Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

How To Choose Tools For Physician-Patient Engagement

Posted on September 22, 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.

To transition from fee-for-service reimbursement to value-based care, it’s pretty much a given that we have to do a better job of getting patients engaged with their physicians and overall plan of care. However, despite the array of intriguing digital health and mobile technologies we have available to get the job done, it’s still not clear exactly how to do it.

But according to one health IT exec, it all boils down to understanding how the various tools and technologies work and integrating them into your practice. Dr. Ali Hussam, CEO of outcomes data collection firm OBERD, suggests that the following tools are particularly important. I’ve listed his suggestions, and added some thoughts of my own:

  • Educational technologies: Physicians can use these tools to make sure patients are prepared to have an intelligent discussion of their health status, he notes. My take: It’s hard to argue that this makes sense; in fact, this concept is so important that I’m surprised it isn’t mentioned more often as part of the broader patient engagement picture.  
  • Electronic questionnaires: Hussam argues that since value-based care calls for quantifiable outcome measurements, it’s smart to use electronic questionnaires, which are more appealing, efficient and sophisticated than paper tools. My response to this is that while it’s a good idea, it will be important that the questionnaires be based on well-defined measures which the provider organization trusts, and these may not be easy to come by at first.
  • Wearables: Patients may already be using wearables to monitor their own health metrics, but it’s time to make better use of their presence, Hussam suggest. Physicians can step up their value by using the information to improve the quality of health discussions and intervene in response to the data if needed.  It’s hard to argue that he’s right about the potential uses of wearables. However, there’s a lot of doubt about their accuracy, so my sense is that many physicians are still reluctant to make use of them given the clinical accuracy questions which still bedeviled these devices.

Along with recommending these approaches to engagement, Hussam offers some tips for implementing patient engagement technology, including:

  • Focus on patient outcome: Hussam recommends sending a patient-determined outcome as the focus of care, and explaining to patients how engagement technology can help them meet this goal. Plain and simple, this sounds like an excellent idea, as patients are more likely to succeed at meeting goals they have embraced.
  • Solicit feedback: Effective engagement tools “should offer patients a sense of individual attention and intimacy by soliciting feedback about individual patients’ entire healthcare experience,” along with offering care data. He argues, I think compellingly, that this exchange of information could help providers succeed under merit-based incentive payment programs.
  • Encourage responses to questionnaires: As Hussam noted previously, providers must collect data to succeed at outcome-based payment models. But he also notes correctly that these questionnaires and help patients achieve their desired health outcomes by tracking what’s going on with their health. No matter how you couch things, however, patients may need additional encouragement to fill out forms. Perhaps it would make sense to have med techs go through the questionnaires with patients prior to their physician encounter, at least at first.

As Hussam’s analysis suggests, engaging patients isn’t just a matter of presenting them with shiny new technologies. It’s critical to align patient use of the technologies with goals they hope to meet, and to explain how the tools can get them there.

Otherwise, both patients and providers will see little benefit from throwing engagement tools into the mix.

When Will Doctors Teach Patients to Not Come In for a Visit?

Posted on July 8, 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.

I’ve been thinking and writing a lot about the shifting medical reimbursement world. Technology is going to be an enabler for much of this shift and so understanding the changes are going to be key to understanding what technology will be needed to facilitate these changes.

As part of this thinking, I recently wondered when a doctor will start teaching patients when they shouldn’t come for a visit. I realize this is a bit of a tricky space since our current liability laws scare doctors from providing this kind of information. Dealing with these liability laws will be key to this shift, but if we want to lower the cost of healthcare and improve the patient experience, we need to make this change.

Turns out, we already do this in healthcare, but it’s not so formal. Plus, it’s usually the older, more experienced doctors that do it (from my experience). I think the older doctors do this for a couple unique reasons. First, hey’ve had years of experience and so the patterns of when someone should go to a doctor or not are very clear to them since they’ve seen it over and over for 30 years. Second, they aren’t as worried about patients returning in the future, so they’re not afraid to educate the patient on when they shouldn’t come for a visit. Third, these older doctors are likely tired of seeing patients for something that’s totally unnecessary.

We’ve had an older pediatrician that did this for us and our children and we loved the experience. In some ways, I think he just liked to hear himself talk and we loved it as parents. There’s no handbook you get as a parent and so we wanted to learn as much as possible about how to take care of our child. Since we had 4 children, we were able to use that knowledge pretty regularly, but even so, it was hard to remember 6 months or a year later what the doctor had told us. It was all very clear when he explained it in the exam room, but remember when to take them to the doctor and when to wait it out was often forgotten 6 months later.

