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#TexasHIMSS: MD Anderson’s Consumer Driven Cloud Based Solution

MD Anderson uncovered a potential problem.  Their physicians were using non-approved cloud based storage programs that they “may or may not” have been using to share PHI.  I will note that they use a pretty broad definition for “consumer driven”.  I define consumers as the target market that, in this case, a healthcare provider must engage to generate revenue that impacts the bottom line.  The inside of the organization collaborates with “consumers” outside of the organization.  That’s, perhaps, because I come from the business world where “consumer driven” is defined as “offerings, plans, or strategies motivated by customer demand or expectations.” In this case they were targeting physicians and not patients.  Yes, anyone who consumes a technology is a “consumer” of that technology, but that would basically make the entire technology world as a whole “consumer driven” because every technology is created with someone and their problem in mind.

SBEXRF-00017872-001Now that I have stepped off of my soapbox, below you will see the three steps they used to solve their problem using cloud based technology.

Step 1: Analysis and Planning

Used support of network and desktop teams.  Reached out to a few employees and received positive feedback.  Need to establish an appropriate scope.  Decided it was naïve to say that they couldn’t put the data they use in that system.  They went forward assuming it would include PHI.  Worked with desktop and network teams to identify actual target technology.  Engaged Information Security early.

Step 2: Prototype Pilot Implementation

MD Anderson used the following process to implement their pilot

  • Implement gradually and with care.
  • Evaluate surveys and usage data.
  • Pilot with a mixed user base, prototype with power users and set end user expectations

Pilot program tips were to address security concerns early, take the time to test support and administrative tools, and don’t forget about the support staff.

Step 3: Support and Marketing

Partner with key groups for support.  Advertise that these services are available.  For internal collaboration I often suggest you communicate these new tools “7 different times in 7 different ways”.  In MD Anderson’s case this included advertising the tool on their very own television station and using the help desk to document users that they knew were already using cloud based storage (perhaps inappropriately) and targeting those users.  One of the ways definitely need to be a training program that highlights any self-service functions built into the new program.

#TexasHIMSS: Mobile Health at Rockdale Medical Center

At Texas HIMSS today I was able to view a use case for Enterprise Mobile.  That’s the term I use to describe the use of mobile devices internal to a healthcare organization.  In this case, Rockdale enabled a single point of workflow across disparate data sources and care locations to enable physicians via a mobile platform.  This platform involved native mobile OS BYOD, medical device drivers, SSO, and Security.

Infographic-Doctors-Prescribing-More-Mobile-AppsWhat drove the adoption of this mobile technology?  There were three main reasons.

  1. Supports compliant workflows: They learned that doctors were using their cellphones to take pictures of images and then texting them to other physicians that were not onsite to get their opinions.  This obviously gave compliance officers a heart burn.  So, they wanted to make the right thing the easy thing by providing a high quality mobile platform that was HIPAA compliant.
  2. Improves care coordination: Data silos are a problem.  We all know this.  This mobile platform provided physicians with access to data in a single application.  They had this access no matter where they were when they needed this data.  This expedited the speed of care in emergency situations.  I’m sure it also answered the common call from physicians: “I go from room to room to room all day. If it is not on my mobile device, then I don’t care about it.”
  3. Encourages engagement: There is 91% US adult adoption of mobile technology.  As a result, these mobile platforms leverage the use of equipment that physicians are already familiar with.  This fact encouraged engagement and interest in the program.   For those of us that make implementation of technology in healthcare a habit, easy physician adoption of technology is pretty awesome.

Analytics have shown that the technology is highly utilized by Rockdale physicians.  It has also provided a competitive advantage in their provider heavy location of Atlanta.  Among other goals, Rockdale’s next steps are to partner with their local EMS and establish objectives to improve the quality of patient care in the Emergency Department.

#TexasHIMSS: Reaching Teens with Digital Health

During a breakout session at Texas HIMSS today, I attended “Reaching adolescents through electronic health portals:  Lessons from the field” by Peggy B. Smith, MA, Ph.D.

