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Patients May like Their Physician…But That Doesn’t Mean They’ll Stay

Posted on November 8, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Medical providers are dealing with a more impatient, demanding patient base than ever before. Armed with research, awareness, and a plethora of online data, today’s consumer patients treat their search for a medical provider in much the same way they would any purchasing decision.

They weigh the pros and cons of each provider, evaluating how each practice would fit their lifestyle and then make a decision.

Unfortunately, that is not the end of the process. Even after a patient chooses a specific practice, they are not even close to becoming loyal patients.

Smooth processes trump provider loyalty

It often surprises medical practices to discover that retaining patients has less and less to do with the medical competence of the office. Today, it may not be enough for a patient to simply like their physician.

For busy patients, the road to loyalty goes directly through the processes and procedures of an office. Studies back this up. Consider this. Sixty-one percent of patients say they are willing to visit an urgent care clinic instead of their primary care clinic for non-urgent issues. This is true regardless of whether they like their primary care provider or not.

The #1 reason they prefer urgent care? Because of difficulty scheduling appointments and long wait times with a primary care physician. According to a study by Merrit Hawkins, wait times have increased by 30 percent since 2014. Patients have noticed.

These long wait times were also noted as one of the key reasons patients will switch practices according to respondents of the Patient Provider Relationship study:

  • Sixty-eight percent say that wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

Reducing wait times is crucial to patient retention

In order to increase patient retention levels, practices must find ways to offset the frustration of long wait times. Consider implementing these three methods of wait-time optimization.

  1. Self-scheduling. It is common for doctors to have calendars booked out months in advance. This can cause patient frustration and turnover. When practices allow patients to schedule themselves, however, this frustration is minimized. With self-scheduling, they can quickly see which doctors are available and when. Since 41 percent of patients would be willing to see another doctor in the practice to reduce their wait, this is a simple way to optimize your scheduling without sacrificing patient experience.
  2. Communication. There are times when long waits are unavoidable. This is where communication is key. Studies show that 80 percent of patients would be less frustrated if they were kept aware of the issue. When you know an appointment is going to be delayed, send out an email or text letting them know.
  3. Texting. If your patient has a question, texting can save them a lot of time. Research shows that it takes just 4 seconds to send the average text message. Compare that to the several minutes it takes to make a phone call. Factor in playing phone tag and you’ve saved both time and headaches. Unfortunately, the Patient-Provider Relationship Study found that while 73 percent of patients would like to be able to be able to send a text message to their doctor’s office, just 15 percent of practices have that ability. Practices in that 15 percent will stand out from their competitors.

In this era of consumer-driven behavior, practices need to prioritize ways to create smooth processes for patients. Medical offices should look at ways to optimize their processes to reduce frustration and wait times for patients.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Bridging the Gap between What Patients Want and What Practices Offer

Posted on October 11, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

With the growing pressure of increasingly complex healthcare regulations, malpractice litigation, and expectations of quality care, modern-day medical practices face an unprecedented set of challenges when it comes to running a successful practice.

Throw in marketing, billing, scheduling, appointment reminders, and all of the other day-to-day aspects of running a practice, and many practices are maxed out.

But while practices are busy juggling this growing number of expectations, patient satisfaction has been falling.

Today’s patients have become accustomed to a buyer-centered approach in nearly every industry. Likewise, they expect the same from their healthcare professionals. Unfortunately, many practices have been slow to adapt.

The Patient-Provider Relationship Study recently found that the average medical provider with a panel of 2,000 patients could lose around 700 patients in the next couple of years. A large number of these patients are leaving due to dissatisfaction with their experience at a practice.

Much of the growing dissatisfaction from patients is in relation to practices not offering the services and technology that they have come to expect. Experts warn that the medical field lags behind every other industry in the adoption of new technology. This inevitably leads to a gap between what patients expect from their medical practice and what practices actually offer.

