by October 17th, 2013
When Healthcare.gov launched, it drew an understandably high number of initial users. Millions poured onto the site, but they weren’t able to sign up for insurance due to technical glitches. As an impartial observer, it was interesting to watch media outlets struggle to find even one person that was able to sign up successfully. The Washington Post even went as far as to illustrate this single newly minted healthcare insurance holder as a mythical unicorn.
Leave it to clashing political tensions to throw the topics of non-functional requirements, project management, and user experience into the limelight. Oh, wait. That’s not what everyone has been talking about since the wake of the Health Insurance Marketplace ribbon cutting…but they should.
There’s lots of finger pointing in the great game of Healthcare.gov Whodunit. However, underneath all of the tensions that bely healthcare reform, there are some key takeaways from the Healthcare.gov case study for anyone looking to build a website as a platform for information dissemination and conversion. Here they are:
It was originally thought that there were only two players involved in the creation of Healthcare.gov. In reality, there were more than I have fingers to count with. A project this colossal requires some serious project management, and project management was clearly lacking here. It has been reported that those in charge were aware of the flaws and were told the site was not ready for launch. The Washington Post reported that “people were pulling out their hair” and complaining “loudly” about the problems the site was experiencing before being moved over to the live server. Those in charge still insisted on rolling out the new site on the original timeline.
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by September 13th, 2013
Congratulations to Perficient client Marshfield Clinic on their 2013 Healthcare Provider Standard of Excellence WebAward in Web Development. The Web Marketing Association‘s annual WebAward competition has been setting the standard of excellence for website development since 1997. Independent expert judges from around the world review sites in 96 industries. The best are recognized with a WebAward. The WebAward Competition is the premier award recognition program for Web developers and marketers worldwide.
by August 26th, 2013
It is a much talked about fact that the healthcare industry lags behind other industries in IT adoption. With constantly changing regulations, security concerns, and the pressure to deliver better care at a lower cost, healthcare providers have not implemented the latest technologies to leverage their data. One solution to these issues is cloud computing.
Cloud computing in healthcare holds many advantages, including:
- Mobility: Data is stored in the cloud infrastructure, allowing provider staff to access it from anywhere, anytime.
- Decreased costs: There is a reduced capital expenditure on hardware and maintenance. Also, hospitals will only pay for the services they use, and challenges can be addressed remotely by IT personnel.
- Better care: The cloud provides a central platform for EMR data, prescriptions, reports, and patient history. When all of this data is available, the risk for misdiagnosis or conflicting treatments is reduced.
- Scalability: As the amount of data healthcare provider house grows, cloud server storage can easily be increased, unlike IT infrastructure.
- Security: Cloud service providers are liable for HIPAA compliance, requiring them to encrypt and securely house data.
- Speed: Working in the cloud allows for collaborating and sharing data in real time. Data is synchronized as it is processed or updated, allowing staff to work together without being in the same place.
Leveraging the cloud would allow providers to meet regulatory compliance standards at a lower cost than implementing traditional technology. Various forms of data are interoperable, allowing for analysis and reporting. While security concerns remain, cloud computing is becoming a viable answer for healthcare challenges. Read more about cloud capabilities in the article, “Perficient’s cloud prescription for healthcare companies.”
by August 26th, 2013
What kind of equation is that? I can understand Member Portal, but OBI? BPM? Well, OBI stands for operational business intelligence. OBI is real-time, dynamic use of analytics that enables a service component to decide, based upon the information available, how to proceed in engaging with a stakeholder. BPM, or business process management, refers to the defining and execution of business workflows. Bringing the two together in a member (could be a patient) portal is a formula to success. All health plans today use a member portal to provide basic, on-demand services. Typically these portals include the ability to review past claims, search for a provider, plan documents describing their benefit program, find industry medial reference databases, enroll for benefits, fill prescriptions, view FAQs about their benefits program and even view and manage funds deposited in high-deductible savings accounts. But, as stated, access is on-demand. The members need to be well educated on the benefits consumption process to help themselves. In many cases, most just stumble through the process. To make matters worse, most of them don’t interact with our benefits site beyond the annual election process or, most importantly, when we have a need.
