In The Know - MEDSEEK News and Expert Opinion on the eHealth Industry

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #6 Leave marketing out of the conversation

Patient portals are increasingly becoming a commonplace as hospitals and physician practices throughout the country scramble to put one in place in time to achieve the proposed Meaningful Use Stage 2 objectives. But putting a portal in place is not enough—organizations must also demonstrate that at least 10 percent of their patients are actually using it. While studies show that portal adoption is highest when an invitation to participate is extended by the personal physician, hospital marketers must also play an important role.

If missing the required 10% adoption threshold doesn’t scare you, here’s an interesting statistic to consider. According to a survey conducted by Deloitte last year,66 percent of Americans would consider switching providers in order to gain access to their medical records through a secure Internet connection. In other words, a competitor’s aggressive patient portal promotion or campaign could put your longstanding patient relationships at risk. By involving marketing in the conversation early and often, your organization can leverage your portal investment to achieve further differentiation and grow market share. But don’t delay, as timing alone can give you a distinct competitive advantage.

In marketing, first-mover advantage or FMA is the advantage gained by the initial ("first-moving") significant occupant of a market segment—often referred to as Technological Leadership. This advantage stems from the fact that the first entrant can gain control of resources that followers may not be able to match. Generally, first-movers are rewarded with profits gleaned from their monopoly-like status and the ability to establish customer loyalty to a more attractive product. In health care, this translates to winning the loyalty of well-educated, well-insured e-patients in your community who are desperately seeking access to online health tools.

Other times, the first-mover is not able to capitalize on its advantage, leaving the opportunity for others to compete effectively and efficiently versus their earlier entrants. These individuals then gain a "second-mover advantage". For example, even if you aren’t first to market, your marketing department may be able to win market share by exploiting how your patient portal is simpler and easier to use, or how it is just another example of the overall great patient experience you provide for patients and families.

Your marketing department is sure to come up with many creative ideas to promote your patient portal and its benefits, but here is a Top 10 list to help them get started:

1. Add a strong call-to-action to your public-facing website
2. Use predictive analytics and precision messaging solutions to identify likely e-patients in your community and target them with portal promotions
3. Capture mobile phone users with mobile apps and smartphone users with QR codes
4. Create and distribute a promotional flyer to all patients as they check in to the ED or through admitting
5. Promote the portal on all billing statements, newsletters and e-publications
6. Advertise your patient portal on all electronic signage
7. Add a patient portal promotion to your hospital’s private television network or on-demand patient education video system
8. Change your ”on-hold” music to introduce the patient portal
9. Train all employees about the patient portal and ask them to wear an “Ask me about” button or badge
10. Consider investing in iPads or Tablet PCs to enroll patients before discharge

Have you been keeping up with the blog series - 9 Things That Will Take the MEANINGFUL Out of Meaningful Use? If not, you can catch up here: www.medseek.com/9things.

Why People are Signing the Petition on change.org >> ONC: Engage Patients & Families in their Health - Enhance Meaningful Use Stage 2

“Patients with chronic conditions spend less than 0.01% of their lives interacting with their health care providers. Patient engagement through access to their health data and supporting education and information is essential so that a portion of the remaining 99.99% of their time can be dedicated to managing their own healthcare.”

“I believe that knowledge is power, and to be better informed with respect to our own healthcare will help us to be active & responsible participants in managing our health.”

“Patient portal technology is critical to helping me take control of my health management and will help reduce healthcare costs in the long run.”

“Positive patient outcomes begins with patient empowerment which can only occur when patients and families are engaged in their health and health care.”

“Because it is important for us to be engaged and have easier access to our medical information. This helps us take control of our own health and makes it easier for us to do so by creating and empowered society you make a healthier population.”

“I believe everyone should be able to know as much as possible, about their own health situation, in order to make the best individual care and management choices.”

