We often think of healthcare as the direct communication between provider and patient in an appointment or clinical setting. However, most of what influences health outcomes sits outside of the doctor’s office: This includes individual health behaviors as well as social determinants of health such as social support systems, access to health education and timely care, physical environment, and financial resources.
As we think about building patient engagement, especially related to preventive care and long-term management of chronic conditions, it’s important to think beyond just the quality of clinical care being delivered. Generally speaking, “engaged” patients are those who feel empowered and actively involved in managing their own health. The specifics of what this looks like may differ by population or condition area, but patient engagement is driven by a few key themes:
– Patient activation: Do patients feel motivated to make choices that will positively impact their long-term health?
– Patient education: Do patients have the information they need to understand how their choices and behaviors impact health outcomes?
– Care navigation: Do patients understand how to navigate the complex healthcare system in order to find and access the care they need?
– Patient support: Do patients have social support systems to help them adopt and maintain positive health behaviors?
In an increasingly technology-driven world, engagement can be improved through strategic and human-centered design of experiences and platforms that help patients manage their health. The following sections outline user experience best practices that can be leveraged to improve patient engagement and influence care quality as a whole.
Patient Activation
Much of the literature around patient motivation and behavior change is built upon theories of behavioral psychology. In her book Engaged: Designing for Behavior Change, Dr. Amy Bucher highlights the different types of motivation that can influence human behavior. These range from controlled (extrinsically imposed “you should…”) to autonomous (intrinsically driven by personal motivations). Understanding patient motivation is key to human-centered experience design.
By Dan Pichette, executive vice president, Output.
When we think of innovation in healthcare, what comes to mind? For many, it may be fancy diagnostic machines or breakthrough drug therapies. But sometimes, it can be as simple as a 3D-printed cover for an insulin pod. A product, or an improved process, that solves a need. While medical settings like hospitals and clinics are good at managing patient care, it can still be challenging to create and manage a culture of innovation.
According to Stanford University, innovation management is the process of taking imaginative concepts from inception to implementation, beginning with “the fostering of an environment where a new idea is encouraged.” In healthcare, stringent regulations and multilayered administration can often discourage this process. Staff in large medical environments often work within silos where close teamwork can incubate new ideas, but whose independence from each other can also isolate communication.
Embracing Innovation
Innovation is a key goal for the World Health Organization. Since 2017, the WHO Innovation Network, a digital and in-person network of global colleagues, has been engaged in learning and sharing events exploring “new ways of applying innovation in WHO’s work to accelerate health impact.” For its part, the American Medical Association has its seven-year-old Medical Education Innovation Challenge, enlisting small teams to propose a change to an aspect of medical education that better prepares students to meet future healthcare needs.
Nurses, the employees most on the front lines of medical care, are welcoming improvements. Nursing Management Journal exhorted that even though the healthcare industry is “innately risk-averse,” nurses must not only embrace new technologies such as AI, virtual reality and advances in genomic science, nurse leaders should proactively foster a culture of innovation, encouraging divergent thinking and promoting autonomy to instill confidence in employees.
Some institutions of higher learning have recognized the role that innovation increasingly plays in the medical sphere. Temple University’s Fox School of Business offers a 12-credit Graduate Certificate in Healthcare Innovation Management designed for current professionals looking toward the industry’s future. These credits can be applied to graduate degree programs such as Temple’s Master of Health Administration or its appropriately named Master of Science in Innovation Management and Entrepreneurship.
A Pandemic Catalyst
There is little doubt that the pandemic has shepherded unprecedented change. A May 2021 McKinsey survey, which polled over 100 industry leaders from medical providers to health payers to pharmaceutical and technology companies, found close to 90% of respondents agreed that the Covid pandemic “will fundamentally change the way they do business, requiring new products, services, processes, and business models.” Two main areas where they expected significant changes to endure: digital acceleration (from telehealth to digitally enabled clinical trials and customer-engagement models) and the workplace of the future (spanning remote patient care and virtual collaboration for professionals in the pharmaceutical and medtech industries).
The McKinsey Healthcare Innovation Through Crisis Survey concluded that adapting to these shifts, among others, will require many healthcare organizations to transform their operations and mindsets. During times of crisis, prioritizing innovation can “help unlock growth in the recovery, provided leaders approach it with commitment and establish key capabilities and processes.”
I’m a grown man who’s afraid of needles. Yes, that’s an inconvenient fear in the time of vaccines and booster shots. This irrational dread plagued me when I scheduled my Covid vaccine. I hoped to at least book an appointment at a pleasant urgent-care clinic that would soothe my nerves. Or perhaps a modern retail pharmacy that offered easy online scheduling.
But the only appointment I could get was at NYC Health+Hospital’s Coney Island Hospital in New York.
