I promised myself that I wouldn’t start this post by talking about the “unprecedented times” brought on by COVID-19, and I wanted to avoid using the words “new normal.” Both phrases are such a common part of my life these days that they almost seem trite.
Alas, I’ve clearly broken my promise. Why did I give in so easily? Because these “unprecedented times,” challenging and sad though they’ve been, are the impetus for a lot of promising change in the world of healthcare, and I’m optimistic that the “new normal” is going to be a friendlier, more convenient, and more modern experience for patients, thanks to the effective deployment of patient engagement technology. It doesn’t negate the tragedy of the pandemic by any means, but this is a positive development that — if properly nurtured — will pay dividends long into the future.
So what’s the real story? Has COVID-19 ushered in permanent changes to the care delivery process, or has 2020 been a year of temporary workarounds that will largely disappear once the pandemic has been contained?
While many people will continue to prefer in-person visits when possible, I think one of the biggest wins to come from the glut of COVID-induced changes over the last six-plus months is that providers — and the technology vendors they depend on — were forced to “meet patients where they are” to maintain continuity of care.
This radical patient-centric focus caused many in healthcare to ask some provocative questions. Does every visit need to be in person? Can we facilitate provider-to-patient communication from a distance without asking patients to download yet another patient portal app? How can these more convenient workflows be incorporated into a post-COVID environment?
By Dr. Deborah Vinton, medical director, emergency department, UVA Health and Inlightened Expert.
The way we talk, think about, plan, and innovate for healthcare delivery has fundamentally changed as a result of COVID-19. For those of us in healthcare, top priorities today are different than they were just a few months ago. Like in so many areas of life, coronavirus is rewriting the status quo.
As a physician on the frontlines, it has become painfully apparent that, as an industry, we have failed to design and develop tools and systems – for us – with us in mind. When it comes to innovating for those delivering the care, empathy is often times out of the process. From PPE (personal protective equipment) to telemedicine and everything in between, the lack of input and understanding may be furthering burnout, negatively impacting patient care, and fueling inefficiencies.
Empathy in innovation: We’ve made progress for patients
In healthcare, we’ve done a better (although not remotely perfect) job of integrating empathy into the design and innovation process for the patient to optimize patient experience. From lobbies to hospital rooms, we’ve seen patient-centric design aimed at delivering more comfortable, less stressful, and seamless experiences.
Patients today enter buildings that are light and airy, no longer have the traditional “sterile” feeling, boast extensive entertainment options, and prioritize patient needs, like access to Wi-Fi and charging stations. Protocols are designed by considering various risks, and prioritizing policies and workflows that will most positively impact the patient. All of these efforts demonstrate a much-needed understanding of – and commitment to – the patient and their experience.
Physicians are left behind and burned out
Like other industries, the evolution of healthcare has been aided by fast-paced innovation and technology. While conversations pre-COVID might have been around electronic health records (EHRs), real-time communication tools, and even innovating the scrubs we wear, COVID-19 has shed light on new priorities and the dramatic gaps that exist in the process for designing provider-centric tools.
According to McKinsey: From 2014 to 2018, there have been more than 580 healthcare technology deals in the United States, each more than $10 million, for a total of more than $83 billion in value. They have been disproportionately focused on three main categories: patient engagement, data and analytics, and new care models.
Consider the quick adoption of telehealth. While the ability to deliver care virtually to the patient was – and still is – unquestionably critical as the country sheltered in place, it has led to a lot of frustration and overwhelm for physicians who are trained to deliver patient care in-person. In medical school, we learn how to read what’s behind the presentation of symptoms and how to ask questions and listen to what’s behind the answer.
But we haven’t yet integrated into the curriculum how to implement technology to feel consistent with the way we’ve been trained to deliver care. We are being asked to understand – and flawlessly use – solutions that can be glitchy, disjointed, and impersonal, while simultaneously delivering care to patients that might be nervous, frustrated, ill, scared, or all of the above.
By Mike Pietig, vice president of healthcare experience, Avtex.
