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Patient Engagement Critical thru all stages of Meaningful Use

  
  
  
  
  

Patient Engagement FrameworkThe Patient Engagement Framework is a model created to guide healthcare organizations in developing and strengthening their patient engagement strategies through the use of eHealth tools and resources. It was developed by the National eHealth Collaborative, in conjunction with nearly a year of collaboration and vetting by over 150 top experts in healthcare, technology and human behavior.

Former ONC Head Dr. Farzad Mostashari says that patient engagement is “the blockbuster drug of the century,” and we at StayWell agree. Not only is there great potential for health improvements for individuals and communities, but great support and investment from the federal government mean the mission has support.

What the Framework itself does, is align the upcoming Meaningful Use Stages to Patient Engagement Milestones. For each phase of this Framework StayWell will be providing insights, case studies and product recommendations relative to the Framework in a series of blog posts ranging from discussions on the stages of Meaningful Use to best practice strategies for communicating with patients to how to efficiently utilize electronic health records.

When an estimated 50% of patients do not take medications as prescribed and up to 30% of prescriptions never get filled, we know that new best practices for patient engagement are necessary. We also know that the current methods have not been effective enough. We all know that examples like this are rampant in the health sector, and set the table for all kinds of potential changes to patient engagement by providers and payers. Using specific examples, previous outcomes and potential new strategies for improving care, StayWell will guide readers through what if scenarios and help generate new ways of measuring, accessing and utilizing patient outcomes to generate best-case results.   

This Framework can help your organization navigate the path toward more efficient and effective models of care that treat patients as partners instead of just customers, focusing specifically on communication, health literacy, and therefore empowerment. It is specifically designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies, and we will cover all of those bases.

Thru new best practices, in-field examples and step-by-step assistance, StayWell has the unique opportunity to assist clients in moving through Stage 2 and beyond as the focus shifts more heavily to patient empowerment. This is where the framework will have its greatest value, aligning the demands of clinicians with the needs of the patients and the escalating requirements of MU.

Stay tuned!

As StayWell grows its advisory role, there will be a series of blog posts devoted to helping you and your company through the patient engagement and health record transition. By learning and strategizing together, both patients and providers can make the best of the new health landscape and empower patients to seek better outcomes.

Transforming Patient Engagement. Who'll Win the Sherman Award?

  
  
  
  
  

Sherman Award for Patient EngagementThere is no bigger potential impact in health care, than that of the provider on the patient. It is for that reason that providers are finally offered an award, “spotlighting best practices in patient and family engagement.” According to John King, President of Standard Register Healthcare, “We have the opportunity to accelerate the transformation in care delivery and a make measurable difference in people's recovery and well-being," by highlighting providers who are truly making a difference.

With this in mind, Engaging Patients has chosen to honor innovative Patient Engagement with the John Q. Sherman Award, created specifically to “recognize and inspire people and organizations to share their work.” According to a press release, the Award will recognize one individual and one health organization or provider institution for their successful work in engaging patients and families to improve care and patient outcomes. The honored work must have occurred between January 1, 2012 and January 31, 2014 and fall into one of the six primary categories of interest: Innovation, Transformation, Collaboration, Communication, Inspiration or Systems Change.

Details of the submission process can be found here.

Providers play a vital role in engagement and outcomes, particularly for patients whose care requires careful management both inside and outside of the clinical care setting. An engaged health plan provider is just as important as an engaged patient.

Founder of Standard Register, John Q. Sherman was a leading philanthropist in Dayton, Ohio with a deep commitment to healthcare and his community. At the onset of the Great Depression in 1928, he led the campaign to raise over one million dollars in just 30 days to build Good Samaritan Hospital. He left a legacy that lives on today through the company’s support of Dayton’s Samaritan Homeless Clinic, in the launching of the organization and now through the John Q. Sherman Award program.

One person can have a tremendous impact on the quality of a patient’s experience. Those who are able to rise above the daily routine and regular bouts of stress inherent in healthcare, most able to connect with patients in a way that inspires and promotes healing, are worthy of recognition.

There are high expectations for nominees, including overall excellence from individual’s and provider organizations who are leaders in their respective field. Specifically, ideal candidates are those who have transformed patient experience in a healthcare setting through one of the six determined categories and those who can show real gains in their ROI. Nominees should be those who take the time to provide patient-centered information and involve all members of the family and care team in joint decision-making.