Perform a thorough gap assessment

According to the study, 60 percent of patients are not completely satisfied with practice logistics such as appointment scheduling, reminders, and communication. In fact, logistics is the area in which patients have the greatest overall dissatisfaction with their practice.

It is important that practices both understand what patients want the most and then complete an assessment to determine areas that need improvement.

The Patient-Provider Relationship Study found that patients want many additional touchpoints, including:

  • Text appointment reminders
  • Appointment alerts by email
  • Appointment alerts by text
  • Being able to text message back and forth with the practice
  • Allowing patients to initiate text messages to the practice

Unfortunately, a large number of practices do not offer these services. The following chart highlights how many practices offer each of these services, compared to a goal of 100 percent implementation.

With the majority of patients expressing dissatisfaction with the logistics offered by their medical practice, it is clear that changes need to be made. This requires the implementation of new, or more robust, technology.

Implement technology without distress

Practices want to be more efficient and provide an improved patient experience, but the fear of making the wrong choices around new technology can hold them back. Each of the aforementioned services have the potential to either improve processes and efficiency or make them more difficult. The outcome depends on the practice’s ability to carefully assess each piece of technology before moving forward.

There are steps you can take to eliminate some of the risk when choosing a new technology. One of the most important things you can do is to ask right questions before and during the selection process. Consider the following:

  1. Who will be impacted by this change?
  2. How will the technology affect your current workflow?
  3. Is the technology compatible with your current systems?
  4. Will the technology meet current and future compliance requirements?
  5. What will the implementation process include?
  6. How have other offices felt about the technology?
  7. What type of on-going customer service and training does the company offer?

When it comes to achieving high levels of patient satisfaction, it is critical that practices bridge the gap between what patients want and what is currently being offered. After performing a gap assessment and carefully vetting available technology, practices will be able to move forward in a way that will reduce the load on employees, create meaningful improvements in the practice, and boost the bottom line.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

MGMA17 Day 2 – The Future of Patient Engagement Looks Bright

Posted on October 10, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Day 2 at MGMA17 started very early for exhibitors when the doors to the exhibit hall opened sharply at 6:30am Pacific Time. It was clear that MGMA organizers were catering to the early-rising-east-coast contingent of attendees. Thankfully there was a warm breakfast with plenty of caffeine options available.

The early exhibit hours provided a unique opportunity to slowly browse the floor and read booth signage fully without being blocked by fellow attendees walking in the aisles…and in some cases without being blocked by company representatives in the booth itself.

As I walked around the exhibits I began to notice that the words “Patient Engagement” appeared frequently. EHR companies, revenue cycle management companies, call center providers and even HR consultants had this nebulous term emblazoned on their booth properties. I thought it would be interesting to ask a few of these companies how they interpreted patient engagement and how they saw it evolving over the next three years.

Josh Weiner, Chief Operating Officer at SolutionReach, was quick to say “Patient Engagement is more than having a portal on your EHR”. He believed that the key to engaging patients was communicating with them in an easy, convenient manner. “For SolutionReach, this means texting. Everyone knows how to text and it’s just so simple to use. A few years ago texting patients was just one-way. Doctors would send a text to a patient and that would be it. More recently companies like SolutionReach introduced the ability for healthcare providers to conduct one-to-one conversations with patients via text. We call it SR Conversations and we have over 4,000 clients using it.”

In the future, Weiner predicted that providers and patients would continue to use SMS texting as the primary means of patient engagement. The key difference is that instead of just sending text messages back and forth we would be sending mini-text-applications back and forth. He cited the example of the latest iOS upgrade which now featured the ability to send a map, a Starbucks gift card and other such applications within an SMS message. He foresaw a day when we will have the ability to send a prescription, a lab test, a referral and an appointment schedule to a patient via SMS.

