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Includes Provider Portals (Patient, Provider, Physician), Payor Portals (member, provider, agents/brokers), and User Experience

4 Reasons Telehealth will Transform Healthcare

There has always been value in being able to reach healthcare consumers remotely, however, the fee-for-service model and health plans have not supported it. Rising expenses, increasing number of Accountable Care Organizations, elevated interest in consumer engagement, focus on population health management and a shortage of healthcare providers are all driving telehealth.4 Reasons Telehealth will Transform Healthcare Andrew Watson, MD predicts that 85% of healthcare delivery will occur in the home in the next five to six years.1 Telehealth provides convenience to an increasingly busy healthcare consumer and expands access to care while reducing costs. Healthcare Providers need to be including telehealth in their plans or they will miss out on a big opportunity to attract and retain healthcare consumers. Here are four reasons telehealth will transform healthcare:

An Increasing Need for On Demand Care - In years past on-demand care meant dropping into a retail or walk-in clinic to get checked out or to get a prescription. Today, on-demand care means online, from the comfort of your home, even in your pajamas if you wish. More and more people are preferring to email their provider questions or video chat rather than stopping into a near by clinic.

Healthcare reform has provided insurance to more than 40,000 individuals who do not have a formal source of care, making them prime candidates to use telehealth. Additionally, there continues to be a growing need for primary care physicians, in fact it is estimated by 2020 there will be a shortage of 20,400 primary care physicians.1 Telehealth provides a great opportunity to expand primary care capacity, tackle the physician shortage and provide convenient and affordable care.

Healthcare Consumers Driving Their Care - Healthcare consumers are becoming more savvy with their healthcare in terms of leveraging their resources and directing their own care based on personal judgement. They are more accountable for their care and taking responsibility for their preventative care plans. Telehealth may just be the solution to meet the needs of the new healthcare consumer who is seeking convenience and ease as they juggle their busy lives.

Regulatory Barriers Being Addressed - The regulatory environment continues to change to help knock down barriers that have stood in the way of telehealth in the past. Reimbursement eligibility for telehealth services is expanding geographically and new laws are ensuring that certain virtual visits are reimbursed the same way in-person visits are. In addition to government mandates, professional groups are focusing on setting guidelines for evidence-based telemedicine and insurers are partnering directly with telehealth vendors to provide virtual care.

An Emphasis on Customer Experience & Continuum of Care - Healthcare consumers are  frustrated with the increased time they spend in the waiting room and the lack of time spent with the healthcare provider.  With an emphasis being placed on customer experience healthcare providers are expanding their hours to accommodate for the demand, however, this is not sustainable. Telehealth also provides a channel for delivering healthcare that can bridge the gap and provide care across the entire continuum leading to better outcomes and an overall improved customer experience.

Telehealth engages healthcare consumers, provides valuable insights for population health management and offers an option that addresses rising healthcare costs and healthcare provider shortages. The time for telehealth is now and providers must leverage it to transform their business models, improve care management and tackle rising healthcare costs.

Look for telehealth to have an enormous impact on healthcare in 2015. Both healthcare providers and health plans need to start embracing telehealth. Check out 10 Trends Impacting Healthcare in 2015

 

Sources:

1 Healthcare IT News
2 U.S. Department of Health and Human Services

 

Healthcare Patient Portals: Lessons Learned from 2014

Mark Polly, Director at Perficient recently posted a blog titled Lessons Learned from 2014: Healthcare and Patient Portals. In his blog post Mark takes a look at the challenges with healthcare patient portals, including Healthcare Patient Portals; Lessons Learned from 2014whether or not patients know they exist and what elements of a patient portal are most essential.

Read Mark’s entire post here and I would also encourage you to read What the Market Says You Need in Your Patient Portal, a great post by Melody Smith Jones, Manager of Perficient’s Connected Health Practice.

Patient portals shouldn’t just be implemented to meet a regulatory requirement, they should be used as an engagement and empowerment tool for patients.

Telehealth – Impacting Access, Cost and Quality

Where did 2014 go? It flew by…then again after I turned 30, I feel like every year is flying by. As this year Telehealth Impacting Access, Cost and Qualitycomes to a close and planning begins for the upcoming year, like most organizations in the United States, my organization is going through an “open enrollment” period for healthcare benefits, allowing employees to make adjustments to their current healthcare benefits for next year. I rarely change my healthcare benefits. I usually just skim through the HR documents in the slim chance something major changed from the year prior. Ninety-nine percent of the time, nothing changes. However, to my surprise, this year, something maj or, and impressive, did change. For the first time, our healthcare benefits were going to include telemedicine. Amazing!