The most progressive health plans have long recognized the importance of Patient Engagement and responded with innovative health consumer programs that promote health for their entire population and deliver targeted support particularly to those with chronic conditions. By recognizing, giving a platform to, and advocating for providers that take these programs to the next level with innovative delivery formats, unique strategies and a collaborative spirit that involves both patients and their families in the care management process. The awardees of the John Q. Sherman Award will no doubt lead the next generation of Patient Engagement.


3 Patient Engagement Tactics To Help Hospital CEOs Sleep Better.

  
  
  
  
  

Patient Engagement for Hospital CEOsA recent Becker’s Hospital Review Article detailed the top concerns of hospital CEOs. Their list of challenges around all aspects of health care points to the complexity--and no doubt the need for some antacids and sleep aids. Data for the story came from the American College of Healthcare Executives' most recent annual survey on issues facing hospitals. Building on this survey, Krames Staywell adds insights into how Health Consumer Engagement best practices can help ease the stress.

Quality of Care. Patient safety and quality of care is with good reason a major concern of hospital CEOs, and Patient Engagement is on the frontlines. Providing quick resources and detailed support thru literature, digital and personal interactions helps patients and providers work together towards safety and quality care. In a customer-centric world, acquiring patients is one thing, but retaining them is a major benefit of patient engagement. Information and digital delivery systems that are useful, non-promotional and ‘on the patient’s terms’ create a strong bond. Physician-hospital relations is another benefit of patient engagement. See our story on how patient engagement begins with physician engagement.

Financial challenges. Hospital CEOs understand that financial stability comes from a combination of identifying the pain points and finding the least invasive means to address them. One of the costliest burdens on a hospital balance sheet is readmissions. Patient Engagement has been shown to reduce readmissions, as well as ER visits. Having a strategy for both the health information and the delivery of the information has been proven to help patients and institutions avoid readmissions.

Sweeping Change. Health care is experiencing the greatest transformation in its history. Here are the pain points and the engagement tactics to help:

  • Healthcare reform implementation.

    • Educating patients about new and changing insurance coverage gives them an active role in choosing their coverage and their care.

  • Care for the uninsured.

    • Beyond digital engagement, there will always be a need for personal interaction. Easy to understand materials written at the appropriate level of understanding--ie, not requiring an RN or an MD to decipher--helps everyone understand their treatment options and helps them adhere to their treatment programs.

  • Health IT

    • Sweeping changes brought about by the mandated adoption of EHRs for Meaningful Use and Patient Engagement have caused turmoil throughout the hospital structure. Add to this the complexities of ICD-10 implementation, interoperability issues, and the cost in both dollars and IT focus and the impact is staggering. However, the benefits to Patient Engagement provided by EHR adoption can’t be overstated. Our research with health consumers underscores their expectation that their personal health data be available to them electronically. It’s a given, not a “nice-to-have.”  Providers can leverage this tool by incorporating valuable, relevant health content, which transforms it into a tool for education as well as engagement.

These patient engagement tips and strategies are not intended to represent the the whole solution--or to minimize the multi-faceted approaches necessary to address these situations. Our intent is to demonstrate how Patient Engagement is a powerful tool that impacts health organizations in many positive ways, and how engagement strategies can be deployed internally to help the organization communicate their ‘business treatment plans’ for positive outcomes. Read about how CIGNA's CEO leverages Patient Engagement. 

Practicing Patient Engagement: Addressing the Patient Mindset

  
  
  
  
  

Patient EngagementThis is an ongoing series focused on practical applications of patient engagement principles. There is much being talked about regarding this topic. To add to the discussion, we will examine trending stories from quality writers and sources and suggest patient engagement practices pulled our 20+ years of online and offline health consumer engagement.

Stephen Wilkins recently posted a story in his blog, We Have Been Socialized From Childhood To Be Passive When A Patient – But That Doesn’t Mean We Are Not Engaged. In this story he points out that patients assume a passive role and follow ‘rules’ when in a medical situation. In marketing, we call these roles personas and use them to match messaging to a certain type of person or behaviors. Wilkins has defined a passive patient role that points out the mindset that providers--and patient education--must overcome. We will take the behaviors of this passive patient persona and offer guidance on practices, materials and delivery methods for effective engagement.

