By Shara Cohen, vice president of customer experience, Clinical Effectiveness, Wolters Kluwer, Health.
Hospitals and health systems are under enormous pressure
to provide high quality care in an environment of declining reimbursements and
shifting payment models. With the rise in value-based payments, provider
organizations must increasingly focus on the health and performance metrics
across whole populations.
Shara Cohen
To provide patient-centered care and remain financially
viable, providers need to adopt technologies that expand the reach and
targeting of their care teams and enable them to forge personal connections
with patients. Many provider organizations have been slow to adopt technology
for fear of de-personalizing the patient relationship. Yet technological
solutions designed for people and their specific, pressing needs can be
incredibly effective.
Take Interactive Voice Response calls (IVR), for example.
These automated calls can extend the reach of care teams who need to find out
from patients how they’re progressing in their recovery. Even better, these
calls give patients a chance to check in with caregivers using the most
natural, familiar technology there is: the telephone and the human voice. From
pre-procedure to post-discharge, here are three ways voice technology can
reduce costs while achieving better outcomes:
1. Staying Connected with Patients after Discharge
Discharge is one of the most critical handoffs in healthcare. Traditionally hospitals have employed nurses to make phone calls to recently discharged patients. But what may seem like a simple chat is in fact far more labor intensive. The volume of calls required, and the time needed to connect with patients, establish rapport and elicit critical information has made this an expensive and time-consuming endeavor. IVR calls can reduce the burden on nursing staff while also increasing the level of constructive interaction with patients.
For example, our team worked with a hospital that used two nurses to call as many patients post-discharge as they could. In a one-month period the nurses made 1,932 calls to patients – and of those calls, only 5.2% resulted in a situation that actually required the nurses’ clinical knowledge. The two nurses then started over, this time using IVR. During a same one-month period, the nurses were able to reach out to four times as many patients and connected with 79.8%. The higher rate of connection gave the hospital far more visibility into the actual health status of its discharged patients. It also saved time so nurses could concentrate on personal patient interventions that required their clinical expertise and training.
2. Breaking Down Behavioral Barriers
Voice User Interface (VUI) design is increasingly
utilized to foster emotional connections with patients and help them self-manage
their conditions. As hospitals and providers look to reduce “white coat
syndrome,” and find ways for patients to feel more comfortable sharing
information in a non-judgmental setting, human-centered VUI design can bring a
unique approach to personalization.
For instance, one of our programs reached out to patients newly diagnosed with diabetes. With focus on empathic VUI design, these patients were asked to report on key indicators such as their weight fluctuation, medications, and access to follow-up care. Flagging logic then signaled any instance when a patient may need a live nurse or some other intervention. Surprisingly, these automated calls also elicited sensitive information that may have otherwise not been flagged.
Most enrollees said depression had hindered their ability to manage their condition and 83% also said they had not discussed these issues with a healthcare professional. When given the choice, over half of those respondents opted for additional phone calls that were specifically designed to offer emotional support. Even more, the depression scores of nearly three-quarters of patients decreased over the course of their interactions.
3. Reducing Readmissions
As a last example, patients who engage with IVR phone calls are less likely to be readmitted to the hospital. At one major hospital system, 80% of enrolled patients engaged with calls and they were readmitted less often than those who did not engage. (10.7% 30-day readmission rate vs. 13%.) This result means that voice technology is helping to solve a known and important health quality problem —reducing the rate of unnecessary readmissions—as well as helping hospitals to avoid Medicare penalties. In addition, the decreased readmissions rate frees up beds for new revenue-generating patient admissions.
And the nurse caregivers are now able to work at the top of their license, increasing their job satisfaction as well as their efficiency. In the end, it’s not just caregiver satisfaction and patient outcomes that improve. Patients also appreciate the follow up from these calls, leading to increased patient satisfaction and HCAHP scores.
Ultimately, scaling patient outreach efforts with
interactive voice technology offers a number of benefits for health systems:
from more efficient and effective care management to better patient outcomes at
less cost. That’s a win-win for providers and patients alike.