Communication is core to delivering exceptional patient experiences every day. In the midst of the COVID-19 crisis, and as patients and their providers slowly move forward, communication is as critical as ever.
Now is the time for providers to review how they’ve traditionally communicated with patients and what adjustments can be made to improve communications in the future. The deferring and cancelation of elective services has resulted in millions of lost revenue, putting even tighter constraints on marketing budgets, so a communications review is imperative.
An alarming 81% of consumers are unsatisfied with their healthcare experience, according to recent research by Prophet. When providers enhance communication as part of the patient experience (PX), the outcomes include improved patent retention, new patient acquisition, increased utilization of health system services, and more.
Well-planned and personalized communication ranks highest in importance in the patient experience, by the patients themselves. More effective communication increases patient engagement opportunities, reduces the volume of incoming calls that the organization is receiving (which helps staff focus on the highest priority items and the most critical patients), and lowers the cost to serve patients and maximize resource utilization, which is especially important now, given COVID has put intense strain on providers’ resources and finances.
To survive and thrive in the new norm, it’s time for providers to modernize their communications approach.
Learn the patients’ communication channel of choice.
Historically in healthcare, outreach has been focused on billboards, direct mail and tv/radio ads as the main communication channels in between face-to-face visits. These marketing blasts are nearly impossible to track for return on investment and do nothing for patient retention. Patients live in a digital world and expect digital outreach.
Going to a hospital or other healthcare practice has always been a stressful process for patients. To ensure that their patients are comfortable, healthcare providers need to make sure they are improving the customer experience as much as they can.
In recent years, healthcare providers have been able to improve the patient experience using technology. Today, there are a number of ways in particular that healthcare service providers are improving the patient experience through comfort and convenience.
One of the fastest-growing trends in the healthcare industry has been the continued development and expansion of telehealth and telemedicine. Going to the doctor for a checkup can be a time-consuming process for all people involved.
Because of the amount of time spent sitting in public waiting rooms and signing forms, it also could lead to the spread of germs. With telehealth, you can receive a full checkup from your physician at home. They can also help to address questions that you have, which improves communication. This technology could drastically reduce the number of people that need to go to a physician’s office.
By Rob Wiley, head of marketing and product strategy, Formstack.
If you’re in healthcare, it’s likely because you have a passion for helping others and solving problems. Those on the IT side of the industry are no exception. Healthcare IT has seen a significant shift from navigating health records in a paper-based system to the digitization of health data—and for good reason.
There are many benefits to digital transformation in the health industry. For one, administrative costs alone in healthcare account for nearly $266 billion per year. By transferring records like medical forms and insurance verification paperwork to a secure electronic platform, healthcare providers can save on administrative spending and put those funds into more impactful areas. Additionally, the digitization of health data streamlines communication between all levels of the healthcare process: from physicians to patients and insurance companies.
But the digitization of health data also comes with challenges that healthcare IT professionals must solve—most notably around the implications of Health Insurance Portability and Accountability Act (HIPAA) compliance, patient engagement and employee empowerment.
Rules and regulations in healthcare are ever-changing, and health providers and practices are expected to stay up-to-date and comply. Ensuring your company maintains compliance and data stays secure begins with your healthcare IT team. Not only does compliance protect your company from stiff penalties and violations, it also safeguards the protected health information (PHI) of customers and partners.
Consider this: A patient is asked to share interest in an elective surgery and decides to opt out. If this document confirming their disinterest in the surgery is stored insecurely using a paper file, this puts the patient’s trust at risk of being breached, and in turn, the decision to opt out of the procedure at risk of being dishonored. Meanwhile, storing this information in a secure, electronic file would reduce the risk associated with data breaches and the file being lost or misread. With a strong IT team following HIPAA guidelines, your practice can stay safe from violations and accidental exposure of sensitive records in the digital world of healthcare.
