Convincing patients to make their care personal

April 26, 2014

Several healthcare IT executives gave HMT nearly 40 best-practice strategies for healthcare organizations to inspire, motivate and reinforce personal care behaviors.

  • Executives should invest equivalent level of resources – if not more – in managing the “process” side of deploying IT systems. Too frequently, the process questions are left on the sidelines while investment funds are allocated toward technology and devices.

  • Never underestimate the need for focusing on the cultural elements of the changes that will evolve in healthcare as a result of a focus on personal care strategies and population health.

  • Teams that include technical, clinical, administrative, operational and financial expertise are much stronger at systems deployment than purely IT-oriented approaches.

  • IT executives should demand the use of interoperable or open source systems for connectivity.

  • Always remember that the person is the center of the system – especially in the new world of ultra-connectivity and consumerism.

– Kevin Fickenscher, M.D., Chief Medical Officer and President, Healthcare Division, AMC Health

  • Design for the patient, not for the physician or hospital.

  • Design for mobile devices so that the patient can track their information, receive alerts and find resources on the go.

  • Make the technology “disappear.” The patient shouldn’t know what vendor their healthcare practitioner has chosen, nor should the technology interfere with the doctor-patient relationship.

  • Put the information in context for the patient by writing at the 6th grade level of comprehension and making the information available in their language.

  • Make it easier to change behavior by setting achievable goals and making it simple to record information.

– Joanne Rohde, CEO, Axial Exchange

  • Create a small number of key personal objectives, define measurable outcomes that help one monitor progress and celebrate incremental wins that reinforce patient, consumer, and member behaviors.

  • Provide HIT-enabled technologies, navigators and coaches to help achieve the personal objectives.

  • Use simple messages to educate patients, consumers and members.

  • Adopt a behavioral change framework that can be easily understood, embraced and followed by the patient, consumer, member and their families.

  • Persevere. One of my favorite quotes from an unknown author is “On particularly tough days when I’m sure I cannot endure, I remind myself that my track record for getting through bad days so far is 100 percent and that’s pretty good.”

– David Muntz, CIO, GetWellNetwork

  • Remember, at the end of the day it’s all about the patient. It’s easy to forget that all of this technical and complex work is to improve the patient healthcare experience. Don’t.

  • Embrace standards and interoperability. When you work with this enormous amount of complexity, it’s tempting to create a new standard instead of working to improve and adapt the current ones. Don’t do that either.

  • Don’t assume you know what’s best, listen. The best way to learn how to improve and innovate a technology is to listen to the users. This doesn’t necessarily mean asking what they want; it’s being sensitive to what they love and what they don’t and learning to hear the truths hidden in plain sight.

  • Just because it didn’t work last time, doesn’t mean it won’t this time. Health IT has been around a while and so it is common to hear many, many people tell you “how things work” and “people have tried that and failed.” Just because people haven’t figured it out, doesn’t mean you can’t. The key is constantly innovating and testing your assumptions and hypotheses.

  • Free the data. Patients have the right to have complete access to their health data. Now is the time for all of us as patients to exercise that right, learn more about ourselves and take command of our health. The good news is that there is now a community of people working tirelessly out there to make it possible together.

– Chris Bradley, CEO and Co-Founder of Mana Health

  • Decide on the right technology that fits across multiple entities in the community and the incumbent EMRs.

  • Have a plan to educate patients on your patient engagement/portal tools. Don’t neglect workflow planning and personnel training. Your registration staff may be the key to help patients sign up and explain the benefits. Examples are: Including sign-up instructions in the discharge planning process at ED discharge and providing instructions upon check out at PCP offices. Consider advertising as a means to educate patients about the benefits of healthcare IT and how they can interact with it, such as print, TV, Website, email, signs in hospital/practice facilities. Offer a class in healthcare IT/patient engagement tools to patients. My car dealer offers a technology class on the navigation system in the car, to which I got invited via email and snail mail; Apple stores offer any number of basic technical classes – why not the hospital too?

  • Hard as it may be, try to think beyond Meaningful Use. Many are pressured into installing patient engagement technology hastily to meet MU deadlines, but try to make a careful, measured decision that will work across the community and be good in the long term where the benefits extend far beyond an MU payout.