At this point, most of us in healthcare have read similar statistics about why we need to do more to address social determinants of health (SDoH) — the conditions in which people are born, grow, live, work and age, and how those factors impact individuals’ health — to improve patient outcomes. These conditions and their resulting social needs include, but are not limited to, a person’s equitable access to nutrition, housing, transportation, education, and employment opportunities.
Time is of the essence to tackle some of these social determinants, especially when coupled with the rapidly shifting patient demographic, sometimes called the “silver tsunami.”
Payer
SDoH studies in no short supply
It seems everyone is in a race to figure out what SDoH approach will move the needle toward lower risk for their patient populations. But payers, in particular, have taken on a hefty amount of the leg work needed with social determinant “barriers to care” studies, because they are generally the most financially accountable, from a population health analytics perspective, to remove them.
Recent news about of these payer SDoH pilot programs and research studies have been both interesting and useful across the care continuum, a summary of which include:
WellCare, which provides managed care plans for over 4.4 million Americans, ran a pilot program on over 33,000 patients, referring them to more than 100,000 community-based social services programs, and was able to reduce inpatient spending by 53%, outpatient spending by 23%, and emergency spending by 26%.
In its Bold Goal 2019 Progress Report, Humana focused on patients in specific lines of business, including their Medicare Advantage program, where 91% of seniors who have at least one chronic condition. They enacted the Centers for Disease Control and Prevention’s “Healthy Days” self-reporting method of measuring healthy vs. unhealthy days and have also screened half a million people for SDoH since 2018, with the goal to screen one million by 2019. Humana notes that these social barriers are “deeply personal,” which requires closer partnership to track and measure population health.
Blue Cross is already instituting food, nutrition, and housing services as part of some of its plans. But it also recently announced an investment of $40 million with Solera Health, to address both mental health and SDoH matters, including “food insecurity, medically tailored meals, transportation, falls prevention, and social isolation” with lifestyle modification programs such as diabetes or management, and tobacco cessation programs.
A study by the Anthem Public Policy Institute says individuals and the public (researchers and journalists) perceive SDoH differently. Individuals tend to lead with concerns about the health care “system,” whether they can find the right provider, followed by whether they have adequate “social support.” The public tends to “frame health outcomes through the lens of structural factors like education and income level perhaps, in part, because these factors are easier to measure.”
UnitedHealthcare and the American Medical Association partnered to expand the existing ICD-10 diagnostic codes being used to identify social and economic barriers to care. This adds 23 more codes to that list, some of which would “indicate a patient’s inability to pay for prescriptions, inadequate social interaction, or fears about losing housing.”
Existing
workflows provide best locale for SDoH communication
Despite all of the various innovative steps being taken to bring SDoH to the forefront, we know that most patients still aren’t talking about SDoH concerns with their physicians. There are many reasons why, but one logical solution to bolster SDoH communication between physicians and patients is to incorporate, at minimum, the ability to identify social needs where they are already doing business — in these EHR, CRM, and other third-party platforms.
As is evidenced by the silo’d health IT data systems that have for too long crippled the health care industry’s transparency and ROI, we know that simply identifying social barriers to care is not enough. Within the designated “source of truth” that is most responsible for driving patient engagement, whether that is an EHR, CRM, or other platform, we need to build — or integrate — expanded capabilities for SDoH identification, referrals, and tracking each throughout the continuum of care to close the gaps that currently exist.
That is not to say that physicians must now wear yet another hat — that of a social worker or a social services case manager. But being asked to solve SDoH from the current physician’s workflow perspective, without integrating SDoH into the patient record, is basically saying to physicians:
“Improve clinical outcomes. But first, you must identify non-clinical data, be responsible for referrals to improve these individual circumstances, and track each of those referrals’ progress, all in different platforms, and none of which talk to one another.”
This is not setting our patients or their physicians up for success.
The idea of a standardized SDoH screening mechanism within the EHR has been endorsed by the National Academy of Medicine, the Medicare Access and Children’s Health Information Program Reauthorization Act of 2015, the 2016 Centers for Medicare and Medicaid Services’ Quality Strategy, and several other organizations, as released in an Annals of Family Medicine study. But unfortunately, in this first U.S. study of its kind to address feasibility, “little is (currently) known about how to capture and present (SDoH) information in community health centers’ EHRs.” Nor did the study conclude how to integrate EHR-based documentation needs into community health centers’ existing workflows.