The digital transformation of healthcare doesn’t just impact the backend of business; it also affects patient experience and how practices are represented to future customers and partners. Healthcare IT professionals have to consider how digitization impacts the user experience and the ease of electronic communication between patient and practitioner. Here are seven important questions healthcare IT teams should ask themselves when evaluating their current digital network and any future improvements:
What systems are patients interacting with when preparing for or during the visit?
How easy is it for patients to provide information to their health provider?
How long does it take for the patient to fill out the intake documentation?
Are patients required to enter duplicate information anywhere?
Is the process convenient for the patient? Are they able to complete the information when and where they would like?
Is there an option to sign electronically and securely?
Does the patient receive copies of their documents for their own record keeping?
Healthcare IT professionals should consider the answers to these questions to determine the top changes they need to make to their digital system in order to improve patient experience and, ultimately, increase the number of patients they serve.
It is encouraging to see many healthcare systems and payors focusing on the impact of social determinants of health (SDoH) and looking for ways to partner with community-based organizations to address and improve these issues locally. Although this is a necessary step, I believe that providing access or referrals to community organizations is not the full answer.
While healthcare systems can provide referrals and connect patients to resources such as food banks or employment resources, it may not be enough to create individual engagement and empowerment to use those resources. We more fully need to appreciate the role played by the environment in which we grow up and the choices available to us in shaping how we respond toSDoH factors as individuals.
As part of an innovation center where we align data science withSDoH to help systematically disadvantaged individuals, I’ve been witness to projects and research that point to the theory of individual resiliency as part of the equation. The American Psychological Association defines individual-level resilience as the process of adapting well in the face of adversity, trauma, tragedy or threats.
A review of the research on resilience by the WHO found that an individual’s ability to successfully cope in the face of significant adversity develops and changes over time, and that interventions to strengthen resilience are more effective when supported by environments that promote and protect population health and well-being. Further, supportive environments are essential for people to increase control over the determinants of their health.
Also, in addition to traditional resilience methods, the emergence of methods to assess an individual’s capacity for self-care are adding significant insights into personal determinants of health. In particular, the needs of the growing population of complex patients with multiple chronic conditions calls for a different approach to care.
Clinical teams need to acknowledge, respect and support the work that patients do and the capacity they mobilize to enact this work, and to adapt and self-manage. Further, clinical teams need to ensure that social and community workers and public health policy advocates are part of the proposed solution. Researchers at the Mayo Knowledge and Evaluation Research (KER) Unit and the Minimally Disruptive Medicine (MDM) program led by Dr. Kasey Boehmer are developing qualitative methods and measures of capacity and individual’s ability for self-care.
Take post-traumatic stress disorder (PTSD), as an example. It has been estimated that around 50-60 percent of people in the US will experience severe trauma at some time in their lives. Around one in 10 goes on to develop PTSD, which is permanent in a third of cases.
But some people who have lived through major traumatic events display an astonishing capacity to recover. A complex set of factors can be attributed increasing an individual’s resiliency to trauma including their personality, their individual biology, childhood experiences and parental responses, their economic and social environment as shaped by public policy, and support from family and friends.
With the new year, healthcare c-suite members are taking a critical look at upcoming market movement to maintain a holistic view of their organizations’ needs. Discussing industry trends at the recent College of Healthcare Information Management Executives (CHIME) CIO Forum, Anna Pannier, senior director of Ascension Technologies at Ascension Saint Thomas, noted the significant change taking place in the value-based care and wellness marketplace as a top concern for healthcare organizations.
As healthcare leaders, like Pannier, look to stabilize their IT strategies and drive meaningful patient outcomes and operational efficiency, they should assess these five c-suite hot-button topics in the next year.
The shift in data analytics
As a more mainstream solution in the healthcare industry, data analytics is not considered the big “game changer” any longer, but it is still a significant investment focus for providers over the next year. Many healthcare facilities assume that once an analytics platform is implemented, they are ahead of the game. Unfortunately though, those same organizations fail to customize dashboards, continuously assess data, or really break down data insights for meaningful change and care decisions. Driving quality outcomes through data analytics to prepare for the future of population health risk management will be a large focus in proactive facilities.