At BinaryFountain, a company that makes a platform that consolidate patient feedback from multiple social media sources as well as from HCAHPS surveys and allows providers to publish positive comments made in those medium as online reviews, they define patient engagement through the lens of reputation management. Engaged patients mean they are more likely to provide a positive comment and if they provide a positive comment, they are more likely to rate the doctor/practice/hospital highly. That, in turn, leads to a better reputation which attracts patients who are more likely to be engaged in their care. In the future, the company believes that quantitative measures for patient engagement will be developed and that these measures will be used in a similar way that the 5-star rating system is used today.

West Communications is a provider of telephony solutions to a broad range of industries. In healthcare, West offers a number of patient communication tools that engage patients via phone, email, and text. They define patient engagement as the degree to which a patient is active in and adherent to their care plan. They saw a bright future for patient engagement – especially as technologies from other industries are adapted to healthcare. The West team, for example, has been working on adding AI-based intelligent IVR capabilities to their healthcare IVR solutions so that inbound calls from patients can be automatically triaged quickly based on needs.

At Stericycle Communication Solutions, Sarah Bennight, Healthcare Strategist, defined patient engagement as getting patients to be active throughout their care journey. “Patient engagement creates trust between patients and providers. It’s more than just pushing information out to patients, it’s true two-way conversations that are relevant to where the patients are in that moment. It means providing patients with useful calls to action – clicking on a button to book their next appointment, download information or connect with the right clinician.”

Bennight sees a patient engagement future that includes new forms of communication through platforms like Snapchat and iMessage. “The younger generation communicates in different ways. They’ve gone beyond voice, text, and email. Healthcare will need to adapt to these new forms of communication. We may even need to develop a healthcare nomenclature for communicating information via emoji’s and giphies.”

Finally, Varun Hippalgaonkar, Senior Vice President of Growth at HealthGrid suggested that patient engagement is the sum total of all the interactions that a patient has with their healthcare providers including face-to-face visits, phone calls, text messages, telemedicine, and emails. The key for Hippalgaonkar was not to try and engage patients across all channels, but rather to zero in on the communication modalities that each individual patient preferred.

“HealthGrid is striving to be the single communication platform for all pre-, day of and post- visit patient interactions. Our platform will provide a consistent patient experience in the communication channel or channels that patients prefer to use. We mine our own interaction data to determine the best way to interact with patients. For example, the analysis of past interactions may reveal that John Smith responds better during weekday mornings via text message and seems to prefer phone calls at night. When a hospital or a practice has the information they want to share with John, they simply put the content in our system and we handle how it will be delivered to him based on his known response patterns.”

Down the road, Hippalgaonkar saw patients interacting with AI-powered chat bots that were so sophisticated that patients would feel they were interacting with a person. These bots would work across the different communication channels providing a consistent experience no matter what modality the patient elected to use.

Hippalgaonkar summed up by saying: “In the end it’s all about motivating patients to make changes to their health or put another way, to engage in their health. We can only achieve this if we communicate with patients in a way that compels them to take action. As an industry, we need to build technologies and processes that takes things down to the individual patient level. We need to use AI, machine learning, personalization and deliver meaningful information to patients so that they are compelled to make a change.”

From these conversations, it was clear that patient engagement meant different things to different people. Yet everyone agreed healthcare needed more engagement and more involvement from patients in order to deliver on the promise of better health at lower cost. Motivating patients to become more involved is not going to be easy, but if the MGMA17 exhibit hall is representative of HealthIT overall, the future is certainly bright for patient engagement.

Full Disclosure: Solution Reach and Stericycle Communication Solutions are both sponsors of Healthcare Scene.

How Does Age Impact Patient Satisfaction?

Posted on September 13, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

If you walked into the average medical practice on any given day, you would see patients ranging in age from 1 to 101. Understanding and adapting to the needs of such a diverse group of patients is challenging. Many offices are struggling with this, and patient dissatisfaction is at an all-time high.

In the Patient-Provider Relationship Study, recently commissioned by Solutionreach, researchers found that one in three patients are likely to switch practices within the next couple of years.