Physician Mindset

First, imagine that you are a physician. Passive patient behavior seems to indicate that the patient doesn’t care about their health. Oftentimes they don’t do as they are told with respect to their health. Many patients don’t ask the doctor relevant questions. Fewer still will challenge the doctor on diagnosis or treatments. And until recent times, the idea that a patient would demand that they engage in shared decision making was virtually non-existent.

Patient Mindset in the waiting area. According to Wilkins, patients have a conversation with themselves before they even see the doctor, often minimizing their problems and concerns.

  • That person looks a lot sicker than me
  • That frail old woman deserves a lot of time and care
  • I don’t need to bring up all my problems or concerns at this visit

Respectfulness and understanding of the demands placed upon our busy doctor

  • I’ll whittle down my list of questions to one or two – surely the doctor will be too busy to answer my questions
  • I’ll just wait until I get home and look up what I want to know on the internet
  • I guess if I were as busy as my doctor I would limit patients to one question just like I have read about
  • Poor guy/gal…he/she is way too busy for me

Memories of previous experiences visiting doctors going back to childhood

  • Doctors never remember who I am – as long as he/she covers the basics I will not make a fuss
  • Doctor wants to be the boss so I will sit here and just listen
  • The last time I asked a question the doctor laughed at me
  • I read somewhere where doctors can “fire” patients if they don’t like them

Waiting Room Engagement Strategy

Providers need to become part of this ‘internal dialogue’ that patients have in the waiting room. They can help patients overcome their passivity by demonstrating that they welcome the patient’s involvement in their care. Having a visible display of patient education materials such as brochures and fact sheets that relate to the physician’s specialty, as well as tip sheets on how to prepare for tests and appointments start the process. But why stop there? Having pads and pens so that patients can write down questions during the appointment could even be captured digitally and placed in queue for a member of the provider team to address in the waiting area or during the appointment.

Patient Mindset During the Examination: Fear of looking stupid.

  • I won’t ask important questions because I don’t know how to ask.
  • I don’t want to appear to be difficult.
  • I am limited in the number of questions they can ask.
  • I will only share what I am comfortable sharing.
  • I am afraid to challenge doctors--even if I disagree with their doctor’s diagnosis or treatment plan.

Patient Engagement During the Appointment

Again, here’s where patient education tools can help providers test and confirm the patient’s understanding of the information, and demonstrate that they’re committed to answering questions and allaying fears. Our print-on-demand patient education has been used by thousands of nurses and physicians at the point of care seeking to support this kind of understanding.  And with the advent of the electronic medical record, we’ve made our patient education resources accessible via InfoButton as part of the patient’s user experience so that they can view the information, including videos, at home via a computer or mobile device when it’s convenient for them.

Knowledge truly is power when it comes to healthcare. The more useful patient education offered by providers, the more patients will understand about their condition, and the more confident they will be in their questions. The end result:  a more engaged patient.


Text Me If You're Pregnant (or have Diabetes). New Patient Engagement

  
  
  
  
  

Krames Staywell and Regence Blue Cross Blue Shield have released the results of their pilot study of text message interventions for pregnant women and people with diabetes. The insights from this collaboration between insurer and health information agency suggests that people respond positively to receiving text messages from their insurance company when the messages are useful, focused and not intrusive.

The pilot offered health text messages to 69 pregnant women and 56 diabetes patients. Participants received weekly text messages with information, health tips, and reminders.

 

Results showed 32 percent of pregnancy participants and 67 percent of diabetes participants found that the information in the messages helped them make positive changes in understanding and/or managing their condition. Significantly, nearly 60 percent of pregnant women and 67 percent of people with diabetes said they knew more about their condition after receiving the text messages. Almost 90 percent of people in the pregnancy program said they found the messages valuable, as did 89 percent of the respondents with diabetes.

The majority of respondents in each group approved of receiving text messages from their insurer. They said the program positively affected their perception of Regence Blue Cross Blue Shield. Ninety percent of pregnant respondents answered either “I like it” (52 percent) or “It’s fine” (38 percent) when asked how they felt about getting health information from Regence. For the diabetes program 100 percent approved of getting messages from Regence — 68 percent liked it and 32 percent said it was fine.