The main barriers cited in the Annals’ study were that EHR-based SDoH tools: (1) Create a too-fragmented view of the patient, with relevant data in too many disparate locations (2) Might add a layer of difficulty to obtain and act on SDoH data (3) If SDoH patient information has been acquired on paper, that requires yet another dual, manual data entry problem when “referral workflows were (already) seen as too time-consuming, especially when no follow-up was planned,” resulting in “an unmanageable follow-up workload.”
To date, the EHR has done a good job of serving most of the goals to take our country’s health records digital. But it is also safe to say that the EHR, in and of itself, cannot be all things to all persons working in health care. In addition to the major enterprise EHR systems, there is a proliferation of specialty, industry-specific EHRs, which may or may not have separate CRM platforms, not to mention all of the other third-party, various other platforms you can see within any one given practice, such as separate billing and referral management types of platforms. There is a reason that “interoperability” among all of these disparate health care data systems has become another hot topic for the industry.
To yield maximum value for our customers, integrating SDoH data is best-approached from a workflows perspective — not just connecting disparate data systems for the sake of “more data,” but to make caregivers’ lives easier, and to create actionable data that enable better business decisions. And we already know that one of the easiest ways to improve efficiency for health care organizations is to remove dual, manual entry between EHR, CRM, and other third-party platforms that hold patient data — these are the first and most valid case studies of how to improve organizational efficiency while bolstering patient care.
There has been a flurry of innovative partnerships and technological improvements to address SDoH, all of which should ultimately be supported by policy changes — each of these as prevailing themes at trade shows and conferences in recent years, such as the America’s Health Insurance Plans’ (AHIP) annual conference, held recently in Nashville. Meanwhile, we look forward to participating in more discussions about how those of us in health IT can do our part — bridging SDoH informational and communication gaps between physicians and patients. This could include integrating non-clinical SDoH concerns into the patient’s clinical record, in and out of these platforms, establishing standards for capturing SDoH to make data-sharing easier, and even incorporating social services databases for more streamlined SDoH-specific “referral management.”
We talk a lot about how to achieve interoperability in healthcare, with all of its disparate data systems, and SDoH is another compelling and recent reason why we must accelerate these solutions, which would ultimately benefit health care and all of its stakeholders — patients, physicians, payers, and everyone in between.
TMR’s study expects neurological navigation systems to emerge as leaders in the realm of surgical navigation systems due to high prevalence of brain tumors. According to the National Brain Tumor Society, approximately 700,000 people in the U.S. are living with brain tumor. This number further incites the need for advanced neurological navigation systems.
Navigating within the precincts of a skull multiplies the risk of damage to the vertebral column. However, advanced neuronavigation devices such as the one developed by Medtronic addresses these concerns. This device, called the StealthStation S8, is a highly efficient system that uses electromagnetic tracking capabilities and 3-D segmentation tools to create tumor models.
Influx of 3-D printing technology in the healthcare sector Operating on tumor models prepares the doctors to operate the actual tumor. It instills confidence in the surgeons that further amplifies the success rate of the surgery. Furthering the use of 3-D segmentation tools, the researchers have invented advanced 3-D printing technologies that are changing the game for surgical navigation.
Researchers from the Tel Aviv University printed the first 3-D heart using the patient’s biological parts and cells. The end stage heart disease can only be treated with heart transplantation. However, the shortage of heart donors stems the need for advancements in the armamentarium of cardiology.
This research has not only given a new direction to regenerative medicines but heightened the demand for 3-D printing technologies. According to TMR’s study, this trend is expected to turn the tides in the surgical navigation systems industry.
Intra-surgical visualization is imperative while performing a surgery. 3-D printing technology transforms a 3-D medical image into an object of the patient’s actual size. A combination of this model and augmented reality (AR) applications offers the surgeons a real-life operating experience in a virtual environment.
This technology helps the surgeons gain a better understanding of the nature of the surgery. It overcomes the shortcomings of single modality imaging and facilitates accurate intra-surgical visualization. Besides, the combination of cloud computing and 3-D printing technology further explores the possibilities in the realm of surgical navigation. It enables the development of prosthetic limbs and streamlines the 3-D printing process. This explains why the clinicians are keen on deploying the cloud computing technology.