The question is why. What is happening to patient loyalty? And more importantly—what can medical offices do to stem the tide?

In addition to studying patient switching preferences, the study also examined the dynamics of generational satisfaction and preferences, posing the following questions:

  • What impact does age have on patient satisfaction and retention?
  • What role does it play in patient loyalty?
  • Which services create satisfaction for the different generations?

A Closer Look at How Age Impacts Patient Satisfaction

To better understand how age impacts patient retention, it is important to take a closer look at the results from each of the key age groups.

  1. Millennials—Satisfaction levels among the youngest cohort were dismal. Millennials are the least satisfied with all aspects of the practice, including the doctor, office team, and practice logistics. In fact, a stunning 81 percent say that they are not completely satisfied with their medical office. Unsurprisingly, millennials are also extremely likely to switch practices in the upcoming years. Nearly half—46 percent—of millennials say they will probably move on to a new medical practice in the next couple of years.
  2. Gen X—The satisfaction levels of Gen Xers lies somewhere between millennials and boomers. The numbers are still concerning, however. Two out of three Gen Xers are not satisfied with their medical office. Around 35 percent say they will probably change practices in the near future.
  3. Baby Boomers—While millennials are three times more likely to switch providers than boomers, there are still a significant number of unhappy patients in this demographic. Nearly 60 percent of boomers are not completely satisfied with their medical office and one in five will switch practices in the near future.

Regardless Of Age—Technology Boosts Patient Satisfaction

It’s easy to assume that everyone who moves on to a new practice does so because they move or change insurance providers. The truth is a growing number are switching for other reasons.

Why are they so dissatisfied?

Picture the average patient in your mind. What characteristics about them have changed over the past few decades?

The biggest thing is that we have become unbelievably attached to technology—it’s rare to find any of us without either a phone, tablet, or computer. We use technology for virtually everything.

This is the area in which medical practices are struggling to keep up. Solutionreach’s study found that this is the exact category in which patients are least satisfied with their medical office. This is true regardless of age. Millennials, Gen Xers, and baby boomers all want more technology.

The biggest gap between what patients want and what medical practices offer is around texting. Texting has been the most used form of communication for over a decade now, but according to the survey less than 30 percent of practices offer any texting options. Today, every office should be able to:

  • Send a text—94 percent of millennials and 87 percent of Gen Xers want to receive texts from your office. But it’s not just the “youngsters.” Two out of three baby boomers also want you to text them.
  • Receive a text—While some offices have started sending out reminder texts, far fewer actually have the ability to have a patient initiate text messaging through the office number. Eighty-seven percent of millennials and seventy-nine percent of Gen Xers say that they want to be able to text their doctor. Once again, boomers are also on board—58 percent say they want to send a text to their medical practice.

Today’s patient lives are completely intertwined with technology. Medical practices will need to adapt to using technology in new ways to connect with patients or risk losing one in three patients in the coming two years.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Patients Frustrated with Poor Practice Logistics

Posted on August 9, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

A new study shows that patients have just about had it with poor practice logistics—things like communication, scheduling, and accessibility. There have certainly been signs this was coming for quite some time, but now the data shows patients really are getting fed up with not having some of the same basic tools they have in service and retail interactions.

The Patient-Provider Relationship Study, which was conducted by Solutionreach, surveyed over 2,000 patients about their recent experiences with different types of providers. Over 500 of those who responded had seen a primary care provider in the past year and were asked questions about that interaction. The questions focused on satisfaction with the provider, their staff, and the practice in general as well as likelihood of switching providers and preferences around communication and accessibility.