What is Telemedicine…or is it Telehealth?

Oftentimes we see “telehealth” interchangeably used with “telemedicine,” but there is a slight nuance between the two. According to Dr. Stephen Perkins, Vice president of Medical Affairs UMPC Health Plan, “Telehealth is a general term describing the delivery of health-related services and information by the use of telecommunication technology. It can include phone calls between physicians, videoconferencing or even robotic technology.” Telemedicine has a narrower definition: The specific use of medical information that is exchanged from one site to another via electronic communications for the health and education of a patient or a health care provider for the purpose of improving patient care. It includes consultative, diagnostic and treatment services1.”

The Impact of Telehealth

As the healthcare industry continues to go through major transformation, it is no surprise that healthcare providers are trying to find innovative ways, such as telemedicine, to deliver efficient and effective patient care. Through telehealth, providers can impact access, cost and quality to help achieve this.

  1. Improve AccessibilityTelemedicine allows providers and patients to bridge the distance and time barriers that separate them. Rashid Bashshur does a fantastic job, describing the impact to access of care from both the provider and patient side2:

Providers2: Accessibility for providers in both remote and central sites relates to convenience, opportunity cost, and work load. Providers located in remote and isolated areas and institutions will have ready access to consultants and referral sources. With telemedicine, they may encounter less “red tape” in arranging for both consultations and referrals. Remote providers may be able to alleviate their work load and coverage during off-hours because of their link to medical centers and the use of non-physician providers. Providers located at tertiary care centers will be able to offer their expertise to a much larger and diverse provider and client population compared to those only seen at their medical centers.

Patients2: The target populations and the major beneficiaries of telemedicine are the geographically remote, the institutionally confined, and those otherwise medically underserved, including inner city residents and the elderly. The substitution of telemedicine for person to-person encounters reduces the need for travel and the related opportunity costs and other inconveniences encountered in the process of obtaining care. Instead of having to travel to distant tertiary care centers for specialized, and sometimes even routine, services, residents of rural areas, correctional institutions, and nursing homes could receive an array of services via telemedicine. Only when it is determined appropriate through consultation with specialists would it be necessary for clients to be referred or transferred to be served at the medical centers.

Patients don’t have to live in rural or remote areas to reap the benefits of access to care through telehealth. Access can also be related to sheer convenience. Many of us truly just don’t have time to get to the doctor. Penciling in a lunch-hour visit with our physician can prove challenging, especially when a can’t-miss conference call absorbs the bulk of our afternoon3. According to Jessica Harper, telemedicine eases this problem -through video, Web chat, or phone, workers can follow-up on a prescription or diagnosis with a physician and reduce the time you spend in the waiting room, flipping through yet another mind numbing magazine3.

  1. Influence Costs – Telehealth reduces overall healthcare costs and can potentially generate an increase in revenue.

Contain Cost – The Center for Information Technology Leadership estimates that widespread use of telehealth systems to promote preventive care, early intervention and effective information sharing could save the United States $3.61 billion annually4. Telemedicine reduces travel expenses, especially for those living in rural communities, where they would need to normally travel hours out of their way to access key health services3. In addition, the number of days of work people take for routine visits can add up in lost wages. According to a recent study, with telemedicine, 92% of patients saved $32 in fuel costs; 84% saved $100 in wages; and 74% saved $75-$150 in family expenses5. Even more astonishing, $1.2 billion could be saved by video consultations between doctors and patients in cases where office visits are not practical5. In addition, many providers actual charge less for a telemedicine consultation than they do for a face-to-face visit.

Increase in Revenue- If time and distance barriers to care are removed, use of service is likely to increase, which in turn increases the volume without declining the cost and resulting in an increase in revenue generation2. Improved operations can also prove to be a revenue generator. According to a recent study in Telemedicine and e-Health, hospitals that utilized telemedicine technology and referred patients to other hospital facilities, specifically children’s facilities, saw their revenue significantly increase6. The research looked at 16 hospitals’ billings before and after they implemented telemedicine tools. Before the implementation of telemedicine, the 16 hospitals recorded 143 transfer patients. After deployment the number jumped to 285, resulting in a revenue jump, going from $2.4 million beforehand to $4 million6.

