Healthcare organizations are already collecting and reporting quality measures for a number of reasons – for reimbursement purposes, to meet regulatory compliance requirements and to provide transparency of outcomes to the community. The requirements of Meaningful Use take the collection and reporting of such measures to an industry-wide standard, essentially setting expectations that move from data collection to data reporting to data utilization in the improvement of quality care. As a CHIME Foundation member, Divurgent has conducted an industry survey focused on the implementation of EHR technologies and the utilization of data in overall organizational strategy and decisions.
Divurgent is in the process of finalizing plans for a second release of the Divurgent Business Intelligence and Data Analytics Model (DIBIDA©) survey, initially launched in 2010. The purpose of the study is to identify the levels of maturity within the hospital marketplace, in the areas of data analytics and business intelligence.
The results of this industry-first survey were released at the 2011 Healthcare Information and Management Systems Society Annual Conference in Orlando, Florida. In its first release, Divugent received responses from over 150 hospitals and health systems across the United States and followed up with interviews aimed at identifying best practices. It was again shared in light of the progress of Sentara Healthcare’s progress in business intelligence and data analytics at Epic’s 2011 User Group Meeting.
At Divurgent, we believe hospitals and health systems that excel in the area of business intelligence will create and sustain competitive advantage over the long term. The ultimate aim of this study is to identify best practices and create a roadmap that providers can follow to implement successful business intelligence and data analytics capabilities and continue to serve their mission.
]]>Providers and clinicians will be challenged with increased data entry demands to meet Meaningful Use Phase 2 regulatory requirements. Time spent entering data into the electronic health record (EHR) may result in increased wait time for patients, less time spent providing clinical care, decreased patient satisfaction and expenditures on personnel to assist with data entry.
A well-designed EHR can decrease these burdens and actually lessen documentation time in addition to the obvious benefits of data portability and patient safety. Increased regulatory requirements for health care providers will challenge IT staff and vendors to provide solutions to meet these demands.
Sites that follow the below guidelines on implementation and maintenance of the EHR seem to have less provider and clinical frustration and dissatisfaction, resulting in better EHR adoption, improved quality of care, and higher levels of patient satisfaction. The following are some examples of activities that should be addressed during EHR design and optimization to ensure productivity during and post go-live:
1.Vendor tools such as favorites, order sets and templates should be readily available and dynamic. Changes to formulary, documentation requirements, or medical practice standards should be communicated to IT by user liaisons or advisory boards well ahead of implementation and incorporated into these tools.
2. Use of alerts, warnings, advisories and hard stops should be very limited. The more these are used, the less effective they become. Providers are counting each click to bypass these items. Alerts must provide meaning and value to the user!
3. Use default responses where appropriate. For example, if 80% of patients need a wheelchair to go to Radiology, make that pre-selected if your system permits. Still counting those clicks…
4. Follow-up initial training to make sure providers are taking advantage of vendor-supplied customization tools and other shortcuts. Providers may have mastered the basics required to enter an order, but may be reluctant to seek help for things that might make entering that order easier. Habits are established quickly; organizations should take advantage of the learning curve to ensure users are aware of the full-scope of possibilities. This pertains not only to those entering information into the system, but also to those who primarily view data contained within the system.
5. Changes or upgrades should be done on a predictable schedule, with ample communication and clinician collaboration. No one likes surprises in the EHR, and changes to the EHR should not be taken as” matter-of-fact” as a change to social media pages. Providers and clinicians should participate in testing if possible – they have found shortcuts and workarounds you are not aware of that may be lost by system changes, impacting workflow and decreasing productivity.
]]>The CMS Notice for Proposed Rulemaking (NPRM) for Meaningful Use Stage 2 elevates the personal health record (PHR) to an all-time high ranking in the world of healthcare IT. We all agree that greater patient involvement and accountability is a very good thing, but there’s one small problem: CMS and the healthcare industry have not informed the public of their duty to make use of the large PHR investment which has been (or will soon be) made on their behalf.
Industry watchers have long known that the promise of PHRs is undeniable. That is, give patients the right healthcare management tools and they will begin managing their own healthcare to the benefit of themselves and our over-burdened healthcare system. While the promise of PHRs is not new, the realization of this promise would indeed be new.
Consider these points:
1. Despite millions of PHRs made available to the public, meaningful use of PHRs can be measured in single percentage points
2. The most popular exemption exercised in MU Stage 1 is the release of information provision, since so few patients ask for their electronic records, and
3. The much deliberated ACO legislation – based on the notion that all healthcare delivery parties should be accountable – leaves one rather important party unaccountable: the patients.
Much can be done to put PHRs on par with other Internet must-haves. The low-hanging fruit to promote adoption is well understood, such as making PHRs more user-friendly and bundling PHRs with “sticky” functionality like self-scheduling. Also, providers can give short PHR demonstrations to patients before the patients walk out the door. But maybe the most potent weapon is advertising. In fact, if HHS can mount a “ask your doctor if you have questions” campaign, surely a PHR promotional campaign would be equally worthwhile.
But, let’s see… who could be the spokesman? Dr. Sanjay Gupta from CNN comes to mind… certainly one of the best known and most trusted Doctors in America. And how is this for an enticement to HHS? If they can sign Dr. Gupta for a TV spot, Divurgent will write the script at no charge. Could be the beginning of a beautiful relationship.
]]>As an author of a book focused on planning for Accountable Care Organizations, I’ve heard from all too many providers and consultants who believe the concept will never take off.
Although I remain cautiously optimistic about this new care delivery model, I am very much looking forward to the results of the Pioneer ACO program.
As you may be aware, the Pioneer ACO program is the latest initiative from CMS’s Innovation Center. The goal is to assess the impact of different payment mechanisms within organizations that have already proven they can accept risk and act as an ACO. More to the point, the goal is to provide better care to Medicare beneficiaries and reduce Medicare’s costs.
The participants have been selected and the program has begun as of January 1 of this year. CMS was looking for up to 30 provider organizations to start the program and they ended up selecting 32 (out of more than 80 applicants) from 18 states. They estimate that, if successful, the program will save $1.1 billion over the next five years.
The first two years of the Pioneer ACO Model will test the shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than the current levels in the Medicare Shared Savings Program.
In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model, which is designed to financially reward patient care when specific quality-of-care benchmarks have been met.
So, why am I excited? Because it won’t be too long now before CMS answers the question many have been asking: “Are we chasing unicorns?” Until then, we only know that more than 80 provider organizations don’t believe so, and 32 have been charged with answering the question once and for all.
]]>The Beacon Community Cooperative Agreement Program will provide new health information technology (HIT) roadmaps, lessons learned, and a multitude of best practices for ACOs to grow their HIT infrastructure and capabilities. The Beacon Program supports awardees in helping them build and strengthen their health information technology infrastructure and exchange capabilities to improve care coordination, increase the quality of care, and slow the growth of health care spending. This is in direct support to the Triple Aim of the Medicare Shared Savings program.
ACOs will face numerous challenges associated with the development of an effective HIT infrastructure. These challenges include: implementation of an electronic health record across the organization, health information exchange across a diverse group of stakeholders and the successful achievement of meaningful use by at least 50% of the ACO’s primary care physicians.
The results and lessons learned from the Beacon communities will be integral to overcoming these challenges. Beacon communities must define, track, and report on their progress toward measurable health and efficiency goals. The resulting experience will inform ACO efforts to support the meaningful use of EHRs and the use of other health information technologies
How ACOs will benefit from the experience of the Beacon communities can best be showb by looking at the stated goals of a select few Beacon communities:
Community – Bangor Beacon Community
Goal – Improve the health of patients with diabetes, lung disease, heart disease, and asthma by enhancing care management; improving access to, and use of, adult immunization data; preventing unnecessary ED visits and re-admissions to hospitals; and facilitating access to patient records using health information technology.
Community – Beacon Community of the Inland Northwest
Goal- Increase care coordination for patients with diabetes in rural areas and expand the existing health information exchange to provide a higher level of connectivity throughout the region.
Community – Southern Piedmont Beacon Community
Goal – Increase use health information technology, including health information exchange among providers and increased patient access to health records to improve coordination of care, encourage patient involvement in their own medical care, and improve health outcomes while controlling cost.
Community – Central Indiana Beacon Community
Goal – Expand the country’s largest Health Information Exchange to new community providers in order to improve cholesterol and blood sugar control for diabetic patients and reduce preventable re-admissions through telemonitoring of high-risk chronic disease patients after hospital discharge.
Community – Delta BLUES Beacon Community
Goal – Improve access to care for diabetic patients through the meaningful use of electronic health records and health information exchange by primary care providers in the Mississippi Delta, and increase the efficiency of health care in the area by reducing excess health care costs for patients with diabetes through the use of electronic health record.
]]>In 2010 the Patient Protection and Affordable Care Act provided the initial legislation that introduced Accountable Care Organizations (ACO) through the new Center for Medicare and Medicaid Services (CMS) Shared Savings Program (Section 3022). Dr. Elliott Fisher is originally credited with introducing the concept to the Medicare Payment Advisory Commission (MedPAC) in 2006 as benefits were being realized from the CMS Physician Group Practice Demonstration Project by 10 leading health systems and physician groups from across the country that were documenting savings and validating proof of some of the underpinning concepts that would set the stage for the beginning of the ACO movement. In 2009 Dr. Fisher, Dr. McClellan and colleagues also identified three key principles to guide reform efforts with a focus on accountability, performance measurement and transparency, and payment reform. Today we have new draft federal legislation being commented on by physicians, clinicians, health information management (HIM) professionals, and educators across the country that will help shape the final legislation for the January 1, 2012 launch of the CMS Shared Savings Program. While many private payer focused ACO models and Medicaid ACO models are also being developed and tested across the nation, key to each ACO’s success will be collaboration and teamwork not just within health systems, physician practices and government agencies, but also across multi-disciplinary teams that HIM leaders will and should be engaged in across the country.
Today we are seeing stronger recognition of the need to drive multi-payer coordination (both public and private) on the establishment, definition and activation of ACOs. Having a strong governance structure in place will be key and one that recognizes the importance of meeting Meaningful Use requirements as the industry progresses toward Stage 3 over the next four years, reporting transition to ASC X12Version 5010 by January 2012, and the looming deadline in 2013 for preparing for the industry wide cutover to International Classification of Diseases (ICD) ICD-10 CM and PCS by 2013. ACOs will be regional entities as they focus on providing care to specific population groups and as the ACO models grow in their multi-payer focus the emphasis on care for the entire population in their region will continue to strengthen. For HIM leaders there are a number of challenges to be addressed in supporting information needs in benchmarking, new importance placed on coding intensity, implications in risk models, meeting needs in health information exchange, new reporting to support goals for transparency, and other areas. However, they come with great opportunities to excel and help make these new models of care delivery an even greater success. Improving the health of the population and meeting the “three part aim” identified by CMS as strategic goals for participants in the shared savings program. Those three aims consist of: “(1) better care for individuals; (2) better health for populations; and (3) lower growth in expenditures.” This is the first of a four part series of articles dedicated to key topics of importance to HIM leaders. Next month’s article will focus on the implications of coding in its importance to benchmarking for the CMS shared savings program followed by July’s article on issues regarding health information exchange and involvement of HIM leadership in making it successful for ACOs.
About the Author: Joe Bohn, MBA, is CEO of Clinical Horizons, Inc. (www.clinicalhorizons.com) and co-author of Accountable Care Organizations: A Roadmap for Success. Guidance on First Steps. First Edition. Copies are available on Amazon.com or contact Joe for discounts available on multi-copy purchases. Joe can be reached at joebohn@clinicalhorizons.com.
References
[1] Centers for Medicare and Medicaid Services. Medicare Physician Group Practice Demonstration Project. Fact sheet available at https://www.cms.gov/DemoProjectsEvalRpts/downloads/PGP_Fact_Sheet.pdf.
[2] Fisher ES, McClellan MB, Bertko J, Lieberman SM, Lee JJ, Lewis JL, Skinner JS. Fostering accountable health care: moving
forward in Medicare. Health Aff (Millwood). 2009;28(2):w219-w231; Flareau B, Bohn J, Konschak C. Chapter 1: History and Case for Action. In: Accountable Care Organizations: A Roadmap for Success. 2011. Virginia Beach, VA: Convurgent Publishing. 2011. p. 13.
[3] CMS-1345-P, Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations. Proposed Rule. I(B)3. Statutory Basis for the Medicare Shared Savings Program. March 31, 2011.
]]>The Meaningful Use and Health Care Transformation Conference on May 20 featured morning and afternoon panelists discussing MU, ACOs, and the future of healthcare. The morning session, “Healthcare Transformation: Navigating the Road Ahead” focused on system redesign and quality improvement for taxpayers and recipients of care. David Groves, Director Ohio Governor’s Office of Health Transformation, said his office is committed to moving from instructional to community based care and talked about Ohio’s Medicaid rate (4% of OH’s budget). He pointed out fragmentations vs. coordination – it refers to multiple providers vs. accountable medical homes, provider vs. patient-centered care, institutional approach vs. continuum of care.
“What Lies Ahead for ONC Meaningful Use and Beyond” lunch session featured a panel of three healthcare executives covering: continuity of principles, strategy and approach; implementation; healthcare transformation; and patient-centered care. Trends to embrace according to the panel are: healthcare transformation – thinking about the plan and executing and in the next two years massively changing to consumer-based healthcare; moving from shared data to advanced care with DSS-based functionality to improved outcomes. The MU2 final rule is anticipated by mid 2012 by HHS and by June 8th slides will be posted on the ONC website. Overall, the panel is concerned about efficiency and workflow changes and notes that accountability is the next step and future goal. The greatest MU debate within the Office of the National Coordinator for Health Information Technology (members of the panel) centered around quality measures focusing on MU2 and broad, but meaningful measures that apply to most providers, e.g. patient engagements, getting and giving referrals, ordering tests, etc.
Q & A For Lunch Panel (Office of the National Coordinator for Health Information Technology, Children’s Hospital Research Foundation, Christ Hospital)
An audience member asked about upcoming pilots in e-prescribing regarding narcotics. Answer: Workflow duality is a major challenge and is a great opportunity for increasing RX monitoring and fighting abuse; will be able to track these usages regardless of cash or claims-based payment.
Patient-portal is vendor specific – should this be regional or community-based? Answer: This can and should be patient-driven. Demand can change this. Think of the “blue button” example; VA did a soft-launch of one-click ability to download one’s own patient data.
Is there potential harmonizing with MU and ACO rule making? Answer: This is the future, rewarding quality and value, and people need to get ready because no one knows what MU2 looks like.
Q & A For Afternoon Panel (TriHealth, Cincinnati Children’s Hospital, Community Initiatives of GE, Mercy Medical Associates)
The afternoon discussion panel discussed “Payment Reform and Accountable Care: How Will It Affect the Tri-State Region?” The panelists defined ACO as a specific payment program, not a general term. All providers are responsible in the care continuum. On the payer side, view ACO as a status of organizational payment and must continually review performance. One panelist answered “What are we being accountable for and what population.” He said the payment reform design model should align with measurable outcomes – must start with premise of intent on increase quality within a community.
How does MU support payment reform? Answer: MU is using technology in a “meaningful” way, including the concept of the medical home, leading to clinical transformation. MU is essential for brining in EMRs – must have that data to understand population health information that allows for clinical transformation to take place. MU should drive positive clinical outcomes, not payment reform. MU is hard and criteria seems abstract. In order to be successful, providers must included end-users to communicate / demonstrate how this data can influence care improvement.
]]>During a recent research expedition, I came across an interesting article in the December 2010 issue of Health Affairs. It provided a clear example of the issues surrounding a move from transaction-based reimbursement to value based reimbursement. As we all know, the US healthcare system is currently structured around transaction-based reimbursement. A provider provides items or services, creates a billing transaction and is then reimbursed by a payer. More transactions, greater reimbursement.
As we also know, the Accountable Care Organization movement is all about transitioning from this transaction-based approach to paying for value. Better outcomes, higher quality, efficiency equals greater reimbursement regardless of how many services are provided or how many claims are submitted. Seems quite logical. In any case, regardless of whether the future is the structure of the ACO or not, I firmly believe value based purchasing is the future.
Now for the interesting article I referred to. First, let me start by saying the physicians have one of the hardest jobs out there and one that is critically important as well. I respect the profession a lot. However, paying providers based on volume has inherent risks. This article took an interesting view of the situation. Basically, the premise was “What happens when physicians acquire MRI equipment in-office?
To answer this question, the researchers used Medicare claims data for approximately 11,000 orthopedic surgeons and 6,000 neurologists. The answer to the question, at least in this study was that the ability to bill for MRI in office led to substantial increases in MRI utilization. For example the orthopedists increased MRI usage by 38%. Of course there are several potential reasons why this might be, however it provides focus on one of the shortcomings of transaction based reimbursement. The economics behind it are flawed, hence the current push towards paying for quality, outcomes and efficiency, as is the case with value based purchasing.
]]>What one hospital charges for a particular procedure varies widely based on a host of factors. Understandably, many providers who are otherwise all for transparency when it comes to patient outcomes are reticent to disclose cost data. There are real reasons for concerns on the globalization of medicine. However, health care is largely a local phenomenon.
What are the compelling reasons for being as transparent with prices as with anything else? For one, increasingly, consumers are armed with price information today that exceeds anything they could have assembled even just a few years back. Also, in the mind of many consumers, price equals quality. Logical or not, this notion has become ingrained as a result of their consumer experience in other industries.
Wine under one label is deemed more expensive than wine under another label, even in the case where the wine has proved to be exactly the same, from the same source, processed and delivered in exactly the same manner.
Reputation Enhances Price – At the supermarket, branded merchandise still sells at a premium compared to store or generic brands that offer the same ingredients, molecule by molecule. Your hospital’s reputation could prove to be the deciding factor in whether or not a patient will plunk down more money to be treated by you over others who, based on all comparison measures, offer exactly the same care and service.
Suppose a consumer does his homework and finds that you and a competitor have entirely equal success rates for particular procedure, and you charge 15% more. Is this a reason to fear price transparency? No, because with all the data available for a consumer to peruse to his heart’s content, the decision to choose one provider over another is multifaceted. Price is one factor, albeit an important one, among several.
Many consumers will go with the lowest price. Many will choose the best value – a blend of price and quality. Short term, there is not much you can do about the prices for some of the procedures you charge. In the long run, everything is up for grabs.
More Business, Lower Prices – The more often a hospital performs a particular procedure, and the more experience its doctors accrue, the better it is able to offer that procedure at a lower price. Even in health care, greater business volumes contribute to economies of scale. In the short run, you can’t do that much about the volume you handle for any particular procedure. In the long run, you could seek dominance in your local or regional area by publicizing your experience in a given procedure. Thus economies of scale could result and price transparency would work to your favor.
At Alegent Health, based in Omaha NE, the prevailing attitude is that consumers have a right and ought to be able to easily know how much a provider charges. Three years ago, Alegent launched My Cost, found at www.alegent.com, an consumer-friendly feature that offers cost estimates for a variety of tests, procedures, appointments, and services.
So, You Want Cost Data – Visitors can simply enter the name of their insurance providers and any co-payment or deductible information. The system then presents a cost estimate that is useful in personal health care decisions.http://www.alegent.com, The visitor is also treated to financial assistance information via links provided, and a phone number in case their anticipated procedure is not listed on the site. Now up and running for nearly three years, more than 50,000 cost estimates have been generated at My Cost.
Alegent’s experience in promoting price transparency has been that consumers appreciate the honesty and openness of the organization. Instead of price transparency scaring away potential business, in this case it has led to stronger provider-patient relationships. Alegent’s CEO says transparency “isn’t necessarily easy, and it does take courage, but in the end it is the right thing to do for consumers and the community.”
Make the Commitment – Commitment to transparency takes guts. Yet, what other choice is there? Fortunately, as we’ll see, there is room for creativity and initiative.
Providing information on the results that your hospital achieves for patients, at the medical condition level, is vital. Your data needs to include patient outcomes with an adjustment for risk based on prior conditions, the overall cost of care, and measurements for both extending through the care cycle.
Transparency also encompasses offering the experience your hospital has in treating specific medical conditions, by volume of patients, coupled with delineation of such treatments based on methods of care offered. Your processes, in the long run, can be improved only by understanding how results are achieved, which methods are most effective, how they might be refined to make critical differences, and what the actual outcome of such refinements have been.
Details Count – Outcomes for a specific medical condition can and should be expressed many ways. For, say, shoulder surgery several validated measures exist such as range of movement, reduction of pain, and ability to function. Still other outcome measures for shoulder surgery include the interval between the initiation of care and return to normal activity such returning to work or playing tennis again.
Data related to the particulars of patients, known as patient attributes, such as gender, age, genetic factors, and prevailing conditions, are vital elements of transparency and are essential for assessing risk. Accurate diagnoses is vital for both the patient and the provider. A transparent provider will publish measures of diagnostic accuracy including cost, timeliness, and completeness.
Outcome measures that only address episodic interventions fall short because they fail to yield results meaningful to the patient. Such short-sited reporting and consequence scoring can be counterproductive and lead to the publication of misleading data.
Failure is not pretty and human beings instinctively want to avoid reporting their own shortcomings, much like organizations. Still, ineffective treatments – errors in procedure, medication, or treatment – and complications following a procedure need to be identified and scored. As unpleasant as this task may be, it is a step on the path to improved levels of treatment and overall service. You cannot fix a problem that you refuse to acknowledge.
Expand Your Measures – A traditional core measure, “the 30-day readmission rate,” tracked by the government, is of course a potential indicator of poor quality. Who wants too many patients are readmitted within 30 days for the same problem.
You may be able to devise your own kind of data measures by tinkering with traditional data measures. For example, you could align your total quality management efforts, such as your Six Sigma Performance Improvement initiatives, around improving the 30-day readmission rate and devote resources to that. In turn, for each of the core measures which need to be fully transparent, you may wish to devise two, three, four or more strategies to ensure that your scores improve over time. Rest assured, other providers will be doing the same.
Costs Mysteries No More – Unlike most businesses, many hospitals, to this day, don’t know what their actual charges ought to be. They charge for this procedure or that based on tradition, competition, payer contracts, or whatever cost data they can scrape together. A comprehensive understanding of true cost is often lacking. If and when the government mandates that hospitals publish price and quality information, they will need the technical ability to do so.
In almost all cases, some web restructuring proves to be vital. There needs to be a huge consumer section that is highly inviting. Take the bull by the horns and invite the consumer to go patrolling through your data. Just as industrial companies publish annual reports with a profit and loss statement, balance sheet, and cash flow analyses, you might choose to offer a five-year projection as to the life cycle cost of a procedure and its follow up.
Implications for Your Hospital – Is transparency part of your agenda for your weekly and monthly meetings?
* Has your hospital developed policies and procedures in relation to transparency?
* Within your own office or division, are top officers involved in the transparency discussion?
* Have you attended any conferences and symposiums on transparency?
* Are you monitoring other providers who have already made the conversion to transparency?
* Are you devising plans to capitalize on the inherent opportunities in offering transparent data?
Hospitals today can harness IT to redefine their relationship with customers and perhaps, equally important, redefine the quality perception of the hospital. The dilemma is that hospital executives invariably believe that they understand what quality is and will point to an impressive array of clinical indicators and outcomes. Results count, but what counts far more is how the consumer defines quality.
The consumer’s perception of quality is likely to differ vastly from that of hospital executives.
How does quality “show up” to the consumer? For many, through their phones.
Many providers have yet to fully embrace the reality that people have cell phones today, that more than 141,000 applications are available for download just on the iPhone, and that people are becoming less reliant on their desktop computers. The explosion of personalized information enables any individual to be in the driver seat, call the shots, and make better decisions about ones own health care.
The Options are Multiplying – The options for contacting, staying in touch, and sending reminders to patients are more diverse and hold more potential than ever before, especially for the provider with systematic IT capabilities designed to connect with the personal technologies that people carry in their pockets.
Consumers will make treatments and provider choices consistent with their personal values and based on anticipated results. Surely delivering expert medical services must be part of the mix? Yes and no. The delivery of expert health care and service is taken as a given – table stakes that you need to have, to be in the game.
Quality is always a moving target and always defined by the recipient, as much as providers wish it was stationary and always defined by them. Consumers will make their choices based on perceived quality, not necessarily on proximity or past relationships. To illustrate: smartphone users tend to invest their time and energy to running their lives more smoothly as a result of this pocket technology. “My life is that phone,” they will exclaim. The hospital system that sends them a text reminder about a “1:30 imaging appointment tomorrow, on Ridge Road,” confirms in the minds of these consumers that their health care institution is in tune with the times.
Me and My Phone – It’s a simple gesture, but a text or voice mail message about a scheduled appointment conveys to the consumer that this provider understands me or at least the way I schedule my time, arrange my affairs, and run my life.
This type of consumer downloads applications for his smartphone, health related applications among them. The variety of apps your hospital could develop for patients knows no bounds: apps on the seven tests for cancer, the first signs of a heart attack, how to perform CPR, what to do in the case of stroke, how to handle fainting or dizzy spells, what to do if someone has suffered a concussion.
A good app can help cement in the minds of consumers the quality of care that your hospital is capable of providing, hints that you are on their wavelength, and helps establish you as the go-to source when “something is wrong.” You could develop apps that accent your strengths, be it oncology, Ob-Gyn, or pediatrics. So, what apps does your hospital offer? Exercise regimens? Nutrition guides? Ailment-specific guides? Medication instructions and compliance assistance? Or none of the above?
Reminders and Amusements – Such patients want reminder pings asking, “Have you remembered to take your medication today?” maybe even three times a day, if that’s the daily pill regimen. For all of human history prior to this age, people either remembered on their own, or didn’t, without the aid of technology. Contemporary human reliance on pocket technology, however, cannot be denied or ignored.
So ingrained is the notion of turning to smartphones for instructions, reminders, updates, cues, formulas, and recipes, that it’s becoming second nature. People are now less reliant on their desktop computers and more reliant on their phone for everything. At the gym, you might see people working with an app-based workout routine that offers 20 different photos in sequence of the exercise that they want to be doing that day.
As the phones grow more powerful, more of the world is connected, more apps of greater utility become available, and life gets more hectic, using IT to support the consumer in ways they want to be supported likely will not be optional.
Ping to Me – Suppose each timed reminder, a “ping” in geek lingo, merits a response from the consumer and the response doesn’t come? With the right system, someone at the hospital will be able to call and say, “Mr. Williams, you haven’t pinged us back to indicate that you’ve taken your heart medication this afternoon. We don’t want you to have to return to the heart center, so please make sure to take your medication and let us know that you have.”
Does this sound like hand-holding? Is it seemingly an inordinate task? Based on the level of personal services provided in other industries, such as home security, the day when hospitals provide personalized updates, reminders, and custom monitoring might not be far off. Indeed to remain competitive, providing such customized attention might become mandatory as well as vital in reducing hospital readmission rates.
At the Women’s Center in the Tampa Bay Hospital, in Tampa, FL, when a patient arrives, she is given a Verizon cell phone. The phone only functions inside the hospital. She can take the phone to the cafeteria, gift shop, or anywhere else in the complex, knowing that she will receive a call only when the Center is minutes away from being ready for her appointment. A friendly caller will say, “Please make your way back. We’ll be ready to begin with you in exactly 10 minutes.”
Not a huge innovation, or is it? Restaurants have employed this technique for years. In hospitals, use of technology for such purposes greatly reduces anxiety. After all, does anyone enjoys sitting around in a waiting room where the minutes hang like hours? Especially when a patient is vitally concerned about some health issue, the ability to walk around versus sitting in a waiting room with other, equally anxious, patients can spell the difference between a pleasant visit and something else.
Among most patients, the perception of quality at the Women’s Center rises, independent of the medical services rendered.
Implications for your Hospital – What are you doing this moment to harness IT in ways that both serve consumers and help to raise their perception of the quality of your services?
* Do you have an appointment reminder system in place?
* Have you captured the requisite data to electronically connect with your customers? For example, do you have their cell phone numbers and email addresses?
* Do you have their permission to initiate such contact?
* Have you harnessed IT to make the patient’s experience more pleasant from the time he or she makes an appointment?
Preregistration, so basic, is more comfortable for people to complete at home rather than in the hospital or in a waiting room.
Duplicate and Triplicate – Time and time again patients complete the pre-registration forms in advance and mail or fax them in, or complete them online. That way, darn it, they don’t have to go through it all again when they arrive! Or do they?
The typical patient is thinking, “I appreciate that you’re letting me pre-register and submit all my medical history to you from the comfort of my home, but let it count for something. Enable this data to actually enter your system and be accessible so that I don’t have to go through this all again when I arrive.” It is anxiety-provoking to have to submit information that you know you have already submitted.
Once they’re inside the hospital doors, what do you do to ensure a patient’s comfort and ease? Do you provide in-house cell phones so that individuals are free to walk versus sit in a lounge chair? Have you scanned a photo of the patient so that your reception people have a fighting chance of greeting him or her upon recognition?
Are your IT systems configured so that the greeter can lookup whether or not the patient was here last week, or hasn’t been here for a year? Such knowledge would impact how the patient ought to be greeted.
Person to Person Connections – Larger questions loom. Does your hospital want patients to communicate directly with their doctors? By phone? By email? Does it make sense to establish doctor’s hours for addressing email? Are the same kinds of considerations being contemplated for nurses and technical specialists? Yes, this is a brave new world in terms of patient accessibility. Still, configuring your IT system so that your staff, from top to bottom, can communicate with patients one-to-one could prove to be mandatory in this ultra competitive industry.
* Is your hospital developing its own apps?
* Are you offering easily accessible frequently answered questions (FAQs)?
Are you using YouTube and Google Video to provide basic instructions such as: here’s how to check in, here’s how to care for yourself following your visit, here are the options if you have this type of ailment? If not, it’s time to get started.
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