Migration of surgical platforms to cloud computing
Cloud computing, though this technology is still young in the medical
industry, it is graduating in the arena of surgical navigation. It facilitates
the high computational power required for surgical navigation. Moreover, the
advancements in the medical image computing techniques such as the graphics
processing unit (GPU) facilitate improved medical image processing performance.
Recently, bioengineers developed a self-navigating medical robot that can
navigate in the patient’s heart. Earlier, surgeons used a joystick to monitor
tiny robots in the patient’s body. However, this newly developed robot works
exactly like an autonomous vehicle. The optical sensor in the robot uses
artificial intelligence algorithms that direct its path inside the heart.
Such discoveries have highly motivated the surgical platforms to deploy
cloud computing solutions. The fact that it breaks the restrictions of physical
location has also inundated its use. A cloud surgical planning application
enables multiple surgeons to work on the same case irrespective of where they
are located. This enables the surgeons to make accurate incisions, thus
facilitating a pain-free treatment for the patients.
The spiraling need for minimally invasive surgeries help the surgical navigation systems gain prominence in the market, states TMR. To sum it all up, surgical navigation gives healthcare professionals the liberty to navigate surgical equipment with tremendous ease. Moreover, the high morbidity because of cancer with nearly 9.6 million people dying in 2018 has necessitated the use of advanced surgical techniques. This has opened the doors for new clinical studies relating to surgical navigation such as molecular imaging and intraoperative microscopy.
The digital age has of course brought tremendous advances to healthcare, but one area in particular has lagged: medical imaging. The sad truth is that two-thirds of the world’s population still has no regular access to medical imaging. In many cases, even those who do have access to the technology still must wait weeks or months for medical scanners to become available. This means that diagnostic results often arrive too late and people do not get treated in a timely manner, sometimes with fatal consequences.
Early detection by medical imaging (or lack thereof) is perhaps the most important factor in the nearly 8.8 million lives lost each year to cancer, according to the World Health Organization. When detected early using medical imaging systems like CT scanners, cancer has a 70 percent to 99 percent survival rate, according to Marshfield Clinic Health System Foundation.
Not all of the limitations in medical imaging are technological, and it is important to note there are simply not enough radiologists and diagnostics experts being trained in this field currently. Even in developed countries like the United Kingdom, there is a serious shortage of senior radiologists; while the workload of scan interpretation has increased by 30 percent in the U.K. since 2012, the number of radiologists has increased by just 15 percent.
But, a key technological
impediment is causing what I believe to be the real reason behind the disparity
in medical imaging: price. For example, CT scanners can cost $3 million, even
before the high cost of maintenance is figured in. This cost is well beyond the
means of most healthcare systems in the world, and most countries can only
afford a few medical imaging systems to service their entire citizenry. Because
of this, even in a highly developed country like the U.S., some insurance companies will only cover a
medical imaging procedure, such as a mammogram, every two years, not every
year. So imagine how hard it is for people in developing countries to get the
timely medical imaging they need.
Fortunately, however, the holdup
in medical technology is relatively straightforward, and it lies at the heart
of the science underpinning almost all medical imaging technology, from CT
scans to MRIs. It is the source of the X-rays, which has remained unchanged since
their discovery more than a century ago in 1895 by the German physicist Wilhelm
Röntgen, who simply labeled this newfound ray “X,” standing for unknown. The
name stuck.
Behind even our most advanced X-ray equipment is the same analog bulb little changed from Röntgen’s era. It looks like a big lightbulb — although far more expensive, about $150,000 to $200,000 each — and similarly needs to be replaced frequently. Also like the common lightbulb, but at a much more extreme scale, these X-ray bulbs produce huge amounts of heat.
In fact, a part of the reason for the rotating inside a CT-scan is to dissipate this heat, as it would otherwise melt through the machine at more than a thousand degrees Celsius. That spinning reaches somewhere in the neighborhood of 13 G forces, meaning the machine needs to be built with the precision of fighter jets — a primary reason only a handful of companies in the entire world are qualified to make them.
