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#HIMSS15: Reducing Readmissions with Post Discharge Text Messages

213022198-compressor Today I had the good luck to happen upon a #HIMSS15 session entitled “Improve Patient Engagement, Lower Readmissions with #mHealth.” I thought that was a bold statement to make on behalf of #mHealth. Since I’m a big sucker for a bold statement, I found myself drawn to the session like moth to flame.

The session was hosted by Richard Imbibe, CFO, and Dr. Thompson Boyd, MD at Hahnemann University Hospital in Philadelphia (approximately 300 staffed beds). Since Hahnemann was facing the same readmissions issues that all hospitals face, they wanted to experiment with the patient discharge processes with the goal of reducing readmissions. They faced a baseline readmissions rate of 26.7%, and they wanted to know what would happen if they messaged their patients post-discharge with reminders of post-discharge instructions. More specifically, they wanted to remind patients to attend their follow up appointments, which were a notable factor in whether or not a patient would be readmitted.

How the Study Worked

Hahnemann studied 368 heart failure patients because they were the “sickest of the sick”.   (more…)

Connected Health Top 10: #1 A Real Retail Strategy for Healthcare

Top-Ten-300x298In this post-reform era of high quality care at a low cost, the healthcare industry has been looking towards the retail industry for strategies used to engage consumers. Lessons learned include how to use the retail setting as a medium for providing care and how to engage consumers outside of the care setting using technology.

What is often neglected when assessing the tactics used by the retail industry is their core competency of using data insights to motivate and incentivize changes in consumer behavior. Connected Health solutions are, in and of themselves, streams of valuable information that can be mined and analyzed to achieve business objectives.

Health plans, and soon healthcare providers, are realizing that understanding consumer data is at the heart of driving loyalty as well as encouraging healthful and cost-conscious healthcare consumer decision making. The drive starting in 2015 will be to establish a single source of the truth on consumer data informed by external consumer data interactions both with an organization and outside of the organization through sources such as social listening and mHealth. These solutions are meant to enhance the consumer experience through the ability to generate insights to determine the next best action across channels. Objectives include: (more…)

3 Patient Engagement Trends to Watch at #HIMSS15

Every year, the week of the National HIMSS conference is marked as the most exhilarating an exhausting week of the year.  The exhaustion comes from all that walking.  In fact, in this year’s #HIMSS15 Mix Tape, my contribution was that ol’ “I would walk 500 miles” songs from the 90’s.

Top 3 Reasons I'm Looking Forward to My First HIMSSFortunately, the exhilaration keeps me coming back year after year.  What do I find the most exhilarating?  Seeing just how far we have come in discussions of patient engagement as the years have past.  It’s actually one of the ways I track the progress of this topic I am so very passionate about.  I remember my first HIMSS conference, back in 2011, where patient engagement was host to nary a conversation at the conference.  Then we were much more interested in HIE and Interoperability (we still are for good reason).  Many healthcare providers at the time didn’t even have a social media profile let alone the capabilities that we have today.  With that in mind, here are three things I expect will be big themes this year in the world of patient engagement:

1. Understanding and Using Patient Data

We recently hosted a webinar entitled “A Real Retail Strategy for Healthcare“.  The healthcare industry has  looked towards the retail industry over the past few years for  strategies used to engage consumers. Lessons learned include how to use the retail setting as a medium for providing care and how to engage consumers outside of the care setting using technology.  What is often neglected is the retail core competency of using data insights to motivate and incentivize changes in consumer behavior. Connected Health solutions are, in and of themselves, streams of valuable information that can be mined and analyzed to achieve business objectives.

As a result, I will be actively looking towards data centric solutions for patient engagement problems.  Stay tuned tomorrow when we discuss the #1 Connected Health trend of 2015 (which may or may not be related to patient data).  While I am at the conference I plan to attend the information session, “Proudly Accepting Patient-Generated Health Data”.

