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

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 - #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.

Not Just Direct Mail…

"Oh, you’re the people that do the direct mailings,” said the conference attendee, as she stopped by our display.

We were attending a conference to announce the merging of two well-known brands – REACH3 and MEDSEEK, and were excited by the number of clients and potential clients who had stopped by to see what solutions we could offer.

To be honest, yes, we do offer direct mail as one of our best practices in reaching your patients and potential patients, but customer relationship management (CRM) is so much more, it is about scientific precision marketing

Precision marketing  is an organizational dedication to understanding the consumers in your market as individuals, and then communicating to these individuals on their terms. Simply put, precision marketing  allows you to:

• Reach the right person,
• At the right time,
• With the right message.

Also, precision marketing is the analytics behind your organization, allowing us to partner with you to meet your strategic goals, by helping to identify the best patients and potential patients to support those goals, using these messages.

Not only does precision marketing  help you analyze your patient and potential patient data, but the effectiveness of using this data can be measured through return on investment. So yes, although we know having a regular CRM program is effective, we can prove the effectiveness to you in regular updates – showing you the numbers achieved through this program. And we can help you measure the effectiveness of your other programs, including email, benchmarking volumes for advertising measurement, and measuring the effectiveness of your classes and call centers.

Our response to the conference attendee really caught her interest, as we explained, yes, we do use direct mailings as part of our strategy to communicating with individuals, but we are also the company that can discover her hospital’s best patients and the potential patients, and we are the company that can provide her with the return on investment to back up our data.

What is your organizational strategy and how can we partner with you to reach that strategy using eHealth solutions and precision marketing?

-- Rachel Hill Smith, account principal, MEDSEEK

ACOs are Dead. Long Live ACOs.

Even before the release of the official rules for Accountable Care Organizations (ACOs) by CMS, there were rumblings of displeasure with the form and format that was being laid out.  Once official, the rumblings became more of a storm of protest from some of the largest integrated delivery networks (IDNs) in the country.  Most notable, the Mayo Clinic, Cleveland Clinic, Intermountain Healthcare and Geisinger Health System were very vocal in their opposition on various complexities, anti-trust and other grounds.  All valid points in my opinion, but is it really just tilting at windmills?

There is no argument that health care costs are spiraling out of control and that current growth rates are untenable in the long term.  A shift of the financial burden has already occurring by employers, and by extension patients, being forced to bear higher premiums and tighter restrictions.  From this new economic reality came the concept of accountable care organizations (ACOs).  At its core, an ACO is a care delivery system where providers are compensated on the care they provide a defined patient population through a series of quality and performance measures and cost benchmarks.  (This is not meant to open a discussion about capitation, HMOs, or any other previous attempt at managing health care costs.  And, for the record, I do think the concept behind ACOs has legs.)

Those legs, however do not necessarily include the ACO in its current form, but rather the concepts of creating long term patient relationships (via patient activation) as a competitive tool and risk sharing as a reimbursement inevitability.  And, if you read the comments by the notable ACO dissenters listed above, you can see that they also agree that the concept is valid and are in fact taking steps to adapt to the new realities of healthcare delivery.

Patient activation is the concept of getting patients engaged and active in managing their own health. Realistically, this can only be accomplished through providing a coordinated set of capabilities and services that draws the patient in and not only continuously provides information, but anticipates that future needs of the patient.  Creating the role of trusted health advisor that is top of mind with patients any time they require healthcare related information is the ultimate goal.  If you look at life from a healthcare perspective, it is a series of care events punctuated by (hopefully) long periods of relatively good health.  Contact with the patient during these periods of good health is crucial to sustaining a long term relationship.  Realistically, this can only be accomplished through the use of information technology tools, notably a patient portal that integrates into an organization’s clinical, education, and messaging systems.

The banking industry is useful analogy.  The more integrated you can make someone’s financial life the harder it will be for that person to move somewhere else to get the same range of services, thus creating a long term source of service utilization and revenue.  Plus it will provide a better overall financial picture for the customer to make better informed decisions.

Integration to multiple systems highlights the challenges of moving into a risk sharing model for patient populations.  For an organization to go at risk, that is confidently state that they can treat a given patient population for a set amount of money, requires tremendous effort in collecting, tracking, and reporting on key quality measures, strong communication and care work flows based on generally accepted best practices – for multiple types of patients across multiple care environments (IP, OP and LTC as examples - and constant monitoring and feedback of patient information, utilization, and messaging.  This requires a huge investment in time, people and capital across an organization, but done right, will yield long term benefits and returns.