The fundamental analog nature of
X-ray devices is why, despite advances on the frontend thanks to the digital
era, we take a step back to the 19th century the moment the X-ray turns on.
Thankfully, however, I am sure it won’t always be this way; there is an
enormously exciting new advance under development, which I am proud to say I am
spearheading in conjunction with some of the brightest minds in physics. This
technology is called ‘cold-cathodes’ — a source of X-ray that works at room
temperature and can be from a device as small as the silicon chips in your
computers. Instead of using heat to generate X-rays, cold cathodes use an
electric field to draw out the electrons that eventually become X-rays (I am
skipping a step or two for the sake of simplicity, but this the key
difference).
Cold-cathode technology has
tantalized with its potential for several years, but my company, Nanox, believes we have found the key to mass
production with a different process, which was originally intended for
flatscreen TVs. We are converting it to far more impactful uses. The intended
result would work very much like a “tricorder” on the Star Trek series: small,
producing far less radiation than current methods, and most importantly,
readily accessible to almost every country and village, no matter how far
flung.
What if we could democratize
medical imaging? What if we could provide at least one medical screening for
every person on the planet every year? Through their ubiquity, cold-cathode
X-ray machines could save lives with early detection, making healthcare more
affordable and accessible to all people globally. Bringing the X-ray into the
digital era is a critical step in achieving true democratization of healthcare.
As an entrepreneur, I can’t think of anything more rewarding than that.
The US healthcare system has serious systemic problems. While the cost of healthcare continues to escalate, access to care is more difficult than ever. As a country we are getting sicker, chronic conditions are on the rise and, for the first time, longevity may be on the decline.
Joe Grace
While the usual constituents grapple with these problems, Amazon has quietly put together a syndicate including Berkshire Hathaway and JP Morgan to provide better and more affordable healthcare for its combined 1.2 million workers.
The joint effort between Amazon and Berkshire is called Haven and makes sense because many companies of size today are self-insured to provide healthcare at lower costs. But this is different. Jeff Bezos, Jamie Dimon and Warren Buffett seem to be personally involved in the development of Haven. So, what could they possibility have up their sleeves?
At the same time, many Democrats running for president are promising single payer health system (Medicare for all) as the solution to controlling costs and providing quality health care for everyone. Republicans argue that this is socialism and will result in unacceptable increases in taxes that will ruin our economy.
While politicians debate, Amazon’s real objective may be to create a health payer to rival all payers with tens of millions of Amazon Prime Members as health plan members.
With Amazon’s buying power, scale and capabilities, the e-commerce giant could create a health payer offering that could render the need for a single payer system moot.
The company’s buying power and clout representing tens of millions of members allows it to negotiate the lowest prices on the planet for drugs and medical treatment. Who knows … maybe Amazon will build its own drug manufacturing laboratories?
And with its fulfillment and shipping capabilities, it could deliver prescriptions to your door (maybe by drone) almost immediately, eliminating the need to ever visit a pharmacy again.
With its rapidly evolving tech platform, including Alexis and health monitoring devices, it could monitor health conditions and contact providers before medical emergencies occur.
What’s more, Amazon could take telemedicine and concierge medicine to another level with connectivity to providers anytime, anywhere, without the red tape that makes healthcare so difficult to access today. And it might even buy large health systems and shake them up by eliminating red tape while dramatically improving access to quality care. Even identity cards from doctors can change in the future. You can expect doctors IDs and specialist ID lanyards turning into digital identifiers in the future.
Lastly, let’s not forget Amazon’s ability to harness artificial
intelligence and machine learning to deliver better, smarter, more efficient
health care without ever talking to a doctor.
Bernie Sanders may be right when he argues that access to quality healthcare is a basic human right. But given all the roadblocks, lobbying and politics blocking the way to a government single payer system, it just may be delivered by Jeff Bezos rather than Uncle Sam. Hold on to your seats – healthcare is about to be disrupted big time.
By Kathleen Riordan and Apurva Subramanian, healthcare experts, PA Consulting.
Over the next decade one in five US residents will be over the age of 65, over 70 percent of whom will require some form of Long-Term Services and Support (LTSS) as they continue to age. The resources required to meet the care needs of our senior generation will triple by 2040.
