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Can ACOs Help Patients Help Themselves?

patient in foregroundThe intent behind Accountable Care Organizations (ACOs) is laudable, focusing on — and rewarding — medical outcomes and patient satisfaction.  However, when accountability seems to fall squarely on the shoulders of our healthcare professionals and medical institutions, while patients can choose whether they follow (or not) providers’ recommendations and healthy behaviors with all the safety nets in place, the risk is lopsided.

All the capital investment and quality reporting systems in the world won’t help ACOs drive desired outcomes if patients don’t uphold their end of the bargain. Exacerbating the issue is a shortage of doctors and increasing costs. With all that’s at stake, healthcare organizations are looking for ways to activate patients toward self-driven health behaviors.

Engaged vs. Unengaged Patients

In her Wall Street Journal article, “The Health-Care Industry Is Pushing Patients to Help Themselves,” Laura Landro points out that studies have shown that patients who are more engaged in their healthcare have lower costs and better outcomes. However, as the Center for Advancing Health has found after reviewing dozens of national surveys, in many cases patient activation is an uphill battle:

  • 50% of Medicare patients do not bring a list of questions to doctors’ appointments
  • 60% of adults do not tell healthcare professionals that they have drug allergies unless specifically asked
  • 30% of adults have never compared a medication received from a pharmacist against their doctor’s prescription (the National Patient Safety Foundation points out that engaged patients and families can help prevent mistakes and oversights, such as identifying incorrect drugs or doses, as well as medication side effects)
  • 61% of Americans do not maintain their own medical record (paper or electronic

Access to Medical Records as an Incentive

Theoretically, an informed patient will be more likely to be engaged and activated in her healthcare. 

Apple recently announced the launch of its new app, Health, which will show data from third-party devices and apps in one place, and share data with other apps and healthcare professionals through a platform called Healthkit.

The federal government is aggressively promoting patient access to medical records through various programs, including the Blue Button connector, which securely provides health records to patients online. As the Blue Button site asks:

“Do you want to feel more in control of your health and your personal health information? Do you have a health issue? Are you caring for an elderly parent? Are you changing doctors? Do you need to find the results of a medical test or a complete and current list of your medications? Blue Button may be able to help.”

Who wouldn’t want to answer “yes” to any of those questions under the appropriate circumstances? 

What patients say and what they do are definitely two different things.

Is Information and Education Enough?

Physicians are among the most educated people on Earth when it comes to health and healthcare, and what they don’t know can be accessed from their extensive resources. Armed with all this information and education, physicians must be the healthiest people alive, right?

Not so fast… a study by the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins University School of Medicine found that 53% of U.S. physicians were overweight or obese. While this is lower than the 64% national average, it certainly isn’t a resounding endorsement for the power of information and education as a standalone solution. 

Information and education are certainly necessary components of patient activation, but it’s not sufficient. Care must be personalized and address a patient’s individual motivations. In her article, Landro quoted Joseph Kyedar, director of the Center for Connected Health at Boston-based Partners Health Care System, Inc.:

"Personalization is a key factor in engaging patients in their health and keeping them motivated to maintain healthy behaviors… People who are disengaged in their health are the toughest group to manage and indeed account for a disproportionate share of health-care costs. Our eventual goal is to get their attention and then use our personalized messaging apps and tools to keep them engaged."

True 1:1 personalization can be challenging, though, in a system with intense patient through-put pressures. 

Patient Activation Through Psychographic Segmentation

Consumer segmentation involves grouping consumers according to similar characteristics for more efficient targeting and engagement.  Demographic (age, gender, etc.) and socioeconomic (income, education, etc.) segmentation are the easiest to implement. However, these approaches are limited in that they assume everyone with certain physical or situational characteristics think and act alike.

Psychographic segmentation focuses on consumers’ values, personalities, and lifestyles.  It helps answer WHY people do what they do, and harnesses motivations to trigger behavior change.  While 1:1 personalization is ideal, psychographic segmentation allows a healthcare organization to efficiently group patients according to shared motivations and tailor outreach accordingly.

c2b solutions has identified five distinct, healthcare psychographic segments and is working with healthcare organizations to implement patient activation programs across various health conditions.  Results from various efforts will be highlighted in upcoming articles, so stay tuned. 

In the meantime, supplementing patient activation efforts with consumer insights will help healthcare organizations realize the medical and satisfaction outcomes they seek.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change

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