While I normally lean towards the positive in providing insights from these breakout sessions, being a presenter is no easy feat, I must start with a couple of not so positive qualifiers.  “Patient portal” was not really discussed during this session.  Rather, “digital means of communication”, such as public websites and social media, is a more appropriate definition of the technologies discussed.  Fair enough on the surface.  However, not knowing the difference between public and secured technologies created a real problem when the presenter spoke of how HIPAA creates barriers to providing teens with health information via digital means.  The patient portal, used thoughtfully, can assuage these privacy concerns.  I feel that the presenter should have understood this.  Her lack of knowledge on portal was amplified when I asked a question related to the timing of the data she collected in Approach 2, mentioned below, in relation to  Meaningful Use Stage 2.  She did not know what  Meaningful Use Stage 2 was.

istock_000037708720smallWith that being said, I will carry on with insights from the session that I did find insightful.  To present these in the correct context, I will mention that digital health in adolescents presents a number of quandaries for the healthcare provider.  While most healthcare decisions and procedures can and do involve parental consent, not all can.  I involved my colleague Dr. Marcie Stoshak-Chavez in defining what decisions and procedures do not involve parental consent.  As she mentioned, although healthcare statutes vary by state, procedures for sexually transmitted diseases, pregnancy, contraception, psychiatric disorders, and drug or alcohol abuse typically do not involve parental consent and include additional privacy rules that exclude parents.  

Since teens can and do use digital technology, and technology is often used by consumers to collect information because of the anonymity involved, it is quite apropos to discuss using digital health means, such as patient portal, when providing care for teens.  This becomes a much more important conversation in those areas of care where parents should not, by law, have a seat at the table.  Of course, it must be considered that oftentimes the devices teens use are not actually owned by them.  This also must be considered.

Essentially, digital health provides the most obvious form of communication between provider and teen.  However, there are many constraints.  What follows are three areas of study that Peggy Smith provided:

Approach One: Web based platform for sexual health for at-risk youth

This method involved avatars named Tiff and Ty that were available for anonymous questions on sexual health via a clinical website (read: not portal).  This research was a qualitative assessment that evaluated the anonymous questions that were submitted via the website.  There were a total of 916 queries received.  Six major question types  were identified in order of frequency:

  • Cost (Might seem surprising at first, but makes sense in decision making that does not include parents)
  • STD testing
  • Birth control
  • Personal health concerns
  • Parental consent and confidentiality
  • Sexual health misconceptions

Some of the questions included, “Does it cost to have a regular check up and pap smear?” and  “I was wondering if yall had HIVSTD testing available and how much it would cost?”  and “Can I come in for birth control and will my insurance voer the cost for it?”

Approach Two: Evaluation of the adoption of electronic platforms by public health professionals 

This method involved studying decision makers for technology platforms within the healthcare provider industry.  This study wanted to understand to what extent public health professionals, the ones making the decisions, were familiar with electronic messaging and what their attitudes towards acceptance of these platforms were.  This is the one where I must mention that the data was collected in 2011, which predates Meaningful Use Stage 2.  I would guess that these figures would be much higher now, but it is interesting to see how failing we were in adoption of these technologies without the financial incentives.  I must also point out that it is likely that the researchers did not describe these digital care methods in the context of portal, since they did not understand the difference between web and portal.  If I were a decision maker, then that would have painted my answer in this case.

At the time of the study, only 37% of decisions makers stated that they currently had these systems in place.  Only 15% of these decision makers stated that they had future plans for implementing these technologies.  Recurrent themes in the research included a lack of confidence in the processes surrounding digital health, the depersonalization of healthcare, and the concerns for privacy.  It is also interesting to note that there was a stated difference in age cohorts.  Older decision makers were less likely to move forward in developing digital health infrastructure than their younger counterparts.