2.  Mobile & Telehealth Takes Routine Care Outside the Brick and Mortar

One of the biggest repositories of patient generated data are found in the device 91% of the U.S. population carries around with them 24/7.  That’s right, mobile.  This year at HIMSS I am interested in innovations that will collectively make up the patient #mHealth platform, what the future of adding mobile data to the patient record looks like, and how those interactions will be used to motivate and incentivize healthy behavior.  Here are some statistics to consider as you take your 500 mile laps around the conference center:

  • 59% said mHealth will change how information on health issues is found
  • 51% said mHealth will change how providers or services send general healthcare information
  • 49% said mHealth will change their overall health management
  • 48% said mHealth would change how they manage chronic conditions
  • 48% said mHealth would change how they communicate with providers
  • 52% said mHealth would make healthcare more convenient
  • 48% said mHealth will improve healthcare quality
  • 46% said mHealth will substantially reduce healthcare costs

Expect to see me at “Reducing the Cost of Healthcare Delivery via Virtual Care” and “Improved Patient Engagement, Lower Readmissions with mHealth”.  Both sessions take place on Tuesday

3. The Next Evolution of Social Media

Early on, I mentioned that healthcare provider Healthcare provider adoption of social media was low in 2011 and 2012.  The last couple of years, we have seen a tidal shift.  Adoption had become popular over the course of 2013 and 2014 as healthcare providers adopted social media with a focus of relaying population health messaging and converting unknown consumers into patients.  In fact, this year I will be speaking at HIMSS in the “How to Convert Unknown Consumer into Patients Using Social Media” roundtable.  Stop by Room S403 on Monday at 11:30 to participate.  We will be turning the room into a social community of its own in the form of a live tweet chat using the hashtag #hcsmIRL.

So what will I be looking for in social in the next two years?  There will be another evolution of social media in healthcare. This will include the migration of consumers from large “mothership” social media sites like Facebook into private social networks. We will also see social functionality beginning to make its way into the patient portal. Lastly, analytics will be much more important to social media with direct ties to CRM and BI.

Hope to See You at HIMSS to Discuss Patient Data, Mobile Health (& Patient Data), and Social Media (& Patient Data)!

You’ve read it right.  Even though the top three trends are patient data, mobile health, and social media…each one is very much tied to a central core.  Patient data is the #HIMSS15 patient engagement mothership.  Here’s to hoping that the #1 patient engagement trend in 2016 will be the Patient Centric Data Warehouse.

Connected Health Top 10: #2 Term “Consumer Engagement” Grows Old

Top-Ten-300x2982014 was a big year for consumer engagement.  However, the term “consumer engagement” has been bandied about the industry quite fervently for purposes more aligned to financial gains than true patient engagement. As a result, while the industry wants true consumer engagement more than ever, they are tired of hearing the term “consumer engagement”. As a result, new trends towards an industry with true consumer engagement will be shaped by two contrasting market forces:

  • A consumer-centric future energized by patient advocacy
  • An overburdened delivery system that cannot provide consumer-centric care on legacy systems

True consumer engagement will remain a focus in 2015 as more patients work with their providers to take responsibility for their health, use technology tools to manage chronic conditions, and utilize social networking to communicate with their peers.

  • 83% of Americans don’t follow treatment plans given by their doctors exactly as prescribed
  • 42% of Americans feel they would be more likely to follow their prescribed treatment plans if they received encouragement and coaching from their doctors between visits

55% of providers say they don’t communicate with patients between visits and 50% of healthcare professionals believe their job begins and ends during regular office visits

Connected Health Top 10: #3 The Market Driven Patient Portal

Top-Ten-300x298Most industry changes leading to patient data access came by way of Meaningful Use. In the future, changes in the patient portal market will be driven by a series of marketplace dynamics. What does the market think of patient engagement? For the answer to this question it is best to refer to a report by Frost & Sullivan entitled “U.S. Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012–2017″.

“The need to fully engage patients as a member of the care team is fundamentally about encouraging individuals to become more involved with their healthcare, so they will be motivated to make behavioral changes that can positively impact their health status. That need will only grow as the healthcare system moves towards accountable care and value-based reimbursement. The importance of this movement cannot be underestimated.”

While it is predicted that hospitals will continue to make steady progress towards MU2 attestation, they will receive low patient adoption rates, which will force the industry to rethink patient engagement. Here are 7 features the market wants to see in your patient portal:

Analysts have suggested that by the end of 2019, 66% of health systems will offer digital self-scheduling and 64% of patients will book appointments digitally. This will result in $3.2 billion in value in cost reduction.  It’s estimated that 75% of all hospital readmissions are preventable.

