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Archive for the ‘Collaboration’ Category

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

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:

 

 

 

 

7 Features the Market Wants in Your Patient Portal: Blog Series

In case you missed it, we recently concluded our blog series on What the Market Says You Need in Your Patient Portal. Two of our healthcare experts, Melody Smith Jones, Manager of Connected Health (@melsmithjones) and Nick Lecker, Director of Architecture and Interoperability teamed up to take a deeper look into the 7 features that the market wants in your patient portal:7 Features the Market Wants in Your Patient Portal Blog Series

Healthcare consumers are at the center of the industry’s evolution and patient portals are going to continue to be a vital tool for connecting, engaging and empowering them.

 

Market Driven Patient Portal: Integration of Data

In our last conversation about  “What the market says you need in your patient portal” we discussed the needs of integration and interoperability. This is an area that, while interesting to the IT team, often does not get a lot of attention. This is not because this topic lacks interest, rather, it’s just not the most appealing topic to talk about. For example, when you are Market Driven Patient Portal: Integrate Dataremodeling your bathroom, you discuss the fixtures, the new shower, the new faucets, even the fancy commode; but do you get excited talking about the plumbing? Likely not, however it is the ability to move and connect the items of interest together that makes the project all come together. If you do not connect something the right way you get water all over…or worse.

So, what does this have to do with clinical and financial data? For one, the data is generally in various systems and data stores throughout the organization and generally it comes from multiple organizations. For example, if you look at these concepts from a health plans point of view, the clinical data is coming from HIE’s, provider facilities, clinical labs, purchased data sources, and others. The financial data is coming from claim systems across multiple lines of business, GL systems, AR/AP systems, and others. All of this data still has to be aggregated, cleansed and organized to make it useful. This is not an easy task and having the strategy, the information models, the plan and the governance are all key to ensuring success of these efforts.

Another reason integration is important is it helps define the consumer of the information. Typically, financial data has been reserved to back office functions or it is used to help define/negotiate the cost of services whether they be premiums, reimbursements, subsidies, etc. With the advent of consumerism, the patient is demanding more information in this arena. Patients want to know what their total cost of services are. They want to know the details of the fees. They want the ability to compare costs, values, outcomes so they can make a well-defined choice. Patients generally look at the cost as the driver, yet there are behavioral changes that need to be overcome; e.g. the higher priced option must be the best, right?

There is a lot still to overcome in this area as providers have typically held on to this information and patients may not be able to understand the complexities of where the money actually flows. Integrating the clinical and financial data is a stepping stone in the path to a full consumer-driven healthcare model. Government mandates are forcing the need for change, however, breaking down the walls to integrate information will not be easy. Meaningful Use Stage 2 (MU2) will be one of the drivers to help make healthcare interoperability a reality.

Core to solving these problems is having a clear understanding of the business capabilities and processes that drive the solutions. Understanding (documenting) the business capabilities, defining the information needs (again documenting) and then defining the business processes (yes writing it down) that act between the capabilities and information will be the blueprints and guides to setting and achieving the vision. With the vision established, we then can begin the process of connecting the dots of where the information lives to where it needs to go and the format which it needs to be in. There are a number of technical challenges given that interoperability is not just a simple plug-n-play solution. The movement of the information needs to follow standards (which by-enlarge exist) yet all of the connections and the subtleties of the content need to be clearly outlined in the road map of integrating clinical and financial data.

This concludes our “What the market says you need in your patient portal” blog series.

Market Driven Patient Portal: HIE Across Diverse Care Settings

So far in this discussion about “What the market says you need in your patient portal” we have been driving toward changes that are core to new engagement models. However, we have not addressed a core enabler: “It’s all about the data!”

Consumers demand access to information that meets their needs and they are not complacent Market Driven Patient Portal: Health Information Exchange Across Diverse Care Settingswith becoming hunters and gatherers for the information is truly about them. Consumers in today’s market demand accurate and up-to-date information about their health profile, just like they do with respect to their financial profile. However, the systems and processes to make that information available are not all there.

There are various sources of the information that are relevant to the patients/consumers (and also to the providers providing care to their patients). Much of this data has been distributed through the provider community. Some of the data is in the provider’s own systems. Some of the data is in the hospitals EHR systems. Some of the data is in outpatient facility systems. Other data is isolated and hard to locate.

