David Chou: Healthcare Needs to be Like Amazon

Feb. 2, 2015
David Chou, CIO at the University of Mississippi Medical Center, talks about the natural challenges and struggles that is patient engagement. He says healthcare needs to be more retail-oriented, and focus on serving end users like Amazon does with its customers.
The requirements surrounding patient engagement for Stage 2 of meaningful use are controversial, to say the least. Many say that getting five percent of patients to view, download, and transmit their data electronically is downright impossible 
David Chou, CIO at the University of Mississippi Medical Center, won’t say that. He does acknowledge, however, that those requirements are difficult, especially thanks to the cultural barriers he faces in his region of the country. UMMC is an academic medical center, the only one in Mississippi, but getting Southerners engaged with their healthcare through electronic communication is swimming against the tide, he says. 
Chou will be speak on this and other patient engagement topics at the Institute for Health Technology Transformation’s (iHT2) Miami event on Feb. 10-11 (iHT2 is a sister organization of Healthcare Informatics). He will be joined by Eloy Villasuso, M.D. an otolaryngologost at Cleveland Clinic;  Alice Noblin, Ph.D the HIM Program Director at the University of Central Florida;  Hans Anderson, the Director of Healthcare Practice at Synechron; and Chris Ingersoll, Vice President of Clinical Architecture at RelayHealth on the panel, “Patient Engagement: Maximizing the Patient/Consumer Experience.”  
Chou recently previewed some of the talking points in a Q&A with Healthcare Informatics Senior Editor Gabriel Perna. Below are excerpts from that interview.
What kinds of patient engagement initiatives have you undertaken at UMMC?
Like everyone else, we do have patient portals, we have a big telemedicine program in terms of patient engagement, we have a self check-in kiosk. What we're missing, healthcare in general, is that retail mentality. Like you’ve got Amazon and they have analytics on exactly what your behavior is and your patterns. That’s what healthcare should aim to be. We need to project what issues each patient is going to have. We’re a lot further away from other verticals. That's where the target should be. This whole discussion around population health management is going to revolve around the patient.
What kinds of challenges have you had with patient portals? 
The biggest challenge is geographically where we’re located. I’m in the southern part of the U.S. Technology adoption is not like it is in the west coast. The cultural barriers are the biggest hurdle. If you’re in a geographical area that's traditional, they prefer to have a doctor call them or have a face-to-face conversation. That's tough. That’s the biggest barrier. That’s what we’re facing in Mississippi, getting the community more engaged and accustomed to using technology. It's not something they're used to doing, it’s not part of their everyday lifestyle. And that’s just the patient perspective, even the medical center’s side, the doctors/medical staff have to be available and respond. I think those two cultural barriers are the biggest difficulties in getting true patient engagement. 
Are you finding the requirements for Stage 2 of meaningful use regarding patient engagement doable
They're doable. For us, we're the only academic medical center and the largest employer in Mississippi.  Being the only level one trauma center and the only children’s hospital, it’s doable because we have the demographic. We are working with the state health exchange as well. But in terms of taking it to next level and getting that true patient portal experience, I think we're a bit behind.  I came from Cleveland Clinic, and I know how they're managing two-way communication with doctors. That’s something we have not churned out yet. 
What do providers have to know to get better portal engagement?
I think it's not what they need to know, it’s changing their behavior and how they practice medicine. They do get called for emergencies, but when that [engagement] floodgate opens you know the patient is going to [contact] the doctor anytime they have concerns. It won’t have to be urgent. So it’s a behavior change more than anything. Most of the physicians they know how to use technology. Everyone has text messaging. Everyone knows how to use two-way communications applications. It's not that they don’t know what they're doing, it’s just not on a professional manner. Some are…but most aren’t. 
Let's switch to patient-generated data, what is your take on this trend? Can this data be useful for doctors?
I think it is useful. There are two things that will happen. You might get data that might not be relevant but I think it will be useful though. You can get doctors data anytime, any place. It can give them something they can use to make a decision on. The challenge will be too much information and a lack of integration. Once we have some sort of integration, it will be valuable because it will provide the doctor more information. It also benefits the patient, it allows them to have data about their personal lives. By having that information, it creates that competitive spirit and will improve their health outcomes. That’s where I see the benefit to wearables. 
What areas should providers looking to utilize this data focus on?
I would say, the easiest thing is obesity and diabetes. That’s probably the number one prevailing thing throughout the U.S. That’s where you can get a big bang for the buck. That would be a great start. 
Getting that back to the Amazon attitude, why do you think healthcare lacks that element of understanding the user, in this case the patient?
Traditionally, healthcare was similar to the airline industry, where their goal for providers was to  keep the beds full. Now, with the new regulatory requirements, the goal is to keep patients from coming. I think that shifted. Also, consumers are getting smarter. People’s lifestyles are changing now vs. ten years ago. People want things now and they want things to be convenient. In healthcare, that has never been a priority. It’s always been, if you’re sick you have no other choices. Now we have avenues that are beginning to destruct that traditional mentality. 
What are you excited about to discuss at iHT2 Miami? 
I would like see what some of the other folks are doing. I know my former employer will be there. I’m hoping to learn more on what they've done since I’ve left there. More so, I want see what others are doing. I think vendors talking about their providing patient engagement from that perspective would be great.

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