Can Your Engagement Efforts Weather the Changing Healthcare Landscape?
The consumer healthcare landscape is undergoing sweeping changes, from the development of patient portals to the advent of mHealth. Part of the groundswell of that transformation is a renewed focus on patient engagement efforts.
We know that engaged health consumers cost less to treat. They are active in their own health management. They consult closely with their providers. Because they listen to their doctors, they often opt first for less expensive treatments and comply more fully with treatment regimens. And thus they tend to have better outcomes and fewer readmissions.
They're also far less likely to delay seeking treatment. Disengaged patient consumers have been found to be three times more likely to have untreated medical needs. That means they arrive at wards sicker from the start — providers have to do more per encounter to stabilize them and heal them. That's costly enough; more costly if they thereafter remain disengaged and don't follow through on the regimen.
Engaged patients keep systems running smoothly. The more engaged your healthcare consumer populations, the better our patient flows on the wards. The lower your readmission rates, the better your reimbursement rates and lesser the Medicare penalties you face.
But with all the change in the healthcare environment comes much uncertainty:
Will the Affordable Care Act be repealed, or heavily modified, following the 2016 election, or will its tenets be strengthened? How will the authority to advance the reform of the healthcare system ultimately be divided between — and accomplished by — the federal government and the states?
Are we ultimately headed toward a single-payer system? If we are, does that mean a move away from healthcare consumerism, or just a realignment of the marketplace?
Given the increasing polarization in American politics, it would be risky to commit to strong predictions at this point. So how do hospitals and healthcare systems plan in the meantime? How can an organization maintain or innovate its patient engagement strategies in uncertain circumstances?
Just what is patient engagement? It may be different things to different leaders.
72 percent of respondents to a leadership survey at the Healthcare Information and Management Systems Society’s (HIMSS) 2015 conference indicated that they believe patient engagement is one of the most pressing issues their organizations will continue to deal with over the next few years. But how are those organizations dealing with it? What is it?
Some leaders, argued Michelle Ronan Noteboom, writing for Healthcare IT News, conflate healthcare tech solutions with patient engagement itself:
"I realize that IT departments can do only so much to encourage patient engagement, but I wonder how many leaders view portals and websites not only as a 'strategy' for engaging patients, but as the actual solution," she wrote. "Just because an organization has the technology to support the viewing/downloading/transmitting of a chart note doesn't mean the patient is participating in his own health and wellness.
"My view is that patient portals are the plumbing in the patient engagement process. Clinical data is the water that flows through the plumbing. If I am thirsty, the presence of plumbing is not enough to quench my thirst — I still need a continuous flow of water. It's also helpful to have a good plumber around to provide professional guidance, when needed."
To fit her analogy, a proper patient engagement strategy would be supported by four pillars: build the plumbing (the tech structure), turn on the water (give patient consumers ready access to their data), continuously remind consumers of their thirst (marketing and communications) and read the meter (track usage and extrapolate actionable trend data).
But there's an implied fifth tenet: be prepared to adjust any of your approaches to any of the first four, at any time, depending on what the data tell you. Patient engagement efforts are, at their bases, efforts to improve efficiency. If you are only collecting data, but not adjusting your strategy to optimize your patients' self-management and compliance, engagement is meaningless.
PatientBond is an example of an innovative platform that allows healthcare organizations achieve all four pillars and the fifth tenet. It enables automated healthcare consumer outreach with a cloud-based system that integrates seamlessly with any EMR/EHR. PatientBond can interact with healthcare consumers through multiple devices (e.g., smart phones, regular cell phones, laptops, desktops, ipads, etc.) through texts/SMS, voice calls, emails, and apps, with response mechanisms for patient participation and data collection. PatientBond also customizes messaging according to a healthcare consumer’s psychographic segment to maximize effectiveness, and continuously adjusts communications mix based on results.
PatientBond will be showcasing its innovation at the 2016 HIMSS Conference & Exhibition (Healthcare Information and Management Systems Society) in booth 4674 at the Sands Expo and Convention Center in Las Vegas, Nev. from Feb. 29 – March 4, 2016. Nearly 50,000 healthcare industry professionals are expected at the conference, where they will learn about and discuss health IT issues, and on the exhibit floor, view innovative solutions designed to transform healthcare.
How can healthcare providers adapt patient engagement strategies to fit the consumer?
That takes understanding of patient consumers as individuals. Effective engagement must rely upon stratified communications — the healthcare consumer population is a whole landscape of segments, each motivated by different words, different channels or different means.
Psychographic segmentation groups patient consumers according to shared values and motivations, allowing a healthcare organization to engage them with communications that resonate according to their personalities. Some patients are proactive, wellness-oriented healthcare consumers, while other are more reactive or disengaged from health and wellness. Two psychographic segments may behave similarly, but their reasons for doing so differ. A “one size fits all” approach to patient engagement will be limited in its effectiveness.
It ultimately must also rely on true interoperability. The question right now: will Meaningful Use bear fruit, or will the unstable political environment vis-à-vis healthcare reform undermine it? How could hospitals and healthcare systems continue to work toward achieving true interoperability without the benefit of a unifying governmental framework?
Moreover, how can the healthcare industry effectively shift to a value-based payment model if so many providers still lack much of the IT infrastructure needed to support outcome improvement? Luckily, for most providers, we're still at an early stage in the process.
A recent study by Numerof & Assoiciates found that while the majority of US providers have entered into at least one value-based payment arrangement with a payer, over half of them reported that value-based payments account for less than 20 percent of their revenue streams. Many organizations are still running pilots and other small-scale, proof of concept programs.
That doesn't mean that there isn't a sense of urgency for more widespread adoption of value-based and other alternative reimbursement models; it's just that the industry as a whole seems to be moving slowly. There's still time to develop your organization's unified patient engagement strategy and put supporting IT and data management structures in place.
A primary barrier? Organizational culture.
Although some patient-consumers are self-motivating and self-managing, many others by nature aren't — they look to their providers to set the tone for the care relationship. Ultimately, those are the healthcare consumers your marketing and communication efforts can help toward healthier living.
Engagement is thus dependent not only on buy-in from otherwise unmotivated healthcare consumers, but from their doctors and other providing staff. Without it, hospitals' patient engagement efforts amount to good intentions with no substance.
Healthcare organizations must build an internal culture that places an emphasis on the development of close provider-patient relationships. Individual doctors must foster trust and exude a caring, concerned demeanor. Clinical communications and marketing campaigns must be aligned to show patients that, not only is their wellbeing valued, their business is as well. These interactions must also speak the consumer-patient’s “language” – that is, use segment-specific messaging to motivate desired behaviors. Providers must look past the stigma of basing a patient relationship on money and recognize that the shift toward a delivery model based on healthcare consumerism demands an approach that encourages repeat business.
The new norm: doctor-initiated follow-up calls and other emotive marketing initiatives that demonstrate the value the organization places on the patient's choice of it as provider. That won't be an easy pill for some providers to swallow — many simply won't see the value. So it's up to leadership to impart that value to them.
It is also incumbent upon hospital leadership to develop service lines that play to healthcare consumers' expectations. Concierge medicine, personalized case management and social work, integrated follow-on treatments and other programs that place an emphasis on the individual consumer should become more commonplace.
The healthcare consumer landscape has been irrevocably reshaped. Whether or not the government will intervene further, or step back and let the market complete reforms on its own is immaterial.
What is important is that organizations continue to develop effective patient engagement strategies, support them with the appropriate IT infrastructure and work to promote a consumer-oriented provider culture.