With the push to HIEs some of the data is now becoming more available to the providers and to the patients they serve. However integrating the data into a holistic view is still a challenge. The information still needs to be gathered / extracted from the source systems, transformed into a structure that the HIE can understand and then there are the issues of translating the codes and values to normalized/consistent terms following a defined set of vocabularies. Additionally, ensuring a unified view of the individual can be a challenge. Enterprises IT groups are leveraging Enterprise Master Person Index (EMPI) solutions to construct the golden record of the individual but this also has its challenges.

Once all of the data is assembled (assuming that it is) the next challenge is to get the information to the right person at the right time. The HIE now needs to be integrated to the rest of the enterprise. Exposing the information in terms of the services or APIs can now begin. Finally the Portal (and this is just one of the consumers) can begin to consume these services and make the information available to the consumers. What’s also of importance is that the consumers can access this data from multiple perspectives. The provider can see full episodes of care across multiple care locations. The patient can see their health profile all in one location.

Having a single view of one’s health profile (or even the illusion of) is a powerful tool. Not only does it provide insights for better care, it breaks down the walls of information silos that have challenged providers and patient’s alike. Again, it is all about the data, and integration and interoperability are the key.

Market Driven Patient Portal: Avatars for Personalized Coaching

In our next installation from the “What the market says you need in your patient portal” series we bring you avatars. These avatars are closely related to our last post on gamification and serious games, but their real value proposition is in what I like to call “high touch digital healthcare.” Many may think that “high touch” and Market Driven Patient Portal - Avatars“digital” cannot exist in the same concept, but oh they can.  We are actually beginning to see that in some cases patients prefer high touch digital to face-to-face care.

Here are some examples:

  • Patient Education: In the realm of patient education, we had a study that used digital avatars with human characteristics to help women through preconception health.  In this case human interaction was not replaced.  Rather, the avatar augmented and furthered the patient experience through the use of digital technology.  The avatar asked initial questions and then triaged the more difficult interactions to clinicians.  This allows clinicians to have more time to deal with complex issues. Add this to a patient portal and you begin to see how patient health concerns can be triaged remotely with the requisite education embedded throughout.
  • Appointment Registration: I love that more and more healthcare organizations are making online pre-registration an option.  Going even a step further many hospitals and ambulatory care centers are digitizing the in person appointment registration, which I mentioned in an earlier post of this series. Let’s add avatars to this process, which adds a “human” touch to an otherwise clinical process (pardon the pun).
  • Patient Discharge: The discharge process is ripe for errors and omissions.  All too many times patients arrive home without having absorbed the right data they need to maintain their health.  The result is often costly readmission.  Even a couple years back I was able to witness a demonstration of the use of avatars during the discharge process.  Through an automated touch display, patients were able to navigate through their discharge instructions in an interactive way.  The avatar even threw in fun questions like whether or not the patient preferred the Red Sox or Yankees (read: the hospital was in Boston).  Patients provided rave reviews for their avatar led discharge experience.  In fact, the experience was rated higher than in person discharge by a wide margin. Now, let’s add this functionality into the patient portal as well to continue that interaction remotely to ensure that those discharge instructions are followed. I’d suspect that you would see a marked improvement in readmissions rates simply because discharge instructions are adhered to.

Overall, avatars and other forms of digital high touch are a win-win-win.  They are low cost (win), add a sense of fun to otherwise lackluster processes (win), and increase quality all at the same time (win). Stay tuned for our final posts in the series where we start to discuss the importance of health information exchange and interoperability as they relate to the patient portal.

Market Driven Patient Portal: Gamification and Serious Games

More than half way through our “What the market says you need in your patient portal” series I bring to you one of my favorite topics: healthcare gamification and serious games.   Games are great at explaining complex systems.  There are fewer places one can find complex systems than in the micro and macro worlds of Market Driven Patient Portal - Gamification and Serious Gameshealthcare.  In healthcare we’ve seen games of multiple types.  Here are some of my favorite examples:

  • Games that help modify user behavior: Humana took a pioneer stance in the world of serious games in healthcare with their Horsepower Challenge.  Using the craze the followed games like Dance, Dance, Revolution, Humana used “exergaming” in 2009 to challenge 20 members of Congress and 2,000 5th and 6th graders nationwide as they “raced” across the country by taking steps with a pedometer.  She also harkened back to a healthcare game I mentioned in a post back in 2011, namely Re-Mission.
  • Games that train wellness behaviors: In the game Re-Mission, a nanobot named Roxxi is injected into the human body to fight particular types of cancer at the cellular level. Those playing the game are also asked to monitor the patient’s health and report any symptoms to the fictional Dr. West.  Each level of the game informs the player on a variety of treatments and on the importance of staying compliant with medical protocol.  HopeLab trial studies, that were published in peer-reviewed journals, revealed that playing Re-Mission led to more consistent treatment adherence, faster rate of increase in cancer knowledge, and faster rate of increase in self-efficacy. Most notably are blood test results, that showed the measured level of chemotherapy drugs in blood to be higher in players versus the control group.
  • Clinical learning labs: These are the types of gaming environments where practitioners can train in virtual learning labs on an avatar.  A great one is foldit: Solving Puzzles for Science.  foldit, funded through a University of Washington grant, is an attempt by game developers to crowdsource scientific research.  Within a few paragraphs of texts, the gamer is educated on what proteins and amino acids are and why their shapes, and what those shapes fold into, are important.  The goal is to have human “protein folders” work on proteins that do not have a known structure.  Scientists can then take folding strategies that human players have come up with while playing the game and automate those strategies to make protein-predicting software that can fight HIV and cancer more effective.  Beyond protein prediction, protein design has even more direct implications to disable a virus.  Thus far there are not many automated approaches to protein design, so foldit’s human folders are a great source of research.

Gamification is the term we use to describe serious games that go beyond strictly trying to entertain.  They have a “higher purpose”, so to speak.  Designers use game techniques to get players to do something not game-like at all.  The possibilities for embedding serious games into patient portals are seemingly endless, but my favorite is in the realm of personalized prevention. The patient portal is a powerful repositiory of patient data and can also function as an empowerment tool. Similar to the build of the patient portal itself, if you want to develop a serious game that works, you must, better than anyone else, understand the purpose of your game.  You must know to whom your game is targeted.  You must devote a lot of time to figuring out what motivates your intended audience.  That understanding must be crystal clear before you even consider how the game should be designed.  Document, in detail, what your experience needs to communicate with the gamer.  What kinds of puzzles best match this experience? Then consider what type of game genre matches these puzzles.  Lastly, consider what platform would need to be used to help the gamer bring action to play.

Building a game that is based on what motivates your audience is what makes a serious game a game.  The market will continue to push this functionality onto the patient portal.

Market-Driven Patient Portal: Social Collaboration

Next in our lineup of “What the market says you need in your patient portal” series is social collaboration.   This topic brings us to the core of a term that we hear a lot in the industry: patient engagement. What is that, really? Any form of engagement requires communication. Right now communication between provider and patient Market Driven Patient Portal - Social Collaborationis getting better, but I’d still say that the relationship is in its “healing” phase. The best way to speed that healing is through creating mechanisms that support healthy communication between the healthcare provider and the patient.

Traditional methods of communication focused on the brick and mortar. There has been noticeable resistance to the idea of email, and far fewer providers offer social capabilities. So why will the market push for it? Because patients are accustomed to using social collaboration and they know it is far more convenient to use that tool over, say, picking up a phone or driving to the office. Providers will find that it is also much more cost effective than standing firm on the old way of doing things.

Patients use social to gather information. The healthy byproduct of this dynamic is a greater emphasis on managing wellness. Every social communication does not require direct communication between patient and physician. Instead, social relies on content to navigate a user towards answers and provides readily available mechanisms to find answers to questions. These “conversations” have the power to personalize experiences on an individual level, as well as deliver rapidly consumable healthcare information that can be personalized to the individual and their health needs. A social collaboration strategy is a success when you are able to engage and interact with the patient in a way that drives them towards the overriding goal of wellness. Everything that you do, or want to accomplish, on the patient portal should support that experience. This not only guides your content and communication objectives, but it can also result in lasting interactions that elevate consumer experience.

To make social collaboration effective, it is important to present content in a fashion and format that makes the most sense to the user. Let’s be honest, social collaboration can be a bit nerve wracking in a HIPAA regulated environment. As such, it is crucial that every social collaboration initiative include a formal governance program. This program will ensure that patient communications stay relevant to the overall goal of wellness. However, with the right strategy, you can embrace the power of social to influence the conversation and amplify the health of your population.