“Health is a function of participation. As Leonard Kish articulates so well in his blog, http://ideasarecheap.posterous.com/acos-and-moneyball-medicine-part-iv-high-prob, we to stimulate innovations in designing next generation of consumer-centric ehealth solutions and ecosystems (including EMRs, PHRs, HIEs)and which creating network effects through an "architecture of participation." Keeping Patient Engagement in MU will be a key driver to move us from provider to consumer centric approaches.”

“I am an educated, informed and competent person who expects access to information that will help me better manage my most valuable asset, my health.”

“Health care is way behind in technology. There's no excuse for paper transactions and delays in client information anymore.”

“As a patient with a chronic disease, managing my health through my own tracking (spreadsheets) is archaic and error-prone. Having the ability to access my medical records through a secure patient portal will help me better manage and be educated about my condition.”

Add your name to the ever-growing list of patients who demand to be included in the healthcare equation. Sign the petition today!

View and manage my health online? Not so fast. The HIT Access Battle. What’s at stake for you.

As the deadline to file comments regarding Meaningful Use Stage 2 is Monday, May 7^th, many organizations and individuals are weighing in passionately about the proposed rule. And the battle for patient engagement and accessing our health information online continues...

The American Hospital Association (AHA) publically released their 68 page comment letter expressing opposition specifically to many of the Patient & Family Engagement measures proposed in Stage 2. Rick Pollack, executive vice president of the AHA states, "Taken as a whole, the proposed requirements for meeting stage two raise the bar too high.” Among their comments, the AHA articulates apprehension for providing patients the ability to view, download and transmit their protected health information via a patient portal, stating “The AHA believes that this objective is not feasible as proposed, raises significant security issues, and goes well beyond current technical capacity.” Additionally they have suggested that the currently proposed 36 hour turn-around time for patients to have access to their health information is too aggressive and should be extended to 30 days. Cue the flood gates for e-patients and patient engagement activists to respond to the AHA’s strong stance.

Christine Bechtel, vice president of the National Partnership for Women & Families and a member of the HIT Policy Committee reacts to the AHA’s letter saying, “It shows that, when it comes to patients’ access to their own health information, the group (AHA) has little interest in advancing Meaningful Use criteria that would result in tangible benefits for patients.” In regards to AHA advocating for a 30 day timeframe for patient access to their health information, Bechtel states “No patient in this day and age should have to wait a full month for access to their own health information, which is vital to their ability to get and stay well. And no hospital should want to do this--especially with payment penalties for unnecessary readmissions about to be put in place.” ePatient Dave also weighs in on AHA’s comments in a message to HHS Secretary Sebelius, “American healthcare is the world’s most costly and is often far from effective. Give Us Our Damned Data –Let Patients Help!”

These two opposing sides of the battle for Patient Engagement roar on, begging the question--as a patient and family member, do you deserve the right to access your health information and equip yourself with knowledge to manage your most valuable commodity, your health? To let your voice be heard, sign the petition to keep Patient Engagement in Meaningful Use. To further support the effort, please comment on the official regulations site before May 7^th.

Stay tuned for MEDSEEK’s comments to CMS about the proposed rule for Meaningful Use Stage 2. For additional information on keeping the Meaningful in Meaningful Use, see our 9 part blog series.

Healthcare - At What Cost? The Need for Price Transparency Continues to Grow

With Meaningful Use, ACOs and the move towards quality-based reimbursements, hospitals are making great strides towards putting the patient at the center of care, except when it comes to cost.

The success of healthcare reform depends upon hospitals and providers engaging patients and equipping them with the tools they need to manage their own health. These tools include secure Internet access to personal health records and family accounts, the ability to go online and self-schedule appointments, see labs and test results, request prescription refills, and communicate with physicians and care team members, ask them questions and share information from home health monitoring devices.

Healthcare providers are forgetting that patients bear the brunt of spiraling healthcare costs and are being forced to shop around for healthcare services, to become healthcare consumers. While great strides are being made to support the patient, the emergence of the healthcare consumer is being ignored.

Consumers expect to be able to compare prices. It’s possibly the single-most important factor when making a major purchasing decision, and there can be no doubt that healthcare services can be major purchases. So why don’t healthcare consumers get to see the price tag before they buy? After all, hospitals provide quality scores, patient charters, and other consumer-like information. Why not the cost?

