The good news is that there is plenty of great content being generated throughout most health organizations to create engaging, effective member and patient customer communications, which we will call “customer communications” to include any recipient. The bad news is that the content is often locked away in siloed systems and workflows, making it very difficult for marketing, customer experience and mobile strategy teams to leverage information in a streamlined, cost-effective way. The result? Marketing promotions and graphics are only available for use in brochures, purchase history data is only accessible for billing, and so on. Content is trapped in the specific system it served originally, limiting its value to the organization.
These challenges can be overcome by implementing the newest concept in healthcare document creation: content lifecycle management (CLM). The goal of CLM is to enable business teams to create and manage correspondence themselves using portals configured for specific document types, such as healthcare plan summaries, coverage change notifications and benefits statements. Implementing a CLM approach can unlock valuable data, avoid dependence on the availability of IT resources, reduce costs, and speed time to market.
Employing a CLM approach requires achieving three important “C’s”: centralization, collaboration and control. Each of these areas plays a critical role in attaining effective communications that speak directly to the customer’s individual needs and desires.
Here’s a look at each of the three C’s:
Centralization
An important step to improving customer communications is centralizing access to content and templates so that they are readily available to business users. Making it possible to reuse content in multiple health plans and versions, for instance, rather than having substantial amounts of duplicate content that is not shared, will improve efficiency and reduce the amount of effort and time needed to update or change data across versions. Changing a plan benefit for example, can be accomplished in one step for hundreds of document versions, rather than having to replace the information in each individual file.
Collaboration
Participation from people outside the primary workflow is often required but can cause bottlenecks. A good collaboration tool sits atop the entire enterprise, integrating people automatically into the workflow on an ‘as needed’ basis. A browser-based system provides the greatest flexibility because it can be accessed by anyone regardless of location.
Guest post by Garret Grajek, chief security officer, dincloud.
A March 2014 study by the Ponemon Institute titled, “Ponemon Report on Patient Privacy & Data Security,” stated that cybercriminal attacks on healthcare organizations have doubled in the past three years. If you follow IT news at all, you know that healthcare organizations are also under attack, with some of the latest of these attacks being what experts classify as APTs (Advanced Persistent Threats). APT attacks distinguish themselves by being persistent attacks orchestrated by an organized (and usually well-funded) institution, either government or criminal, with a specific target and purpose for the attack.
APTs distinguish themselves from past “script kiddies” and accidental hackers who execute “crimes of opportunity” (e.g. they find a site that they can do an SQL injection and see what data they can download). Advanced persistent threats however follow the opposite workflow – they select a target and then use any and all mechanisms to obtain access to the data they desire.
You’re in healthcare – but should you care?
Healthcare IT systems are a target rich environment for advanced persistent threats attacks. What’s the reward? PHI (Personal Health Information) and PII (Personal Identification Information). PHI/PII for hackers is the gift that keeps on giving! With someone’s identity information, hackers can create multiple accounts – financial and other – for the purposes of fraud. This was seen in mid-August when Community Health Systems announced that it had fell victim to an APT attack earlier that year from an APT group based in China. Chinese hackers stole medical records for 4.5 million patients, according to a regulatory filing from the healthcare provider. And how can we forget the security breach at HealthCare.gov, the government’s health insurance marketplace.
Healthcare has the same type of information, and more. User identities, associated e-mail addresses, phone numbers, street addresses, and often insurance, credit, and other key PII information (like employer’s and spouse information), are held by health care providers. Attackers know this, and for these reasons, health care entities have become an easy target for advanced persistent threats attacks.
Guest post by John Olajide, president and CEO, Axxess.
The home health delivery model has become more prevalent in recent years as a cost-effective, patient-preferred alternative to traditional hospital and skilled nursing settings. Approximately 12 million U.S. individuals receive care from more than 33,000 agencies for acute illness, long-term health conditions, permanent disability, or terminal illness — according to a survey by the National Association for Home Care & Hospice (NAHCH).