Approach Three: Global portal for information across continents

The method here was to use the upgraded website teenhealthclinic.org to provide a number of health education tools.  These included a presence in social networking, a short message service, and health education webisodes.  These webisodes targeted 16 and 17 year olds that were mostly Latino.  They used the concept of “Edutainment” (education + entertainment) to provide information on topics such as HIV testing.  Story ideas were based on real stories, contained entertainment value, provided context of audience lives, and focused on characters and their relationships.

There wasn’t much information provided on the impact of this approach other than to point to the “issues that HIPAA presented” when it came to public websites.  Again, knowing the difference between public website and portal would be helpful here.  Also, one information session participant commented that providing webisodes like this would have astronomical production costs.

Reaching Teens with Digital Health

Teen health education can oftentimes be a divisive topic, but the debates on this topic will not make these issues go away.  In fact, it has been proven via cost data that limiting healthcare to teens generates a major drain on the healthcare system.   With all of these facts in mind, do you believe technologies like patient portal can be used effectively in the area of teen health?

#TexasHIMSS: “Godfather of PCMH” & the Future of Medicine

I am at Texas HIMSS this week in Dallas, Texas.  The opening keynote was provided by IBM’s Paul Grundy who has also become known as the “Godfather of the Patient Centered Medical Home”.  He provided a good overview of the history of efforts surrounding connecting data to care.  Towards the end of his chat he defined how healthcare will transform in the near future.  Here are his thoughts, and I would love to hear yours:

  1. dallas 1Healthcare will become more data driven: This is clearly at the heart of what Paul Grundy, and the patient centered medical home movement, is passionate about.  The driving question here is “Where is the data and how does it impact care at the elemental level?” with the goal of having all data available and able to act upon.
  2. Every person will have a plan: This is an interesting one for me.  My mind immediately harkened back to the Connected Health Symposium a couple of years back when Joseph Kvedar, MD spoke of using genetic data for personalized preventive medicine.  You can read my post about it here.  There is also a post by Dr. Marie Stoshak-Chavez on whether we will ever see personalized preventative medicine in the future.
  3. The delivery system will be team based:  Check out this piece on the core principles and values of team based care.  They correctly point out that care has not always been a team sport.  In the “good old days” meaning “still happening today sometimes” all care was curated by the doctor as the “all knowing sage”.  The complexity of modern healthcare provides us with a situation where the entire team needs to work together harmoniously to provide care quality.  This brings us to….
  4. Managing a population down to the person:  Here is what I hope is the “patient centered” part of PCMH. It my (not so) humble opinion, the healthcare of the future will not reach its fullest potential until it is truly patient centered.  This means that the patient needs a seat in team based care.

What are your thoughts?  Do you think he nailed it, or are there some holes in his vision of where medicine will evolve into the future?

Participatory Medicine Meets Participatory Design

Most times when the word “participatory” enters my lexicon it is closely followed by the word “medicine”.  I’m a fan of participatory medicine.  If you don’t believe me, then you can look here, or here, or here for written proof.

Participatory medicine is a care model in where the role of the patient is active, enabled, and emphasized.  Participatory medicine requires the “mindful” inclusion of the patient in the care delivery process.  When you see online patient communities forming, then you see participatory medicine at work.  You will also witness shared decision making, patient participation on the treatment team, and evidence based patient choice.  The director of the U.S. National Institutes of Health has been quoted as saying:

As opposed to the doctor-centric, curative model of the past, the future is going to be patient-centric and proactive. It must be based on education and communication.

These are the types of sentiments that make someone like me very happy.  The fact that I get to play a role, even though quite small, in this movement is the kind of intrinsic motivator that gets me up each day happy to do my work in Connected Health.

hands-raised-participateIn Connected Health we design technologies meant for patient engagement.  They are the communication lines that extend outside of the eight minute patient visit and into the lives of patients wherever they are when healthful decision making counts.  As a result, another participatory term set is beginning to exit my mouth more frequently.  That is, namely, participatory design.  Participatory design, also known as cooperative design, emphasizes active inclusion of all stakeholders, even those that do not know how to use Photoshop, in the design process.  Key to this end is the end user.  In our case that means the patient.  By using participatory design, we are able to create environments that are more responsive and appropriate to a patient’s cultural, emotional, spiritual and practical needs. User empowerment is built into the core of this process.