The industry is reaching a tipping point and CMS – the primary payer for these services – is going to look for innovative ways to curb costs while maintaining high-quality, patient-centric care. Value-based payment models in other health service organizations incentive providers to do just this. Historically, LTSS have been left out of value-based care payment arrangements; however, with the increase in use and cost of LTSS, CMS is gradually incorporating value-based care models in this industry to nudge providers into more innovative ways of delivering care.
For example, in 2019, skilled nursing facilities began
receiving quality-adjusted payments for all Medicare Fee-For-Service (FFS)
patient-stays. CMS is now withholding 2 percent of all Medicare FFS payments
and giving facilities the opportunity to earn this back through an assessment
of its performance on the 30-day all-cause hospital readmission quality
measure. Recent results show that 73 percent of nearly 15,000 skilled nursing
facilities reporting data received payment penalties for performance on the
hospital readmission measure, with 20 percent receiving the maximum penalty of
the entire 2 percent withholding.
Now is the time for long-term care organizations to act, as the initiatives CMS is proposing will significantly affect the industry. On the agenda for CMS is a range of payment incentives including:
Adding two new quality measures in 2020 to assess health information sharing from skilled nursing facilities to other providers and to patients.
Transitioning all Medicare Part A payments to skilled nursing facilities into a new model that reimburses based on the clinical condition of the patient and their service needs.
Implementing new payment rules for all Medicare-certified home health agencies to incorporate home health services into value-based payment models by eliminating therapy thresholds in determining payments and reimbursing based on the clinical condition of the patient.
Potentially expanding the Home Health Value-Based Purchasing model across the US.
Increasing payment adjustments up to 8 percent by 2022 for Medicare-certified Home Health Agencies operating in 9 HHVBP pilot states.
The payment models in both skilled nursing and home health represent a shift that CMS is making to include all ancillary providers into the value-based care arena. Long-term care organizations can learn from hospitals and physician groups who proactively approached this coming wave of value-based payment reform. Organizations that are collecting and acting on data in a timely manner, establishing efficient cost-reducing processes, and integrating effectively within the care continuum will thrive in the new financial environment.
So how can long-term care providers implement an effective value-based care model? Follow these four steps.
Understand value-based program requirements and determine the necessary people, processes, and technologies needed to adjust operations to achieve program success. The challenging part for long-term care is going to be in operationalizing new value-based care program requirements. Those organizations that can effectively arrange the right people, processes, and technology stand to soar above the rest. Advancements in technology have enabled organizations to progress further, faster. Currently, many vendors in the market offer telemedicine technologies and remote patient monitoring applications to care for high-acuity patients in more effective ways. For example, long term care providers can use telehealth to provide support to elder patients allowing them to stay in their homes longer. A great example is the Argenti care technology program in the UK that placed a configured Amazon Echo device in on-demand senior care services, the pilot was highly successful and improved outcomes and reduced cost. Some skilled nursing facilities are even investing in putting in motion detectors in patient rooms to assess movement anomalies to ensure patients get the right care when they need it. Investing in the right technologies to ensure a high-quality care experience can accelerate a LTSS provider’s ability to adapt to value-based care models.
Use data and processes improvement methodologies to recognize and reduce unnecessary costs and develop best-practice processes. Long-term care service providers should already be collecting and using data to generate insights to inform best-practices in both the cost and delivery of care. The Visiting Nurses Association of New York, the oldest nonprofit home and community-based health organization, is already using robust data analytics to drive clinical and operational decision-making by creating a model to proactively predict when a patient may benefit from a different or higher level of care. For those organizations without a robust data analytics strategy, steps can be taken to capture, track, and analyze clinical and claims data to understand population-based characteristics and care needs. In doing so, LTSS organizations can establish benchmarks and reporting to create the drive toward more clinically and cost-effective approaches to care.
