What Can Urban Health Care Learn from Rural Innovation?
Transforming health care requires hospitals to think outside the box; as a result, we’ve seen a surge of revolutionary innovation — from architecture to mHealth apps. One Colorado community is taking a novel approach to addressing a common cost-driver in health care: emergency services.
In the City of Centennial — a suburb of Denver with just under 110,000 residents — emergency services are making house calls, acting as an extension of the community’s health providers. While the experiment appears to be working well, bringing health care to an underserved community, the logistics of implementing a similar program in an urban center like New York City may seem insurmountable.
The answer may lie in consumer-driven health care — providers must tap into the right kind of consumer to drive demand for a similar urban EMS model.
Simple Solutions with Impressive Results
Sometimes thinking outside the box generates simple ideas that work — like the five-step checklist championed by Dr. Peter J. Pronovost, renowned intensive care specialist physician at Johns Hopkins Hospital — which led to a 44 percent decrease in central line-associated bloodstream infections in just four years. More recently, it’s Centennial, Colorado’s emergency response process that’s gaining attention, according to a joint story produced by NPR and Kaiser Health News.
Rick Lewis, chief of emergency medical services at South Metro Fire Rescue Authority teamed up with local ER doctor, Mark Prather, to come up with an alternative to the full on ambulance and fire truck response that is typical of a medical emergency call.
The alternative “mobile care unit” is a souped-up station wagon, loaded — not with a more powerful engine — but with medical supplies that allow care providers to treat certain ailments or minor injuries on scene rather than taking patients to the ER.
While a few stitches might have meant a trip to — and a lengthy wait in — a busy ER, the mobile care unit is equipped with a suture set. It also features a mini medical lab for running a blood chemistry or checking for strep throat. Another difference is that the response team is made up of an advance practice paramedic and a nurse practitioner who can prescribe basic medications.
According to one team member, this new approach represents “… that mid-level between the acute care you receive in an emergency department and what the paramedics can currently do.”
In addition to keeping non-emergency patients out of the ER, the cost for diagnosing and treating a patient in a house call is around $500 — about one-sixth of what an emergency room visit would cost.
The service takes advantage of Colorado’s EHR network, allowing dispatchers to check medical histories to determine whether the mobile care unit or an ambulance is the more appropriate response, and allowing the nurse or EMT to call up patient records during a visit. The only downfall? Insurance companies won’t pay for the service yet. But if it continues to demonstrate cost advantages, such innovation should be incentivized with appropriate reimbursement.
Making It Work on a Larger Scale
While offering the service in a city of millions seems daunting, hospitals could roll out similar programs for specific segments of consumers. To do so effectively, they need to understand which patients are most likely to benefit from, and seek, the service. This involves profiling communities and consumer populations for risk and disease incidence. This would also include profiling consumers to identify segments whose motivations and behaviors are consistent with this approach to care.
There are valuable services in the marketplace that provide “heat maps” of certain demographic characteristics and health condition propensity. What’s missing is a navigation device for healthcare organizations to identify clusters of current and prospective patients based on their personalities, attitudes and motivations (i.e., psychographics).
The psychographic segmentation model developed by c2b solutions is 91.1 percent predictive of which of five unique classifications consumers fit into based on their attitudes towards health and wellness, personal motivations and communication preferences.
Based on these insights, hospitals can drive awareness and market a “mobile care unit” solution similar to Centennial’s innovative program, scaled to fit a particular segment, making it more manageable than trying to create a one-size-fits all approach for 8 million potential patients.
The more targeted approach also helps hospitals build market share as they address demands for quality care and value in today’s cost-conscious, consumer-driven health care environment.
Aside from providing healthcare organizations a depth and breadth of psychographic insights, c2b solutions is also working with national data compilers to map its 5 psychographic segments to the zip code level across the U.S. More on this innovation will be covered in future articles, but it will be a capability that allows healthcare organizations to target communities (urban and rural) with services preferred by specific patient types based on their motivations and attitudes.