The time is right, and the solutions are there, for health plans to enhance the member services by moving from a passive, on-demand model to an active, assertive one. Doing so will increase member satisfaction, important for retention with the advent of Health Insurance Exchanges (HIXs) and consumerism in the benefits insurance marketplace, decrease the cost to serve, and increase the productivity of the health plan resources engaged in their services operations. Leveraging OBI and BPM, delivered through a mobile-enabled platform, is the way of the future!
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by July 15th, 2013
Stress is a killer and each of us struggles with controlling stress in our own way. Often stress relief comes in the form of equally destructive behaviors including over-eating, smoking, watching too much television, etc. As a result, stress is a serious contributing factor to higher healthcare costs in the form of heart attacks, cancer and many chronic illnesses. The challenge is that stress is hard to control and, worse yet, it can really snowball out of control.
Over the years, there have been many ideas to help people reduce stress: meditation, exercise, calming music, hobbies and, of course, beer drinking. At Perficient, we like solutions that use gaming or gamification to reduce stress. One interesting approach is a small device call the PIP biosensor. The PIP biosensor is a Kickstarter project that aims to help folks mediate stress by objectively measuring symptoms, digitally visualizing the results, and then gamifying stress reduction. It’s the latest in an avalanche of sensors aiming to increase body awareness and health. Read the rest of this post »
by June 19th, 2013
The words, “because I said so” were like nails on a chalkboard for many children. I was lucky enough to rarely hear those words. I was blessed with parents that took the time to explain why they were taking the decision they were and as I got older willing to discuss decisions further, allowing me to make my case for important things like why I needed a hundred dollar pair of jeans (I never got them!). This is probably why my skin crawls today when my doctor tries to mandate a course of action to me rather than take the time to explain his reasoning or discuss alternative options. The decision is made for me, not with me. Who died and made him king, especially when it comes to my health?
According to a recent research study in the US, 70% of patients preferred making medical decisions with their doctors. Interestingly, of those, only one in seven would disagree with their doctor over treatment, some saying it would not be socially acceptable or would damage their relationship with the doctor1. What is that about? If the US healthcare system is ever going to increase quality of care while reducing costs, the mentality needs to shift from doctor is the all mighty king to patient is key.
What is Shared Decision Making?
Patient-centered care is one effort to rectify this power imbalance between physician and patient. The Institute of Medicine (IOM) defines patient-centered care as: “Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.2”
A key component of providing patient-centered care is shared decision making (SDM). SDM is a collaborative process where patients are provided with evidence-based information on treatment choices and are encouraged to use this information to have an informed dialogue with their physicians to help them make the healthcare decisions that best align with their values, preferences and lifestyle3. “SDM honors both the provider’s expert knowledge and the patient’s right to be fully informed of all care options and the potential harms and benefits. This process provides patients with the support they need to make the best individualized care decisions, while allowing providers to feel confident in the care they prescribe.4”
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by June 12th, 2013
My colleague, Terie McClintock, recently posted a blog about the relationship between the patient experience and the level of patient engagement on our Oracle blog. A correlation between the two concepts is often assumed, but does one actually influence the other? Terie did some research into the effect that patients being engaged in their care had on the outcome of their experience.
After completing a little research I found that 62% of patients who were given access to their provider notes took their medication as prescribed and “felt more in control of their care” at one very large provider organization. Does “feeling more in control of my care” equate to a positive patient experience? I have written before about this topic! I am happy when I can see the data but this is healthcare, so we need data to support this conclusion.
Engaging patients through information sharing does help improve patient experience and may also reduce costs. According to a study about hip and knee replacements, those providers who shared data such as the incidence of those that surgery did not help, the incidence of those who had the surgery and had worse pain, information about alternatives such as physical therapy, and more, there was a 38% fewer hip replacements and 26% less knee surgeries in the same population. These examples truly reinforce that Healthcare organizations must utilize consumer-centric technology solutions to deliver quality care and content.
Terie found that when information was shared with patients, there were fewer surgeries conducted. But does that mean that while they were engaged they had a better experience? Patients may have declined care due to the information they were provided, but these statistics don’t show impact on quality of life or happiness level. Have you seen a correlation between engagement levels and experience? Do you see a correlation?
