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When Patient Communication with Doctors Becomes Ridiculously Easy

Posted on December 7, 2018 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.

It’s always nice to talk about the value of improved communication between doctors and patients. It’s another thing to read a story about the impact of making that communication easy.

That’s what I found when I read this amazing story by Ethan Bechtel, Co-Founder and CEO of OhMD. For those too lazy to read his whole write-up, Ethan received a late night email from one of his pediatric customers that said the following:

This is the type of email that every healthcare IT company founder dreams of getting. As Ethan says:

I always believed that we could truly have a positive impact on healthcare if we just made patient communication ridiculously easy.

But I never thought I’d get an email quite like that.

Pretty spectacular way to frame it. Although, he does offer this important perspective:

The obvious truth is, OhMD didn’t save that child’s life, the doctor did. She devotes her entire life to her patients and goes above and beyond to provide incredible care at all hours of the day.

But if we can just play a small a role in helping great doctors be amazing doctors, then we’ll have a real impact on patient care.

It’s great to hear stories like this. Thanks to Ethan for sharing it. Certainly there’s a balance we have to reach in this regard. We can’t expect our doctors to be at our beck and call 24/7. They need to have a life too and to not feel responsible for every patient’s whim. However, it’s great to see what simple communication can do to improve the experience for both patient and doctor.

The Rise of Urgent Care and Retail Clinics – Or Is It The Rise of Convenient Healthcare?

Posted on December 5, 2018 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.

It doesn’t take a rocket scientist to see that primary care faces more challenges than it’s ever faced before. Not the least of which is being one of the lowest paid medical professions with rising medical school prices which encourages more doctors to choose specialty medicine and eschew primary care. What’s astounding is that this trend stands in stark contrast to what patients want from primary care. Patients want more convenience while the medical establishment is turning out fewer primary care doctors which creates a shortage of doctors and long wait times for primary care visits.

As Lydia Ramsey notes in her tweet below, urgent care offices are popping up everywhere. Combine that with retail clinics and the future of primary care is facing a lot of serious questions.

The reality is that most patients don’t want to go to urgent care or retail clinics. They’d much rather go to their PCP. Why don’t they go? The simple answer is convenience.

It’s much more convenient to hit the urgent care or retail clinic than it is to go to their primary care doctor. Some of this has to do with a shortage of primary care doctors which means long wait times to be seen. In other cases, it’s the really poor experience patients have had visiting their doctor in the past. I don’t need to list off the litany of bad patient experiences that we’ve all had when visting doctors. It’s like a universal PTSD experience that everyone has gone through.

Dave Chase offered his take on the rise of urgent care:

I’m not sure about his reference to the “devastation of primary care.” I’d be interested to hear why he thinks primary care has been “devastated.” Is he referring to over-regulation and underpayment? Is he referring to the shortage of docs I mention above? Is he referring to the rubber stamp PCP visits that are required to see a specialist in many insurance plans and in many ways ruined the PCP visit?

No doubt, primary care has been one of the least appreciated medical professions. However, primary care doctors didn’t do themselves any favors either. In many ways it reminds me of what Uber and Lyft have done to the taxi industry. Taxis could have embraced all the conveniences that Uber and Lyft provide, but they chose not to do so. Why not? Because they felt like they didn’t need to change since they had a virtually monopoly on the industry. Would I rather get a taxi? Yes, but I don’t because Lyft is more convenient. Sounds a lot like PCPs, doesn’t it? We’d rather go to a PCP, but an urgent care or retail clinic is more convenient.

Going back to Dave Chase’s comment that “If there’s proper primary care in a community and ethical hospitals, there’s no need for separate urgent care.” I might agree if he’d say there was less need for a separate urgent care. Urgent care does some really great work in off hours. However, the real problem is defining what he calls “proper primary care.”

I do think that if PCPs would have embraced better patient experiences, urgent cares and retail clinics would be much smaller. That said, does anyone think we can put that genie back in the bottle? I don’t think so. I believe our future healthcare system is going to have urgent care, retail clinics, and primary care.

The real question is what can PCPs do to make sure they thrive in this new mixed environment? I’d suggest that the first place to start is convenience.