The results were pretty stunning. Only 35 percent of patients were completely satisfied with their primary care provider and thirty-four percent of patients said they were considering switching primary care providers in the next couple of years. In addition, 12 percent had switched in the past year. And, quite a few left for reasons other than things like changing insurance or moving. Just under 40 percent of those who had switched said they left because of customer service and experience issues. The problems they listed included:

  • Feeling more like a number than a person
  • Trouble getting appointments
  • Poor communication with/from the staff
  • The staff were not friendly
  • Not satisfied with the staff (other than the provider)

These are very fixable issues. We’re talking almost entirely about the personal perceptions of patients about their interactions with staff, with just a couple exceptions. And those exceptions have largely to do with communication and access, which are also pretty manageable things to change.

You can improve communication and appointment scheduling, and with the right technology, you can do it in a way that feels more personal as well. Not surprisingly many patients want to schedule appointments online and they want options for email and text for communications like reminders. In fact, 79 percent of patients said they wanted text messages from their primary care providers.

It’s important to note that these things don’t just improve the patient experience outside the practice, they save time for staff, which means a better experience when patients are in the practice. So why are providers so hesitant to invest in tools that can fix this problem?

To some degree, it appears to be about fears that these investments won’t pay off—in added reimbursement or return on investment (ROI) from savings. In a study conducted by HIMSS in 2015, providers cited time constraints and lack of reimbursement as barriers to improving patient engagement. The truth is many of the things that fall under “engagement” can also be seen as “customer service,” and patients want better customer service. In another study conducted by MicKinsey, patients said they had similar expectations of service from healthcare providers and non-healthcare companies.

While there will never be added reimbursement for smiling or greeting patients by name, there are some clear areas of ROI that can make up for that. Email and text reminders have been shown to reduce no-shows by 30 to 50 percent, saving the average primary care practice about $40,000 a year. Online appointment scheduling not only saves the practice on scheduling calls, which generally take four to eight minutes, but it can also help patients find earlier appointments, shortening wait times.

For providers who worry that texting with patients will suck up more time with no reimbursement, there is hope as well. Texts take only about four seconds on average while the average call is more like two or more. Also, texts can be responded to at the convenience of providers and staff. There is no need to play phone tag, which is a waste of time for everyone.

When it comes to reimbursement for engagement and service activities, it’s time to think bigger picture. Reimbursement can be time saved. It can be patients retained. It can be increased compliance or fewer phone calls. There are a lot of ways a better patient experience can translate into a better bottom line.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Clinical Insights from Social Media Data: Amplifying Patient Voice with Symplur

Posted on May 31, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed

What data from social media can help healthcare organizations?

One of the biggest challenges of online and social data is the sheer volume of unstructured data. Can your physician read all your tweets and postings? Hopefully not. Physicians have data and work overload, a daily report of steps taken from activity trackers or online social media use hurts their ability to treat patients. HealthIT solutions can help process this data and find patterns and changes.

I had a conversation with Audun Utengen about actionable insights into healthcare from his company, Symplur. At Datapalooza he participated in a panel and mentioned the rich amount of patient data that can be found on twitter (shocked gasp followed by a furrowed brow). Symplur signals tracks online engagement.  You can find healthcare insights from conversations really quickly. They provide tools that help healthcare providers get patient insights where they are naturally interacting. There is value in meeting patients where they are, and patients are discussing their healthcare online.

Originally, the assumption was that patients would not say things online. Sensitive topics do not naturally show up in social media use- fewer people are discussing gonorrhea online than receive treatment for gonorrhea. Providers assumed that things which are protected patient information would not show up on twitter. They were wrong. As most social media users know- it’s shocking what people will post online. Not every aspect of health is on twitter but patients want to engage online.  They go to twitter because they want their voices to be heard. They want things to change. They can’t be ignored on twitter. They want their voices to be heard by people in decision-making positions.