The survey also asked participants to rank how they wanted to get information from Regence. Respondents ranked email messaging first, followed by text messaging for the diabetes group. For the pregnancy group, texting came in third — behind both email and getting information from a website.

Janna Kimel, Senior User Experience Researcher at Regence,  conducted phone interviews with participants, and reported her findings at last year’s Healthcare Experience Design conference in Boston.

“Several people said to me over the phone ‘I really feel like Regence cares’,” she said at the time. “Do you have any idea how that feels as a person who works for a health insurance company?”

She noted that people shared specific actions they took that were directly related to the texts including enrolling in a nutrition plan or filling out a birthing plan. Kimel said the participants in the programs seemed to enjoy the text messages for different reasons. “With diabetics, the strongest motivation is staying alive,” she said. “[They say] ‘I don’t want to be alone, I don’t want to do it alone, and this little text message I get every day makes me feel less alone.’ Pregnant women worry much more about physical than emotional things. They like having specific things to do.”

With dramatic shifts in the way insurers communicate with their members, text messaging will become a larger part of payer-to-patient engagement. The findings from this pilot are encouraging in that while texting might still trail the more established information delivery from email and websites, there is a positive effect in both patient use and payer sentiment. We will be working to further explore text messaging in both studies and in the field with our clients.

Regence Blue Cross Blue Shield insures 2.2 million members in Idaho, Oregon, Washington and Utah.

Krames StayWell is the industry leader in patient education and consumer health information solutions. See Krames Staywell at the upcoming HIMMS14 show in Orlando at Booth 2929.

Krames Staywell "Don't Miss" HIMSS14 Patient Engagement Speaker List

  
  
  
  
  

HIMSS14 Patient EngagementThere is a concentration of high-powered speakers and workshops regarding Patient Engagement at HIMSS14. All of the workshops are appealing, but our ‘don’t miss list’ includes:

1. Patient Engagement: Health IT Solutions for Both Patients and the Care Team (February 26, 8:30 a.m. – 9:30 a.m.; Room 300)

Panelists Rosemary Kennedy, PhD, RN, MBA, FAAN and Sarah R. Tupper, MS, RN-BC, LHIT, CPHIMS, will present findings from two health IT patient engagement studies. The first measured the impact of kiosks, portals and mobile phones on decision-making, adherence to care plans and healthcare outcomes. The other study dealt with the development and rollout of a patient engagement portal to support interdisciplinary care teams in engaging patients.

2. How Technology Can Enable Care Anywhere, Anytime (February 25, 10:00 a.m. – 11:00 a.m.; Room 224A)

Regardless of where a patient may be, supporting their well-being regardless via devices and apps is the driver for healthcare technology developers and providers. Kaiser Permanente technology innovation executives Wendy Lee and Faye Sahai will discuss how an "Imagining Care Anywhere" experience allows teams to better integrate to patients and providers.Learn how their approach personalizes health experiences through technology.

3. Engaging Patients Through a Compelling Web Experience (February 24, 1:00 p.m. – 2:00 p.m.; Room 224A)

Compliance and the stipulations within meaningful use Stage 2 is the focus of this talk. Every practice will face these challenges as they strive to improve access to patient data via health information exchanges and online patient portals. PinnacleHealth System’s CIO Steven Roth and director of strategic technology services Joel Arker will provide details on how to increase the adoption of an online patient portal. Also discussed will be ways in which existing web capacities can be used with a patient portal, and best practices for executing your plan.

4. Unlocking the Patient Care Benefits: Maturing EMR Adoption in Primary Care (February 25, 2:30 p.m. – 3:30 p.m.; Room 207C)

Electronic medical records are dramatically advancing patient-provider relationships. Neil Gardner, president and board chair of COACH: Canada's Health Informatics Association, will discuss how achieving higher levels of adoption maturity provides a roadmap for ongoing use of EMRs in primary care. Gardner will discuss:

  • Change management challenges associated with introducing EMRs in primary care settings

  • A systematic approach for realizing long-term benefits from EMRs for patients and providers though continuous improvement

  • The value of using a maturity model to map the adoption journey and measure progress against locally-inspired goals

  • The real-world and practical utility of applying such a model, both for the early adoption stages and in maturing ongoing adoption, targeting both broader and higher levels of

  • Explain how health informatics best practices contribute to achieving better health outcomes through the use of such tools

 

All of the above sessions will take place at the Orange County Convention Center. We hope to see your there. And if you’re Tweet-minded, check out what we’re up to by following us @KramesStaywell or visit us at the show at Booth 2929.


