department.

The technology was finalized in 2013, clinical definitions were published on an internal website dedicated to physicians and circulated to the medical community. For example, in 2013, there were 878 inpatients with the diagnosis of malnutrition and 1,104 in 2014. We believe these statistics are the result of acceptance across the disciplines and recognition of the value of a standard definition for malnutrition in the pediatric population.  The table below illustrates the progression of the process, growing acceptance, and sustainability.

The following matrix demonstrates the Documentation Integrity rollout of People, Processes, Technology, and Tools: 

Communication Plan

Initial discussions took place in which the Chief Health Information Management and Exchange Officer and the Chief Information Officer met with the Division Chiefs, and Chair of Pediatrics to lay out the planned approach of “people, processes, and tools” in this initiative. Once these senior leaders were comfortable with the tools and approach, the communication planning began. A project of this magnitude required a solid communication plan in which we crafted and targeted our communication by discipline, providing routine updates to Division Chiefs, Health Electronic Record / Health Information Management members and Utilization Review Committee members. From there, we asked these team members to cascade this information to their peers. At first, communication was provided monthly until we determined an appropriate cadence to the messages. Now, these updates are delivered quarterly.  We sought to augment our communications with a more “grass roots” approach through numerous lunch-and-learn events within departments. We also conducted (and continue to conduct) face to face meetings with providers as needed. In addition, the team participated in clinical rounding; however, after discussion with medical staff, we determined that this wasn’t the most appropriate vehicle for this communication. Rather, the team found that it was most effective when monthly communication and engagement was reported to the Health Information Management / Health Electronic Record Committee and Utilization Review Committee.

Outcomes

In the first year of the Clinical Documentation Integrity program, prospective payment for Children’s Health showed an increase in reimbursement rather than a decrease—this was an expected result. Case Mix Index continued to increase annually until 2016, when we reached a plateau. Bill drop days declined from 5 days in 2011 to 3.5 days in 2016. Of note, however, is the fact that as of 2017, the bill drop days has increased to 5 days due to other factors. The increase in CMI was FTE-neutral in that no new FTEs were needed as a result of the CDI initiative.

With implementation of computer-assisted coding, data analysis showed that coders captured an average of two additional diagnosis codes per inpatient discharge, which resulted in an increase in case mix index (CMI) of 7% prior to clinical documentation team staffing. These results proved to us that technology is a big contributor to improved documentation, and to this day, CMI continues to grow with clinical documentation team staffing.

As a specialty referral system, many of our providers see a set population of patients with similar documentation requirements. This presented an opportunity for us to standardize templates for these patient populations, due to the general lack of variation in documentation. The design process focused on evaluating workflow and providing drop downs with co-morbid conditions that were usually present in the population. Once we rolled out standardized templates, the CMI increased, documentation was completed in less time, and provider satisfaction improved.

Our analysis showed a prevalence of documenting manifestations of the disease process rather than documenting classifiable conditions. With this understanding, the multidisciplinary team developed standardized clinical definitions, which led to agreement across the medical staff on diagnosing co-morbid conditions, improving efficiency of clinical communication and increasing CMI. The net result is that clinical communication was streamlined and improved by standardization.

Additionally, our analysis showed providers were not consistently capturing co-morbid conditions that were associated with the principal diagnosis. This finding led to Children’s Health and the team to work with providers to redesign their templates, resulting in a more effective means of capturing these diagnoses without adding to the standard workflow.

Case managers have an increased awareness of APR-DRGs, severity of illness and expected length of stay, allowing them to be more actively engaged in assuring complete documentation.

Lessons Learned:

• The value of the CDI team working closely with the medical staff, leveraging focused communication, is immediately evident at month end when there is a drop.
• Monitoring KPIs and reacting/responding quickly assures no slippage.
• Keeping material fresh and relevant is the key.
• Provider response to queries time decreased immediately when providers were given a visual queue that a query was older than 24 hours (measured in June of 2014 and then again June of 2017 following the query redesign). Automated queries on specificity in 2018 also showed the same trend.
• Continued refreshing and packaging of the material within the provider workspace has allowed sustained improvements in our documentation.

Clinical documentation integrity can improve provider workflow, assure accurate population representation, support more complete clinical communication, and provide positive financial impact. Our CDI program has shown the test of time, accurately representing the acuity of our patient population.

Scenario: How more accurate CMI impacts the bottom line

To understand the impact, you need to know that total reimbursement is figured by multiplying an organization’s base rate by the CMI weight (Base Rate x CMI Weight).

Each hospital’s base rate is different, so we’ll use hypothetical numbers to illustrate the impact. Let’s say that your base rate is $10K. Under this scenario (using the CMI example below), in 2012, our organization would have been reimbursed $17.6K per patient ($10K x 1.76), but in 2019, the same patient population would be reimbursed at $26.1K ($10K x 2.61), an increase of nearly $10K. While this is a general illustration, it’s easy to see how even a small incremental change in CMI accuracy can result in significant impact to your organization’s bottom line.

Our goal is for programs to accurately reflect acuity and capture co-morbid conditions. One example is our nutrition program, which expanded based on our ability to capture more frequently the diagnosis of malnutrition. Ultimately, our efforts have helped us better support the unique healthcare needs of our community.