  1. Improve Quality-Enhancing quality of care, through more timely delivery care, care coordination and patient engagement is also an advantage to telemedicine.

Timeliness to Care – The National Healthcare Disparities Report (2009), states that, timely delivery of appropriate care has been shown to improve health care outcomes and delaying health care can lead to a diagnosis at a more advanced disease stage and reduce opportunities for optimal treatment5. The window to receive treatment for many disorders is typically small and early detection and diagnosis can be vital. Ongoing remote monitoring and the ability for patients to check in with providers via telemedicine, before something worse happens, makes a positive difference in patient outcomes and satisfaction7.

Care Coordination – According to Kevin J. Boyle, “Transition care typically includes both patient education and medication management components to help ease the transition from hospital to residential facilities and reduce readmissions. While face-to-face communication is ideal, it is often impractical. Telemedicine provides a quick, convenient and more affordable forum for assessing patient recovery, assisting with medication management and keeping patients on track with discharge instructions. Advanced high-definition video capabilities can also help clinicians’ document key indicators of recovery and conduct demonstrations for self-care or physical therapy techniques8”, especially those with chronic conditions.

Patient Engagement – Providers can involve their patients in their own healthcare, thus improving compliance and, over time, clinical outcomes. Randall S. Moore, MD, MBA, states that, “One of the most interesting and promising outcomes of telehealth programs has been the increase in patient participation and self-care. Because patients have an active role in their care plan and are in more frequent contact with their healthcare provider, they gain a better understanding of their condition and become more compliant in their care.9” Patients want to take a more active role in their healthcare and see technology, such as telehealth, as a mean to helping them achieve this important goal.

Telehealth has continued to grow as a unique way of delivering care to patients, while greatly improving access, reducing cost and positively impacting quality. The number of patients using telehealth services is expected to jump from the 350,000 in 2013 to about seven million by 201810. Despite this staggering increase in users, there are still some barriers preventing its wide-spread use, such as resistance on the part of providers, limited insurance coverage and reimbursement, and privacy and security issues. However, over the past few years these challenges seem to be lessening as the healthcare industry, as a whole, is understanding the benefits of telehealth and from the looks of it, it seems like telehealth is here to stay as a recognized part of healthcare delivery.

What do you think? Do you think telehealth and telemedicine can change the healthcare industry?

Resources for this blog post:

  1. http://www.upmchealthplan.com/pdf/smart_business/February_2014.pdf
  2. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/44995/10916_2005_Article_BF02257059.pdf?sequence=1
  3. http://health.usnews.com/health-news/articles/2012/07/24/pros-and-cons-of-telemedicine-for-todays-workers
  4. http://www.corp.att.com/healthcare/docs/connected_hc.pdf
  5. http://accesstelehealth.org/benefits/lower-cost
  6. http://healthworkscollective.com/waxcom/116071/using-telemedicine-increase-hospital-revenue
  7. http://venturebeat.com/2014/10/20/why-telemedicines-window-is-finally-opening/
  8. http://www.healthmgttech.com/articles/201210/improving-care-coordination.php
  9. http://www.psqh.com/janfeb05/viewpoint.html
  10. http://www.healthitoutcomes.com/doc/barriers-to-telehealth-s-growth-0001

Gearing Up for 2015: 10 Trends Impacting Healthcare in 2015

HITS SNAPSHOT – GEARING UP FOR 2015 10 Trends Impacting Healthcare in 2015Technology is a major player in the evolving healthcare environment, and organizations are increasing their health IT budgets to adapt to the “new” industry. Having the right technology in place can enhance patient experience, help meet regulatory requirements and provide key insights that reduce costs and improve outcomes. In our recently released HIT SNAPSHOT we have identified ten trends impacting the healthcare industry that can help determine which technology investments should be made to achieve the greatest return on investment.

Download the guide now

Top 10 Healthcare Industry Trends Blog Posts from 2014

Top 10 Healthcare Industry Trends Blog Posts of 2014As we wrap up 2014, let’s take a look at the top 10 blog posts from our thought leaders. These blogs were published on Perficient’s Healthcare Industry Trends Blog.

If you missed these you may want to take a look.