So are ACOs really dead?  No.  Much like any new concept there are going to be multiple variations and models that will need to be played out over time to see what works.  With that being said, any healthcare organization that does not think that they will be held more accountable for the quality and type of care they deliver and the meaningful impact they make on the patients they serve are in for a rude shock.  Will this require more work and investment by HCOs?  Yes.  With the ultimate payoff be patient loyalty and, in turn, financial stability?  Absolutely.  The question that remains is how long can healthcare organizations wait to secure their future?  I say sooner rather than later.

--Jim McGregor, Sr. eHealth Strategist

Learn more about MEDSEEK and ACOs.

What are your grandparents doing online?

Where do your grandparents spend their time?  When they aren't spoiling their grandchildren they are almost all online.

Today, there are 69.6 million grandparents in the US, and this number is expected to grow to over 76 million between now and 2015. In a recent report, Nielsen reveals this growing market segment of Internet users (they account for nearly 32% of the active audience!) is one to watch closely. So, where do these tech-savvy grandparents spend their time when they are online?

It should come as no surprise that sending and reading emails was the number one online activity. But it was closely followed by accessing their online personal health records.

Grandma may not be an avid texter and might not check into her social media accounts on her smartphone right now, but she will be soon. Mobile use as well as social media activity is also increasing as the older population increases their usage of smartphone apps.

It's an undeniable fact: our grandparents are active, connected, spend money and are online. Just last August, Pew Internet reported that the fastest growing demographic for Facebook and other social media were age 50 and older.

Marketing professionals, especially those in the healthcare market, MUST include this segment in your marketing plans or you will miss a significant opportunity.

Click here to view the Nielsen Wire Article: U.S. Grandparents Share More than the Love.

Do you remember having a computer that wasn’t mobile?

For the first time smartphones are outselling computers, according to an IDC report that documented the surge of smartphone purchases in the fourth quarter of 2010.  Interesting note, when CNN covered the IDC headline, they did not reference smartphones; instead they referred to smartphones as “mobile computers”.

Let me ask you, true or false: “I never leave home without my wallet or purse, my keys and my smartphone.”

So what does that mean to those of us in health care?

Many us are getting ready to go to HIMSS11 in Orlando in two weeks. We will see many sessions and vendors highlighting Meaningful Use, EMRs,  HIEs and ACOs – a glimpse at the foundation of what will become the future of health care. But I wonder… with all of these changes taking place, what will be the buzz at HIMSS in five years?

The stethoscope was invented in 1816… 200 years later, will we still be using one? How much will IT advance? Will social networking take a bigger share of healthcare information? Stage 1, 2 and 3 of Meaningful Use will be complete. HIEs will be deployed. NHIN will be in place. ACOs will be the norm. What will be new on the horizon?

I predict:

• a new mobile eHealth ecoSystem will emerge

• tablet computers will replace laptops just as they’ve have replaced tower computers

• MP3 downloads of discharge instructions will replace CDs just as CDs replaced paper documents

• live video discussions with a physician from my smartphone or tablet computer  will replace specific face to face office visits

                       …and the list goes on.

Yet as we face the challenges of 2011, 2016 doesn’t really seem that far away. Does it?

Have you hired your hospital’s Social Media Manager yet?

If you haven’t…  you will  soon. There is no denying the impact of Facebook, YouTube, Twitter and other social medial online resources. We have seen the rise of patient-focused social websites such as Patients Like Me and the impact they have on patients and their families. The HITECH Act will continue to encourage the use of the internet as a primary channels to improve health care.

In the not too distant future, it is easy to see how these types of sites will become much more integrated into engaging patients and their families with their own health care – especially as the patient becomes a “partner in care” as part of the growing ACO movement. 

A recent article in American Medical News describes how Seattle’s Swedish Medical Center has hired a Social Media Manager to interact with patients and families – and physicians as well. Do not make the mistake of looking at social media websites as fads… they aren’t. Those who embrace social media and build a social media strategy into their marketing plans and into their internal programs will be counted as the leaders, not the followers.

Click here to read the full article.

Marketing in health care is changing… quickly!

According to a recent blog post in the World of DTC Marketing:

“A February 2010 survey by HealthLeaders Media found that 76.6% of senior managers at US healthcare organizations—including CEOs, physicians, finance, technology, health plan, marketing and quality leaders—expected patient experience to become more important to marketing in 2010…”

This is not just about patients - marketing to physicians is also changing. A recent report from eMarketer states:

“Physicians have become heavy online and mobile users, tapping the internet to research conditions and medications and to stay current on industry news and procedures. As a result, online promotion to healthcare professionals is growing in promise and importance, especially as it relates to enabling physicians help their patients and do their jobs efficiently…”

Marketing in the traditional ways works, but without an eMarketing strategy it is ineffective. What does your eMarketing strategy look like?

To read the entire blog post click here.
 

Where Do Americans Go for Healthcare Information?

…Number 1 answer: The Internet