The decision of when to go to the doctor and when not to go to the doctor is always a challenge and I always forget when I should and when I shouldn’t. Far too often my wife and I error on the side of caution and take our kids in for needless visits. We don’t want to be irresponsible parents and not take them. With my own personal health, I likely wait too long to go to the doctor because I’m busy or I can just tough it out when a quick visit to the doctor would make my life better and avoid something worse.

I guess this is why we see so many health decision tree apps out there. They try and take the collective knowledge and help you as a potential patient know if you should go in for the doctor visit or not. However, most of them are really afraid to make a hard conclusion that you shouldn’t go to the doctor. Instead, they all end with some sort of disclaimer about not providing medical advice and that you should consult a healthcare professional for medical advice. I’m not sure how we overcome the liability of really offering a recommendation that doesn’t need the disclaimer. Although, this is exactly what many of us need.

What do you see as the pathway forward? Will the consumer health apps be our guide as patients? Will doctors start spending time educating us on when to come for an office visit and when not to come? Will they want to do this thanks to ACOs and other value based reimbursement? Will doctors leverage the consumer health apps or a PHR tool to help their patients with retention of the concepts they teach them about when to come in for a visit?

The Virtual ACO

Posted on April 26, 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.

“Virtual ACOs may be the next big thing for small practices,” says our host Dr. Tom. “I want to talk about how independent practices can lead and not just follow the shift to value-based care.”

Who here has looked at or talked to someone about virtual ACOs?

My guess is that most small practices haven’t really heard about it. Maybe it has to do with most doctors being too busy to consider other innovation. I’ll admit that the idea of a virtual ACO is a new one to me and so I was interested in the discussion that Dr. Tom from Kareo led on virtual ACOs.

The concept of a virtual ACO makes sense. Basically use technology to provide coordinated care across the care system. In fact, that’s what most patients think is already happening with their care, but we know it’s generally not happening. We all know it should and most doctors would embrace the ability to have the right information in the right place so that their patients get the right care. I don’t know anyone who’s against that principle.

However, as was pointed out in the chat linked above, the financial model for a virtual ACO is up in the air. There’s no clear financial model that makes sense. The care model makes sense, but the financial model is a mess.

Dr. Tom did make this assertion in the virtual ACO discussion:

Although S. Turner Dean responded with something we’ve talked about quite a few times before:

I love Dr. Tom’s optimism that this new world of value based reimbursement simplifying things, but I’m not sure it will be any simpler than fee for service. That’s not even taking into account the fact that we have the whole infrastructure set up to handle fee for service and that we know how it works. Set that aside and I’m still not sure that a virtual ACO would be any less complicated than our current fee for service world.

What do you think of the concept of a virtual ACO? Will it simplify medicine? Will it help doctors love their work again? Will it help the independent physician practice survive?

Full Disclosure: Kareo is an advertiser on this blog.

Outsourced Medical Billing #KareoChat on Twitter

Posted on August 26, 2015 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.

On Thursday, August 27th at 9 AM PT (Noon ET), I’ll be hosting the #KareoChat where we’ll be discussing the good and bad of outsourced medical billing. You can follow along tomorrow on Twitter by watching the #KareoChat hashtag or by checking out my tweets on @ehrandhit.
Outsourced Medical Billing Twitter Chat
Here are the questions we’ll be discussing in tomorrow’s Twitter chat:

  1. Why are many practices choosing outsourced billing over in house?
  2. What are the disadvantages of outsourced billing?
  3. How will ACOs and value based reimbursement work with an outsourced billing company?
  4. How do you select a high quality outside billing company? What differentiates these companies?
  5. Does your outsourced billing company need to have tight integration with your EHR? Why or why not?
  6. What are the pros and cons of outsourcing your billing to your EHR vendor?

I’m particularly interested in people’s responses to question number 3. I think many in healthcare understand the good and bad of doing the billing in house or outsourcing it. Although, I’m pretty sure I’ll learn even more on the Twitter chat tomorrow. However, how things like ACOs and value based reimbursement will impact an outsourced billing company is still a really important topic of discussion. Will it drive more people towards outsourcing their billing or will it mean more practices bring their billing in house? I’ll be interested to hear people’s thoughts on tomorrow’s Twitter chat or feel free to start the discussion in the comments below.

We’re Hosting the #KareoChat and Discussing Value Based Care and ACOs – Join Us!

