The term “patient engagement” has emerged as this year’s buzz phrase much the same way “patient portals” were a couple years ago and even similar to “electronic health records” and “meaningful use” before that. Volumes of articles, case studies, white papers and educational sessions have been dedicated to the topic of patient engagement and even at this years’ annual HIMSS conference patient engagement as a topic discussed was the rule and not the exception. With every step through the maze of booths in Orlando it seemed as if the words – “patient engagement” — were whispered and shouted from every direction.
Patient engagement is now synonymous with health IT, yet the topic is proving to be one of healthcare’s stickiest wickets because no matter whom or how many people you ask there seems to be a different response or definition to the term and how it is achieved.
With all of this uncertainty and confusion about patient engagement, I set out to see if I could define the term by asking a number of health IT insiders what they thought “patient engagement” meant, or what it meant to them. Their insightful and educational responses are what follow.
MobileSmith is an online app development platform, enabling hospitals and health organizations to create custom, native apps, across iPhone, Android and iPad devices, without any coding required.
Elevator Pitch
We have a platform that allows a marketing department with no development experience to create custom, native mobile apps. With us, any hospital can enhance their patient engagement strategy, without coding, and without the cost of hiring developers.
Founders Story
The earliest foundations of the company that would become MobileSmith, were laid in 1993. Back then, the company, known as SmartOnline, sold software to assist small businesses. SmartOnline became one of the early pioneers of the SaaS (Software as a Service) model that we use today. The company worked to adapt to the constantly changing technology. In 2010, the company hired Bob Dieterle as senior VP and general manager. He advocated and orchestrated a complete overhaul of the company services, and focused the company, instead, on the budding industry of mobile applications. The company wanted to deliver organizations a means to quickly create and manage apps to connect to their consumers, without having to rely heavily on an IT department. Working to that end, the MobileSmith online platform was developed, and in July 2013, the overhaul was complete, as the company rebranded itself as MobileSmith Inc. and has since focused entirely on delivering quality and cost-effective mobile apps to organizations.
Market Opportunity and Strategy
There are several app development platforms out there, such as Appcelerator or Kony. These platforms still require a programmer or developer to write code for the apps. Our platform requires no coding whatsoever. A designer or marketer can easily come to us and use our platform to design, prototype, build and deploy an app. While we have clients from a variety of fields, healthcare providers have found our platform particularly useful. With healthcare IT departments swamped with EHR implementation and marketing desperately trying to enhance patient engagement options, our platform has been able to fill their needs without placing any further burden on their IT, and avoiding the higher labor cost of developers. As only 35 percent of healthcare providers offer mobile apps, according to the HIMSS Analytics Survey, there is a clear need in the healthcare industry for our platform, and several organizations have found us to be an excellent means of enhancing their patient engagement via mobile apps.
Guest post by Dane D. Hallberg, strategic advisor, M3 Information.
Hospital readmissions continue to be a major contributor to soaring healthcare costs and a drain on the U.S. economy. According to the Robert Wood Johnson Foundation, 4.4 million hospital readmissions account for $30 billion every year, while 20 percent of Medicare patients are expected to return to the hospital within 30 days of discharge. The Affordable Care Act of 2010 requires the U.S. Department of Health & Human Services to establish a readmission reduction program.
This program provides incentives for hospitals to implement strategies to reduce the number of costly and unnecessary hospital readmissions. Centers for Medicare and Medicaid Services (CMS) has created quality programs that reward healthcare providers and hospitals with incentive payments for using electronic health records (EHR) to promote improved care quality and better care coordination. The reasons for hospital readmissions include adverse drug effects (ADE), lack of a proper follow-up care, inability of patients to understand the importance of their medications and diagnoses, unidentified root causes, and misdiagnosis. Technology could play a vital role here by properly documenting, tracking, diagnosing, monitoring, and enabling better communication between patient and provider.
Adverse drug events constitute the majority of hospital readmissions. A cohort study, including a survey of patients and a chart review, at four adult primary care practices in Boston (two hospital-based and two community-based), involving a total of 1202 outpatients indicated that 27.6 percent of these ADEs were preventable, of which 38 percent were serious or fatal. Human error was the leading contributor to these ADEs, followed by patient adherence. Additionally, patients who screened positive for depression were three times as likely to be readmitted compared to others.
Our analysis indicates that 28 percent of adult hospital stays involved a mental health condition. A study of Medicaid beneficiaries in New York State determined that, among patients at high risk of rehospitalization, 69 percent had a history of mental illness and 54 percent had a history of both mental illness and alcohol and substance use. We know that a properly implemented mental health screening protocol can lead to effective diagnosis, and that proper management of these issues can positively impact the reduction of hospital readmissions.
Further studies show that most cases of readmissions for certain chronic conditions have an underlying mental health issue, which appears in patients who have not been previously diagnosed for a mental health condition (i.e., anxiety, bipolar disorder or depression). For example, anxiety and/or depression increases the risk of stroke and decreases post-stroke survival, and plays a key role in diabetes treatment as 33 percent of this patient population is found to be depressed and patients with bipolar disorder have reduced life spans. Other cases where depression affects the patient’s survival and treatment cost include hypertension, stable coronary disorder, ischemia, unstable angina, post myocardial infarction and congestive heart failure.
An important point to note: congestive heart failure is the major driver of hospital readmissions in the U.S., accounting for 24.7 percent of all readmissions. Another study concluded that patients with severe anxiety had a threefold risk of cardiac-related readmission, compared to those without anxiety.