Demand for home health services is seeing an increase as more baby boomers turn 65 daily and choose to receive their health care services at home. Recent surveys of older adults are showing a preference to receive healthcare in the dignity and comfort of their homes. As an example, surveys by the American Association of Retired Persons (AARP) consistently show that over 80 percent of older adults want to remain in their homes and communities throughout their lives. Several surveys show the same trend in the wider patient populations; and technology innovations are making it possible to deliver quality healthcare services to patients at home.
While the increased awareness in and recent growth of the home healthcare sector is promising for home health agencies, critical to their success is the adoption and integration of the right cloud-based technology to increase operational efficiency, ensure compliance with stringent regulatory requirements and improve patient outcomes.
Technology can also assist in preventing home healthcare fraud. While fraud can occur in all sectors of healthcare, home health is unique in that the caregiver visits the patient in the home. A common example of fraud in home health is when a caregiver submits documentation for visits that were not made and the home health organization, in turn, submits claims to insurance providers for such services without obtaining proof that such service was actually rendered. Home health agencies would be wise to protect themselves from the possibility of this type of fraudulent activity by a disreputable employee.
It’s called healthcare for a reason. Technology is a powerful tool, but people are the solution. The Twine Health Collaborative Care Platform allows for the co-creation and tracking of personalized care plans that serve as common ground for continuous collaboration between patients, coaches and their clinicians. Patients get support from their care team, on their terms whenever, wherever they are: so they reach their health goals faster and focus on living.
Healthcare has lost its way. In recent years the “care” has fallen by the wayside — victim of flawed automation efforts, perverse payment models and the constant pressure to reduce costs. Technology is a powerful tool. However, if not used properly it’s impersonal and the human connections, which are critically important to caregiving, get lost. People are the solution to better healthcare.
People are the most underutilized resource in health. Twine Health changes the game by empowering them to take an active role in their care, learning along the way, and overtime building self-efficacy. Twine Health surfaces patients who need help at just the right time, allowing them to remain effective even as panel sizes grow. Coaches provide the ongoing support and expertise that is key to successful behavioral change. This also allows clinicians the time and focus to practice at the top of their license, interacting directly with patients when challenging medical conditions arise.
Elevator Pitch
The Twine Collaborative Care Platform is a new class of digital health technology that helps patients build self-efficacy via continuous support from coaches and their clinicians. Spun out of research performed at the MIT Media Lab, and proven cost effective via clinical trials and commercial pilots, Twine delivers results that cannot be ignored – 90 percent of patients reach their health goals (e.g., blood pressure < 140/90) within 3 months at 1/3 the cost of the standard of care.
Founder’s Story
John O Moore MD, PhD
John Moore, MD, PhD, is the co-founder and CEO of Twine Health. Moore’s passion for a better healthcare system started during his medical training where he was frustrated to learn that the best diagnostic and treatment capabilities did not result in healthier and engaged people. To be successful, Moore realized patients had to be in control of their own care, but also recognized the clear need for expert support. Moore came up with the idea for Twine Health during six years at the MIT Media Lab where he studied the healthcare delivery model and created a revolutionary approach to care: technology-supported apprenticeship. Bringing together advances in health psychology, learning science and human-computer interaction, Twine is designed to become the primary tool for teamwork between patients and clinicians. Before attending medical school, Moore received a BS in Biomedical engineering, and was a Fulbright Scholar.
Marketing/Promotion Strategy
Patients, coaches and clinicians are looking for a better way to provide and receive care – a way to make health care healthier. Twine Health provides clinicians, and the health organizations (HCOs) they work for, an effective and scalable chronic care platform that improves outcomes, reduces costs and increases patient and clinician satisfaction. The results speak for themselves:
Various forms of payment reform are in play throughout US healthcare today, and with good reason as we search for the right combination of incentives, alignment and engagement that produce systemically better health outcomes at lower overall cost.