I didn’t expect much. It’s public health, after all. So, when I walked into the hospital, anticipating dingy hallways staffed by soulless zombies, I was shocked to be greeted by friendly and helpful staff who admitted me—right on time—to a modern and clean facility. The nurse administering my vaccine couldn’t have been more supportive.
I walked away a changed man—slightly less afraid of needles, and with a different perspective on public health. Somehow, the largest public health provider in the country managed to capture my initial visit and create a customer for life. How? This public health organization had started viewing patients as consumers, much like its private, national counterparts.
It made me think: If NYC Health+Hospitals can do it, surely more public health providers can make their patient experience positively pleasant, just like large, well-funded private systems have been doing for a while.
The key: treating patients as consumers who have a choice in where they receive their care.
COVID has certainly turned patients into savvy telehealth consumers.
The mantra of the American consumer has always been, “I know what I want, and I want it now.” We apply this to everything from clothes to cars to computers. But healthcare, especially virtual care? Not so much. Prior to Covid-19, however, most consumers didn’t even know immediate, remote access to healthcare was an option. They simply accepted clunky EHR portals, long wait times and in-person visits where virtual would suffice.
By Chris Evanguelidi, director, enterprise healthcare Market, Redpoint Global
The growing healthcare consumerism trend has empowered millions of patients and healthcare consumers to take more control over their individual healthcare journeys, in and out of the doctor’s office. Healthcare is no longer viewed as strictly a relationship between a patient and a doctor, but as a collection of disparate experiences all geared toward improving outcomes.
Wearables, telehealth, patient portals and other digital-first touchpoints all contribute to an expectation among patients for a consistent experience centered around their ongoing care and well-being. To meet the expectation for a personalized experience, healthcare providers are prioritizing the development of an understanding of their patients outside of a clinical setting.
A recent Dynata survey, conducted in collaboration with Redpoint Global, explored consumer perceptions about their healthcare experiences. The research revealed that more than half of consumers surveyed (57%) said that how well a healthcare provider understands them as a patient and creates a personalized experience was one of the most important considerations when choosing a healthcare provider. In addition, poor patient experience and a lack of personalization and patient understanding was cited by survey respondents as the top reasons patients consider switching healthcare providers (as well as healthcare plans).
Engage with Consistent Relevance
What does it mean, though, to develop a personal understanding of a patient? An electronic health record (EHR) – a modern version of the traditional chart – often lacks important data that reveals a contextual understanding of what makes a patient unique. And by having this data, providers are then able to engage a patient with a relevant experience across the healthcare journey. Data such as social determinants of health (SDOH), medication adherence, risk tolerance, diet and exercise programs and data from wearables are important attributes that reveal patient behaviors and preferences that form a personal understanding.
Possessing this detailed knowledge of behaviors and preferences also aligns with the value-based care approach to healthcare. In parallel with the rise in healthcare consumerism, a value-based care model that ties financial compensation to improved outcomes makes it even more important for providers to compile a single patient view.
One key challenge for providers in compiling a single patient view that is then used to deliver a personalized omnichannel experience is siloed data and processes. A single provider network or healthcare organization, for example, often has multiple EHRs that don’t share data. In addition, because PII data and PHI data also typically live in separate systems, it is extremely difficult for healthcare organizations to deliver hyper-relevant communications.
Consider, for example, a marketing organization tasked with closing care gaps and segmenting out only basic patient data – name, age, address, etc. They might send an email to men over 50 urging them to schedule a preventive screening. With a single patient view, however, the same marketing team might improve outcomes considerably by matching the recipient to a preferred provider, recommending optimal times, offering transportation options to someone without access to transportation or leveraging other social determinants. By delivering the right message at the right time and on the right channel, the preferred outcome – a scheduled appointment/closed care gap – has a higher chance of success.
Close the Experience Gap
By knowing all that is knowable about a patient through a single patient view, an organization can leverage advanced segmentation rules based on everything that makes a patient unique – current health condition, social determinants of health, etc. – to allow for efficient and effective personalized messages and communications to key segments, returning the most value for a provider group or health plan. Particularly in a VBC healthcare model, there is a direct revenue link between hyper-personalized content through advanced segmentation and improving health outcomes.
The Dynata survey shows a pronounced gap between the type of experience healthcare consumers expect to receive from their provider and the experience delivered. More than 90 percent of patients said that it is either “important” or “very important” to receive relevant communications from their provider and healthcare plan that accurately reflect an understanding of their healthcare journey, yet just 50% say they are very satisfied with the relevance of the communication they receive.
A single view of the patient is the key to closing the experience gap, finally delivering patients and healthcare consumers the personalized omnichannel experiences that improve outcomes and lead to happier, healthier patients.