Connected Health Top 10: #4 Telehealth Meets Routine Care

Top-Ten-300x298Over the course of a few short years we have seen doubts about the effectiveness of telehealth technology transform into wide-spread adoption of those same technologies. Now that telehealth has proven successful at managing chronic conditions and care in remote rural settings, we will see this trend continue as health systems realize that breaking down the geographic boundaries around care offers not only new streams of income but also more cost effective mediums of care.

The industry has witnessed retail clinics growing in popularity over the past few years. Estimates are that the number of retail clinics across the United States could reach 3,000 by the end of 2015. These retail clinics provide basic health services for patients that would otherwise go to the ER for a non-emergency medical care at a more affordable cost. However, growing routine care outside of the brick and mortar will evolve well beyond the retail clinic. The trends are set to make 2015 the year of direct-to-consumer telemedicine for more routine healthcare services.

Added to the care continuum will be the new role of “physician “extender”. These individuals serve as a first line of care for many patients as doctors continue to delegate tasks and monitor patients digitally. Telehealth services for routine care are then extended through video-based visits, smartphone apps, SMS messaging, and responsive websites that provide “asynchronous patient data exchange”. For everyday care, a triage nurse can act as a community manager over a social community of patients with the same conditions or interests. The industry is already witnessing trendsetting brands, such as Cleveland Clinic and Mayo Clinic, offering these services via cable television and mobile applications, respectively. This growth will be met with an increased rate of reimbursement for telehealth by health plans that are also getting in on the action by providing sponsored telehealth programs of their own.

  • The number of patients worldwide using telehealth services will rise from less than 350,000 in 2013 to roughly seven million in 2018
  • revenue for telehealth services will balloon tenfold, from $440.6 million in 2013 to $4.5 billion in 2018
  • A report published last month by Research and Markets estimated that the global telemedicine market will have a compound annual growth rate of 18.5 percent through 2018.

Connected Health Top 10: #5 The Next Evolution of Social Media

Top-Ten-300x298Over the course of the short history of Connected Health, there have been a few evolutions of social media in healthcare. These include:

  • 2011 – 2012: Healthcare provider adoption of social media was low
  • 2013 – 2014: Adoption is popular with varied levels of maturity. Focus is on relaying population health messaging and converting unknown consumers into patients.
  • 2015 – 2016: Going into the next two years, there will be another evolution of social media in healthcare. This will include the migration of consumers from large “mothership” social media sites like Facebook into private social networks. We will also see social functionality beginning to make its way into he patient portal. Lastly, analytics will be much more important to social media with direct ties to CRM and BI.

The ability for patients to connect with other individuals who are dealing with some of the same, or similar health issues, is a powerful draw towards private social networks. Over 40% of health consumers say that information they find on social media sites influences the way they deal with their health.  According to Chilmark Research, patients also report their approval of their healthcare providers using social media for information that may help with a diagnosis or treatment option. In other words, social media has gained recognition and importance in healthcare as one of the influencers that can assist with, and improve upon, the quality of care.

In 2015 social media’s influence will continue to grow as doctors involve themselves more fully. Examples include physicians reaching patients on private, secure Facebook pages tracking their patient’s chronic care management. Patients, particularly those under 40, are becoming more involved with social media sites to understand and manage their health issues, which indicates significant changes for communication in healthcare going forward.

Connected Health Top 10: #6 The Patient Digital #mHealth Platform

Top-Ten-300x298Patient mobile health (mHealth) is beginning to move beyond just a “cool technology” and toward more practical approaches for care delivery. According to PEW Research, over 90% of the world’s population has some type of mobile device, which makes mHealth technology an important connection point for both local and global health. This technology will bring:

  • New apps that connect patients to physicians for real-time monitoring of vital information. Innovations include heart rate, pulse, blood pressure, blood sugar, weight, body temperature, symptoms of asthma, etc.
  • Expanded use of SMS (Short Message Systems) to send health information tips and reminders to patients. Text messaging was used at a Los Angeles county hospital to motivate patients that had used the ER as their primary source of care to have increase protocol compliance and decreased use of the ER.
  • Responsive websites that act like apps fall into favor over mobile applications given that the smartphone market is still restricted to 56% of the US adult population.

Wearable technologies will be among the most compelling innovations in 2015. These will be found in both devices and clothing embedded with fiber optic sensors that can capture track patient data. One of the most important trends will be the inclusion of biofeedback as a way to engage consumers in their health.