Patient’s online discussion have positive impacts on organizations. The key is to be proactive about patient engagement online. Stanford did a study looking about patients’ engagement at conferences. Typically, you will find 1 patient in the top 1 percent of influencers. While this number is low, conferences which have a higher percentage of patients active as top influencers have a greater reach. Want to increase your Healthcare voice and conference audience? Engage patient advocates online. Engaging patients is commercially valuable in amplification. Future patients get more insight as well.  Audun Utengen and I looked at the data from Datapalooza and found that 11 of the top 100 influencers were patients.  That is way ahead of the median number for all healthcare conferences- in 2016 the average number of top influencers that were patients at a conference was one.

“They did a great job giving patients a voice at the conference. I am impressed.”

-Audun Utengen, Co-Founder of Symplur

Healthcare Stakeholder breakdown of the top 100 influencers ranked by the Healthcare Social Graph Score.

Datapalooza had a higher than average reach and a unique blend of participants. Audun Utengen described some of the unique features of the conference:

“The social conversation from the conference was very dynamic. From the 9,366 tweets, 80% included at least one mention. Lot’s of connections were made and we witnessed the typical “flattening of healthcare” that social media is known for by breaking down the barriers between the stakeholder groups. Below is a network analysis graph showing the flattening and the conversational patterns between Twitter account and their healthcare stakeholder groupings.”

Conversations blend between different stakeholders in the healthcare conversation at Datapalooza

The ability for many stakeholders to access information and interact with each other in one place is one of the advantages of twitter. Using hashtags can help stakeholders learn about content about a specific topic quickly. One of the things Symplur is allows is the visualization of keywords surrounding conversations on twitter. When looking at the conversations from Datapalooza the topic of “patients” was very high. Unsurprisingly, “data” is the topic of focus. Patient, Health and Patients rounded out the top conversation topics.

Keyword Frequency Analysis Graph

Symplur Signals have been used for over 200 healthcare studies. They partner with academic research centers seeking more information from online conversations. Companies can also look at competitors in their area and see how they compare. Does a nearby provider have more positive mentions on social media?

Data from online interactions can also give insights into patient health. Social usage has unique implications for mental health. Frequently, online behavior change can predict mental health change. Pediatricians and Providers are in a position to see online behavior in their area and help families understand the implications. If bullying is a problem in your area providers can know their patients will have higher stress levels and provide resources and support. Certain behaviors and even emojis indicate a higher risk of depression. A suicide that will predictably happen based on social data will not show up in clinical records. Listening to what patients want us to hear will help provide greater support.

The sheer volume of social data can mask its usefulness. Online activity and data can be difficult to process for many clinicians. In a world of ever-increasing data and patients reporting everything from steps taken a day to now online behavior many providers have data overload. Data insight tools such as Symplur filter data into a format that allows physicians and systems to use it to improve patient outcomes.

I Really Don’t Want to Be Your “Worst” Patient

Posted on April 29, 2016 I Written By

The following is a guest blog post by M. Maxwell Stroud, Lead Consultant at Galen Healthcare Solutions.
Max - Healthcare IT
“I really don’t want to be your “worst” patient. Really, I don’t.”  These are the words that I think to myself as I prepare to ask my new specialist if he has interfaces with either of the hospital labs in my hometown 40 miles away.  My provider humors me and lets me know that if I go to one lab he will get a fax, and another and he will be able to view the results in a portal.  Sigh.

I have for a long time kept all of my care to one healthcare organization in town – in part because I am a firm believer in one chart for one person and I personally don’t want to have to deal with the mess of coordinating all of my records or manually schlepping things from office to office.  I love the concept of “one source of truth” and I know how far away we really are from that.  So why venture out of town and (gasp) to different healthcare organization?  Because that is where the best specialist was that was seeing new patients and mine had left town.

As a patient, I get to make that choice.  I get to decide where I get my care – as I should.  I also make the choice knowing that it will result in me having two distinct medical records in orgs 40 miles away from each other.  I also know that it means I am, at times, going to have to put on my advocacy hat and make sure that my records are correct, that my labs got where they need to go and that everyone has the information that they need so that I can get the best care.

