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Health Care IT Extends Its Reach to Patients Outside the Hospital

nurse-calling-patientAs health care providers get a handle on meaningful use of EHRs, they are beginning to explore the potential value of other health IT– particularly mobile health (mHealth) devices to help patients manage chronic conditions outside the hospital. And it’s not just providers that are pinning higher expectations on digital technologies.

With National HIV/AIDS and Aging Awareness Day falling on September 18, the AIDS Institute is looking to target adults over 50 living with HIV or at risk of HIV infection by distributing on-demand content to their mobile devices.

These strategies — designed to meet the individual needs of patients — represent the industry’s transition to more consumer-driven health care. They address the need to connect people with information and increase collaboration between patients, their loved ones, and health care providers. But are they reaching as many people as they could?

Keeping Patients Healthier At Home

From text messages sent to mobile phones to at-home monitoring equipment that capture patients’ vital signs, hospitals are testing innovative approaches to meet meaningful use objectives in terms of population health. Recently, H&HN magazine took a look at how hospitals are leveraging mHealth to manage care for patients with chronic diseases including diabetes, obesity and heart disease.

So far, the results are promising.

At the University of Chicago Medicine, a pilot program that uses automated text messaging for patients with diabetes saw average blood sugar readings lowered by 1 percent for average patients and nearly 2 percent for patients with poorly controlled diabetes. More importantly, only 5 percent of the patients required physician involvement, leading to lower health care costs.

How does the program work? Once a month, patients receive a text asking if a refill was needed. If the patient replies “yes,” an outreach health coach arranges for the refill, eliminating the need for the patient to call the doctor’s office. The patient also receives texts asking how often medication is being taken. If the patient isn’t taking the medication as prescribed, or if the patient fails to reply to the tests, an outreach health coach calls to check in with the patient.

Given the penalties hospitals face for preventable readmissions, the use of mHealth to keep track of patient health after discharge is growing in popularity.

Rockford Memorial in Illinois, for example, uses technology to follow congestive heart failure patients who are not eligible for visiting nurses under Medicare guidelines.

The program, which began as a six-month trial in November 2012, now uses 80 telehealth monitors to capture weight, blood pressure and pulse rate readings that are shared with the hospitals cardiology medical group. Nurse practitioners and cardiologists analyze results to determine if intervention is needed. The program has enjoyed dramatic success, reducing readmissions from 25 percent to 9 percent. 

Two Beacon Community programs in New Orleans and Detroit are also taking advantage of mobile platforms.

The txt4health campaigns, advertised across traditional and social media channels, encourage consumers to take a diabetes assessment and enroll in a program that sends four to seven messages a week based on risk levels. Alison Rein of AcademyHealth, which is conducting the programs, notes that the program is aimed at generating awareness of risk factors and the consequences of not managing the disease. Results are still being gathered, but the programs are two more steps in the right direction.

Six Tactics that Drive Success

Many of the successful initiatives share some common factors. H&HN highlighted five elements:

  1. Teaming up with community partners to share resources and reach the target audience
  2. Designing the initiatives’ outreach, enrollment and messaging to suit the individuals
  3. Leveraging traditional and non-traditional approaches to drive engagement
  4. Engaging health care providers to promote the use of mHealth among patients
  5. Identifying the critical benchmarks to measure from the start

But there’s one additional factor that can help organizations achieve optimal results:

  1. Using psychographic segmentation to understand individual patient motivations in order to hone messaging, identify preferred communication channels and influence behavior more effectively  

One-size-fits-all messaging has limited effectiveness — even when it goes out to a segment with a shared chronic condition such as diabetes — because do not all think alike or are motivated by the same things.

Your ability to understand individuals’ unique lifestyles, emotions, motivations and attitudes towards health care helps determine whether an initiative falls shorts or hits the mark. The c2b Classifier asks 12 questions to separate consumers into five psychographic segments with 91.1% predictability:

  1. Balance Seekers 
  2. Willful Endurers
  3. Priority Jugglers
  4. Self Achievers
  5. Direction Takers

Each segment is unique in its approach to health and wellness, and are influenced by different priorities and messaging. Based on these segments, hospitals can fine tune initiatives to maximize engagement across the entire targeted population. Willful Endurers or Direction Takers, for example, may benefit more from having an “outreach health coach” while Self Achievers need a less hands-on approach. This approach enables hospitals to take meaningful use to the next level without wasting resources.

c2b solutions is partnering with an IT company specializing in EHR and automated messaging (text, email, IVR/Interactive Voice Response, etc.) to integrate psychographic segmentation insights into patient outreach. This will allow us to address opportunities such as 30 day readmission, medication adherence, and case management, in a seamless way that minimizes disruption to hospital processes. In future articles, I will share the results of these efforts.

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

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