So, what if patients were crowd-sourced more regularly to solve all of those challenging patient engagement issues?  For example, many of the biggest challenges I see on provider websites occur because it is challenging for an employee of a health system, the ones actually making the final decisions, to release their mind from the confines of their day job.  This usually means that the content of the public website is architected in the way that employees see the organization: by department or facility.  Problem is, this gets in the way of patients trying to find the information they need to be more healthful.  Patients shouldn’t have to navigate 5 layers deep to find content specific to their condition or health concern.  Patients won’t work that hard.  Instead, the hub of digital patient engagement should have, at its core, the patient user experience.

Not being new to the public website creation rodeo, I’ve found the process and final product to be greatly improved through the addition of patient voices throughout the entire website design process.  I’ve never met two patient populations that are the same, so while there is general advice on tailoring a message to patient needs, insight should always be collected from the target market in question.  This insight informs the nuts and bolts of information architecture and the engagement of graphic design.

As a result, a one and done approach to patient feedback is good.  An iterative approach to patient feedback on site design is better.  Co-designing a site with patients?  I would love to see that on every provider website.  By using participatory design to reach out to patients in the beginning of the relationship, with the website that engenders a culture of participation, then it makes it that much easier for that participation to be embedded throughout the entire collaborative care model.

In Managing Finance at Hospitals, the Proof is in the Data

Assembling data is both a technical and political challenge.  I’ve been involved with multiple hospitals where the finance and clinical teams never really collaborate and therefore the lenses put on either domain is not terribly realistic.  Truly merging and using the data requires clinical and financial leaders to establish trust and shared goals that promote an environment of accountability.  The key to trusted data is transparency.

Profitablility and Cost ManagementCombining clinical and financial data for cost management is a popular topic given the political and economic environment. This activity generally includes these data requirements:

  • Claims data for diagnosis codes, patient demographics and encounter information and services provided; this data usually resides in the patient billing system
  • Clinical data such as labs for quality and outcomes ; this data usually resides in the EMR, EHA or other ancillary clinical systems
  • Accounting and finance data from the general ledger, budget and sub-ledger systems.

Assembling this data requires a robust technical architecture that easily stores the data relationships with contextual integrity along with the ability to resolve patient or person identity. Once the data is assembled, leaders of the organization can build disease registries to manage the cost of care for populations and to model service line profitability, analyze payer contracts and more. The most important benefit of this transformation is that the organization begins to speak a common language of accountability and front line managers begin to understand the relationships between volume drivers and departmental workload leading to increased ownership of controlling these variables.  The costing step is important ensure the data as well as the transaction level calculated cost is fully accessible to decision makers.  All too often we hear that “my patients are sicker than theirs” or my surgical device has better outcomes.  The proof is in the data!

The Oracle Enterprise Health Analytics (EHA) platform in concert with the Oracle Hyperion Profitability & Cost Management (HPCM) solution facilitates the merging of clinical and financial data to perform costing calculations. This fully burdened cost data associated with other clinical metrics such as quality and outcomes measures answer both administrative and operational questions.   Using the Oracle platform, patient volumes, outcomes and operational measures are not viewed in an independent environment but instead become dependencies to understanding case mix index, reasons for readmissions, and staffing mix (on a case level), among other things.

Perficient offers design, implementation and support capabilities for Hyperion Profitability and Cost Management (HPCM) and Oracle Enterprise Health Analytics (EHA) solutions as well as the full Oracle Hyperion EPM suite of solutions.  We are a silver sponsor for the #OracleIC14  and we are looking forward to talking with you about Health Analytics and Population Health.

Stop by to meet our dynamic team at the Partner Networking Zone, Marriott Copley Square, 4th Floor to discuss new ways to optimize your systems, along with new solutions that will take your organization to the next level.

Join us in Boston! Follow our healthcare experts on Twitter @Perficient_HC and check our Healthcare blog.