Artificial Intelligence (AI)
Artificial intelligence and machine learning in healthcare has now surpassed data analytics on the new investment frontier. The industry has already seen AI application in pathology and radiology in the past year. Eighty percent of healthcare professionals believe that AI is helping to reduce physician burnout, according to a MIT Technology Review survey. Respondent hospitals said AI has increased patient consult time, improved team collaboration and boosted productivity through workflow enhancements.
Similar to data analytics, the CIO will need to work with leadership groups in both the clinical and business sides to determine AI use cases across their evolving organizations. Thought typically applied to clinical care, applying automation and AI on the operations side will drive workload transformation across key business functions.
Greater emphasis on patient engagement
With most organizations having a fully implemented EHR, healthcare organizations are looking to make the most of their long-term investment. Added pressure from value-based care documentation and reimbursement initiatives, as well as increased consumer expectations, drive emphasis on patient engagement. Yet, meaningfully connecting and interacting with healthcare consumers in their patient care plans still lacks.
In fact, pointing to limited or complicated instructions for the everyday patient, a study in the Journal of General Internal Medicine found that hospitals are not properly preparing patients to take advantage of patient portals. More healthcare organizations are now seeking around-the-clock direct patient portal support, as an extension of their IT service desk’s capabilities. This coupled with remote virtual monitoring will drive improved patient outcomes in the next year.
By Erin Jospe, MD, chief medical officer and SVP of account management, Kyruus.
As clinicians, we pride ourselves on our ability to provide care that meets the clinical needs of our patients and to call upon our colleagues when their skills are needed. We advocate for our patients in word and deed, and we are committed to our common mission of caring for our fellow human beings with warmth, sympathy, and understanding as much as with scalpels and drugs. We took the Hippocratic Oath, and we execute upon it in a deeply personal way.
However, for something that is inherently so personal for many of us, it is shocking to learn that so many of our patients—60%, in fact—are prepared to switch to another provider. It feels like a betrayal, and we can’t help but feel hurt just a little if we continue to cling to the idea that healthcare should be more than merely transactional.
Healthcare consumer research shows that patients do continue to value the quality of their interactions and experiences with us, with 84% saying that our communication skills and approach are extremely or very important to them. Likewise, 88% of respondents hold our clinical expertise in the same regard. So why are so many looking for new providers?
The answer is access. Access in the form of a sooner appointment. Access in the form of online scheduling. Access in the form of a more convenient location, accurate insurance information, and insightful feedback from other patients like them. Access is what matters when it comes to where and with whom consumers choose to receive their care.
Being seen quickly is consistently one of the top priorities consumers cite when selecting a provider. Nearly 60% have searched for a provider who could see them sooner and 39% have actually switched to see a different clinician as a result. We can conclude from this that having alternative sites of care and delivery mechanisms that can accommodate this need for timeliness can, at a minimum, keep patients within our networks.
Because convenience is such a prominent driver in patient behavior, we need to embrace it by either creating space within our schedules – which is often nearly impossible – or integrating with other care modalities, such as through virtual visits and urgent care or retail clinics, when appropriate, to ensure our patients’ needs are met.
Each day in the U.S., about 10,000 seniors turn 65. By 2050, there will be 83.7 million seniors in the country, representing about one-fifth of its population. Even with the growing awareness of health and fitness, it’s a hard reality that about three-quarters of these older Americans live with multiple chronic health conditions, ranging from diabetes to dementia, meaning that ongoing care and monitoring is simply a fact of life.
The way we deliver senior care has been evolving, and more patients are seeking to “age in place,” which means that they opt to remain in their own homes for as long as possible while receiving any necessary medical care.
This desire to remain at home is driven by many factors including a desire for comfort, access to friends and family, familiarity and privacy. Not to mention the economic benefits – with the cost of nursing homes easily topping $70,000 a year.