Here are some statistics to consider:

  • 59% said mHealth will change how information on health issues is found
  • 51% said mHealth will change how providers or services send general healthcare information
  • 49% said mHealth will change their overall health management
  • 48% said mHealth would change how they manage chronic conditions
  • 48% said mHealth would change how they communicate with providers
  • 52% said mHealth would make healthcare more convenient
  • 48% said mHealth will improve healthcare quality
  • 46% said mHealth will substantially reduce healthcare costs

Connected Health Top 10: #7 Collaborate Across the Care Continuum

At the center of all Connected Health trends you will find healthcare organizations that struggle to provide care and services across care paradigms and organizational siloes. For that reason, there will remain great demand within the healthcare enterprise for collaboration tools that can be used to unite communities of employees that must work efficiently in an environment where complex tasks meet arduous clinical and business processes.

In light of this ongoing evolution in the way business is done, enterprise collaboration technology can be used in the healthcare industry to help employees interact, form relationships, make decisions, and accomplish synchronized work in real time. Healthcare organizations that use personalization, enterprise search, and enterprise social capabilities are creating a competitive advantage by enabling their knowledge workers to share information quickly and effectively across a complex hierarchy. These actions drive innovation and the likelihood for success in the new world of healthcare.

  • 25% of employee’s time is spent looking for information
  • Knowledge workers spend at least 15 to 25% of their workday searching for information and only half of the searches return useful information
  • 45% of employees use the wrong information to make decisions in an average week

Within the connected enterprise, care and education take on fluid new forms that are not confined to geographic boundaries. Once upon a time, a single expert would only be available to those with immediate access to this expert. Now experts are available to the world. In one instance, a pediatric specialist saved the life of a young girl using an innovative surgical technique. Several months later, this surgeon was contacted about a patient across the nation that was suffering the same peril. Using video streaming protected by the secured infrastructure of an enterprise portal, the surgeon was able to lead the on-the-ground team, and the second child was also saved.

Connected Health Top 10: #8 Interoperability Steps Into Limelight

Top-Ten-300x298Healthcare organizations are beginning to realize that enabling consumer engagement and population health strategies are not possible unless the capability of effectively and efficiently communicating across care venues and systems exist as well. This is a big ask considering the increasingly complex care continuum that matches patient to care provider. This calls upon Connected Health and Interoperability solutions to work together in new, mission critical, ways.

  • For health systems this is made more complex due to the mergers and acquisitions activities of the past few years that have left a complex system of systems in its wake.
  • For the health plan this is made more complex by the complicated montage of systems that are required to navigate data through an even more complex process payment of care post healthcare reform.

When making decisions related to collaborative technology investments, the CIO has traditionally viewed integration with the EHR as the most important decision making criterion. However, it is now becoming more clear that while the EHR serves as a critical source for healthcare information, more often than not the EHR is just one of tens or hundreds of systems across an organization that need to be integrated to gain business value from Connected Health investments.

Greater Data Access vs. Data Security

Patients continue to want greater data access to their care data. Connected Health and Interoperability must work together to balance this want against the need for increased assurances of the confidentiality of health information. Due to new and existing trends both inside and outside of the industry, data security will become increasingly important to the healthcare consumer.  Experian predicts that healthcare breaches will increase due to:

  • Potential economic gain
  • Increased digitization of records.
  • Introduction of wearable technologies to care protocols

HIPAA data breaches are at an all-time high with a recorded 138% jump in the number of health records breached in 2013 as compared to 2012

38% of providers said electronically exchanging data decreases their ability to separate sensitive health information from other data being exchanged.

Connected Health Top 10: #9 The Real Consumerization of Care

Top-Ten-300x298Speaking to patients about money is often viewed as distasteful in the healthcare setting. However, as both national and state healthcare legislation evolve, and the cost of care soars under the weight of aging boomers and patients with multiple chronic conditions, the patient’s dual role as a consumer of healthcare services will become clearer.  As a result, the time is upon us where the office of finance will become increasingly interested in joining the office of medicine and the office of marketing in the topic of consumer engagement.

There is an ongoing debate about whether patients should also be considered “consumers”.  The best answer I have heard to this question implied that calling a patient a “consumer” does not imply that they are not also a patient.  There is not a single spectrum with patient on one end and consumer on the other.  Instead, we have an industry where our patients can also, at times, be consumers as well.  This is the case when patients need to make consumer choices about their care.