Follow me on twitter @teriemc

View my recent blogs:

Elevating the Role of Finance within the Hospital

Enterprise Warehouses: The Gift that Keeps on Giving

Balancing clinical effectiveness with profitability

Connecting the Dots at Oracle Industry Connect | #OracleIC14

Healthcare executives will get together to discuss how to use data to manage populations, increase efficiencies and advance personalized medicine, among other topics at the Oracle Industry Connect, an event that will take place on March 25 and 26 at Marriott Copley Place in Boston.   The agenda includes keynote sessions on big data informatics and healthcare analytics, with speakers from Mayo Clinic, Pfizer, UPMC, Walgreens, and other industry leaders.

Oracle Industry Connect

The Health and Life Sciences breakouts will showcase how these organizations are implementing enterprise-wide data warehouses and analytics capabilities that provide a comprehensive view of healthcare operations—patient visits, diagnoses, test results, prescriptions, referrals, and more—making it possible to arrive at insights that can lead to improved patient care and outcomes.

Perficient is uniquely positioned to deliver the Oracle Enterprise Health Analytics (EHA) platform as well as strategic healthcare analytic roadmaps.  Our Oracle EHA based analytic solutions and dashboards provide clients with a short time to value solution that meets immediate needs around disease management, operational efficiency, costing and profitability and quality.

Stop by to meet our dynamic team at the Partner Networking Zone at #OracleIC14, at the Marriott Copley Square 4th Floor to discuss new ways to optimize your systems, along with new solutions that will take your organization to the next level.

Join us in Boston! Follow our healthcare experts on Twitter @Perficient_HC and check our Healthcare blog.

Follow me on twitter @teriemc

Population Health: Informatics for Clinical Decision Flow & Costs

At the Fourteenth Population Health Colloquium in Philadelphia, Perficient’s own Lesli Adams, MPA, took the stage with Sanjay Udoshi, MD and Brady Davis to present “Shared Accountability: How Informatics and Data for Clinical Decision Workflow engages Consumers on the Quality/Cost Equation.”  This Mini Summit presentation was sponsored by Oracle Health Sciences and Perficient.   The kick-off of the presentation was fun because it introduced the speakers as a business analyst geek (Lesli), an innovation and strategy guy (Brady) and a doc in the box (Dr. Udoshi). The presentation was targeted at the opportunities for quality improvement and cost control including wellness and chronic disease care gaps.  At the risk of seeming biased, this presentation was one of the more practical, down to earth approaches at this week’s Colloquium event.

Why do I believe that? Well, I felt that many of the attendees at the Colloquium were seeking real how-to knowledge.  Not that the big healthcare organization’s experience in implementing population health management aren’t valuable insights, but there was a lot of buzz about whether population health management can be done in a cost effective manner, and this presentation addressed the type of informatics required to change traditional approaches.  The first step was to outline the process in a slide called Population Health Management 101.  The key concept was moving paper processes for care management to a digital platform to analyze and manage costs, see figure 1.

pop1

 

Figure 1. Population Health Management 101

 

pop2

 

Figure 2. Re-engineering Clinical Care

 

The second idea was to re-engineer clinical care to identify and manage care gaps.  The first step is to identify the key populations to be managed, then determine the key Goals for that population, and finally to manage addressing the gaps in care or Action Arms (Figure 2).  Note that different populations have unique goals but subsequently could have common Action Arms.  To address creating the care gaps and related Action Arms, the healthcare organization has to have a strategic vision for these target populations and combine that with the right tactical tools, namely informatics.  The challenge of creating these informatics isn’t simply addressed with technology tools, but requires several key steps including:

  • Structured Data Capture vs Natural Language Processing (NLP)
  • Diagnosis Naming Conventions
  • Establishing the Digital “Gold” Standard”
  • Influencing the Problem List
  • HCCs and Chronic Disease Management
  • Best Practice Alerting and Health Maintenance Modifiers
  • Guideline Based Bundles and Closing Care Gaps

Addressing Care Gaps is very practical advice for healthcare organizations seeking to really manage populations. Creating informatics solutions that support closing preventive, chronic and restorative care gaps will drive health care value for patients and health plans alike.  Creating these informatics requires data mining, process re-engineering and the ability to extract data from modern electronic health record systems.  Building patient-centric plans of care based on this process will need to be supported through proactive outreach as well.  The key is applying technology tools in novel ways to enhance shared decision-making between the clinician and patient.