#HIMSS14 Tweet Volume Off-the-Charts

  
  
  
  
  

Healthcare TweetsChances are you have already seen a Tweet with the hashtag #HIMSS14. This could be the breakout year for Twitter blasts from this massive Health IT conference.

On his blog, ChuckWebster.com, he compared #HIMSS12 and #HIMSS13 daily tweet volume. Last year, Tweets from the most followed conference attendees resulted in 34,381,995 Impressions from 2,760 Participants.  #HIMSS13 Sunday was  50% higher than #HIMSS12 Monday. If those numbers predict a trend, then #HIMSS14 will be a keypad tapping, 140-character, HIMSS-a-palooza.  

Webster comments, “Personally, I just think of this build-up the weekend before #HIMSS14 as a form of psychology ‘tetany’, a medical term meaning increased excitability.”

The fun has already started--and we’re still in the week before the conference. One trending hashtag,  #HIMSSpickuplines, is causing some laughs and some controversy. The mild innuendos of an IT crowd are fairly tame. For example, one Tweet from this stream says, “My dear, what Big Data you have,” and, “Come on Baby light my FHIR.” But others are using the social channel itself to call the stream as inappropriate. We observed in this stream that HIMSS chapters and Conference Social Media folks are commenting and following this hashtag. As health care professionals, (with names attached to Tweets!) we trust that all will be good clean fun.

Krames Staywell has take a slightly more info-focused approach to our contribution to the #HIMSS14 twitter stream. Check out what we’re Tweeting from #HIMSS14 by following @KramesStaywell or visit us at the show at Booth 2929.


Payer Calls Out Cost Benefits of Patient Engagement

  
  
  
  
  

describe the imageThe Houston Chronicle blog recently talked with David Cordani, president and chief executive officer of Cigna, to discuss how heightened doctor and patient engagement in disease prevention and maintenance leads to better treatment coordination that can reduce health care costs. According to the story, “Cigna’s plan has been to first and foremost improve the health of the employees and their families. That will translate to lower costs.” Certainly that is something all payers and providers can agree on.

The City of Houston, which enlisted Cigna to provide coverage for its employees, saw positive results from a plan that not only provided coverage for care, but also encouragement for self-care. Cigna asked employees to perform self-health assessments in order to provide a baselines and information  to better determine health risks. “Within about one year--of the people ranked as high or medium risk-- more than half dropped a category — to medium or low risk — as people got access to preventive care and medicines.”

Giving employees access to health information led directly to action. In fact, while approximately one quarter of the people insured by the city accessed preventive care the year before Cigna became the city’s vendor, that number more than doubled in Cigna’s first year.

All it took were basic wellness practices: physicals, lab tests and information to drive these results. That’s why Krames Staywell is committed to the development of  simple, easy-to-use offers patient engagement solutions that fit the specific needs of doctors, patients---and the insurance company.  

Putting health-minded tools in the hands of the insured can help all of these parties. For example, the Krames Staywell Symptom Checker app helps people determine the appropriate care for common health symptoms and minor injuries on their mobile device -- helping them apply the right treatment, while potentially avoiding unnecessary trips to the ER. This application can be customized, including links to physicians or urgent care centers, and contains 81 adult care guides, 89 pediatric care guides and 160 photographs. Content is written by Drs. Barton Schmitt and David Thompson, whose clinical protocols are used by more than 10,000 physician practices and 90 percent of medical call centers. Their protocols have been tested in more than 150 million symptom calls, and are endorsed by the American Academy of Pediatrics. Read the Case Study here.