Read the recent LA Times article:
Healthcare pricing still a struggle for consumers
Comparison shopping for medical procedures can involve a web of billing codes and arcane terminology, despite efforts in California to simplify things.
http://www.latimes.com/business/la-fi-adv-medical-prices-20120415,0,7106684.story

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #5 Believe if we build it they will come

In parallel with the new or updated objectives in Stage 2, also came new or updated Engaging Patients and Families measures which must be demonstrated in order to collect incentive payments. Among them are two measures that, for the first time, hold providers and hospitals responsible for patient behavior:

• Over 10 percent of patients seen by the EP (or their authorized representatives) view online, download or transmit to a third party their health information
• Over 10 percent of patients discharged from the inpatient or emergency department of an EH or CAH view, download or transmit to a third party their information

To better understand how healthcare organizations viewed these new requirements, in mid-March we attended a HIMSS Virtual Briefing: Stage 2 Meaningful Use, Implementation Standards, and Certification Criteria: An Overview of the Proposed Rules. During the Q&A portion of almost every session, providers debated the realism behind the proposed measures. During these sessions, and in dozens of conversations with client organizations since then, what became clear to us is that most organizations have little experience with online patient engagement and therefore have no baseline to know with confidence whether or not these measures are realistic.

Based on our extensive experience implementing patient portals for health systems and hospitals, we believe these thresholds to be obtainable if healthcare organizations have a well thought out strategic plan to promote the portal and its benefits. This plan should be founded on the basic tenet that patients are hungry for information that will help them live longer, healthier lives and a large subset of patients is already comfortable using the Internet to get it. For example, according to Deloitte’s 2011 Survey of U.S. Health Care Consumers, two in three survey respondents (66 percent) said they would consider switching to a physician who offers access to medical records through a secure Internet connection.

But how can organizations identify those patients in their communities that are likely to be e-patients and effectively communicate with them to drive portal enrollment and adoption? First and foremost, organizations should seek advice and support from their patient portal vendor. Most systems have built-in tools to drive portal adoption. Our technology, for example, enables a “Bulk Enrollment” process wherein patients are automatically opted into the portal and receive email communications promoting its benefits. A safe, secure, but simple verification process occurs downstream to ensure patients can be quickly identified and authorized for login.

Predictive analytics and precision marketing can further help identify patients in the target area who are likely to have Internet connectivity, their access preferences (broadband or mobile), and those who are most likely to manage their health online. Hospitals can use these reports to identify patients who are likely to want, need, and use a patient portal and to determine the right mix of offline and digital marketing tactics to reach this audience.

Further, we encourage organizations seeking direction to reach out to organizations like the Society for Participatory Medicine for advice and support. The Society for Participatory Medicine is a 501(c) 3 public charity devoted to promoting the concept of participatory medicine by and among patients, caregivers and their medical teams and to promote clinical transparency among patients and their physicians through the exchange of information. The Society supports numerous activities to help promote participatory medicine and the e-patient movement.

The reality is this. From banking to blogging, Web, mobile and social media technologies have changed the way people manage their lives in every aspect except health care. Healthcare consumers and the ONC now expect your organization to deliver an online health experience on par with all other industries and research shows your patients are willing to switch hospitals or doctors to get it. If you don’t already have one, you need to immediately embark on developing a strategic plan that will not only allow you to collect Meaningful Use incentives, but also capitalize on the e-patient movement to win lasting health related loyalty in your community.



MEDSEEK’s ePatient Engagement Propensity forecast application leverages the advanced science of our ecoSmart predictive analytics solutions to perform a real-time analysis of national or organization-specific patient databases to help hospitals and health systems identify patients who are likely to need specific health services and engage online. Request a free sample report for your market.