Summary:

• A multidisciplinary clinical documentation integrity program supports success
• Technology underpinning is fundamental
• Restructuring templates can more accurately reflect patient acuity, streamline documentation efficiency, and improve provider satisfaction
• Automated queries in workflow facilitates provider response
• KPIs and data analytics keep you on track

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At the nexus of Healthcare and Technology emerges solutions aimed to improve patient outcomes and satisfaction, while making the jobs of clinicians safer and more effective. The primary driver of these solutions is to address industry-specific challenges faced by these populations. One such solution at the convergence of Health and Tech that is beginning to show signs of maturity is Telehealth—the remote delivery of healthcare services over an audio and visual telecommunications platform.

We are experiencing an exciting time for Health Tech, as a whole. We are seeing climbing rates of adoption of digital health tools among consumers, including wearables and Telehealth applications. New players are emerging in the healthcare industry leveraging technology to bring new delivery models to consumers. State and Federal legislators are discussing ways to reduce barriers to Health Tech innovation, while encouraging industry leaders and new players to look toward solutions like Telehealth, as the new norm.

From a technological viability standpoint, we are more capable of delivering Telehealth effectively in multiple healthcare settings than ever before. I serve as Chief Information Officer for Consulate Health Care, a national leading provider of senior healthcare services. Our talented team of Health Tech pros and vendor partners are currently implementing Telehealth in a controlled test group of our Skilled Nursing Facilities.

Telehealth platform integration with legacy e-health record systems and single application sign-on capabilities helps to streamline utilization by cutting down on the amount of time it takes for clinicians to become familiar with new technology platforms.

We are seeing the industry’s most advanced wireless internet networks provide seamless, two-way interaction through high-resolution cameras and crisp, clear VOIP communication. We are integrating our Telehealth platforms with electronic patient recordkeeping systems to send and receive information quickly and securely, while allowing Telehealth clinicians to monitor the status of patients in real-time. In other words, the technology needed for effective Telehealth platforms already exists.

While technological capability is an essential element to industry-wide adoption, it is not the only element. The healthcare industry at large has a significant amount of work to do as it relates to policy making, security, education and talent development, as well as overall trust and adoption among patients and clinicians.

These barriers are similar to circumstances occurring in other emerging technology trends, such as Future Mobility or Blockchain—where the technology fueling these trends already meets or exceeds the needs of the consumer, but overall adoption remains moderate at best due to a lack of governance and policy, infrastructure, security and overall consumer trust.

Healthcare providers looking to offer Telehealth solutions to their patients must treat training and development with the same regard as tech implementation. At Consulate, we view this as a culture-changing initiative to meet and exceed the needs of our patients, while improving the employee experience and work-life balance of our clinicians and physician partners.

Let’s face it—in today’s healthcare environment, clinicians are busy—making tech implementation and culture-change challenging, at any scale. This reality constitutes the “make it easy” approach essential to successful team implementation. Telehealth platform integration with legacy e-health record systems and single application sign-on capabilities helps to streamline utilization by cutting down on the amount of time it takes for clinicians to become familiar with new technology platforms.

Another barrier to address is onsite and remote physician team integration. While Telehealth physicians engage patients remotely through an audio/visual platform, at its core, the technology introduces new groups of physicians to existing clinician teams. Onsite care teams and Telehealth clinicians have to learn how to effectively trust each other and work together to leverage the platform’s full capacity.

While it is up to the individual clinician to be adaptive and open-minded when it comes to learning, and actually using new patient care technology platforms, it is the responsibility of provider organizations to ensure their care teams have the knowledge, resources, infrastructure and accountability measures in place to ensure platforms like Telehealth are utilized to their fullest capacity.

Part of training and education is helping onsite and remote clinicians, as well as ancillary staff understand the evolving administration and payer management ecosystem. On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a rule that updated the Medicare Advantage program by allowing plans to include “additional telehealth benefits” as part of Medicare basic benefits starting in 2020. The plan requires that providers comply with applicable licensing requirements and laws for the state in which the patient is located and receiving care. This is important for care teams to know and comfortably communicate to support staff and consumers, as Telehealth become a more widely-adopted resource.

As we have seen in the past, integration and culture-change initiatives will converge to promote Telehealth as a trusted resource among care teams, over time. This trust will extend to the patient community, as care teams demonstrate familiarity and ease of access. Additionally, increased accessibility to physician-led care helps to ensure quality outcomes and patient satisfaction—helping consumers become more comfortable and accepting, or trusting, of Telehealth. Consulate’s Skilled Nursing Facilities with Telehealth offerings are already showing decreases in un-necessary patient readmissions to hospitals and emergency rooms visits due to extended access to physician-led care.

As trust builds between onsite practitioners and remote physicians, care teams will have more resources to treat patients, helping to cover patient care needs over long periods of time and shift changes—aiding to offset physician burnout through a balanced, team-oriented approach to quality care.

As the technology continues to develop and converge with consumer electronic mobile devices, future applications of Telehealth show signs of increased scalability and utilization among patients and clinicians—bringing its value to more hospitals, long term care and skilled nursing facilities, as well as assisted living and home care environments. Tech integration working in congruence with team implementation will bring Telehealth into more health care delivery models faster, helping more patients and communities benefit from its power.

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