The Extraordinary Value of Chronic Care Management As Seen Through The Lens Of The Patient

Posted on November 28, 2018 I Written By

The following is a guest blog post by Spencer Kubo MD, Chief Medical Officer at CareCognitics.

The concept of adding chronic care management (CCM) to primary care practices is appealing on many different levels, but implementation has been sporadic.  The dismal uptake is multifactorial and is largely based on the perception that the value (return) may not be worth the investment.  However, Wendi Capers, Practice Manager of Priority Health Group, a primary care practice in Las Vegas, Nevada, recently relayed to me three patient stories that are guaranteed to change your perspective.  This group was an early adopter of CCM and is using Cariatrix as their CCM provider.

Patient #1 is an 82-year-old male veteran who was becoming increasingly isolated, lonely and depressed after the death of his dog.  The patient did not have any family or friends.  He had no physical complaints that would have necessitated a call to his doctor and did not feel he had any reasons to request an appointment.  The Care Ally from Cariatrix noticed that the patient was not responding to the regular emails and texts that give reminders about upcoming preventative health measures. She called the patient and astutely picked up on the feelings of isolation. After their conversation, she found a program that could provide animal therapy for vets.  She also located a community center that held classes in Tai Chi, one of the patient’s favorite forms of exercise.  The patient is responding well to these interventions and has “turned around.”  Now the patient promptly responds to the emails/texts, and even calls the Care Ally every month just to check in, clear signs of greater engagement and well-being.

Patient #2 is a 62-year-old male with diabetes that was not well controlled, as evinced by a baseline A1C that was elevated to 11.9.  When asked about the suboptimal A1C result, the patient was taken aback, saying, “I can take care of myself.”  Again, this patient did not see the need to contact his doctor.  But the CCM team slowly won him over through multiple contacts.  The Care Ally then observed during medication reconciliation that there were extended periods between refills of his insulin and oral medications.  The patient at first did not acknowledge this gap, but then finally admitted that the co-pay had forced him to delay refills. He remarked, “I can eat and heat my home, or I can get my meds, but I can’t do both.”  The Care Ally was able to petition the manufacturers for hardship papers, and now there is no gap in prescription refills.  Most importantly, his A1C has been reduced to 7.9!

Patient #3 is an 83-year-old male who has a cognitive impairment.  After an annual wellness visit, the primary physician ordered home health care visits to help with the patient’s weakness and general limitations.  However, the patient became increasingly disoriented and refused to let the home health aide into the home, thinking she was a photographer.   As in the other cases, this patient was not responding to the regularly scheduled emails and texts that are standard components of CCM.  However, the Care Ally received an automated alert, read about his refusal to admit the home health aide in the EMR, and then called the patient directly.  The Care Ally immediately recognized the patient’s disorientation and called the police department to do a well check on the patient.  The police found the patient to be obviously confused and called an ambulance to take the patient to the hospital for an emergent evaluation.

You will notice some common themes in these patient stories.  The first is that the CCM program had established a digital two-way communication platform with the patient.  This is a game changer from the traditional paradigm of medical interaction, which is dependent upon the patient calling the office to report a problem.  None of these patients felt they had any reason to call the doctor’s office (in that they were unable to recognize that they were in need of any care). However, the lack of responses to email and texts served as an indicator to the Care Ally that something might be amiss. In the traditional paradigm, corrective actions are initiated only AFTER the patient contacts the doctor about a problem.  In the new CCM paradigm, there is outbound communication that can help detect problems even if the patient is not contacting the clinic.

Second, the CCM program could provide VIP services that truly made a difference in patient outcomes–these are simple yet extraordinarily effective.  One problem with the term “VIP Services” is that many think of limousines, suite upgrades and free meals.  But here we see that “VIP Services” can be low cost but directed interventions to resolve specific issues facing a patient.  Most clinical practices do not have the resources to contact patients who are not complaining, and most do not have the resources to respond to the cases above in the same proactive fashion that CCM allows.  A CCM program can truly provide that competitive edge and get medical practices paid for the effort!

Third, these examples point to the synergistic effects of technology and the human touch.  Technology is an answer because it can help us monitor patients for signals and provide additional communication channels.  But we need the human touch in many cases to really make the difference.  As a practicing cardiologist, I get excited about how much technology can help, but at the same time, I am humbled by how much technology still cannot do. It is the balance of technology and human touch that will be a game changer in healthcare.