Lesli Adams outlined what I see as the key factor to population health management: cost management.  The integration of clinical information and financial data is key to cost management and often this data resides in silo’ed or separate software applications.  The ability to manage costs by having standardized pathways, then examine costs at a Patient Level will lead to better decision-making and more cost effective care.  Putting the disciplines in place to examine physician variability against the standardized pathways is the enforcement technique to bring costs under control.  When organizations commit to collecting and cleaning this level of costing information, then profitability reports by service line, DRG and Physician become reliable tools for key decisions about operations.  One of the highlights of the presentation was micro-costing examples to highlight the key decision points for clinicians.

Lesli Adams will be presenting at the Oracle Industry Connect event on Tuesday and Wednesday, March 25-26 in Boston.  For more information on Perficient’s informatics offerings, especially related to Population Health Management, please contact us.

Population Health: Getting the Process Right

It was a privilege to attend the Fourteenth Population Health Colloquium in Philadelphia starting on a snowy St. Patrick’s Day.  One of my favorite sessions on Monday afternoon was led by Terry O’Rourke, MD who postponed his celebration of the holiday to present “Managing Populations: The Role of a Large Health System.”  CHE Trinity as a healthcare organization treats 18 million patients a year and Dr. O’Rourke had a great Snow in Philadelphiaperspective on the challenges of population health management.

Dr. O’Rourke stated that CHE Trinity was one of the largest home care providers in the United States and that their healthcare organization encompassed 86 hospitals and 21,600 physicians.  More importantly, CHE Trinity was participating in 6 bundled payment programs and 29 patient centered medical home programs.  His observation that “All Healthcare is Local, All Healthcare Standards are National” comes from an understanding of the need for clinically integrated networks and the role of data driven decision making in reducing variations in outcomes.  Terry noted that despite hard work on adopting standards that there is still a wide variation in healthcare delivery.  He also noted that the lesser but still significant variation in outcomes across a large healthcare organization was more proof of the resiliency of human body than the careful adoption of standardized procedures.

The key to his presentation was the observation that clinicians need to lead the effort to standardize care, not hospital administrations or others.  CHE Trinity created a unified clinical organization with the help of outside consultants that streamlined many silos within the large organization into a whole unit.  As a result of unifying the clinical organization, Dr.  O’Rourke noted that operating cash flow margins improved to 9.4 – 9.6% across the system.  The second step beyond unification was to improve their reporting to encourage data driven decision-making.  It was interesting to see how the metrics were converted into grades, like school grades, for easy consumption and judging performance.   The different Terry O'Rourke Presentationhospital boards had GPAs ranging from a low of 2.1 to a high of 3.6 on a 4 point scale.  The goal of the data-driven decision support process was to improve the ease of consuming and acting on the information.

To summarize, Dr. O’Rourke said that “good care is cost effective care.”  Clearly, CHE Trinity is focused on bringing a level of consistency in clinical procedures in population health management and improving cash flow margins in the process.  As with most organizational business solutions, the focus on people and process yields the best results with technology playing a supporting role was my observation.  The focus on people, patients, as the central figure in their clinical processes is real population health management.

How ProHealth is Innovating Population Health Management Webinar

The process of effectively managing population health while consistently measuring and reporting its outcomes can be a challenge for healthcare providers.

How ProHealth Care is Innovating Population Health ManagementWe will be having a conversation with Christine Bessler, CIO and VP of Information Technology at ProHealth Care and Juliet Silver, Director of Healthcare Advisory Services at Perficient on Wednesday, March 26. We will be discussing some of these issues as well as how ProHealth Care was the first healthcare system to produce reports and data out of Epic’s Cogito data warehouse in a production environment.