Build relationships with providers across the care continuum to create open lines of communication and develop smooth processes for patient care transitions. Crucial to the success of long-term care organizations in transitioning to value-based models is the ability to develop clear processes and means of communication with providers along the patient care continuum to ensure smooth transitions in and out of care and a streamlined flow of information among providers. Currently, NYU Langone Health is partnering with 11 high-quality skilled nursing facilities to create a preferred network where organizations are coming together to improve care transitions by openly sharing quality, readmission, and length of stay data. In doing so, these organizations are learning from one another to improve their own performance standards and proactively prepare for additional upcoming incentives created through value-based care payment models. The transition to a culture of continuous improvement is often a challenge for organizations, as employees at all levels have to recognize and work to overcome the ineffectiveness in largely entrenched processes and procedures. However, in building a culture of continuous improvement where all employees have the capacity and ability to step outside of their daily whirlwind of job demands and look for efficiencies ultimately leads to innovative and productive ways of thinking and acting.
Partner with local community organizations to enhance your current service offerings. Value-based care models are intended to keep costs down while ensuring patients continue to receive high-quality medical care. The elderly population is a vulnerable population and requires additional support systems in place to have all their health care needs met. Building connections with local community organizations to help patients as they transition out of nursing care to their home or while receiving in-home care can set your organization up for success. Local area agencies on aging can connect long-term care providers with the right community resources to support their patient populations. Local community organizations can provide support with social care needs like transportation, fall-risk assessments, nutrition and meal preparation, community-based engagement, all of which have been shown to not only reduce hospital readmission rates, but also improve the health and well-being of the elderly.
Long-term care service providers need to invest time and budget into comprehensive data collection and analysis, implementation of process improvement methodologies, and advanced technological devices to proactively adjust to payment reform. Navigating the integration of value-based care models for long-term service and support organizations can seem like a dauting journey. But we have seen that organizations that prepare effective strategies for implementing the four activities outlined above are more likely to experience a smoother transition.
Tech Mahindra, a provider of digital transformation and consulting services and solutions has announced the acquisition of Mad*Pow, a strategic design consultancy headquartered in the US. The addition of Mad*Pow to the Tech Mahindra portfolio is expected to help bolster capabilities in customer experience (CX) and digital transformation such as research, experience strategy and service design, user experience design, behavior change design, content strategy, mobile app and web development, design ops, data science and analytics.
The Boston-area consultancy will complement to Tech Mahindra’s existing offerings and capabilities across design, marketing and commerce.
CP Gurnani, managing director and CEO, Tech Mahindra, said, “Mad*Pow’s acquisition is in sync with Tech Mahindra’s global digital charter. With this collaboration, our digital footprint will take a deeper root not just in the US, but in the wider ecosystem world over. I welcome the Mad*Pow team into the Tech Mahindra family, and I am confident that together we will achieve greater success.”
A
pioneer in the experience design field, Mad*Pow leverages strategic design and
the psychology of motivation to create innovative experiences and compelling
digital solutions for global clients. Mad*Pow’s unique human-centered design
approach is fueled by deep empathy and an understanding of behavior science,
which will create real differentiation for Tech Mahindra’s 900+ customers.
Will Powley, founder and chief creative officer, Mad*Pow, said, “Tech Mahindra’s experience and reach will enable Mad*Pow to scale faster by greatly enhancing its digital transformation offerings with existing and potential clients. The collaboration will also create vast opportunities for Mad*Pow to provide it’s unique and differentiated strategic design services to Tech Mahindra’s large global customer base.”
Vivek Agarwal, global head of corporate development, Tech Mahindra, said, “We are excited to announce Tech Mahindra’s key acquisition of a digital asset in North America. The addition of Mad*Pow to Tech Mahindra family will greatly enhance our ability to create and deliver enhanced customer experiences for our global clients.”
Mad*Pow’s
acquisition underlines Tech Mahindra’s focus on digital growth, under the
TechMNxt charter, which focuses on leveraging next generation technologies and
solutions to disrupt and enable digital transformation, and to build and
deliver cutting-edge technology solutions and services to address real world
problems to meet the customer’s evolving and dynamic needs.
By Abhinav Shashank, CEO and co-founder, Innovaccer.
Fact 1: As per the latest data made available by the Office for Civil Rights for HHS, more than 208,000 privacy-related complaints have been made in the last 16 years.
Fact 2: If a hospital makes a call to a patient
to remind them of their upcoming appointment, they might receive a class action
complaint about violating the Telephone Consumer Protection Act.