#1. What the Market Says You Need in Your Patient Portal
by Melody Smith Jones | June 19, 2914

#2. Connected Health Trend Countdown: #1 Health Plans Go B2C
by Melody Smith Jones | February 5, 2014

#3. Changing Delivery and Spending of Medicaid Through DSRIP
by Priyal Patel | May 22, 2014

#4. Healthcare Gamification: Avoiding Chocolate Covered Broccoli
by Melody Smith Jones | February 4, 2014

#5. How Enterprise Mobility Management can Improve Patient Care
by Kate Tuttle | May 7, 2014

#6. Perficient Ranked One of the Largest Healthcare Consulting Firms
by Kate Tuttle | August 25, 2014

#7. Connected Health Trend Countdown in Review
by Melody Smith Jones | February 6, 2014

#8. Apple: The New Digital Hub for Healthcare Data
by Kate Tuttle | September 9, 2014

#9. Healthcare Benchmarking
by Priyal Patel | July 9, 2014

#10. The Problem with Health IT is in the Definition
by Kate Tuttle | October 13, 2014

 

 

4 Tactics that Drive Successful Enterprise Content Strategy

Last Friday I completed my stint on an enterprise portal (intranet) project for a provider with nearly 60,000 employees.  Having a national presence, the organization I worked with has complex internal collaboration needs.  While the implementation of such a technology is complex, the content strategy needed considerable attention.  It also just so happens that yesterday we published our primer on internal collaboration entitled The Connected Healthcare Enterprise.  Combining these timely learnings, I account for you below three critical items you need to consider when developing your enterprise content strategy.

1. Content Governance

modern computer technology in businessWhile content governance is oftentimes the least glamorous aspect of content creation, a good content governance process will ensure that the content found in the enterprise stays relevant, on message, and updated over time. The purpose of content governance is to ensure appropriate processes are in place for managing the contents of the intranet in a controlled and orderly way. Strong content governance starts at the strategic level and flows down through a series of key stakeholders throughout the content lifecycle.  This requires a cross-functional committee, including a cross-representational group of employees by role, content creators, content approvers, and other stakeholders across the organization, to help guide the strategic content efforts of your enterprise portal into the future. This content committee can be a sub-committee to the larger governance efforts that surround the intranet.

2. Content Audit

To create a content strategy that is practical for the organization, it is important to understand current content.  We took our customer through a thorough content audit process, which helped identify key content types as well as the complex taxonomy that would drive important tools such as search.  This content audit also provides the opportunity for content creators to take a realistic inventory of current content and decide what stays, what goes, and what needs to be updated.

3. Content Creation Workflow

Creating a piece of content for the enterprise necessitates teamwork. The content authorship process requires a series of individuals to work together from creation to publication. The workflows for this content management process can be assigned within an enterprise content management tool for easy automation. Key considerations for this workflow include:

  • Defining Need for New Content
  • Content Creation
  • Content Approval
  • Compliance Approval
  • Pushing Content to the Live Server
  • Content Archive Plan

4. Content Consumption

Making healthcare work requires employees to digest a lot of information daily in order to provide quality care and services.  This mass of data is too much for any given individual to do on their own. That is where the true power of an enterprise content strategy  becomes apparent.  Tools like enterprise social exist to help communities of people digest a lot of information quickly.  Healthcare organizations view the benefits of internal collaboration as a way to take advantage of “crowdsourcing” to solicit input from thought leaders across the organization.  Even better, it causes a dramatic decrease in the primary communication tool that is burying us all: Email.

So, there you have it.  Be sure to check out the  The Connected Healthcare Enterprise white paper to learn how you can transform the standard healthcare intranet into a powerful engagement platform for healthcare providers and health plans.

How Biofeedback is Set to Transform the Quantified Self

During the Connected Health Symposium last week, I noticed a significant trend that I have since been calling the “next big thing for the quantified self movement”.   What is the next big thing in a world dominated by fitness trackers and mobile apps?  That next big thing is biofeedback.  I gained access to quite a few innovators while at the conference.  They note that while clinicians have been using biofeedback for eons in order to understand any number of things about a human body, most of those tools do not come in a patient-friendly package.  Thanks to these innovators, now they do.  Here are four examples quantified self devices that use biofeedback to help patients understand and manage their health.

Choose Muse

It is hard to make brain data real to a patient.  As a result, up until now there has been virtually nothing a person can do to improve Screen Shot 2014-10-28 at 12.01.25 AMtheir brain health. Psychoanalysis is highly stigmatized, which causes an even bigger drift to form between patients and cognitive health.  In order to fix this, clinicians have created a consumer friendly, clinical grade EEG to provide patients with their first real contact with their brain. The device is called Muse, and it is being dubbed “the brain sensing headband”.