Mental healthcare providers are facing a crisis. The growing number of Americans seeking mental health care is putting a strain on psychologists, and it’s affecting those who need help the most.
In fact, according to the 2022 COVID-19 Practitioner ImpactSurvey by the American Psychological Association (APA), roughly 53% of psychologists agreed that they work more than they did a year ago. Moreover, the same survey revealed that 60% of psychologists are unable to take on new patients because they’re already at capacity.
Mental health care providers need help to handle this influx of patients. This is where healthcare IT comes in. By helping providers manage their schedules and keep track of patient information, healthcare IT can help ease the burden on psychologists and allow them to meet their patients’ needs more effectively.
By Subhro Mallik, SVP and head of life sciences business unit, Infosys
One in five Americans suffers from chronic pain. Apart from disrupting lives, chronic pain costs the U.S. about $300 billion in productivity every year. Treatment usually involves different types of interventions, such as medication, exercise therapy, cognitive behavioral treatment etc., and the participation of both patients and their healthcare providers. Unfortunately, a highly inadequate pain management infrastructure, which has fewer than 6,000 physicians for treating 50 million patients, is unable to give patients the one-on-one attention they need.
Because they are not supervised, many patients fail to keep up with the prescribed exercise regimen, which happens to be all-important for rehabilitating chronic pain. But now, there is a real possibility for care givers to use digital interventions to remotely monitor and engage with patients to improve compliance as well as treatment outcomes.
Several digital solutions, including mobile apps, sensors, digital medical devices, fitness trackers and wearables, play a role in chronic pain therapy. What’s more, they can be applied across lines of treatment to achieve different purposes – from improving medication adherence to enabling telerehabilitation. A major benefit of digital intervention is that it allows providers to design personalized treatment plans in collaboration with patients, which has been linked to improvement in self-care. Last but not least, these tools help pain management physicians and care givers stay connected to their patients. Here are some scenarios:
Connect with patients to motivate and engage
Providers can deploy a digital platform to gather data from patients’ mobile apps, fitness trackers, and devices to track exercise performance; this insight tells them if they need to personally intervene with feedback or a revised program. The platform itself can also act as a virtual coach, gamifying the exercise routine, supervising patients and motivating them to do better.
Studies show that better engagement makes a significant impact on treatment outcomes. When patients suffering from chronic musculoskeletal pain were given a combination of education, sensor-guided exercise therapy, and one-on-one remote health coaching over a twelve-week-long program, they displayed high engagement and also reported reduction in pain.
By Victoria Wickline, SVP of partnership success, Get Well.
More than 2.5 years after COVID-19 was first identified as a global health crisis, the healthcare industry continues to grapple with the challenges the pandemic has laid bare, including harsh realities surrounding unequal distribution of care and health inequities.
Further exacerbating these devastating care gaps is the fact that the pandemic caused many people to put off aspects of their healthcare, with 41% of U.S. adults reporting that they have delayed or avoided medical care — either because of job loss, health insurance coverage losses, closed facilities, or just simply wanting to avoid being exposed to the virus.
As patients avoided hospitals and doctors’ offices, conditions like cancer, heart disease, and other chronic illnesses went undiagnosed or untreated during the pandemic. In the first four months of 2020, breast cancer screenings were down by 89% and colorectal cancer screenings were down by 85%. As a result, The National Cancer Institute anticipates a surge in cancer death and predicts that the number of people who will die from breast or colorectal cancer in the United States will increase by nearly 10,000 over the next decade because of COVID-19’s impact on care.
Healthcare System’s Loss in Financial Revenue:
Besides the obvious detriment to public health, especially for vulnerable and underserved populations, these care gaps have drastically cost health systems financially. Revenue lost in 2021 was projected between $53 billion to $122 billion due to the lingering effects of COVID-19.
Fast forward to 2022, U.S. hospitals and health systems continue to struggle with regaining their financial health and many are facing another year of negative operating margins, with most organizations seeing declining margins, revenue, and inpatient volumes following the surge of the Omicron variant. Just this past month, the healthcare industry was reported to have the most job cuts compared to any industry in 2022 with a 54% increase in layoffs compared to numbers reported in June 2021.
Re-Engaging Patients Through Personalized, Digital Experiences:
Today, the healthcare industry is trying to pick up the pieces and health systems are looking to re-engage patients in their care — and improve the overall health of their patient populations as a result. To do so, health systems must redefine what the patient experience looks like. This re-engagement should center on providing a personalized, digital experience. Innovative AI-driven technology layered with an empathetic human element that adds a personal touch can lead to engaged patients and improved outcomes.