Read the full Houston Chronicle story here: Cigna CEO advocates doctor, patient engagement to reduce costs

True patient engagement gets into each patient's head

  
  
  
  
  

Patient Engagement is in the Heads and HandsIf only it were as simple as matching a demographic 'type' to a
treatment or a piece of health information to create the optimal patient or member engagement plan. Alas, we've long recognized that info preferences in terms of topic, tone, format, etc. are influenced by more than demographics. To deepen our understanding of the many factors that shape how people respond to messages about their health, we recently sponsored a study on consumer "PATH types" (Patterns of Adapting to Health). The initial findings demonstrate that attitude is everything -- and that's something that you can't predict by merely knowing the age, gender and income of your target.

For a look at our initial PATH study, view our slideshare presentation at
http://tinyurl.com/AHIP-PATH.

In a recent blog post, http://www.hhnmag.com/ quoted Kate Berry, CEO
of the National eHealth Collaborative. "Different consumers enter the
health care system with different cultural backgrounds, needs or
expectations. Hospitals need to better grasp those nuances if they
want to truly excel at patient engagement." The nonprofit is in the
midst of developing a "patient experience framework" that maps out the
different types of consumers, their ideal experience and how they want
to engage with hospitals. 

The eHealth Collaborative has developed the following framework to
guide providers through escalating levels of patient engagement.

Inform Me

  • Basic levels of patient engagement
  • Emphasis on the use of simple tools
  • Convenience and accessibility

Engage Me

  • Use of eHealth tools and resources
  • Patients have access to their electronic health record
  • Encouraged to use fitness trackers and other eHealth tools
  • Able to complete administrative tasks online

Empower Me

  • Advanced patient engagement activities through substantive use of health IT
  • Use of secure messaging between patients and providers
  • Integration of basic patient-generated data into EHR systems
  • Online quality, safety and patient experience ratings
  • Participation in a health information exchange or similar effort to
  • enhance care coordination between provider settings

Partner With Me

  • Providers use health IT to make the patient a true partner in his or her care
  • Support patients with condition-specific management tools and access
  • to care summaries
  • Integrate ongoing patient generated data on self-care, wellness and
  • home health device data, into their EHR system
  • Patient records connected to public health reporting systems
  • Coordination of care happens seamlessly across primary, specialty and
  • acute care providers

Support My e-Community

  • Fully leveraged eHealth tools connect a patient with their full care team
  • Support his or her care management both in and out of the healthcare setting
  • Tools and activities include fully interoperable EHRs, record sharing
  • among providers and non-provider members of the patient's care team
  • Patients and caregivers provided with online community support from
  • providers, opportunities for e-visits
  • Patients given information on cost comparisons and outcomes reporting
  • Providers at this phase will likely be found participating in an
  • accountable care or patient-centered medical home model

"The reality is that, while health care is all about patients, the way
our system works hasn't necessarily been very patient-centered in
general," Berry says.

In a world full of information choices, people have developed different needs and different
preferences for how actively engaged they want to be in their own care.
These variations on 'type' include patients who want to know everything
about their condition, and others who want the doctor to tell
them what they need to do or know. Also important to note is that fact providers
are different too. 

Patient engagement has become top of mind for hospital leaders as
their organizations shift to a more value-driven approach and as
related meaningful use requirements continue to kick in. It affects a
hospital in many ways, from patient care to readmissions, technology,
health literacy and patient satisfaction. Similarly the challenges of
member engagement in today's reform-driven landscape are consuming the
attention and energy of health plans that seek to drive behavior
change in their population.

KSW will be watching this closely as we continue to refine our content
development and deployment strategies. We'll soon be releasing the
full results of our PATH study. Watch this space!

- See more at: http://www.nationalehealth.org/stages-patient-engagement-framework#sthash.KMa58TzL.dpu


Finding Video Humor in Meaningful Use and ICD-10

  
  
  
  
  

Humor in Meaningful UseIt might not exactly be SNL, but Meaningful Use and ICD-10 are inspiring some to take a humorous approach. 

Struck By Orca is 66 pages illustrating dozens of artists' visual interpretations of their favorite ICD-10 codes. Artists include healthcare professionals, entrepreneurs, and professional artists. Here's their video showing some of the interesting illustrations of painful mishaps. (Pause the video to see the captions, for example, "V95.42xA Forced landing of spacecraft, injuring occupant, initial encounter." All codes and descriptions are verbatim. 

Not to be left behind, Meaningful Use has also inspired some funny moments--from the patient's perspective. Clearly, Andy Samberg needs to look into health care videos. 


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