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.

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.

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.

The Next Generation of Patients: Healthcare Expectations of a 17 Year-Old

There was a fresh face in the hallways of MEDSEEK this summer - Luke Wilson, a rising high school senior who interned with our sales and marketing departments. He worked with sales operations to understand the current market place and helped research new marketing campaigns before returning to California to start his senior year. Luke wrote a few blogs from his newly acquired, unique perspective: that of a 17-year old who grew up in a world that always had email, the internet and cell phones and got an inside look at the current state of the healthcare system. This is the first post of his three-part blog series:

I came to intern with MEDSEEK with no prior knowledge of healthcare technology. With few visits to the hospital and no desire to watch the news, I really had no clue of how healthcare works in our country (see my next blog post for more on that). What was strange to me, as I started working with MEDSEEK, was learning how far behind healthcare technology is. I have grown up with technology in my life: I don’t remember a time when I wasn’t able to access the internet, I have always been able to contact my parents through their cell phones, and I build websites and learn coding languages for fun. So when I hear that if I go to the emergency room while I’m here in Birmingham that they won’t be able to find out I’m allergic to penicillin unless I tell them, and that I can’t go online and get my health records from my home-town hospital, and that some hospitals are still storing patient information in filing cabinets with locks, I’m astounded.

Having technology be a part of my entire 17 years of existence has brought some expectations with it. So if healthcare executives are asking themselves (which they should), “what does the next generation of patients expect from us?” let me move you in the right direction:

• I expect everything to be easy to understand. I have never read an instruction manual in my life, and if I come to a website that looks jumbled or confusing, I click that ever-ready back button on my browser.
• I expect to be able to log in to my account and find all my health records. I want to see the X-rays of my broken wrist and even have the ability to share it with my friends on Facebook.
• I expect be able to schedule appointments online. Even the California DMV offers this capability, and they are known for their terrible customer service.
• I expect to be able to instant message my doctor, and have someone who knows my medical history message me back.
• I expect to see one, easy to understand bill that I can pay online.
• I expect to be able to get an estimate of the cost of a certain procedure online. (Yet another feature the California DMV offers.)

… and the list goes on. So, though this list from an interning 17-year-old may not seem too important, it is proof that healthcare needs to quicken the pace and get on track with the times.

Learn more about how MEDSEEK is keeping up with the times with our online patient experience.

Read all of Luke's Blogs:

• The Dangers of Self Diagnosing
• What if People Actually Understood Healthcare?

The Two Most Common Healthcare Technology Myths

Myth #1: Older people won't know how to use a patient portal solution.  

Last year the fastest growing adopters of social networking were baby boomers. Okay, so maybe 85 year olds won't use the Internet as much, but their caregivers do. What if their adult children who are responsible for their care live miles or even states away?

The next logical question may be how this new type of patient will learn to use this new patient portal technology. While manuals and documents do exist, onsite and online training are also available, the reality is these users...young and old, will teach themselves. Think about it. Have you read your bank's online users guide? Or Amazon's? Not likely.  You have just figured it out.

 

Myth #2: The younger generation won't use a healthcare portal because they are not sick.

Young adults are on Mom and Dad's insurance much longer than they used to be, and are getting more preventative care at an earlier age. In the recent article by the American Academy of Family Physicians, 90% of the respondents ranging in age from 19 to 26 said they have a place of regular care and visited their healthcare provider at least once in the last year. The majority of those visits (59%) were for regular exams or preventive services, and 9% were for the management of a chronic condition.

What will keep them engaged? Online access and mobile access - where teenagers and young adults spend a majority of their time. Online scheduling and emailing providers are just two engaging tools hospitals can use to begin building those relationships to attract and retain young patients for years to come.

Learn more about how your health system can implement MEDSEEK's patient portal solutions.

--Travis Moore, Vice President Patient Experience, MEDSEEK

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.