When a Patient is Also a Consumer

Healthcare reform has certainly had a role in making this trend come to life, but patient advocacy work on the subject of price transparency is also moving this trend.  Still more, it is likely that state mandates will provide the trend with its truest form.

It has been said that price transparency mandates should reach the legislating bodies of at least 5-7 states in the near term. Given the interconnectedness of health systems, and the care they provide across geographies, a change in one state will have a ripple effect across the entire healthcare market. For example, in 2014 Massachusetts legislated that healthcare organizations must provide pricing information to consumers. Any health system that relies on the millions of patients within Massachusetts, through either brick and mortar or telehealth, will be similarly impacted by this legislation.

Tactics that Support the Real Consumerization of Healthcare

For millions of consumers, awareness about price, costs, and alternative options will snowball when compounded with their newly self-insured status coupled with the soaring cost of care. Implications include:

  • Strategic marketing efforts that align with a healthcare consumer’s smarter selection of services
  • Growth of disruptive models for payment
  • More consumer friendly processes placed around invoicing statements and billing for healthcare services
  • Increased collaboration between the source of care (health systems) and the payment of care (health insurance plans)
  • Paradigm shifts in services delivery

Ultimately, the increasing patient demand for price transparency will put the health system to the test. Innovation will be a high priority as health institutions seek to control costs while offering better service in the quest for better outcomes, fewer admissions, and fewer readmissions.

 

Connected Health Top 10: #10 Slow M&A & “Preserve & Extend”

Top-Ten-300x298The world of Connected Health is in constant motion.  It is good fun for me to watch the data churn that then helps us predict the Connected Health trends across the next 10 years.  If you are curious about what that brave new world looks like, then you can see in “Creepy or Cool?  A View of Connected Health in 2025“.

There is much in store in the world of Connected Health over the course of the next year.  Over the next two weeks I will publish this year’s Top 10 Trends for Connected Health in 2015, and then we can all celebrate everything Connected Health together at the 2015 HIMSS conference.  I’m looking forward to it!  Without further ado, I present trend #10:

Slowing M&A Causes “Preserve & Extend” Mentality

Until recently, hospitals across the country have been swept up in an avalanche of mergers unlike any we have seen in the past two decades. In 2013, hospitals and health systems announced 98 new combinations, which was a 3% increase from the previous year and a 51% increase from 2010. The acquired organizations’ total operating revenue was $32.3 billion.

However, the volume of hospital mergers and acquisitions declined in 2014 according to industry analysts. Irving Levin and Associates reported that there were 72 hospital M&A transactions in 2014 through Dec. 19, 2014, which represents a 27% drop compared to 2013. Slower M&A activity was also seen in home health and hospice deals, which dropped by 11% in 2014, as well as physician groups, which fell by 12% in 2014. This mentality is being driven by a two-fold concern:

  1. Healthcare markets have been historically local, which makes sense given the great diversity in patient populations across the country. Some are concerned that acquisitions by large national conglomerates will silence this local market voice.
  2. Hospital system arguments that acquisitions improve patient outcomes and healthcare delivery within a population are losing court battles against the argument that these large health systems would not hurt local competition.

It is now expected that that the general slowdown witnessed in the latter half of 2014 will extend into 2015 as hospitals search for joint ventures and partnerships agreements over mergers and acquisitions.

What impact will this have on Connected Health?

Hospital systems will shift away from the “rip and replace” mentality of the past few years and move towards a “preserve and extend” mentality.  According to Chilmark Research, this will lead to the layering of health IT functionality on top of legacy systems rather than a complete replacement of those legacy systems.

While this measure would seemingly reduce costs, health systems must now factor in the increased costs associated with the integration of complex data systems that feed Connected Health technologies. This is most often witnessed in the, oftentimes, hundreds of data systems that need to be integrated to make both enterprise or patient focused portal or mobile technology function properly.  One recent example for me is found in the world of portals that help physicians collaborate across the care continuum.  To make this collaboration system thrive, the portal must integrate with 9 different EHR that the health system acquired over the past few years due to the growth in M&A activities.  These EHRs now need to be integrated, along with a host of other applications, so that these solutions can be extended across the enterprise.

Stay tuned for trend #9 that will be released tomorrow!