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #4 Fail to integrate the patient portal into your over-arching eHealth strategy

There’s no doubt that the Office of the National Coordinator is orchestrating a digital health transformation. Federal recommendations for Meaningful Use Stage 2 require provider adoption, patient and family engagement, and health information exchange. These requirements, which are synergistic with patient expectations, will help address the aging population, fundamental shift in reimbursement, and quality issues associated with multiple sources of patient records, but a patient portal alone is insufficient to meet the acute need for strategic patient engagement and patient care coordination. Hospitals and health systems need a long-term strategic digital health plan.

Due to the fundamental market shift in reimbursement models that is underway, hospitals are attempting to reinvent their care delivery model to prepare for the new risk and reward-based plans. This is leading to rapid acquisition of physician assets, provider consolidation, and the establishment of Patient Centered Medical Homes to help with Care Coordination. Patient Activation, Population Health Management, and Telemedicine are all essential in order to reduce costly readmissions and reduce the burden of chronic disease. Hospitals will need to dig deep into processes and systems to see where more efficient tools can be put in place and will need sophisticated analytic capabilities.

Transformative changes are particularly critical as hospitals gear up to care for an increasingly sick and aging patient population. The Baby Boomer generation is so big, it’s literally been coined the “Silver Tsunami.” Nearly two-thirds (35 million people) of the Boomers have at least one chronic health condition and that trend, unfortunately, is expected to continue to rise. That explains why, on average, Medicare recipients see seven physicians a year across four different practices and the average hospital has to coordinate care for 229 physicians across 117 practices. The costs associated with treating these patients and coordinating their care are staggering. Most hospitals need help prioritizing their IT budget and developing a strategic IT plan that will help control these costs.

To better balance margins, their comprehensive digital health strategy further needs to incorporate digital tactics that are proven to attract and retain more well-insured patients. This strategy needs to account for the reality that, according to the Deloitte 2011 Survey of U.S. Health Care Consumers, two out of three patients are already willing to switch providers just to gain online access to their medical records. That means the first hospital in a competitive marketplace to offer a competitive patient portal is going to have a significant jump on dominating ePatient market share.

Healthcare organizations need a consulting partner that has extensive experience helping hospitals realize new cost savings through precision marketing, process automation, online communication, self-service, patient activation, and reduced utilization. They need to be the experts in identifying digital health tools that will improve the bottom-line and prepare the organizations for survival in the “new era” where there will be less money, overall, in the system.

Choose a partner with a proven ability to help hospitals generate new sources of revenue by finding and attracting high-value patients, generating repeat business, cross-selling profitable services, and driving well-insured patients to money-making assets like centers of excellence and surgery suites. The strategic eHealth plan should outline how any IT nvestment you make will help you influence patient behavior and sway utilization patterns on both sides of the equation, leading to balanced margins.

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #3 Wait too long to get started

To put it bluntly, if you don’t already have or are not well on your way to having a patient portal in place, you are in trouble for Stage 2. The proposed rule requires both physicians and hospitals to make patient health information available online AND demonstrate that at least 10 percent of patients are accessing it by calendar or fiscal year 2014, respectively. This is no small undertaking, as just implementing a patient portal can be a long, albeit rewarding, process. In addition, additional time must be allowed to achieve the enrollment and adoption measures.

To help healthcare organizations understand why they simply cannot afford to wait two more months, weeks or even days to embark on their patient portal journey, we’ve worked hand-in-hand with patient portal project leaders at some of the nation’s largest health systems to identify the key phases that all patient portal projects must go through on their way to successful adoption.

1. Plan – Successful patient portal projects require considerable planning. If the portal is ever to deliver on its promises of engaging and activating patients, it's essential to tie the project into the organization’s overarching clinical and IT strategy. During this phase, health IT leaders will need to plan for the infrastructure costs, as well as the costs associated with having the proper support mechanisms in place for patients and physicians. This is when you must also determine your rollout strategy – will you soft launch to employees only, will you start with physician offices first, hospital patients first, or go live with all patients at once? Whatever your strategy, you need to assume there will be cultural resistance and plan accordingly to overcome it.