On the first day of HIMSS 2014 in Orlando, I stepped into a bewildering echo chamber. “We’re doing population health,” repeated everyone, be they physicians at a hospital whose EHR system my company implemented, the IT directors of other hospitals looking to update their EHR system or competing EHR experts. Everyone was interested in buying it, and everyone was interested in selling it. On one particular walk of the floor a colleague quipped, “Will there be a prize for the one millionth person to say ‘population health?’”
Despite this obsessive buzz nobody seemed able to define what population health is. It’s the proverbial elephant described by touch rather than sight. Is it a concept of health or a study of the various factors that affect health? Is it a course of action for the treatment of the population in its entirety or individual patients only?
The Affordable Care Act, which cites population health as an essential component of its mandate, aims to expand access to the healthcare delivery system, improve the quality of care, enhance prevention, make healthcare providers responsible for outcomes, and promote disease prevention at the community level.
All of this is commendable, but, in the end, what is population health? What does it look like? Will we recognize it if we achieve it? A friend of mine on the payer side observes that vendors claim it’s everything and providers don’t know exactly what they want it to be. Put those together and the term becomes meaningless.
There are additional questions about population health that remain unanswered. Is it an outcome, as the ACA approach suggests, or is it a foundation built on big data, analytics, ACO tools, bundled payments, systems consolidations or something else? At every HIMSS booth, the answer to these questions was a resounding “Yes.”
Guest post by Darin VanderWell, Director of Product, DocuTAP.
Rumors about the next phase of the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program has prompted concern among healthcare providers. To truly understand meaningful use Stage 3 and its impact, it is important to differentiate between the rumors and the truth.
The final rule for meaningful use Stage 3 has yet to be published, so discussion on its effects are based on available drafts. Even those drafts are in question since the December 2013 announcement that Stage 3 would be delayed until 2017. One reason cited was to allow more time to research the impacts of Stage 2 before finalizing Stage 3. The delay will be particularly important for that research, since compared to Stage 1, 2011 Edition, there are so few Stage 2 vendors certified currently.
As for what is expected, the attention turns from data capture and access (Stage 1) and information exchange (Stage 2) to improved outcomes in Stage 3. One expected goal is to simplify and reduce the reporting requirements on those attesting. Some of that change can be achieved by consolidating the program’s current objectives, which I expect hospitals and providers will welcome, provided it truly reduces the reporting burden and does not coincide with other, new objectives and reporting requirements.
Stage 3’s goal of improving outcomes will be incredibly interesting – through November 2013, CMS had disbursed nearly $18 billion in incentive payments. Until now, the program’s success has been judged by the number of participants adopting certified EHRs. At some point during Stage 3 (or thereafter), we will know whether those payments have truly improved outcomes.
Tonic was founded by a collaboration of scientists, consumer marketing experts, user interface designers and software programmers to finally solve the crippling challenges of medical data collection, including poor response rates, low patient engagement, high cost and limited ability to personalize care based on a patient’s answers.
So we went out and built a medical data collection platform for clinicians, providers and researchers collecting and using patient information everywhere.
Elevator Pitch
Tonic Health is the world’s best patient data collection platform: fully customizable, super fun and friendly, and accessible anywhere, it solves all the major data collection headaches for hospitals and health systems everywhere.
Product/Service Description
Tonic is the world’s best patient data collection platform: we integrate extreme patient engagement, robust CRM capabilities and real-time predictive analytics to dramatically improve the process of gathering, analyzing and using patient data.
Used by 10 of the Top 15 largest health systems in America, Tonic provides a Disney-like experience to a wide range of data collection needs, including patient intake, patient screening and risk assessments, patient satisfaction, patient-reported outcomes, patient education and much more.
Founder’s Story
Prior to co-founding Tonic, I (Sterling Lanier) founded a company called Chatter (www.chatterinc.com), which is a leading market research firm that works primarily with Fortune 500 brands. During a pro-bono project I was doing for a breast cancer research program at UCSF, I realized the way that most healthcare professionals were collecting and analyzing data was woefully behind the best practices used in the corporate world. Engagement was pitiful, turnaround times were glacial and patient care was suffering.
So I teamed up with my co-founder Boris Glants (who is the technical brains behind our success) and we set out to flip the whole system on its head.
In a change of pace, and in the spirit of patient engagement, the following graphic from Primacy speaks to the importance, and the need to engage patients online to educate them and bring them to a practice’s door.
According to Primacy, an award-winning agency known for creating digital experiences with impact: “Investing money in your hospital’s website can drive traffic online and to your door.”
Primacy analyzed the traffic and paid search activity of five hospitals during 2012 to see if any patterns emerged. It turns out some did. Take a look at the infographic below to see which clicks matter the most.
In the new healthcare ecosystem that is increasingly migrating to cyberspace, who can healthcare consumers rely on? Who in the healthcare service supply chain will prevail? Who will be the next Amazon or Yelp? Chances are it will be the organization that can deliver and mediate a centralized consumer experience – connecting healthcare consumers not only with care and treatment options, but also with pharmacists, labs, therapists, clinics, wellness coaches and other resources along the care chain.
More today than ever before as the care conundrum continues, fewer and fewer crave office visits, hospital stays or trying to reach physicians by phone. When we’re well, we see no reason to visit a physician. When we’re sick we increasingly wait until we’re sicker. And when we’re somewhere in between, we avoid calling because we know we’ll be put on hold. If there were a better way to consume healthcare, most of us would likely take it.
Interestingly, within this conundrum lies an opportunity for the myriad of healthcare players – from payers and providers at one end of the supply chain to wellness tacticians, retailers and mobile tool providers at the other end – to create a sustainable dialogue with healthcare consumers.
In a change of pace, and in the spirit of patient engagement, the following