Finally, it is important to assess the value of CCM in terms of revenue, improvement in quality scores and other hard metrics.  But there is a “softer” side to the value equation that makes CCM valuable and helpful to patient outcomes.  These stories from the “trenches” of CCM providers happen all the time–they form a compelling testament to the value of CCM!

About Spencer Kubo, MD
Spencer brings a diverse set of experiences and expertise to the chronic care management strategies of CareCognitics. Previously, he was Medical Director of the Heart Failure-Heart Transplantation Program of the University of Minnesota, where he authored over 250 original articles and abstracts. He has also been Chief Medical Officer or a consultant to numerous medical device companies developing breakthrough treatments to improve the lives of patients with cardiac diseases. He maintains a part time clinical practice and most recently was the Physician Lead of the Heart Failure Service Line for Allina Health. In that capacity, he leads a multidisciplinary group focused on improving outcomes of heart failure patients treated at any of the 12 hospitals and over 90 clinics in the Allina system.

Note: John Lynn, Founder of Healthcare Scene, is an advisor to CareCognitics.

Voice Technology: A Disruptive Force in Healthcare

Posted on November 19, 2018 I Written By

The following is a guest blog post by Adam Sabloff, CEO of VirtualHealth.

Voice technology is a disruptive force across many industries, and healthcare is no exception. In sync with tools like Amazon Alexa and Echo, voice-user interfaces (VUI) have the potential to take care management to the next level, and the advantages extend far beyond simple conveniences for patients. 

The world of healthcare lives in siloes: patients, family members, doctors, care managers, and health aides, just to name a few. All are inputting valuable health information from disparate systems, devices, and other sources—resulting in a fragmented view of the patient’s health.

A growing number of healthcare innovators, myself included, believe that voice technology is one solution that can help bring all the pieces together.

I joked during a presentation at Amazon’s VOICE Summit, where I addressed the use of voice technology as a patient engagement tool, that I had received a late-night text from my sister-in-law that four flavors of Goldfish crackers – which she knows I love – were being recalled due to salmonella. Imagine if Alexa knew my ordering behavior, understood what I had in my pantry and alerted me immediately to the recall. Now imagine if Alexa also automatically sent me a box to return the bags in question or merely alerted me to throw out my Goldfish stash and arranged for my refund.

When you apply those “what ifs” to healthcare, they take on new, more significant meaning.

Transforming Care Delivery with Greater Insights

Driven by the massive popularity of Alexa and Google Home, VUI is transforming care delivery by empowering providers with greater insights like these and better engaging patients in behavior change that leads to overall better health and outcomes. Implementation of VUI can enhance process across a variety of use cases such as:

  • Prompting patients to schedule appointments and follow through with care plans
  • Reminding patients about medications
  • Guiding patients through procedure preparations
  • Standardizing care information provided before or after treatment.
  • Enable interaction to complete assessments

The sky is the limit when it comes to implementing VUI, but the immediate goal is identifying medium-risk individuals before they become high-risk. What if Jane just had knee surgery but lives in a 4th floor walk-up? Her care team knows that compliance with her discharge plan may prove difficult. Voice technology can be the intuitive, patient-friendly layer that allows data to flow into healthcare systems faster.

Aging at Home

One of the biggest topics being addressed these days is Medicare’s unprecedented push into the home—a shift driven by an aging population that is outgrowing the amount of available senior living beds.

By weaving VUI-based smart home products like Amazon Alexa and Google Home into the fabric of healthcare technology, we can provide a better quality of life to seniors while allowing them to age gracefully in the comfort of their own homes.

Last month,, an Amazon spokesperson told a reporter that the company frequently receives positive feedback from “aging-in-place” customers who use Alexa’s smart-home features as an alternative to going up and down stairs. Amazon’s Echo Show is another product that offers users Tap to Alexa, a screen interface that lets users who are deaf and hard of hearing tap common commands. Microsoft, for its part, recently launched an A.I. for an accessibility program to create inclusive, affordable technology.