2. Design - This requires involvement from a cross-functional team of stakeholders, most of whom are juggling competing priorities. Don’t be tempted to back down here…getting the right people on the project team upfront is important― and their grass roots support will prove to be an important component of overcoming physician and staff resistance later on. Think carefully about the rollout strategy you identified in the planning phase and prioritize portal features to drive adoption at each phase. Your vendor should offer their expertise here, but focus groups and patient surveys can also be helpful in understanding which features are most desired in your market. Be ambitious, but know that you don’t need to add all features at once or you may not go-live within the required timeframe.

3. Build – The amount of time required to build the portal framework, incorporate outlined features and functions, and integrate data from backend systems varies greatly depending on your portal strategy. Portals developed in-house will undoubtedly take the most amount of time because employed resources are highly unlikely to have experience with similar projects and are more easily distracted by competing internal projects. Systems integrators or custom-build vendors will be quicker than in-house resources, but not by much, since everything will still be designed and built from the ground up. Vendors who offer out-of-the-box software can deliver in the shortest amount of time, but you want to be sure their solution is highly configurable to accommodate your organization’s specific workflow and business objectives.

4. Test - When patient portal projects run behind or need to be accelerated, it’s tempting to cut down the testing phase and that’s a big mistake. All of the work you’ve done in prior phases to ensure the right features and functions are included and to overcome cultural resistance will be negated if you prematurely expose the portal to physicians and staff before it is ready for primetime. Testing not only exposes areas where the portal may not be performing 100 percent as designed, but it often reveals opportunities to adjust and improve workflows. Existing workflows may be incorporated during the design phase, but when these are exposed through the portal, it is common for organizations to identify things they want or need to change to support new efforts to better engage patients and families as partners in the care process.

5. Train and Support - Coordinating training and developing internal support systems is essential to the project’s success. Financial staff, front office staff, back office staff, clinicians, administrators, everyone is impacted by a robust patient portal and training plans need to be comprehensive and thorough so that everyone can be enthused about and effective at using the portal to improve patient care and satisfaction. Ensure training is relevant to the audience, take it to their working environment whenever possible, and again consider offering incentives to encourage participation. Make sure everyone knows how to obtain support and reassure them that responses will be quick and dependable.

6. Launch – This is the phase where the proverbial rubber meets the road and all your planning, creativity and hard work come together. Launch is comprised of myriad activities including portal promotion, patient enrollment, responding to requests for support, and system adjustments.

7. Reinforce - After the launch phase, you’ll need to reinforce desired behaviors and measure your success against thresholds outlined during the planning phase. Be open to suggestions from patients, clinicians and staff and communicate go-forward plans for enhancing the patient portal on a regular basis.

To better understand how much time should be allotted for each of these phases, click here to request a free copy of a sample patient portal implementation timeline. The sample timeline that will be provided is based on MEDSEEK’s Blueprint™ implementation methodology, which ensures patient portal project success by leveraging strong, effective and proven best practices and processes.

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #2 Use the Meaningful Use objectives as your patient portal buying criteria

“e-Patients are driving a healthcare revolution of major proportions. The old Industrial Age paradigm, in which health professionals were viewed as the exclusive source of medical knowledge and wisdom, is gradually giving way to a new Information Age worldview in which patients, family caregivers, and the systems and networks they create are increasingly seen as important healthcare resources. But the emerging world of the e-patient cannot be fully understood and appreciated in the context of pre-Internet medical constructs.”

Tom Ferguson, M.D. | Austin, Texas | January 2006

Traditionally, initiatives aimed at enhancing the patient experience focused on improvements to the physical structure or the inpatient episode of care. While these tactics are necessary simply to maintain a level playing field, they are no longer a differentiator. In an industry where valet parking, waterfalls in the lobby, flat screen televisions and posh private rooms on par with those at upscale hotels have all become cliché, hospital leaders should be looking for ways to create an online patient experience that provides a distinct competitive advantage.