By using the device, patient can improve their cognitive functions and see their outcomes in real time.  This device has also shown promising in the treatment of depression and other mental illness.  Since this treatment is wrapped in the quantitative self trend, it does not receive the same reluctance that stigmatized psychoanalysis does.  This provides promising new treatment options.

HeartMath

During the Connected Health Symposium, it was noted that 75% of physician visits are stress related.  Patients are often made to feel that they arScreen Shot 2014-10-28 at 12.02.55 AMe “stuck with it” and there is nothing that can be done.  However, a really neat connection between the heart and the brain can be used, through the power of feedback, to manage stress related illnesses such as heart disease.

I’m not sure if you knew this, but there is a “brain” in the heart that senses and responds to emotions and communicates through nerves to the brain. This heart-brain communication provides us with a way to manage our stress and  get heart healthy through the use of biofeedback.  Using biofeedback through tools like HeartMath, patients can gain windows into their hearts and brains to self manage their stress response. While this is certainly empowering for prevention of heart disease, heart disease patients have been studied, and have improved outcomes through using the HeartMath biofeedback system.

Stay tuned for an upcoming experiment that is set to merge the Muse and HeartMath technologies.

Sensoree

Screen Shot 2014-10-27 at 11.32.19 PMIf you work in healthcare technology, and you go to a Connected Health Symposium, then you will get your fair share of interesting conference performances.  In one such performance, we were introduced to Sensoree, which is a company that creates wearable technology that show visually, through light displays, what the individual wearing the technology is feeling.  This proves incredibly helpful for patients with Autism and Alzheimer’s that do not have the ability to communicate their emotional states readily.  Sensoree introduced these technologies by having circus performers wear them during an acrobatic dance routine.  As they danced, you could see their emotional states changing as a red glow of nervousness as the performers began turned into a blue glow of of focus to a purple glow of bliss.

 

BioBeats

This last bit, called BioBeats, is a platform for merging entertainment with healthcare.  In one very compelling move, BioBeats partnered with music crew Far East Movement in an attempt to connect millions of listeners to their health by way of mobile phone enabled heart beat sensors.  As Far East Movement performed, they encouraged their fans to record their hard beats.  By the time the song was over, they had collected over 1.5 million heartbeats that were, in real time, transformed into the beat that lived in the background of their performance.  Check out this “Turn Up The Love” performance below.

Perficient Provides PIH New Tools In The Fight For Global Health

Kent Larson, Director at Perficient recently posted a blog about Partners In Health (PIH) and the new Microsoft tools they are using to help enable their mission to provide a preferential option for the poor in healthcare.

PIH is one of many organizations leading a coalition to combat the Ebola outbreak, working alongside two other organizations – Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone. To help enhance communication and collaboration both domestically and internationally, PIH is migrating to Microsoft Office 365.

Perficient is assisting PIH with their migration to Microsoft’s Office 365 (O365) solution. O365 will allow users to access their email from anywhere in the world on any computer or mobile device with access to the Internet. OneDrive for O365 will enhance collaboration between all PIH users, both domestically and internationally. The platform will provide PIH with a reliable and secure communication toolbox, including storage and collaboration tools. Deployment of O365 across PIH sites in Africa, Haiti, Russia, and the U.S. will enable PIH’s mission to provide a preferential option for the poor in healthcare  and will be an important tool to enhance communication as they respond to the Ebola outbreak in West Africa.

To read Kent’s entire post and to learn more about the mission of PIH click here.

How to Create Habit-Forming Technology Solutions

Last week, I was at the Connected Health Symposium in Boston.  It is with great pleasure that I relay what I was taught during my favorite session by Nir Eyal author of “Hooked: How to Build Habit-Forming Products”.

shutterstock_78240940 copyWe know that mobile devices change our day-to-day behavior, but why are mobile devices so good at changing our habits?  To understand how, we must understand what habits are and how they are changed. Habits are impulses to do a behavior with little to no conscious thought.  When you think about it, social media sites like Facebook, Twitter, Instagram, Pinterest, and SnapChat get us to do some pretty bizarre behaviors as habits.  Now, over the span of just a few short years, billions are using these social platform as day-to-day habits that require little to no conscious thought.