While a number of aging in place-focused technologies like these are already available, more still are being explored. We are seeing seniors embrace today’s connected devices to stay safely independent. Everything from blood pressure and glucose monitors to motion sensors are making seniors’ homes safer and smarter. Furthermore, voice devices can serve as the central data hub for all the connected devices in a person’s home. 10 years from now, I anticipate that most seniors who live independently will do so in smart homes equipped with passive devices that continuously monitor vital signs and activities of daily living. I also foresee the use of other monitoring devices, such as food trackers that monitor inventories and replenish when needed.

Addressing Social Determinants

Social factors such as lower income, education level, or high-crime area have been shown to significantly affect health outcomes. Subsequently, social determinants can cause care gaps such as difficulties with transportation, proper nutrition, understanding educational materials on a specific condition, or lack of a support network to help ensure compliance.

According to Lyft, 3.6 million Americans have transportation issues that prevent them from getting to or from doctors’ appointments, and 25% of lower-income patients have missed or rescheduled their appointments due to lack of transportation.

That’s where voice technology can help.

If John Smith needs to go to the doctor and Medicaid will pay for the appointment, John can say, “Alexa, I need to go to the doctor next week.” Alexa might respond, “Your doctor is available at 10 am on Tuesday. I’ll arrange for a Lyft to pick you up.”

It’s the same with nutritional needs. If John says, “I need meals,” Alexa might say, “You’re on a low sodium diet. Your choices for this shipment include asparagus or carrots.” By making solutions easier to reach, VUI can close the care gaps more efficiently and effectively than a care manager reaching out via email or phone.

To be sure, there are a lot of lofty ideas out there when it comes to VUI and healthcare, but it’s not practical to boil the ocean; instead, it’s important to hone in on those aspects of healthcare where it can have the greatest impact in the shortest amount of time.  By engaging patients in their homes – particularly those who make up the most high-risk, complex populations – VUI applications can keep patients out of the doctor’s office or hospital, while still providing strong outcomes.

About Adam Sabloff
Adam Sabloff, CEO and Founder of VirtualHealth, is a nationally recognized leader and executive in the healthcare industry. Adam’s impact in the field can be traced back to the mid-2000s, when he co-created the Ritz-Carlton Residences in Baltimore and discovered a significant gap leaving seniors and the chronically ill without access to essential care delivery and technology.

That insight, coupled with the loss of a loved one to a late-stage diagnosis, led Adam to develop VirtualHealth, the first comprehensive care management solution purpose-built for integrated value-based care. Designed for use by payers and providers, the platform aggregates and normalizes patient data from multiple sources effectively providing healthcare organizations with the tools to provide proactive, quality care.

Adam is a frequent speaker at healthcare and technology events, including the annual J.P. Morgan Healthcare Conference, Parks Associates’ Connected Health Summit, and the Amazon Voice Summit where he discusses topics including the need for advanced health IT solutions to achieve a true “whole-person” view of the patient.

The Common Thread Connecting Top-Performing Practices

Posted on November 14, 2018 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 top-performing practice. Isn’t that what every organization in the healthcare industry is striving to become? But how do you get there? According to MGMA’s recent Winning Strategies From Top Medical Groups report, there are a few things that top performers have in common—from exceptional strategy, to smooth operations, and strong culture. But one interesting finding of the study was that top performing medical groups have a radically different approach to investment than the rest of the industry.

In an era of cutting costs and reducing overhead, many medical practices avoid spending money like the plague. However, top performers do the opposite. They are significantly more likely to spend additional money on their practice. They then maximize the returns on these investment, ultimately achieving lower overall operating costs. As MGMA President and CEO Halee Fisher-Wright, MD, recently said, “We have found that better performers are systematic about improvement and continually invest time and effort in new resources while maximizing the tools and information already available to them.”

Technology for the Future

If top-performers are investing more, where is that money going? One of the best investments—not only for today but the future as well—is technology. Emerging technologies are a critical aspect of the future of the healthcare industry. In fact, an SAP/Oxford Economics study recently found that 70 percent of healthcare executives say that investing in technology is essential to a practice’s growth, competitive advantage, and the quality of a patient’s experience. Thomas Laur, global president of SAP Health, explained, “Digital innovation will fuel the next wave of breakthroughs in healthcare and accelerate the broader shift toward data-driven care for healthcare organizations. Unlocking actionable data insights in real time is critical for the future success for value-based care.”