– Suzanne Cogan, Vice President, Sales and Client Relationships, Orion Health

In any health IT project, there a several key elements that we all recognize are likely to lead to success. Typically these include:

  • Well-publicized senior-level executive support, applications that are easy to use, applications that meet a genuine need and solve a problem for the end user, concerns like privacy and security of information are carefully and reliably addressed, training and support are easily accessible.

Translating this to the world of personal healthcare strategies, this means:

  • High-level support for the initiative means the organizations most visible senior leaders are publicly seen to support the initiative.

  • Ease of use means that the application is patient friendly, uses appropriate language, preferably adapts to the users’ education and knowledge levels.

  • Solves a problem for the patient means things like [I] can easily communicate with my provider, gives me the information I need to better manage my health, etc.

  • Privacy and security, along with consent, for example, see PCEHR project in Australia [].

  • Patients need to be able to access training and support material and technical support resources.

– Chris Hobson, Chief Medical Officer, Orion Health

  • Attempt to capture the patient with multiple devices on-site and off, this means employing kiosks, mobile and Web solutions. Don’t rely on a single device or medium.

  • Focus on technology that does not just meet MU requirements but makes the current patient healthcare experience easier. Does the technology: reduce no-show rates; reduce wait times; enhance data-accuracy? Look for the basic building blocks.

  • Pick a vendor that can implement the integrations but understand usability outweighs integrations. Capable vendors can integrate with most or all HIS in some fashion even without the cooperation of other HIS vendors. EHR-branded solutions rarely provide the functionality to increase patient engagement hence the concern with 5 percent adoption rates.

  • Adoption rates are not just driven by the technology. Work with your vendor to create a strategy and a plan to drive adoption. The average patient has most likely not encountered portals before. Patients need to be introduced to new technology in order to discover the value in them.

  • Understand that different strategies work in different care settings. Look for solutions that allow optimization and configuration not only to your organization as a whole, but also down to the clinic level within your organization. This will help address the particular needs of each facility and workflow.

– Ben Bau, Vice President and General Manager, Patient Self-Service Solutions, Vecna

  • One is to be sure physicians can reach patients via the kinds of methods and devices patients have.

  • Another is to be sure messages being given to patients are consistent across providers and the community.

– Jeffrey Rose, M.D., CMIO, TriZetto Corporation

  • It is not just about the patient and physician. The technology must extend to care givers and the extended family. Many times, you have the patient and you have their circle who also talks with the physician and wants to stay apprised of the care plan. That technology must extend that social circle out to that extended care group from an engagement standpoint.

– Mason Beard, Senior Vice President, Solutions, Wellcentive

  • I would refer to our discussion about data quality being king.

  • Also having the information that is presented to a patient should be as specific to that patient as possible. Whether the patient is diabetic or has a certain health insurance plan, the physician should know the patient and know what is important to that patient. Those things are critical.

  • Another is having intuitive software and having technology that the patients use not be another silo of data. It has interoperability and be a team coordination of care tool and point of interaction

  • Rewards are fundamental. I like to say that patient engagement is the final frontier because currently the incentives for patients to truly be responsible for their part of their healthcare aren’t really there. The industry is appropriately first tackling the physician engagement part of the equation with reimbursement reform, such as accountable care. But until patients themselves have their own dollars and cents at risk, they will continue to not do their part. Rewards are critical for motivating patients.

– Paul D. Taylor, M.D., CMIO, Wellcentive

  • Free the information. Ensure patients have universal access to their health record. Ensure that patients can use their own data to augment this record. This includes breaking down silos, liberating health data, documents and images from departments and service lines that do not publish to the health record today.

  • Let patients liberate their data from your organization so that they can share it with their care network.

  • Build/buy a patient communication platform. Ensure that patients have a constant method to communicate with your organization. This includes the communication from their devices such as a step counter, home blood pressure monitor or other personal health applications/devices.

  • Build a social media strategy if you don’t have one already. Ensure your social media strategy allows patients to participate in the conversation. Use it to communicate best practice in personal care, and gather feedback on population health.

  • Build and constantly maintain a care library that is patient facing. Include visuals, videos, images and diagrams that help a patient better inform themselves on their role and importance in the care process. Make it as interactive as possible. Build it into an app if you are really inclined to inform.

– Paul Lipton, Senior Market Segment Manager, Imaging Clinical Information System (ICIS), Agfa HealthCare

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