It goes to say, then, that creating a habit-forming technology solution of any type would require us to speak directly to the unconscious mind.  To do this, Eyal advocates what is calls the “Hook Model”.  This is defined as using experience design to connect a user’s problem to your solution with enough frequency to create a habit.  To do so, it is critical that your solution include the following four components of a hook:

  1. Trigger: A trigger is a cue to action that prompts the user to perform a habitual action.  These triggers come in two forms.  You have external triggers in the environment that tell us what to do next. Common external triggers include what we call “calls to action” in marketing, which is the “Buy Now” request.  A friend telling you to try a certain solution is also a powerful external trigger.  However, it is the internal trigger that is the most important.  Internal triggers are associations in someone’s mind that inform what to do next.  These associations come from emotions, routines, situations, people, and places. Ultimately, this requires you to have an intimate understanding of your user’s painpoints and how they respond to those painpoints.  For example, people with depression check email more. The theory behind this association states that  people suffering from bad emotions turn to their technologies to feel better. Generally speaking: Lonely = Facebook, Bored = YouTube, Confused = Google. We use these technologies to escape negative valence states. So, how do you make better products and services that help people live healthier lives?  You need to understand what internal trigger you are creating an association with.
  2. Action: An action is defined as the simplest behavior done in anticipation of reward. The reward need not be in the form of Screen Shot 2014-10-26 at 8.08.31 PMpoints and leader boards.  Want examples of the most compelling rewards used by leaders today?  Scrolling on Pinterest. Searching on Google. Play button on YouTube.  These are all “rewards” in that studies have shown they relieve enough tension in the human mind to create an addiction to our mobile phones.  There is a formula you can use to predict the power of reward found in these singular behaviors. That formula is B=M+A+T.  According to BJ Fogg, in order for any behavior to occur, we need motivation, ability, and a trigger.  Motivation is the “energy for action” (how much we want to do a behavior). Six factors to increase motivation include: seeking pleasure, avoiding pain, seeking hope, avoiding fear, seeking acceptance, and avoiding rejection. Ability is the capacity to do an action (how easy or difficult it is to do).   Six factors can increase or decrease ability: time, money, physical effort, brain cycles, social deviance, and non-routine. This is why we are more likely to do something when we see someone we know doing it. We are also more likely to do something we’ve done before . X-Y access that’s Ability (how easy) vs. Motivation
  3. Reward: To get at the heart of reward, we have to start in the brain.  More specifically we have to start in a portion of the brain called nucleus accumbens, which has some unusual properties. When they allow lab animals to trigger this portion of the brain by pushing a button, those animals will continue to do so obsessively.  In fact, the machines have to be forcibly removed.  At first it was assumed that this portion of the brain activated a pleasure center.  That was not correct.  It actually activated the “stress of desire”. The thing is, there is a way to stimulate this itch that we crave to scratch. Within the premise of “the unknown is fascinating”, variability causes us to increase focus and not let go. If a reward is given on a variable basis, then it spikes activity in the nucleus accumbens. One import variable reward system are “rewards of the tribe”, which are things that feel good that come from other people like empathetic joy, partnership, and competition. Social media is a erasure trove for rewards of the tribe.  Rewards of the hunt, like gambling, also provide the variability that we desire. The information rewards we receive from search engines like Google are good examples of a reward of the hunt. The social media activity feed works in the same way  (that’s not interesting, that’s not interesting, wait, that’s interesting!).  Then there are rewards of the self.  A search for self-achievment has an important element of variability, which is why people are happiest when they are trying to reach a goal (as opposed to having already achieved that goal).   Mastery, competency, and control are rewards of the self.  Ultimately, variable rewards are about scratching the user’s itch but leaving them with the mystery of what will happen next.  One of the ultimate examples is the email inbox.  The quest to clear your inbox can be seen as a game because the little icon signifying that you have mail told you to do something.  Making that little icon go away is an important variable reward that keeps us coming back for more.
  4. Investment: This is a variable of the hook that most companies neglect, and, therefore, presents the greatest opportunity for growth. They receive a variable reward.  What’s next?  “Investments”are defined as the load for the next trigger.  Unlike physical products that deteriorate over time, habit forming technologies appreciate and get more valuable the more they are used because of the investments in stored value. The more content that is collected in iTunes, the more value it has and the better it becomes. The more accounts I connect in Mint, the more valuable it becomes to me.   The more followers I have the more interesting Twitter becomes. Users need to be able to store their value in your technology solution.  This value is stored as a reputation that a user can “take to the bank”. How likely are you to leave a platform after you have stored value in terms of reputation?