During the session, Christine will be answering the following questions:

  • How did they deliver clinically integrated insights to 460 physicians
  • How access to analytics allows their physicians to easily see which patients need important health screenings or care interventions, setting the stage for enhanced preventive care and better management of chronic diseases.
  • How ProHealth Care’ developed their strategy to integrate data from Epic with information from other EMRs and data sources to deliver clinically integrated BI
  • How ProHealth Care is positioning itself to deliver against an advanced self-service BI capability in the future.

Juliet will share insight into the methodology applied to establish data governance as a discipline at ProHealth Care, and how the Business Intelligence Competency Center came to be.

Christine Bessler will answer these questions and more during our free webinar on March 26th at 1:00pm CT.

To register for the webinar click here.

 

The Social Support Group Coming to a Provider Near You

What are the benefits of online patient communities?

I find myself answering this question quite a bit lately.  It struck me this week that I have never answered this question on the blog.  But, first things first, what is an online patient community?  Online patient communities are, essentially, condition specific socially enabled support groups.  These networks provide patients with an opportunity to connect with those that are experiencing similar challenges.  Together this collective of voices provides helpful discussion and the sharing of resources.  By their very nature, their benefits are many.  However, when they are organized by a trusted authority in care, namely healthcare providers, the benefits grow quite dramatically.

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So, here is my list of the benefits of online patient communities.  Have any more to share?  I’d love to hear more from your experiences in the comments section below.

  • Social provides connections to those that are not mobile.  Let’s just be honest, appointment scheduling conflicts and transportation difficulties are typically a part of the patient experience.  It is oftentimes the case that patients and patients-by-proxy (caregivers) cannot physically attend a support group.  Any opportunity to lift barriers during the course of treatment is a welcomed reprieve from everyday turmoil.
  • Patients-by-proxy are more likely to open up.   According to Pew research, while 33% of patients participate in online patient communities, more than half of patients-by-proxy do so.    In that same survey, 34% of these caregivers actively read patient commentary about a specific medical issue online and 22% of those caregivers actively reach out to those that might have similar concerns.
  • Online patient communities provide support without bounds. Social networks are used, quite frequently, by the retail and consumer goods industries for consumer outreach purposes.  I don’t know of a loyalty program  stronger than one that could be used to save lives.     Social communities are a fabric of ties that lead to sources of support, information, and collective experience.  The goal of these communities is to foster communication between those without knowledge and experience to those that can “mentor” and provide support.  More informed patients are healthier patients.  Some of the tangential benefits of this enablement include: 1) Better understanding of health and medical conditions, 2) Improved recall of the care plan, 3) Feeling more in control of care, 4) Taking better care of themselves, and 5) Better adherence to medications as prescribed.

There are some additional benefits for the healthcare provider as well:

  • Better sample groups mean better research.  For those researchers aimed at helping through analysis, online patient community demographics are actually a more accurate representative sample of a given patient population than can be found in a traditional support group.  There are two studies that back this claim up.   One study looked at an online patient community specific to scoliosis.  Researchers found that the members of this community had similar demographics to the scoliosis population as a whole.   Another insight is taken from the fibromyalgia group on PatientsLikeMe that showed this group to be representative of those with that condition at large.  Why is this?  Breaking down geographic boundaries is a great way to also break down the socioeconomic and cultural chasms that often exist in traditional groups.
  • Time efficiencies in group care. Check out any online patient community and just underneath the surface you will find the voice of the members mentioning that they were unable to get the medical information they needed from their clinician.  So, these patients often turn to Dr. Google.  Using these communities, clinicians can provide accurate information is a mass customized format to an entire community of similar patients.  This is particularly helpful in those instances when new information or alerts need to be provided to the entire population at one time
  • Strengthens the partnership between patient and provider.  Let’s just be honest, a typical physician schedule does not often leave time for participating in support groups.  With a provider sponsored online patient community, a clinician, in the form of the community manager, is on call 24/7.  Provider sponsored clinicians that act as patient advocates to address general and condition specific questions to the entire community are a valuable asset.  Many clinicians are surprised at how different the questions patients will ask in online patient communities are from those they will ask in the doctor’s office.  For example, migraine patients will often ask Dr. Google “will I die from this?” while physicians rarely if ever hear that question in the office.
  • Social synchronization with care protocols.  When these social features are enabled through the patient portal, patients become truly enabled with knowledge.  There, within a single view, patients can take their new found knowledge and then apply that knowledge to their care protocols.  This experience can be taken a step further through gamifying that experience.  For more information, please check out “Healthcare Gamification: Is it time for Physicians to prescribe gaming to patients?” and “Beyond Gamification: Revolutionizing Healthcare with the Quanitifed Self“.

