The HITECH Act created an immense opportunity for healthcare providers with the appropriate tools and culture to thrive by engaging with their patient populations. There are example after example where organizations are skating quickly towards who the payor is becoming, the patient. Couple the rise of mobile devices with the advent of organizations like The Leapfrog Group, Accountable Care Organizations (ACOs), and the creation of Health Savings Accounts (HSAs), and it’s now incumbent upon health systems to provide a quality patient experience before, during, and after care. It takes a village to do healthcare right. With the patient quickly becoming a larger payer of the reimbursement pie and Uncle Sam incenting for quality care, the organizations that enable patient satisfaction through quality patient-provider relationships and technology are ultimately the ones who will be rewarded with delivering care in the future.
A quick detour down memory lane. I mentioned previously the HITECH Act, from that was born Meaningful Use (a.k.a., MU or more recently, Promoting Interoperability) and a series of alternate payment models (APMs) which began to aggressively tie reimbursement payments to quality outcomes. Prior to MU, healthcare providers were not required to document patient visits electronically, at least in order to get reimbursed by CMS. So, engaging with patient’s electronically surrounding their care was far and few between dating back to Hippocrates. Rome was not built in a day and to expect that healthcare organizations were going to instantaneously know how to drive patient NPS scores as a result of legislation is crazy talk.
The aforementioned payment and outcomes models have aggressively shifted the business dynamics of healthcare. Patients are becoming more financially responsible for their care through high-deductible health plans (HDHPs) and healthcare providers more financially responsible for reducing utilization. Unfortunately, the data show that financial incentives are a stop-gap measure to prompting engagement in healthcare. Engagement happens when patients and their support systems have consistent lines of communication with their provider, understand their care plan, and can easily access resources for help. The proverbial Nudge towards behavior change.
To be sure, it’s very difficult to do healthcare correctly. Considering the true determinants of health and our health literacy, it’s not hard to understand where the greatest potential for impact rests. However, given the realities of collecting self-pay balances, healthcare organizations are steadily realizing that increasing patient-provider communication, verifying a patient’s understanding of their care plan, and efficiently exchanging medical histories across healthcare eco-system’s leads to higher patient engagement. I pay my bills on time when I understand the costs, quality work is provided, and communication is consistent, how about you?
Further, it’s clearer now more than ever that healthcare is not immune to consumerization, it just took longer to arrive. If anyone reading this has worked in or is a frequent flyer of healthcare, they know technology adoption happens over longer time periods and information assimilation is more asymmetrical than any other industry. After all, efficacy is pretty important when your outcomes are another person’s life. So, how can healthcare organizations skate towards the rise of the new consumer and payer more effectively?
Providing care to patient’s is the highest of callings and one of the most difficult professions in the world. The relationship that a patient develops with their healthcare provider(s) (Doctor, Nurse, Tech, etc.) is the single greatest driver of their overall experience. By that virtue, culture is the singular most important aspect of any organization’s success. Seth Godin outlines three pillars of being indispensable (Generous, Dignified, and Humane) all of which make-up what anyone should ask for in a healthcare provider, in addition to talent. Side note, everyone is dispensable. Hiring individuals who embrace empathy inherently is critical to creating and sustaining culture. However, hiring for empathy is undoubtedly a very difficult thing to do. Really, how can you measure for something like empathy? Will the New England Patriots please stand up?
The type of care you are receiving also has tremendous impact on the patient experience. Different support systems will be in place for the varying degrees of care provided. I.E., going in for lip injections will not require the same amount of follow-up as say, a co-morbid 65-year-old. Whereas, now that millennials are becoming parents, the requirements on pediatric facilities to take a multi-modal approach to engagement with parents is even more critical. The millennial generation is the first generation to grow-up in the digital era and you can believe the right text message, at the right time, to the right person (a tongue in cheek on a famous healthcare mantra) will continue to evolve and drive patient satisfaction. The quality organizations are those who understand who their patient population is and play into those strengths.
So, culture is a linchpin for creating a quality brand. What does an effective technology adoption strategy look like for engaging with patient populations? As an up and coming consumer of healthcare, it’s unfortunate that HITECH created mismatched agendas and did not require a common programming framework for healthcare software programs from the jump. The nation’s healthcare communication channels (EMRs, HIEs, Patient Portals, etc.) are a patchwork quilt at best right now. However, as I alluded to earlier, text messaging seems to be the most preferred way of communicating with patient’s today. Much like our banking industry allows us to access our money from pretty much any terminal in the country, text messaging is ubiquitous across telecommunications carriers. The question then becomes, how can we take better advantage of the technology that virtually every patient has in their pocket today?
To be sure, there are numerous other quality communication tools built within the patchwork quilt that are paramount to organizations communicating longitudinal patient histories, scheduling appointments, getting consent forms signed, etc. The patient portal is to patient engagement what the glove is to the hand in baseball. And, despite all the misgivings about data-blocking, Epic is really the only EHR vendor that creates a unified patient experience as long as you operate within their community of providers. Other organizations (disclosure, I currently work here =)) have realized the importance of communicating across multiple healthcare eco-systems and developed vendor-agnostic patient portal tools to satisfy that demand.
Building a care setting with healthcare providers that give a darn and are enabled to communicate with their patients efficiently through technology is going to be extremely attractive to the next generation of healthcare consumers. Consumers who will be armed with their own money (HSAs and HDHPs), the best mobile device in history (thanks to Moore’s Law), and are beginning to make-up the largest population of healthcare consumers in US history. So, who is going to create an technology enabled environment with healthcare providers that give a, Nudge?
P.S. I get it, expecting your doctors to be on text threads and monitoring patient communications through portals with every single patient is not realistic. But, that’s why there are 2-3 healthcare workers for every provider in this country.