This is how customer attitudes change and habits are formed. If you are building a technology that requires habits, then you need to ask these five questions to know if you have been successful:

  • What internal trigger is the solution addressing?
  • What external trigger gets the user to your solution?
  • What is the simplest behavior in anticipation of reward?
  • Is the reward fulfilling yet leaves the user wanting more?
  • What “bit of work” is done to increase the likelihood of returning?

Eyal ended his talk with a discussion on the morality of manipulation.  Designing habit-forming products is a form of manipulation. As a result, engineers of these solutions need to be careful. We need to be responsible for the impact we have on changing user behavior by using this power for the force of good by fixing one of the world’s problems.

In Healthcare, Connectivity Is Not Collaborating

Interoperability between different electronic health record (EHR) systems is one of the most important requirements that hospitals and physicians must meet as they prepare their systems for attestation in Meaningful Use Stage 2.

However, let’s examine the real goals of interoperability within healthcare: In Healthcare Connectivity is not Collaborating

1) To make sure “information follows the patient regardless of geographic, organizational, or vendor boundaries”

2) To have at least one or more instances in which providers exchange an electronic summary of care with all the clinical data elements between different EHRs. Establishing this connectivity does not insure the real goal of collaborating across the continuum of care for the patient’s benefit.

The debate still rages on the role of the patient in this interoperability process as well. We have all, as patients, had our medical files spread across a family doctor, multiple hospitals, specialists, health plans and today, even multiple pharmacies. The prospect of creating a complete picture is staggering, let alone having all of those healthcare providers really collaborate on our behalf. Is it the patient’s responsibility in this ever-changing healthcare electronic revolution to compile this electronic mess into a coordinated whole or will the industry magically create it as a result of Meaningful Use Stage 2?

It is worth arguing that interoperability in Meaningful Use Stage 2 only creates a baseline of connectivity between two or more systems to exchange information and puts in place the ability of those systems to use the information that has been exchanged. It does not create collaboration on behalf of patients within the healthcare provider community, especially between competing players like local hospital systems or healthcare providers versus payers. Having the ability to connect only trades fax machines for electronic transactions, if tools aren’t employed for physicians for example to collaborate over a single patient.

In advocating for collaboration, let’s examine the reality of an exchange of a set of electronic transactions about a patient versus where the process would need to be for genuine care coordination. Today, a fax from the hospital to the family physician is the notification that the patient was hospitalized and needs follow-up in coming weeks. Based on the type of hospitalization, a call between the attending physician and family physician may be warranted, and a potential referral to a subsequent specialist may be in order. Simply communicating electronic documents doesn’t address the interaction between key people in the decision-making process and the assumption that the inclusion of unstructured physician notes will suffice may be optimistic.

This means that health information exchange is different than health information interoperability. Exchange is necessary for interoperability, but it is not sufficient by itself to achieve health information interoperability, especially to streamline real collaboration on behalf of patients. It is time to examine an expanded view of both interoperability and health information exchange to promote ease of collaboration between the parties involved, including secure physician to physician communications – electronic or instant message, for example, and secure physician to patient communications. As an individual patient having to deal with multiple patient portals today for communicating with my healthcare providers, there is a real concern to address this issue sooner rather than clean up confusion later.

Can we define collaboration in a way that traverses healthcare’s landscape of emerging connectivity?

Sure, it’s huge, but this is my favorite new iPhone feature

I’m having a good laugh at all of the memes floating through social on the “hugeness” that is the new iPhone 6.  Apple even wisely predicted the size sentiment (℅ super user research) and landed a spot featuring Jimmy Fallon and Justin Timberlake that provides a few laughs.

So, while size-by-size comparisons are even a thing in my household (husband has the new phone while I’m skipping a version), I’ve found that my favorite features of the new release are actually a part of iOS8, and, therefore, I don’t need to get the new phone, and the extra inch of screen size that provides, to have them.

So what new iPhone feature has me all giddy and excited?  Safety.  FOSgNia

Let me explain.  I’m a big fan of the Quantified Self, and, as a runner and biking enthusiast, I like apps that help me track my progress.  I especially like when those apps are extensible and connect to provide an entire Quantified Self experience.  I’m not here to talk about HealthKit, though.   I’m here to talk about a lack of functionality I have found in these apps when it comes to safety.  I’m a woman running or cycling alone, and sometimes, if my work day creeps into the evening, the sun goes down before I get started.  I’ve combed the app store trying to find an answer, and there really aren’t good answers out there.  What I need is:

  • A way to alert loved ones passively if I run into trouble while I’m running or riding my bike.  It’s not really reasonable to expect that I can reach for my phone and make a call if I’m, for whatever reason, not able to complete those steps in the process.
  • A way to inform an EMT that may arrive on a scene when I am unable to communicate.