Getting Scientific About Healthcare Social Media: Medicinal Sites

© elkor 2009The journey into the (officially scientific) exploration of healthcare social media would not be complete without a look into the realm of healthcare specific networking sites that I’ll playfully call “medicinal sites.”  These are closed sites that are aimed exclusively for those with either a certain designation or disease state.

In today’s lineup, we will explore two specific sites.  One of these sites is meant for physicians and the other is meant for patients.

Doximity

Although Doximity was not mentioned in the University of British of Columbia study that spawned this blog series, I am going to start here for good reason.  Although they are a relative newcomer to the space,  Doximity has experienced very strong growth.  Last year Doximity doubled their network to a total of 250,000 members, which is 25% of all physicians in the US.  What I find fascinating about Doximity is that it was started by the AMA.  It’s oftentimes the case that, in the David vs. Goliath world of social media, hip start ups are the ones that people want to follow.  The AMA now finds themselves in a situation where they have more users of their social network than they do actual members.

Doximity does a few things right.  It’s most popular features, beyond making upgrades that make the user interface more like Facebook or LinkedIn, include:

  • An API that enables “Facebook Connect” for easy authentication
  • A built in recruiting tool called Talent Finder
  • A continuing medical education (CME) platform
  • A “digital fax line” that allows physicians to receive their faxes (I know…don’t get me started) through their network via a personal fax number

PatientsLikeMe

PatientsLikeMe is a site where e-patients can collaborate with one another in a peer-to-peer supportive setting.  The site was launched in 2004 by the family members of an architect that contracted amyotrophic lateral sclerosis (ALS) at the age of 29.  They had originally raised millions, literally, in a failed attempt to find a cure for ALS.  They also created this patient social network to go along with that effort.

PatientsLikeMe now has over 200,000 members with groups for approximately 1,800 disease states. The most popular networks are neurological diseases such as ALS, multiple sclerosis and Parkinson’s, but there has been growth in members with HIV/AIDs and mood disorders like anxiety and depression.  Cancer, with its numerous subtypes, has been a more challenging group to tackle.  I have found that these subtypes often form their own online patient communities.  You can find a list of these on e-Patient Dave’s website, which I definitely recommend you visit if you want to learn more about how patients are using social in life altering ways.

One of the most incredible things about PatientsLikeMe is not as obvious.  Let’s consider a typical patient journey: we get sick, we go to the doctor, the doctor captures data during that visit including family history, bloodwork, scans, biopsies, etc.  Then there is the follow up appointment.  Perhaps a follow up call by a nurse.  But as I often say, that’s only 1% of the story.  It is the other 99% of the time when that patient is out there in the real world that matters a lot.  So, where do we get all of that data that takes place during the “meantime”.   PatientsLikeMe is often heralded as the producer of the most compelling clinical data the health care industry has ever seen for this reason.

As compelling as this data may be, it’s only a speck of sand on the beach.  There is far better data capture to be had by socially integrating patient and physician in a meaningful way.  This takes me back.  Way back.  To a post I actually wrote in 2011.  What I said then will be where I end here today:

“Patients are online.  Physicians are online.  However, these two groups are running in different social circles…this presents a true medical problem.”