As an example, providers are paying much more attention to the small percentage of patients with the highest costs, including patients with chronic conditions. As a result, they are identifying these patients, establishing care plans and engaging care coordinators and patients to improve outcomes. Less attention, however, is being focused on the powerful capability to better connect, communicate and coordinate care among the multiple providers that care for a patient. This caliber of care coordination has the potential to improve outcomes across the entire patient population and is rooted in results that suggest a coordinated network of providers, each capable of high quality and cost effective care, with appropriate information about the patient available to them, can deliver improved outcomes across large patient populations.
Patient populations may be systemically managed under various forms of accountable care, commercial shared savings, Medicare Advantage and full risk – or managed by episodes of care, bundled payments, etc. The shift from fee-for-service to “fee-for-value” incentivizes preventive care, best practice care, and high-value delivery of care and it puts a premium on the ability to coordinate care.
Therein lies a very significant challenge: The collective group of providers that interact with a large patient population are invariably part of different organizations, with different technology platforms or no platform at all and are dependent upon fax machines, phones, and paper to exchange documents and communicate. The provider groups also possess differing incentives: the “at-risk” provider attempts to influence improved health and financial outcomes while other providers may still be receiving fee-for-service payments.
Reconciling these challenges and harnessing the power of care coordination is now possible via referral coordination. One of the most powerful mechanisms for coordinating care are the hundreds of thousands of patient referrals made every day between various providers, with Primary Care Providers (PCP) being the largest initiator of consulting and diagnostic referrals on behalf of their patients. Providers need to communicate with each other when they are treating the same patient, and these patient transitions between providers represent a significant opportunity to realize high value care.
The referral itself is equivalent to a PCP or patient making a decision on which provider to “hire” to provide the needed care. This referral decision and the coordination of the referral are critical to the delivery of better health at lower cost, but improving the overall referral process requires key elements to be implemented consistently:
Guest post by Steven Chau, CTO and co-founder, Doctor Quickly.
Healthcare is one of the last industries to be disrupted by technology. Although unprecedented levels of biomedical knowledge, surgical procedures, and condition management have been amassed, we are not using them to their potential to create the tools to improve healthcare experiences. A balance of privacy and policy regulations with technology is the key to creating a secure yet efficient healthcare system.
The State of Healthcare
A staggering portion of healthcare costs are wasted. According to the Institute of Medicine (IOM), $765 billion or 30 percent of the 2009 total U.S. healthcare spending was wasted. Key areas that were tracked include unnecessary services, services inefficiently delivered, prices that are too high, excess administrative costs, missed prevention opportunities and medical fraud.
Key findings:
Overused services, defensive medicine and higher-cost services total $210 billion in excess cost;
Medical errors, care fragmentation and preventable complications total $130 billion in excess cost;
Duplicative costs to administer insurance and insurances’ administrative inefficiencies drive $190 billion in excess cost;
Product prices beyond competitive levels total $105 billion in excess cost;
Missed prevention opportunities like primary, secondary and tertiary prevention total $55 billion in excess cost;
Fraudulent claims total $75 billion in excess cost.
Additionally, there will not be enough physicians in the next few years to meet the growing demand. The Association of American Medical Colleges (AAMC) projects a shortage of 62,000 physicians by 2015. This shortage is expected to increase to 91,000 by 2020. This physician deficit is due to an aging Boomer Baby population, the insuring millions of new patients through the Affordable Card Act, and the retiring of a large number of doctors in the coming decade.
Technology can curb inefficient health management, increase knowledge sharing, and improve access to a shrinking physician pool. However, proper precautions must be taken to safeguard patient information privacy while empowering healthcare providers to provide more efficient care.
HIPAA
Healthcare technology is largely regulated by the Health Insurance Portability and Accountability Act (HIPAA). It was created in 1996 to protect the privacy of electronic patient data, known as protected health information (PHI) and to restrict access to PHI. Predating the iPhone by 10 years, the HIPAA rules were strengthened in 2013 to increase rigor on de-identifying PHI, to broaden HIPAA’s reach to include all entities that touch PHI directly and indirectly, and to notify affected parties if a PHI breach has occurred.