While
these two facts may not necessarily be related to one another, we clearly need
to take a hard look at the increasing calls to protect patient privacy. But
does that mean providers cannot send a text message to their patients?
Certainly not!
California’s latest policy for text
message technology for Medicaid plans: A case study
The
1991 Telephone Consumer Protection Act (TCPA), which was put in place to
safeguard people from automated text or other telephonic messages, limits
organizations from reaching out to their patients through text messages. TCPA
can also levy financial penalties on organizations if they are found guilty of
violating their policies. On the other hand, the Health Insurance Portability
and Accountability Act of 1996, or HIPAA, require every “Covered Entity or
Business Associate that comes into contact with Protected Health Information
(PHI)” to follow the compliance policies, something that is accepted as a rule
of thumb in the healthcare world. For any organization looking to reach out to
patients remotely, both HIPAA and TCPA policies are extremely important to
comprehend and follow.
In
today’s context where patient engagement through text messages has emerged as
one of the biggest avenues for optimizing care quality, the TCPA is losing its
sheen to some extent in the healthcare domain. While no one denies the
importance of TCPA, it does cause some roadblocks for organizations looking to
enhance patient engagement in remote areas and population segments.
The
California Department of Health Care Services (DHCS) recently issued a policy
to set guidelines regarding how Medicaid plans can safely use the text
messaging technology to connect with beneficiaries. This is critical since one
out of three people in California are Medicaid beneficiaries.
The
latest ruling allows organizations to reach out to their patients through text
messaging after submitting an approval form to the concerned regulators clearly
mentioning the structure as well as the intent of such reach out campaigns.
They also need to create proper avenues for privacy protection and give users a
clear opt-out option. However, once such campaigns are approved, the payer can
then run such programs without any additional regulatory clearances. Further,
such outreach messages must be made available at no cost to Medicaid members.
What can we learn from the example of
DHCS?
According to a study, hospitals could reduce their discharge time by 50 percent if conducted by secure text messaging, saving healthcare facilities an average of $557,253 per year.
Secure
text messaging is indeed a big deal. Make no mistakes, privacy and security
should still remain the top-most priority while enabling such mechanisms, and
password protection is something that we should all consider. However, in an
age when we are shifting our focus on precision medicine and advanced robotic
surgeries, the ability to create a secure system for text reminders should not
be a big deal.
The
text message service is indeed the most prevalent form of communication for Americans
younger than 50, and about 80% of people state it as the preferred way of receiving
notifications. The latest DHCS policy will empower payers to connect with their
populations like never before, an ability that would allow them to initiative
preventive care and scheduling, while ultimately reducing care and cost and
improving outcomes. It can be safely assumed that the latest initiative by DHCS
is a breakthrough step in this direction.
Organizations need the ability to meet
their patients where they want
I
remember one of my friends asking me a very simple yet important question, “If
I can connect with my colleague based out of London in literally 10 seconds,
why does it take my provider so long to tell me that my appointment has been
canceled?” I had no answer.
We
cannot expect a person whose calendar is booked for the next 10 days to walk
into a clinic for a regular check-up and wait idly for a couple of hours due to
inefficient scheduling practices. Worse still, imagine a situation where a
person takes time out to visit a facility for their Annual Wellness Visit (AWV)
only to find out that their appointment has been rescheduled for the next week.
A simple suggestion of taking aspirin as a first-aid measure in a potential case of a heart attack sent through an SMS on your way to the hospital can help a patient significantly reduce the damage. Remote patient outreach is an important prospect for today’s practices, if not a necessity. It’s really that simple — connect with your patients to know them better, to treat them better, and to make them feel better with minimum interventions. While organizations can still sustain under value-driven contracts without such streamlined patient communication mediums, we cannot keep believing that we would cross that bridge when we come to it.
The road ahead
Consumerism
in healthcare was never a widely-discussed topic until very recently, however,
things are changing and how! Innovating while respecting the mandates in place
should be the road ahead, definitely. The government is supporting new-age
initiatives, federal healthcare agencies are bringing in new policies, and
large payer and provider organizations are exploring ways to maximize patient
satisfaction. Examples set by organizations such as DHCS will act as an ice
breaker for other agencies and organizations wanting to break free to cater to
the unique needs of the 2020s.