The technologies expected to create the highest return on investment include:

  1. Efficiency-fueling technologies. Most healthcare organizations are riddled with inefficiencies throughout their patient care processes. One of the biggest inefficiencies lies with unwieldy administrative processes. In the healthcare industry, 31 percent of employees deal solely with administrative challenges. As a comparison, across other industries, just 13 percent of workers perform administrative work. That’s a whole lot of wasted time! Technologies that standardize and streamline administrative processes will reduce this burden, improving efficiency levels and overall patient care. This includes automation of appointment reminders, recall messaging, billing, scheduling, and more.
  2. Technology that personalizes care. For years and years, uniform medicine has been the norm in healthcare. The large majority of patients with the same disease will end up receiving the exact same treatment as one another. This is not the most effective nor efficient way of treating patients. It is estimated that a staggering $700 billion each year is spent in the U.S. on health care efforts that do not improve health outcomes. This is where the technology of personalized medicine comes in to play. A variety of tools are emerging that target patient’s health at an individual level. From technology that predicts a patient’s likelihood of contracting any given disease to technologies that can take into account an individual patient’s makeup before prescribing medications, more and more options are available for personalized care. And these technologies are very popular with patients. According to one study, more than three-quarters of consumers say they would like to undergo diagnostic tests that develop personalized prevention or treatment plans. Implementing these options differentiates you from the competition.
  3. Patient engagement technologies. Todays’ digital patients want access to tools that give them greater understanding and control over their own care. Since patient engagement is a major goal of the healthcare industry as well, implementing technology that engages patients is a no-brainer. From patient portals to text messaging to targeting patient education, the options to get patients involved and excited about their care have never been more diverse.
  4. Security-based technology. Data breaches and security concerns have become a hot-button issue in the industry. While it is impossible to completely eliminate all security threats, there are more and more options to safeguard your data. Some of the most exciting trends include next-generation firewalls (NGFWs), block chain technology, cloud-based securities, secure messaging and health information exchange, and biometric security applications. You can read more about each of these emerging technologies here.
  5. Remote-health monitoring. Remote wearables and apps are not only fun and popular with patients, but can also provide healthcare providers access to extended monitoring, greater disease prevention, and improved fact-based care decisions. Practices should look for ways to maximize the use of remote monitoring tools.

In order to obtain long-term success, healthcare organizations need to find ways to invest in the future. Looking at some of these most popular technologies is a great way to get started. Choose just one or two that you would like to focus on and then expand from there. This will put you in a great position for the future.

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.

Social Diagnosis? – Fun Friday

Posted on November 9, 2018 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.

It’s Friday as we start to head into the holiday season. A lot of fun and a lot of stress. What an interesting juxtaposition when it comes to your health, no? The good news is that I’m back again with some Fun Friday humor for you. When I saw this cartoon, I loved it immediately:

What’s interesting is that there is so much potential for collaborating with other doctors around challenging diagnosis. I first realized some of the opportunities there when I learned some of what Health Tap is doing.

It’s still a little bit of a wild west for many, but the fact that a patient or doctor can go online and get help with challenging healthcare situations is a very good thing. Technology will continue to enable this. I just hope it’s not quite as depicted in this cartoon.

When Payor Innovation is Driven By Government

Posted on October 15, 2018 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.

This tweet from Jamey Edwards, CEO of Cloudbreak Health, inspired a really interesting discussion in a Twitter DM (direct message) group I’m in called Healthcare Disruptors. For those not familiar with private DM groups, in this case, there’s a group of 49 people on Twitter that are part of this group and members of the group regularly share information, events, insights, etc and the group comments on it.

Private Twitter DM groups aside, one of the comments in the group highlighted a concept I’ve heard for years. The government (largely Medicare and Medicaid) is the largest payor and the private sector has been taking its queues from Medicare and Medicaid for years. Is it any wonder that we haven’t seen much evolution in the payor space when we’re waiting on a massive government entity to drive the innovation?

Waiting for government to drive innovation largely explains why healthcare hasn’t evolved.