To read Terie’s full post, click here.
by June 10th, 2013
Sometimes social media is too popular for its own good. The fun and frivolity of finding Mini Oreo Peppermint Cheesecakes on Pinterest (that exists) or figuring out what the Official Grumpy Cat is up to on Facebook (he exists too) often get in the way of conversations regarding the real collaboration problems faced by the healthcare enterprise. Whenever social media enters the conversation as a potential solution to the healthcare collaboration problem, it is often brushed off as that “cute thing they tweet about.”
But, what is social, really? Social is a way for communities of people to digest large volumes of information quickly. We live in an
information rich world, and data overload is this digital world’s greatest side effect. Way back in 2008, a technology research firm called IDC tried to account for all of the 0s and 1s that make up the current store of digital data. They found that in 2007, the world had amassed 161 billion gigabytes of digital data. If each byte of data is one character in a book, then 12 stacks of books could have been piled up from the Earth to the Sun with the digital data collected at that time. But that data growth keeps expanding exponentially. By 2010, those 12 stacks reached from the Sun to Pluto and back to the Sun. From now until 2020, the digital universe will double every two years.
Yes, this information comes in many varieties. Some people (read: me) really want to know what Grumpy Cat is up to. However, we see these masses of big data in the healthcare enterprise daily. Clinicians need to wade through the mountains of medical research that impact care decisions daily. Researchers need to find and figure out the facts and figures that impact public health. Within the organization, employees need to find the information they know exists among the applications, content, and knowledge workers grouped in different, often hidden, locations across the organization.
Many people believe that social media is the instigator of this data overload. I am of the belief that, instead, social media was our collective response to this overload of data. The amount of data available is so vast and so complex that we can only digest it as communities of people interested in similar topics. Instead of being that “cute thing”, social media becomes mission critical to the healthcare organization living in fast moving times. A healthcare enterprise enabled by social would have:
- Departmental sites that are transformed into dynamic community hubs with quick ways to call, interact, and filter information
- Care coordination across multiple settings with activity feeds that can track care processes across the care continuum
- New mediums for knowledge dissemination, which becomes particularly important during a disaster
These are just a few examples, and there are plenty more. What are some of your favorite examples of the healthcare enterprise enabled with social?
by May 20th, 2013
Today I am lucky enough to attend the Patient Experience Summit at the Cleveland Clinic. I’ve spent a lot of time talking to people (it’s a condition inherent to my disposition). I have asked gobs of attendees what has inspired them to join the summit over these few days. The overwhelming majority of attendees, clinicians themselves, are interested in the “traditional” patient experience. By traditional I mean patient is in front of me, within the confines of the brick and mortar clinical care setting, and I would like to optimize that experience for them.
This is a noble goal. This is why they practice medicine, right? Well, here is the problem. Any given patient, and we are all patients really, spend only 1% of their time within the clinical care setting. However, it is the other 99% that determines whether they return or maintain their health. As a result, providing care and managing chronic conditions for a patient population requires helping patients live healthy at home, at school, at work, in their neighborhood and in their community. Where are conversations about that 99% of the time and how we can extend the patient experience to all of the places where it also counts?
To impact care at this level, healthcare organizations need tools that can become a natural extension to a patient’s every day life. We need to get into the conversations that patients are already having in their heads when they are not right in front of us. This can be a challenging user experience issue indeed. However, with 84% of US adults using the internet daily and 85% US adult adoption of mobile phones, digital health provides some of the most important tools that a healthcare organization can use to keep their population healthy.
by May 13th, 2013
The healthcare industry is experiencing revolutionary changes stemming from the rapidly shifting role of the patient within the continuum of care. This is resulting in high demand for easier access to healthcare professionals, access to online medical information, and alternatives to traditional care. There are few other places where this market shift has been more dramatic than in the area of telehealth technology. I thought I’d share three of my favorite implementations of telehealth as of late. The use of these technologies (read: Robots!) is changing the way healthcare organizations deliver meaningful results to local and remote geographic locations.
Boston Children’s video monitoring robots
Boston Children’s has an impressive telehealth program that includes video-monitoring robots. These 4-foot-6, 17-pound, two wheel robots help with post-operative consultations. They act primarily as a means of videoconferencing, which gives the families of hospital patients a way to keep in touch with doctors and nurses in between post-surgical appointments. Equipped with cameras, audio gear and a video screen for a “face,” the robots are operated remotely by Children’s Hospital staff. In addition to facilitating communication, they can take video and close-up photos of surgical scars or other key areas of interest to help medical staff monitor recovery.