Wait. What?  The patient is the only person in this continuum of care who is making sure the right person has the right data at the right time?  Yep.  Some might say that I am a control freak or that I need to relax a little – but I am informed by the life experiences of the patients that have been a part of my life.  I have seen what happened when my father got admitted to the hospital without an accurate medlist available.  I have seen the binder that my sister has to carry with her on the train that has her MRIs and PET scans to take to her next oncology appointment in the city.

It blows my mind that just a little over a month ago I was at the largest healthcare IT conference in the country (HIMSS16) discussing interoperability, and now I am on the phone with the nurse at the clinic because she cannot find my lab results … “Oh wait” she says “they are in the print and scan pile.”  Great.  Just great.

I have heard the argument that patients are not interested in their data.  There is a chance I could be an outlier – I live my life in a world of health data and I am acutely aware of how it is used in my care and the care of others.  I really think the truth is you don’t know how important it is to you until it becomes important to you.  One life event, one family member’s crisis, one rare diagnosis – and you begin to understand that you are the most important person in your own healthcare.

We have centered record keeping around the physical location of care.  This makes sense when you think historically.  Patients used to be less mobile, receive care locally and lived locally.  Additionally, the role of the “legal medical record” is a legal representation of the care provided and decisions made by a healthcare organization.  Organizations still need to document medical decision making, but patients are becoming more and more mobile.  People move from city to city, or even within health networks in the same town.  In the digital age, even if the legal medical record lives with the provider —  the data needs to follow the patient.

We can do better by patients and consumers.  The information is there, it is just not yet connected in the way that will make it available, actionable and meaningful to everyone who needs it.  It’s not just about finding an easy button to import discrete data, but also a culture change.  Truly putting the patient at the center of the data is simultaneously mission critical and more than a little revolutionary.

About M. Maxwell Stroud
M. Maxwell Stroud, MSW MSW is a Lead Consultant at Galen Healthcare Solutions with a professional background in both healthcare and social work. Max has been consulting in Health IT for over 8 years.  She has worked with every aspect of health IT in ambulatory care including facilitating clinics through the transition from paper to electronic formats, supporting teams through major system-wide upgrades as well as add-on implementations and integration projects.       Max has a passion for collaborative process and building processes that bring all stakeholders to the table to build systems that meet the needs of the business organization, the providers and the patients.  Max can be found on Twitter at @MMaxwellStroud

Lessons Learned from Patient Engagement Efforts in Louisiana

Posted on March 28, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: Check out the video recording of our interview:

2016 March - Lessons Learned from Patient Engagement Efforts in Louisiana-blog

For our next Healthcare Scene interview, we’ll be chatting with Jamie Martin and Linda Morgan from the Louisiana Health Care Quality Forum (LHCQF) on Wednesday, March 30, 2016 at Noon ET (9 AM PT). After putting on an incredible session on patient engagement at HIMSS, I can’t wait to have LHCQF join me to share many of the experiences and learnings that have taken place in their efforts to promote patient engagement in Louisiana.

You can join my live conversation with Jamie Martin and Linda Morgan and even add your own comments to the discussion or ask them questions. All you need to do to watch live is visit this blog post on Wednesday, March 30, 2016 at Noon ET (9 AM PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’re hoping to include as many people in the conversation as possible. The discussion will be recorded as well and available on this post after the interview.

As we usually do with these interviews, we’ll be doing a more formal interview with Jamie Martin and Linda Morgan for the first ~30 minutes of this conversation. Then, we’ll open up the floor for others to ask questions or join us on camera. Jamie, Linda and the team at LHCQF have done some phenomenal work in promoting patient engagement in Louisiana. I’m looking forward to learning from their experience and insights so we can see more of it happen across the nation and world.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

Hyperportalotus: Condition Whereby Patient Has Too Many Healthcare Acquired Portals

Posted on March 7, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed the last day of HIMSS 2016 (which is most of you since the keynote area was pretty empty), you missed a number of interesting keynote sessions and other education sessions. However, as I thought through the sessions that day, this comment from a patient attending one of those sessions really stood out to me:

Based on the reaction of the crowd to this comment and my own experience talking with thousands of doctors and patients, this is a very common problem. Meaningful use encouraged providers to have a patient portal, but this had the unintended side effect of what I’d call portal proliferation.