Posted on June 23, 2015 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.

ACO and Value Based Reimbursement Twitter Chat
We’re excited to be hosting this week’s #KareoChat on Thursday, 6/25 at 9 AM PT (Noon ET) where we’ll be diving into the details around Value Based Care and ACOs. We’ll be hosting the chat from @ehrandhit and chiming in on occasion from @techguy and @healthcarescene as well.

The topic of value based care and ACOs is extremely important to small practice physicians since understanding and participating in it will be key to their survival. At least that’s my take. I look forward to hearing other people’s thoughts on these changes on Thursday’s Twitter chat. Here are the questions we’ll be discussing over the hour:

  1. What’s the latest trends in value based reimbursement that we should know or watch? #KareoChat
  2. Why or why aren’t you participating in an ACO? #KareoChat
  3. Describe the pros and cons you see with the change to value based reimbursement. #KareoChat
  4. What are you doing to prepare your practice for value based reimbursement and ACOs? #KareoChat
  5. Which technologies and applications will we need in a value based reimbursement and ACO world? #KareoChat
  6. What’s the role of small practices in a value based reimbursement world? Can they survive? #KareoChat

For those of you not familiar with a Twitter chat, you can follow the discussion on Twitter by watching the hashtag #KareoChat. You can also take part in the Twitter chat by including the #KareoChat hashtag in any tweets you send.

I look forward to “seeing” and learning from many of you on Twitter on Thursday. Feel free to start the conversation in the comments below as well.

Full Disclosure: Kareo is a sponsor of EMR and EHR.

Do We Want a Relationship With Our Doctor?

Posted on June 22, 2015 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.

As is often the case, this weekend I was browsing Twitter. Many of the people and hashtags I follow are healthcare and health IT related. Many of the tweets related to the need to change the healthcare system. You know the usual themes: We pay too much for healthcare. We deserve better quality healthcare. We need to change the current healthcare system to be focused on the patient. Etc etc etc.

This wave of tweets ended with one that said “It’s all about the relationships.” I actually think the tweet had more to do with how a company was run, but in the beautiful world of Twitter you get to mesh ideas from multiple disciplines in the same Twitter stream (assuming you follow a good mix of people). I took the tweet and asked the question, “Do We Want a Relationship With Our Doctor?

If you’d asked me a year ago, I would have said, no! Why would I want a relationship with my doctor? I don’t want any relationship with my doctor, because that means that I’m sick and need him to fix something that’s wrong with me. I hope to never see my doctor. Doctor = Bad. Don’t even get me started with hospitals. If Doctor = Bad then Hospital > Doctor.

I’m personally still battling through a change in mindset. It’s not an easy change. It’s really hard to change culture. We have a hard core culture in America of healthcare being sick care. We all want to be healthy, but none of us want to be sick. Going to the doctor admits that we are sick and we don’t want anything to do with that. If we have an actual relationship with our doctor, then we must be really sick.

From the other perspective, do doctors want relationships with their patients? I’ve met some really jaded doctors who probably don’t, but most of the doctors I’ve met would love an actual, deep relationship with their patients. However, they all are asking the question, “How?” They still have to pay the bills, pay off their debts, etc. I don’t know many doctors who have reconciled these practical needs with the desire to have a relationship with their patients.

The closest I’ve seen is the direct primary care and concierge models. It’s still not clear to me that these options will scale across healthcare. Plus, what’s the solution for specialists? Will ACOs and Value Based Reimbursement get us there. I hear a lot of talk in this regard which scares me. Lots of talk without a clear path to results really scares me in healthcare.

What do you think? Do you want a relationship with your doctor? Do doctors want a relationship with their patients? What’s the path to making this a practical reality? Are you already practicing medicine where you have a deep, meaningful relationship with your patient? We’d love to hear your experience.

Population Health Polls

Posted on August 11, 2014 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.

I was thinking about population health today. It’s become a hot topic of discussion now that a lot more healthcare data is available for population health management thanks to EHR adoption. Although, in many ways, the various value based reimbursement and ACO programs are a form of population health. I guess, for me I classify all of these efforts to improve the health of a population as population health.

I just wonder how many organizations are really working on these types of solutions and how much of the population health is just talk. Let’s find out in the poll below.

I’ll be interested to hear how organizations are approaching population health. Also, let’s do another poll to see how much people will be working on population health in the future.

I’d love to hear more details to your responses in the comments. If you are working on population health, what programs are you doing and what IT solutions are you using to support it?