Because of this, home healthcare services have been growing in popularity, despite the fact that patients who receive care at home are more likely to experience a higher 30-day readmission rate after leaving the hospital, compared to those in nursing homes. Still, the lower costs and comfort make home care an attractive option.
Your Doctor is Only as Good as the Information They Have
One challenge that home healthcare providers face is consistency in tracking and communicating information to the patient’s primary doctor. Not only information from care at home, but also information from clinics or hospital visits. This lack of insight into patient data can significantly increase the cost of care for patients because without access to the full history of the patient, unnecessary tests may be run, wasting both money and the doctor’s time. It is reported that a whopping $210 billion is spent annually on unnecessary medical care each year in America. Put in perspective, this is almost twice the U.S. 2019 federal education budget.
Further, there can be even more serious consequences to this lack of information and tracking. Without access to accurate patient records, medical errors are more likely because, for example, the patient may have an allergy unknown by the care provider. Medical errors are in fact the third leading cause of death in the U.S. Each year, approximately 250,000 patients in the U.S. die due to such errors.
To prevent these tragedies, an up-to-date, accurate patient file that is updated at each point of care is crucial. This can be most efficiently accomplished via electronic records that are patient-centric and follow a patient wherever they go to receive care, keeping specialists informed throughout an individual patient’s journey. This bridges the gap when a patient switches providers or sees a new physician because each professional has a patient’s detailed medical history, already available to them.
The HITECH Act and Where Electronic Health Records (EHR) Can Go Wrong
Despite the obvious benefits to the implementation of Electronic Health Records (EHR) – it alone is not the answer. The HITECH Act – or Health Information Technology for Economic and Clinical Health Act was signed into law by President Barack Obama in February of 2009. A key aspect of the Act was to promote and expand the adoption of health information technology, specifically, the use of EHRs by healthcare providers. Prior to this, only 10% of hospitals had adopted EHRs.
Unfortunately, after more than $36 billion was spent on the project, and most doctors have indeed moved to electronic health records – the solutions were implemented in such a way that they are not interoperable with one another. So while one hospital may have impeccable electronic patient records – there was no way to efficiently transfer that information to another care provider, blocking the effectiveness of the initiative.
Further, some of the independent EHR systems were difficult for doctors to use and could cause dangerous mistakes, such as recording a child’s weight by default in kilograms rather than pounds, leading to the prescription of incorrect doses of medication.
Although electronic health records (EHR) are firmly established in the medical landscape, ongoing progress necessitates that providers keep up with emerging trends. Here are five of them.
1. Combining Artificial Intelligence and Voice Recognition with EHR
Artificial intelligence (AI) has already shown promise for assisting doctors with making diagnoses or recognizing historical trends about a patient’s condition. However, several companies are investigating bringing AI to EHR via voice recognition capabilities.
At Vanderbilt University Medical Center, providers can query the tools by posing questions in natural language. For example, a physician could ask a voice-enabled EHR system for details about a patient’s last recorded iron levels from blood tests. The system would inform the doctor of those levels, plus tell them whether they’re in a healthy range.
Allscripts and Northwell Health also recently struck a deal for a platform that blends AI with EHR and collects data from clinicians. Using voice commands within patient care could be especially useful for providers who have their hands full.
2. An Increased Emphasis on Mitigating EHR Errors
When the ECRI Institute released its 2020 report containing the top 10 health technology errors to be aware of in the coming year, EHR issues were mentioned multiple times. The first instance related to providers potentially being overwhelmed with notifications from EHR platforms, ignoring some of them and perhaps overlooking a genuine issue with a patient as a result.
The report also brought up the risk of medical data not including information about implants in patients that are sent for medical imaging. The study recommended providing a single place to enter or check for the presence of implant data in an EHR. Finally, the ECRI Institute cautioned that EHR mistakes could happen when a medication administration order sent by an EHR platform does not match the dosage time the provider intended.
This coverage of such mistakes will likely cause health care facilities to assess their systems and see if the issues exist there. If so, they’ll look for ways to reduce those problems.