What do Disney, Apple, Southwest Airlines, Mayo Clinic, USAA, Amazon, Pandora, and Kaiser Permanente have in common? They all sell the same thing.
Whoa! That’s crazy talk. What’s that you say?
Yes, each of these organizations knowingly and deliberately differentiates and competes on customer experience. In fact, each one delivers the best customer experience in its respective industry, as measured by Net Promoter Scores.* Whether delivering immersive entertainment, personalized radio or healthcare, these companies make an emotional connection and engage their customers in extraordinary ways.
Within healthcare the importance of the patient experience cannot be overstated. Our personal health and well-being is synonymous with happiness and is manifest in our personal experience. For many of us, being sick, in pain or in fear for our life (or the life of a loved one) tends to heighten our perceptions and amplify every experience. It’s during such times when a kind word can seem like a grand benevolence, and the slightest oversight feels like a cruel insult. As such, providers should invest as much energy in delivering the best possible customer experience as they do in delivering safe and effective treatment.
Patient satisfaction is not patient experience
The Beryl Institute defines patient experience as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” Unfortunately, the standard method for measuring patient perceptions about healthcare is a collection of survey questions. Don’t get me wrong; we need a consistent method for assessing patient perceptions to make apples-to-apples comparisons between organizations. The Consumer Assessment of Healthcare Providers and Systems (CAHPS**) survey offers healthcare consumers and financers just that – information by which to make such comparisons. However, the subjective survey data alone is insufficient for providers to fully comprehend and then systematically improve patient experiences.
I won’t belabor the difference between patient satisfaction and patient experience here, but I will draw your attention to Fred Lee’s work on this subject. Lee aptly compares Disney with American hospitals in his best-selling book If Disney Ran Your Hospital: 9 ½ Things You Would Do Differently. I strongly encourage you to invest 17 minutes watching his funny and exceptional TEDx talk on the fundamental difference between patient satisfaction and patient experience.
Amazing Charts, a provider of electronic health records and practice management solutions, issued its healthcare predictions for 2015. Some interesting predictions here I thought you might find worthwhile. Concierge medicine, which I’ve said for some time is going to have a lasting impact, especially in the era of the Affordable Care Act, made the list.
Patient engagement, and consumerism of healthcare– somewhat of a slam dunk — appears here, too. I believe we’ve get some clarification on what that movement means this year. Amazing Charts agrees.
Also, wearables (oh, wearables, will you become more than a fad?) makes this list, and telehealth is here, too; I think we’ve finally reached the saturation point of telemedicine. This year should show strong results that I hope will validate its role at the point of care. We’ll finally get to see if payers get the message.
Here’s the full list of healthcare predictions for 2015 from Amazing Charts:
Membership Medicine Comes on Strong: The patient membership approach to medicine will grow in all forms, including value-based Direct Primary Care (DPC), high-end concierge medicine and primary care services contracted directly by employers. Market-driven medicine, fueled by changes occurring in healthcare today, such as inexpensive health plans with very high deductibles, will continue to encourage consumers to explore more cost-effective alternatives for primary care.
Patients Help Define the Experience: The patient, in partnership with the provider, will help define the care experience going forward. This trend will be powered by technologies that enhance face-to-face interaction in the exam room. One example is the projection of an EHR onto a large display screen to facilitate information sharing between provider and patient. This in turn will help reduce errors and misdiagnosis, as well as motivate patients to take a renewed interest in their own healthcare and treatment options.
EHRs Get Personalized: The EHR market will further mature and become customizable for individual patient needs and treatment plans. Intuitive data analytics will play a critical role here, helping clinicians measure, assess and manage their specific patient populations to better define specific gaps in clinical care and introduce the latest evidenced-based treatment procedures or diagnostic techniques.