Rather than using the Meaningful Use objectives as their patient portal buying criteria, organizations should look at the portal as an opportunity to address the 360-degree online needs of patients, which begin with their search for health information, progress to their experience with the organization’s public-facing website, and continue through the ongoing stages of post-acute disease management. By addressing patients’ comprehensive needs across the care continuum, healthcare organizations can separate themselves from the pack and become the “e-patient preferred” provider in their respective communities. In this way, their online patient engagement investments will help them not only achieve the 10% patient access threshold required to collect Meaningful Use incentives, but directly impact core strategic goals of winning lasting patient loyalty, improving the quality of care, driving revenue, and maximizing the return on strategic assets and service lines.

Taking a strategic approach to online patient engagement requires an understanding that at the end of the day, patients want to live as near normal a life as possible, independent of their medical problems. Research and our own experience have taught us that patients really want access to online tools that will help them manage their health as easily as they manage their bank accounts. While Meaningful Use Stage 2 is a step in the right direction, patients’ existing expectations far exceed being provided basic access to their health information. Online banking users don’t just view their account balance or transaction details; rather, they interact with the data—making payments, transferring money, applying for credit, asking questions, and so on.

Just as banks provide a single web presence for customers to open and manage their checking accounts, savings accounts, credit cards, and mortgages, your patients expect the same from you. While self-service technologies will never completely replace human resources, e-patients prefer the convenience of self-service transactions and are highly likely to choose a hospital that offers them. Extending conveniences like online bill pay, appointment scheduling and pre-registration are basic requirements to engage connected patients or their family members – these are barebones capabilities they will expect based on their interactions with other industries.

Request a copy of a sample Patient Portal RFP.

9 Things That Will Take the MEANINGFUL Out of Meaningful Use - #1 Separating Your Inpatient and Outpatient Strategies

If you asked your patients to define “meaningful” technology, they’d tell you they want access to online tools that will help them manage their health as easily as they manage their bank accounts. Just as banks provide a single web presence for customers to manage their checking accounts, savings accounts, credit cards, and mortgages, your patients expect the same from your healthcare organization. At the end of the day, what patients really want is to live as near normal a life as possible independent of their medical problems.

With provider consolidation on the rise as hospitals and physicians face the pressures to reduce the cost and improve the quality of healthcare, the challenge becomes obvious. Asking patients to access one portal for inpatient information, plus multiple portals sitting on top of a smattering of best-of-breed EHR systems in the outpatient environment, will only lead to a patient experience that is further disconnected, disjointed, and dysfunctional.
You can imagine the disappointment felt by a patient with a chronic disease or multiple conditions who expects a single online source to manage their health, but instead finds they are forced to navigate multiple portals, with various usernames, passwords, and user interfaces, none of which consistently include the same data, features or functions.

As organizations develop a patient portal strategy, they need to select a solution that will enable their organization to serve as the source for full patient engagement across the continuum of care. By addressing the entire healthcare activity stream and information exchange for patients through a 360° experience, organizations can not only collect Meaningful use incentives, but leverage their investment to directly impact core strategic goals of winning lasting patient loyalty, improving the quality of care, driving revenue, and maximizing the return on strategic assets and service lines.

To continue reading about ways to create a 360-degree patient experience by combining your inpatient and outpatient strategies, read the White Paper: The 360-degree Patient Experience.

Conference Recap: Forum of Health Care Strategy

It’s another great conference by the Forum of Health Care Strategy attended with representatives from all over.

Yesterday was a half day session where Dan and I attend some informative sessions by two of our MEDSEEK clients presented under the physician relations track:

-Heather Boler, from CHRISTUS, did a great job detailing marketing tactics she uses to drive patient volumes to her employed physician practices. Interested parties should reach out to her because she’s willing to share some awesome tools they’ve developed!

-Brian Michels, from Provena St. Joseph Medical Center, presented on the data analytics and tactics he uses to identify volume leakage and their impacts on his physician relationships .

Then we listened to Chris Goeschel’s presentation on patient safety entitled Getting to “Better”-Innovative Practices for Improving Quality & Safety. It was a dynamic session on how science and caregivers can and are transforming the practice of healthcare. You can make a difference.

--Maureen Andrews RN, MBA,Director, Physician Relationship Outreach System, MEDSEEK