Providence Saint Joseph Sends Robots to Stroke Patients
Want more robots? You can find more robots via Providence Saint Joseph in Burbank. They will be using this telehealth technology to help stroke patients using a computer monitor to review initial tests, diagnose, and direct treatment. This robotic system includes indoor wayfinding technology that helps doctors direct the robots to patients within the unit. Why bring in the bots? Well, not all hospitals have interventional neurologists, and evidence shows that stroke patients have far better outcomes when they are treated as soon as possible by these neurologists. With technology, we can now make the very best specialists available to the world, or at least to the San Fernando Valley.
Children’s Hospital of Philadelphia’s REACH intervention
Don’t want robots? Well, you don’t need them to provide great care using telehealth technology. From a telehealth perspective, Children’s Hospital o Philadelphia offers home monitoring for infants using video and audio connection and clinical follow-ups through REACH intervention. REACH helps patients recognize early changes in health status before crisis. The REACH intervention uses daily online communication and a clinical information system that harnesses the power of speech technology to create a virtual home monitoring system using any telephone in combination in combination with video-conferencing and a web-based educational system. This model gives families the opportunity for visual and audio contact with sub-specialists, and provides a means of home-based clinical follow-up during the critical early weeks after surgery.
by May 9th, 2013
Michael Porter, who leads Perficient’s Portal practice, posted a blog yesterday called “If You Build a Patient Portal Why Won’t They Come?” This article is a response to a post of the same title by by Steve Wilkins and also relates closely to a recent post on our blog by Marcie Stoshak-Chavez. Michael does a great job of giving background on patient portals as well as providing his insights on what can make a portal more successful. Here is part of Michael’s response to the original article:
A lot and I mean A LOT of hospitals, clinics, doctors, etc are spending many cycles getting it all to work. Much of that work is brute force labor just getting a myriad of systems to talk to each other. In many ways, it’s a classic systems integration play. However, even after you get a site up and running, you may face problems. How do you actually engage the users of the patient portal to come and use it?
Steve Wilkins brings up some interesting issue the Mayo Clinic has had in increasing usage.
Upon reflection, Manley admits that “simply making services available doesn’t cut it.”
“Unless you are engaging patients, you won’t meet meaningful use requirements. [Messaging and other mechanisms] need to be a part of your practice.”
Manley is quoted as saying that “patient engagement has been a part of what Mayo has done for a long time. Meaningful use, especially Stage 2, is a catalyst to kick it up a notch.”
In many ways, this challenge has more to do with classic consumer engagement scenarios faced by those who run commerce sites or who are trying to create a community. I love the quote, “simply making service available doesn’t cut it.” I think that quote hits it on the head. Steve does have three suggestions as to why just throwing out some data on a site won’t work: Read the rest of this post »
by April 24th, 2013
Earlier this week Phil Fasano, EVP & CIO at Kaiser Permanente, wrote a blog post posing the question: If other industries have proven that IT can improve processes and reduce costs, why has healthcare been so slow to adopt? Phil’s post discusses the current state of healthcare IT as well as what entrepreneurs can focus on in the future. Here are a few key points from the article:
- If we hope to… improve the quality of care and make it available to more people, while still reducing costs – it is imperative that our health system embraces new and disruptive technologies.
- According to Insight Research, health care IT spending will grow 9.7 percent annually between 2012 and 2017. That compares to an annual 6.4 percent growth rate in overall healthcare spending.
- IT systems have…revolutionized financial services, and as a result banks have since saved billions of dollars as consumers first used ATMs for deposits and withdrawals, and then started to pay their bills and make purchases online. According to a Bain & Co. brief, transaction costs have dropped from $4 at the teller window to just 8 cents when paying a bill via a smartphone.
- EHRs are already proving to save lives and costs, from identifying redundant tests and dangerous drug interactions to revealing trends in treatment outcomes.
The healthcare industry has a great opportunity to employ IT to improve the quality of care and lower spending. But where do we start? Phil suggests that entrepreneurs in the healthcare space being by focusing on: Read the rest of this post »