The iOS answers to these problems:

  • Share my Location: When I’m ready for a run, iOS lets me set up a window for when and who I want my whereabouts shared with.  I can set up the time parameters I have for my run, say 7:00 p.m. – 8:00 p.m., and share my location with my husband and best friend until I alert them that I am home.  If they don’t hear from me when they are supposed to, then they not only know something is up, but they know where I am as well. What I’d love for iOS to add is a way to send an alert if I fall during a run or ride.  I know, because of the ActivBeacon app, that this is possible.  The downside of ActivBeacon is that, for whatever reason, the app malfunctions and turns my volume up to full blast when I have both music and the app running at the same time.  Eye of the Tiger loses its motivational effectiveness at that volume.  Trust me, I know.
  • Medical ID:  The Medical ID, part of the Health App can be used by medical responders to know of any allergies or medical conditions I have and who to contact without unlocking my phone.   To do so, open the Health App and click on “Create Medical ID” that you see in red.  In the Medical ID you can add our name, birthday, height, weight, medical conditions, medical notes, allergies, medications, blood type, and organ donor status.  You can also add your emergency contact.   You will also want to make sure that you have the “Show When Locked” feature on.

So, there you have it.  If you know of any alternative options for exercise safety, then I’d love to hear about them!

The Meaningful Use Marketing Fail Keeping VPs up at Night

In a recent chat with the VP of a large health system, I learned what keeps him up at night.  His organization, like many across the nation, has invested mountains of time and money in Meaningful Use Stage 2.  Like most health systems (all but 11% says research groups like KLAS) they chose to invest in the patient portal modules available through the EHR vendor.  This Blog_What-Keeps-You-Up-at-Night2is largely because most Meaningful Use patient portal decisions are being made by IT, as opposed to business.  At the top of the list in IT decision making criteria is integration with EHR.  So, VPs like my new friend at this large health system are able to cross off the features required via Meaningful Use quite easy.  All except one…

They are having a heck of a time getting patients to actually adopt the patient portal technology.

It appears as though the “if we build it they will come” concept hasn’t quite held true in the case of patient portal.  In fact, the statistics are rather staggering.  Recent research discussed in the HealthData Management article entitled “Patient Portals Not Yet Go-To Platform for Patients” reveals:

  • Almost half of patients don’t even know if their physician has a patient portal
  • 11 percent are confident their physician “does not” offer one

And here is the kicker for a recovering marketer like myself:

  • Less than half of those surveyed–49.2 percent–report actually being shown a patient portal by their primary care physician either during a visit or outside a visit

And why is this keeping folks like my VP friend awake at night?  Well, first and foremost it is because healthcare providers like him are fans of patient engagement and want to provide patients with the tools they need to stay healthy.  Taking it a step further, Meaningful Use Stage 2 is a financial incentive.  The criteria for getting those incentive dollars are not met when you build a patient portal.  They are met when a critical population of patients adopts the technology. Early results are in, and patients are not adopting.

So, what’s the the underlying problem here?  Well, it’s multifaceted, but much of the error falls in building patient portals that are not user centric.  he user, the patient, is and should be the center of our universe.  However, it is oftentimes not the department of IT, the department largely in charge of Meaningful Use, that invests in stores of knowledge like user experience.   I’ve also been met with many blank stares across conference room tables when I ask healthcare provider portal teams about campaigns their marketing team have created to drive attention to the portal and journey maps that have been created across their patient digital experience to drive patients into the portal.  In my opinion, Meaningful Use is one of the biggest marketing fails I’ve seen in my career thus far.  There is not alignment between IT and the rest of the organization on the measures needed to drive patient engagement.  In my opinion, which has now been validated by this research, a campaign that does not also consider physician adoption of portal technology is a campaign waiting to fail.  If the physicians are not using it, then their patients will not either.

This is why I began the dialogue a few of months back on what the market says you need in your patient portal.  The market, which in reality is simply cumulative actions of patient populations, is the most important input into the creation of a successful patient portal.  You can see some of the components of a user centric patient portal in that series: