7. Engaging with patient-generated data

9. Engagement efforts: staying the course

1. Introduction

INDEX

4. Designing to engage

3. A patient's story, an industry's need for interoperability

6. Technologies that engage

Q&A on how technologies can support patient engagement

2. It's time to focus on patients

Q&A on the technological revolution of AI and machine learning

8. Simple ways are best

5. Portal problems, portal fixes

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The Evolution of Patient Engagement:

Rethinking How to Best Engage Patients

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IN FOCUS

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While there were sessions on improvements to patient portals and their broader adoption, more sessions presented an expanded view of patient engagement. For instance, the topic of using technology to enhance the patient experience promoted the idea of digital engagement as part of an overall patient experience strategy for providers.

MSSA, PMP, FHIMSS, Senior Manager, Personal Connected Health Alliance

The theme of patient engagement had a strong showing at HIMSS17.

Presenters at a number of sessions demonstrated a maturing view on how to best engage patients.

John Sharp

Other topics that broadened the scope included

the concept of social determinants of health as a way of understanding the need to personalize patient engagement and meet social needs.

Senior Manager, Personal Connected Health Alliance

Several sessions provided examples of patient-generated health data and remote patient monitoring that put this data into the hands of patients and providers to create a participatory setting. Topics that discussed Open Notes and the narrative of patient stories focused on how to humanize health data. New technology, like virtual reality, was promoted as a way of engaging patients in virtual environments.

HIMSS Social Media Ambassador

There was plenty of talk about the   during HIMSS17...

Jane Sarasohn-Kahn zeroed in on one sure thing...

Jane Sarasohn-Kahn

“Against these uncertainties, there’s one certainty with which the health IT community must deal: The patient as an increasingly cost-conscious, demanding and empowered health consumer.  If health-tech companies understand, appreciate and respect patients-as-consumers, they can conceive, design, and grow products and services that help drive individual and population health, inspire positive retail-style experiences and boost healthcare providers’ business models.”

uncertain  state of affairs  in healthcare

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MD, CEO, engagedIN

Vice President, Information and Analytics Service, Carolinas HealthCare System

Pam DeSalvo Landis said that when addressing technology design issues, healthcare organizations need to remember that “the same type of heuristic [design] principles that apply to the experience on Zappos should apply to the patient portal."

# 1

View article

Thankfully, some useful patient portal design tips emanated from HIMSS17:

# 2

During the kick-off session of the half-day HIMSS17 UX Forum, Kyra Bobinet pointed out that there are two components to a good user experience: The most basic is "just to not tick people off." The other, more advanced opportunity is to elicit “delight” – a strategy that is practiced by leading consumer companies such as Apple and Disney.

Pam DeSalvo Landis

“You ask [patients] to do something like search for a doctor through the portal and they can’t. At first, you think, ‘Well, if they would just do this and this, they could figure it out.’ They also ignored a news function even though we thought it was really important and thought, ‘if they just clicked on it they realize it’s something they have to have.’ Well, if I was 10 inches taller and 30 pounds lighter and 20 years younger I could be a supermodel, but that’s not going to happen. So that’s the wrong approach to take,” Landis said.

What’s good for the consumer is good for the patient.

# 3

Put patient needs first.

Kyra Bobinet

Make the experience pleasing.

During this journey, however, she has also been burdened with managing all the details of her healthcare.

For that, she is thankful.

For that, she is frustrated.

She has received excellent clinical care from top healthcare providers – and this has helped her survive.  

Meet Irene Stroud

Irene Stroud is a Stage 4 lung cancer patient.

While healthcare providers are looking to partner with patients, trust in the ability of their portals to do so is middling – at best.

When queried about confidence in their technology vendor’s ability to meet advanced patient engagement goals, respondents to a HIMSS Analytics study conducted last year ranked their confidence at a 3.33 level on a 1 to 5 scale.

Geeta Nayyar

As a medical doctor, healthcare IT professional and mom, Geeta Nayyar yearns for the day when healthcare organizations can make interactions as easy as retail and banking experiences.

“When I think of these experiences and what they have in common – they’re very simple. These industries meet me where I am as a consumer; delivering information to me when I need it without my having to seek it out. By automatically sending me relevant emails or push notifications (all with my consent), I am kept up-to-date in real-time,” Nayyar wrote. “I look for healthcare to have similar retail and banking tools — not different or fragmented solutions. The best solutions should be invisible and elegant just as they are in every other industry,” she concluded.

MD, Chief Healthcare & Innovation Officer, Femwell Group Health

The scope of patient engagement is being broadened to include the challenges of behavioral health. Evidence of the outcomes of personal connected health is a new thread. Finally, the topic of patient empowerment through digital health is emerging, as patients and caregivers in the HIT community share their experiences with chronic conditions.

Attendees heard how personalization also is being enabled through the application of customer relationship management technology.

In fact, 42 percent of respondents indicated that less than a quarter of their patients were highly engaged.

More than 70 percent reported having less than half of their patients highly engaged.

70%

9%

75%

25%

50%

42%

Patient Engagement...

Indeed, only 9 percent of survey respondents overall reported high rates of engagement in a large share (more than three-quarters) of their patients.

Irene’s Sister Lead Consultant, Galen Healthcare Solutions

Max Stroud

The day-to-day stuff that she has to do to take care of her own health – that is not working so well.

“She is getting some of the absolute best care with technology that is working very well to keep her alive.

Filling out forms with the same data points over and over again or carrying images on a CD from one place to another. She really is the only person responsible for her healthcare data in the entire healthcare ecosystem. It becomes a cumbersome burden for someone who is already sick,” said Max Stroud.

View presentation

Health IT Programs Louisiana Health Care Quality Forum

66% of survey respondents who had used a portal reported positive experiences

48% pointed to specific difficulties or challenges

When the Louisiana Health Care Quality Forum conducted a survey to gain insight into patient engagement from the state’s residents, the organization quickly discovered both sides of the proverbial coin.

One respondent said: “I changed doctors to get one that has a patient portal. My child has special health needs, and it lets me make sure medications are correct and ask our doctor questions.”


Jamie Martin

Marketing & Communications Louisiana Health Care Quality Forum

On the flip side, another respondent said: “I tried it once and was told to come to the office to get my information because it isn’t in the portal, so what’s the use of having a portal in the first place.”

Nadine Robin

Access to Information

These frustrations, most likely, emanate from the fact that patient engagement efforts are falling short. According to a survey of healthcare leaders conducted by the New England Journal of Medicine Catalyst, a “strikingly” low percentage of patients are highly engaged.

Read Survey

Chronic Care Management

Sarasohn-Kahn pointed to studies showing that healthcare consumers are dissatisfied or struggling with:

Costs

Sure enough, however, the healthcare industry has a lot of work to do...

Documents that need to be shared

Eventually Irene assembled a  “cancer tote bag”  to ensure that whatever healthcare provider she was seeing had all the relevant and necessary information, said Max who is also a HIMSS17 Social Media Ambassador. 

Live from #HIMSS17: Meet Social Media Ambassador Max Stroud

Health proxy information 

The bag included everything from: 

Her most recent scans

Medical power of attorney language

Information about a clinical trial

Max asserts that her sister’s story illustrates how the lack of interoperability and the resultant inability for providers to truly access a patient’s complete story have a negative impact on the patient experience. With improved interoperability, patients could engage in their care more easily. As such, patients could simply concentrate on getting well, as the healthcare system takes responsibility for data sharing and care coordination.

Laura McCrary

The good news!

Read article

Executive Director, KHIN

It’s possible to bring portals up to snuff.

Case in point: The Kansas Health Information Network (KHIN) in Topeka has found a way to enable patients to receive all of their health information in one location, rather than through the more traditional electronic health record-tethered patient portal, which forces patients to use a portal for each provider. Instead, KHIN connected the HIE to a statewide patient portal in January 2015 and is now able to send patients their care summaries from hospitals and clinics across the state as well as sending discreet HL7 data. Patients don’t need to sign in to three or five portals only to write down the information from one on a piece of paper and transfer it to another. “We automatically forward to a patient’s EHR, via the portal, anything that we get, including notes and reports. We didn’t think it was a big deal but, apparently, this isn’t done much across the nation,” said Laura McCrary, KHIN’s executive director.

Ed Martinez

Connected devices can benefit patients in a variety of ways – keeping them out of the hospital being perhaps the most valuable, according to Drew Schiller. For example, when Sutter Health provided heart patients with connected scales and heart monitors that shared information via remote patient engagement platform IgetBetter, leaders expected about eight patients to be readmitted, but they ended up having zero readmissions – which amounts to a $216,000 cost saving.

Drew Schiller

Connected Devices

Assistant Vice President, Informatics, Geisinger

Mobile Messaging System

Portals are not the be-all, end-all when it comes to patient engagement. Here are just a few of the other technologies that surfaced during HIMSS17:

Chanin Wendling

Delivering personalized healthcare to a patient population of more 3 million is no easy feat. But Geisinger Health System is creating tailored interactions with each patient through customer relationship management (CRM) technology. “Some [patients] prefer a lot of data and analytics from the doctor to take them through their options to their care, some just want doctors to tell them what to do. Some prefer handholding. Some respond better to the drill sergeant approach,” said Chanin Wendling.

CIO, Miami Children’s Hospital

Customer Relationship Management

CEO, Validic

Miami Children’s Hospital is using a mobile messaging platform that enables care providers to easily engage patients in their care by communicating, not via a portal but through real-time text messages. “So, [we’re] talking well before the visit, during the stay and after the stay,” said Ed Martinez. This continual connection is paying off, as such mobile connectivity “has helped not only drive the experience and engagement, but without a doubt, it has improved our profit margins. We went from 2 to 3 percent profit margins to 7 to 10 percent profit margins by having the constant engagement and feedback,” he said.

Meet Kate

When Kate Sheridan was in fifth grade, she developed flu-like symptoms but didn’t recover in the typical pre-teen way. Instead, she received 15 diagnoses, was hospitalized five times and went from being a competitive athlete to confined to a wheelchair.

“I walked into appointments as a person and sat down as a diagnosis. It was difficult to decide what information to share and when,” Sheridan said.

Lessons from an Empowered Patient and her Caregiver

At one point, she started to experience excruciatingly painful hot burning sensations in her knees and neck. During a visit with a cardiologist, he asked if she had any tingling or numbness in her feet – and she said she did. He was surprised that she did not report this as a symptom.

That night, her parents made a list of symptoms…

There were 26 of them – and Sheridan had never mentioned more than 10 in any single appointment.

Her parents also set up an Excel tracking system to keep better tabs on her health. “The data moved from a burden to a tool. Placed into this organizational framework, all this data became my story that we could use to work with doctors to better predict and understand my illness,” she said.  From that point on, Sheridan, who is now a student at George Mason University, has been able to better engage in her care and control her health.

66% of patients

Indeed, according to survey results presented during a HIMSS17 session...

65 percent of providers said that their patients are either much more engaged or somewhat more engaged when patient-generated health data (PGHD) is used during the clinical encounter.

< 40% of consumers

Similarly, 66 percent of patients said they are either much more or somewhat more engaged when using PGHD during the encounter.

The problem: Less than 40 percent of consumers have ever provided PGHD to their healthcare providers.

65% of providers

View video

General Manager, HealthGrid

Drew Vaughn

For example, Healthgrid sends post-discharge summaries to all patients after they visit providers. To meet patients’ needs, HealthGrid now includes a school note when sending these discharge summaries to pediatric patients. “So not only do they get vital clinical information, education about problems and medications, but they also get a school note so they can take that to child’s school,” Vaughn said. “So, very, very simple things like that create redeeming value for the patient and then they are much more apt to want to connect and communicate with their providers.”

Drew Vaughn thinks that healthcare providers should strive to make life simpler for patients as well – and points out that providers don’t have to move mountains to do so.

View article for additional poll data

It looks like patient engagement efforts are heading in the right direction!  According to a 2017 poll of 200 chronic patients conducted by CDW Healthcare...

70 percent of respondents said they have become more engaged with their care in the past two years, representing a 13 percent increase from last year.

13%

According to the survey results, 74 percent of participants joined a patient portal (a nearly 30 percent jump from 2016 results), which resulted in 69 percent speaking with their healthcare provider more often and 69 percent of respondents accessing their healthcare information online.

74%

30%

Janice McCullum

To gain even more traction, providers need to identify patient needs before they offer the digital tools to accommodate them. Additionally, they must provide technology system support as well as educate patients on the optimal use of patient portals. Perhaps most important, though, providers and vendors need to get on the same page as patients, according to Janice McCullum. “My pet peeve is the disconnect between what providers and vendors call patient-engagement programs and what patients actually need to become more engaged with their healthcare providers,” McCullum pointed out.  “For starters, patients need to have a voice in their care and they should have full access to data related to their care, including their complete health record,” she went on. “Without fully including patients in their own health care decisions, patient engagement programs are nothing more than paternalistic compliance programs.”

HIMSS17 Social Media Ambassador

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ABOUT HIMSS HIMSS is a global voice, advisor, convener, and thought leader of health transformation through the best use of IT with a unique breadth and depth of expertise and capabilities to improve the quality, safety, and cost-effectiveness of health and healthcare. Through its network of over 1 million professionals, including 64,000-plus members, HIMSS advises leaders, stakeholders and influencers globally on IT best practices to ensure decision-makers have the right information at the right time to make the right decisions. HIMSS North America, HIMSS Analytics, Personal Connected Health Alliance, HIMSS Media and HIMSS International (HIMSS Europe, HIMSS Asia and HIMSS Middle East) are the five business units of HIMSS. A not-for-profit headquartered in Chicago, Illinois, HIMSS has additional offices in North America, Europe, United Kingdom, and Asia. ABOUT HIMSS MEDIAHIMSS Media is the fastest growing B2B media group focused exclusively on healthcare and technology markets. Through its suite of market-leading brands, such as Healthcare IT News, Healthcare Finance and MobiHealthNews, HIMSS Media delivers news, analysis and must-have information to an audience of senior healthcare and technology influencers. HIMSS Media is also the leading producer of important live events, such as the Privacy & Security Forum, Pop Health Forum, Revenue Cycle Solutions Summit and Big Data and Healthcare Analytics Forum.

  

Thank You for reading!

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Jennifer Esposito

General Manager, Health and Life Sciences, Intel Corporation

Q: How do you view/see the intersection of patient engagement and technology?

A.

Patient engagement has been a hot a topic for a while now. There are varying definitions, but if you think of patient engagement as any mechanism that more directly involves patients in their own treatment decisions and owning their own health, or that increases a patient’s knowledge, health literacy and ability to navigate the healthcare system (i.e., patient activation), there are many opportunities for technology to accelerate and enhance patient engagement and make it part of routine care. Making patient engagement part of routine care is really an essential element in driving patient satisfaction. There is increasing evidence that patients who have more knowledge and skills around how to manage their conditions and who take an active role in treatment decisions have improved outcomes and lower healthcare costs. For the inpatient setting, this could involve enabling collaboration at bedside between providers and patients using monitors that display treatment options, or that provide education about a patient’s disease or condition. For patients at home, technology such as wearables or other sensors can support patients in tracking progress and send data to providers who can intervene, if necessary.

With Ergotron, we are working on industrial design to improve user experience with mobile devices in clinical workflows. The collaborated design enables providers to wirelessly share content, which facilitates communication between patients and providers. Similarly, we are working with Oneview, which has a solution that aims to engage patients in their care before discharge from the hospital. The tool can be used to prepare patients and families for discharge with video education, goal completion and real-time collaboration with their care team to discuss patient preferences and needs. We have also partnered with AccuHealth, a Chilean-based company focused on monitoring patients through tele-monitoring. The company has developed a unique model where patients are accompanied and guided 24 hours a day by a team of trained professionals with the goals of helping patients adhere to treatment and promote self-management – and intervene early if problems arise.

Q: What types of technology-based solutions is Intel supporting around patient engagement?

Q: How is data being leveraged to better understand patient preferences and involve patients in decisions around their health?

In general, data analytics and cloud platforms combined with advances in computing power are being used to drive evidence-based decision making and improve patient care. When we’re specifically talking about patient preferences, though, patient-reported outcomes (PROs) are critical. Collection and use of PROs are being increasingly required by the Centers for Medicare & Medicaid Services for more and more conditions and care settings. PROs are questions answered by the patient that help reveal their values and preferences not only around health, but also around social, cultural and family considerations. Technology-based solutions that make it possible to collect, process and interpret these measures can be used in shared decision-making encounters between providers and patients to inform conversations and prompt dialog between patients and providers to achieve patient-centered care. Leveraging these new sources of data generated by the patients, and making it convenient for patients of all ages to generate this data (e.g., through devices, over the phone), so patients themselves can communicate results to providers will be important for further accelerating patient-centered care models.