The patient who commented about her “hyperportalotus” said that she knew that she had portals for most of her providers, but she couldn’t keep track of which provider was on which portal. No doubt she was embarrassed when she couldn’t remember how to log in to that many portals as well. Plus, the last thing any sick person wants to do is go searching through 9 portals to find the one that has the information they need.

What concerns me most about Hyperportalotus is that I don’t think there’s a clear pathway to treating this debilitating problem. There are some treatments that make it better, but the problem still remains and I don’t see a cure for the problem coming anytime soon. Is the government going to come out with a portal non-proliferation treaty? I don’t think so.

Before I get a wave of pitches that you’ve solved this problem, I’ll make it clear that I don’t think the patient being an HIE of one is a scalable solution. That idea might work for some patients, but it won’t work for most. Plus, the complexity of each portal having their own format and design causes so many issues with the concept of the patient being the repository and aggregator of their health information.

I’d love to hear how people think this will play out? We got a bunch of doctors on the portal. Now what?

No,The Patient Isn’t Disrupting Your Workflow!

Posted on February 26, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Just recently, I had a personal experience which highlighted a serious problem in how hospital staffers handle health IT workflow.

The backstory is as follows. I was dispatched to the emergency department of a local mid-sized community hospital after complaining of chest pain and shortness of breath. (Turned out it was an asthma attack, not a cardiovascular complication, but the on-call doc I spoke with wasn’t taking any chances.)

This hospital ED seems efficient and well-run. Moreover, the clinicians and techs are uniformly attentive, thorough and patient. In other words, I feel safe and well-cared-for there.

That being said, I had a few experiences during this ED visit which I suspect are endemic to the industry. No one of these issues seemed serious in and of themselves, but collectively they gave me the sense that my feedback on what I observed wasn’t welcome.

They included the following:

  • When I called attention to the fact that my blood pressure reading was unusually low (80/60) they dismissed the data as a blip and discouraged further discussion.
  • After the expected EKG to rule out cardiac concerns , staff left the leads attached to my skin to allow further testing if needed. Because the adhesive attaching the leads to my skin came loose now and then, you guessed it, alarms went off. When I suggested that the leads be either reattached or removed, the tech’s response translated to: “Honey, you have no business asking these questions.”
  • When I tried to find the results of the tests they were running via the MyChart app on my phone (yes, they’re an Epic shop), none of them were available, even though the doctors already had them.

None of these issues represent a staggering problem. My blood pressure did normalize, we handled the EKG lead stickiness issue without incident, and I did get my test results as soon as the doctor had them. I got a nebulizer treatment and some feedback on my overall health, and went home feeling much better.

That being said, I still find it unsettling that I was discouraged from taking note of what I saw and heard, and had no access to test results on the spot that would have put many of my concerns to rest.

More broadly, I object strenuously to the “doctor knows best” scenario that played out in this setting, at least where IT workflow was concerned:

  • While I understand completely that nurses and techs are besieged with needless noises and suffer from alarm fatigue, treating my response to those alarms as trivial doesn’t seem appropriate to me.
  • Failing to share data on the spot with me via the portal deprived me of the chance to discuss the data with my ED doctor. Instead, I only got to go over the data very quickly and mechanically with the nurse at discharge.

What bugs me, ultimately, is the intangible sense that I was perceived as a force breaking the IT workflow rather than a participant in it. This incident has convinced me that we need to transform the way HIT systems are designed, in a manner which brings the patient into the process of care. You clinicians need my eyes and ears to be on the case too.