Leveraging AI-driven Technology for Patient Retention:
Healthcare organizations must reach out to patients where they are, with the information they need. This means not waiting for the patient to proactively engage and request care; information and scheduling resources should be at their fingertips. While everyone may not have access to the internet, the vast majority of the population – 97% – own a cellphone with access to text messages. In healthcare’s effort to digitize, we must also keep in mind not to marginalize underserved populations with lower socioeconomic statuses. However, with a read rate of approximately 99%, text messaging provides a solution to engage populations across all socioeconomic statuses with personalized messages to re-engage people who have been avoiding or delaying medical care, while fostering healthcare plan loyalty and closing care gaps.
But for this type of outreach to work, it must go beyond simple text messaging. Automated text messages sent to patients who need to schedule appointments is only a small slice of effective re-engagement. Successful personalized digital outreach should be based on a comprehensive 360-degree patient profile, ensuring that patient needs and offered resources are tailored to their particular health journey. This comprehensive patient profile should include patient-specific engagement data, such as the last time they visited their primary care physician, and personal preferences, including language choices. It should also incorporate location data, like what relevant providers are practicing in the patient’s preferred location.
The key is that behind the actual text messages is a real human providing personalized healthcare guidance. The combination of targeted outreach and human touch points will provide that personalized, digital experience that healthcare systems have been struggling to prosper. A tailored message that sounds authentic and empathetic can make a significant difference with re-engaging patients and driving them to take action with their care.
Don’t forget the Human Element:
The support of someone who can intervene, scale care, and escalate to care teams if needed means that the patient can more quickly get back on track with their care, and the healthcare organization can scale outreach and non-clinical tasks without additional internal resources.
“How do I access my medical records?” “I’m unsure how to schedule an appointment through my primary care provider?” “Where can I access this healthcare information?” These are all questions patients ask when navigating the healthcare system that need the human touch to ensure patients’ needs and resources are tailored to their particular health journey.
A high-tech digital strategy paired with high-touch human intervention combines the best of both worlds: innovative AI-driven technology and a caring touch that leads to engaged patients and improved outcomes. As an organizational retention strategy, this kind of holistic virtual care navigation can be a win for both health systems and the patients they serve.
A Digital-First Strategy That Yields Tangible Results:
Take Adventist Health for example, a nonprofit integrated health system that designed a digital-first patient outreach service that initially targeted adults who had not had a routine wellness appointment in the past 18-24 months. This outreach leveraged community-based virtual navigators and consisted of multiple SMS messages to engage patients and offer assistance with scheduling appointments with a primary care provider. Within four months, this digital-first strategy reached over 160,000 inactive patients and produced the following results:
92% of the identified dormant patients received SMS text outreach that offered assistance with scheduling healthcare appointments.
In total, more than 40,000 new wellness visits and follow-up visits were scheduled with primary care providers.
As a result, $7.9M was reclaimed in revenue for this specific patient population within just 15 weeks.
The Bottom Line
A digital-first consumer experience enables organizations to retain patients in networks, provides an enhanced experience, and improves patient health — all invaluable benefits, for both patients and providers alike. Every patient who receives outreach to re-engage them with their care is one more patient who is more aware and active in their own health journey. Revenue recapture is a positive side effect of ensuring that the healthcare industry is succeeding with what it’s meant to do — keeping populations healthier for the benefit of society.
By James Talcott, MD, SM, senior medical director, Oncology for Eviti, NantHealth.
A recent study from the Journal of the American Medical Association reported that while the U.S. spends nearly two times more per capita on cancer treatments, related mortality rates were only nominally lower. The analysis was a cross-sectional review of 22 high-income countries assessing the correlation between cancer treatment expenditures and 2020-associated fatalities.
In fact, nine of those listed—countries that invested significantly less in cancer care—have lower mortality rates. This study proposes an interesting new perspective: increased spending does not guarantee better results.
So how, then, can we optimize care? As new cancer treatments are constantly emerging, it can become overwhelming for providers to sift through data and treatment options to find the most appropriate—and cost-effective—plan for patients. Oftentimes, patients see quicker and more efficacious results when directed to the right treatment plan early on. This is where early intervention and treatment-validation technology becomes a key factor in optimized cancer care.
Improved Visibility and Patient Empowerment
Treatment-validation technology connects payers and providers, offering access to an advanced research library platform supplying tools and data analytics for the delivery of high-quality care. Clinicians can view thousands of proven treatment regimens, federally registered clinical trials, expected treatment outcomes, and predicted costs, all during the process of curating the best plan for their patients.
The ultimate goal in cancer care is singling out the most efficient and direct treatment plan—bypassing lengthy (and often costly) trial and error methods. In addition, when the patient is empowered with options and stated preferences, based on provider information, they help gain an understanding of the benefits as well as potential side effects of available treatments. This builds and promotes important conversations between them and their physician about their treatment course ahead.