To solve this problem, there are two options First, the government could evolve more quickly and create new models for reimbursement that change the landscape. Is there anyone holding their breath on this one? Don’t get me wrong. I’m quite intrigued by Medicare’s attempts to push telehealth related reimbursement codes and their decision to try and reimburse based on the time spent with patients instead of how much you document in the record. These are big changes and I’m hopeful that they’ll be good changes. Not to mention ACOs which will hopefully help show us the path to a full value based reimbursement world and get us off the fee for service treadmill.

That said, I’ll never forget a CMS listening session that I went to. Someone asked about a specific policy and when we might hear the details of the final rule. The CMS representative said, “Pretty quickly.” Then, he corrected himself and said, “Government quickly which probably means months, not years.” The government moves slow. That’s just the reality. This is why innovation in healthcare shouldn’t depend solely on the government.

The other way for innovation to occur is for other payors to lead the innovation. When was the last time that payors did something really innovative? When did Medicare take something from the private payor space because it was an innovative solution? I’ll admit that I’m not a complete expert on the payor space, but I asked some friends and so far none of us have remembered a time where this happened.

What’s going to change this? The answer to that is not clear. Do you see something I’m not seeing? The better promise comes from something outside this traditional system disrupting healthcare as we know it. It feels like something like that needs to come, because Jamey is right that this is a big problem for many Americans, both republicans and democrats.

What Can the Casino Industry Teach Healthcare about Patient Experience?

Posted on October 4, 2018 I Written By

The following is a guest blog post by Spencer Kubo MD, Chief Medical Officer at CareCognitics.

Two of the hottest topics in medicine today are patient engagement and patient experience.  It is well accepted that patients who are engaged in their medical care have better outcomes, compared to patients who “passively” receive instructions, likely due to variable adherence to doctor recommendations.  It is also becoming increasingly clear that patients who have better experiences with medical contacts will have higher levels of patient engagement. But the medical community has been slow to identify, measure, and implement the specific steps that would enhance patient levels of engagement and experience.

This lack of momentum within the medical community is not surprising to some since “traditional” interactions with medicine are now often viewed by patients as paternalistic.  Indeed, many practitioners within the medical community have trouble adopting the term “customer” and still favor the use of “patient,” viewing medical interactions as inherently different from consumer interactions.

These challenges have caused doctors and health care administrators to look outside of the medical community for better ways to improve the patient experience and engagement.  The CareCognitics team spoke to a Product Manager at Nordstrom, a company with legendary customer service and loyalty, who noted, “The most important factor in making the customer feel special is to create the sense that the sale or interaction was special to both the sales associate AND the customer.”  And in many instances, doing this creates no additional cost to Nordstrom; the very basic rules of respect and personable service are all that are needed.

In our work at CareCognitics, we’ve seen success with improving patient experience and engagement using a similar focus on making the patient feel special.  CareCognitics is a digital health company founded in 2016 that leverages casino and hospitality loyalty principles, along with data science, to improve the patient experience.  Sunny Tara and Vishal Argawal, co-founders of CareCognitics, shared some of the “secret sauce” that is already helping five clinics in Nevada and California: “We started small and focused our efforts on chronic care management, especially since these activities were well supported by chronic care management code CPT 99490 and therefore brought in additional revenue for each clinic.” Here are just a couple of the ways that Tara and Argawal were able to ameliorate patient experiences by leveraging the best practices of the hospitality industry.

Make the conversation two-way: Traditional communication with patients, outside of in-person doctor’s visits, usually occurs via phone and is restricted to business hours.  CareCognitics developed a HIPAA compliant digital platform so that patients could engage in a dialogue with the medical team using a format that was convenient to the patient’s schedule and not confined to office hours.  Tara also commented, “We were also pleasantly surprised to break many myths about digital literacy in the Medicare population – over 70% of patients were responding to texts and emails.”  People loved having a “conversation” and felt the platform provided a much more interactive experience with the doctor’s office. “Our success is not defined by the technology we use, but rather by personalized content that is delivered to the patient every month, that reinforces the feeling that their doctor cares about their well-being.  We use technology and digital channels to strengthen the patient-physician relationship and provide personalized care at scale,” Tara explained.

Offer encouragement and a personal touch: “Let’s face it – completing tests as part of a chronic care management (e.g. flu shots and mammograms) is not very exciting,” says Agarwal.  Each time a patient completes a test, CareCognitics sends a congratulatory note and a message on the importance of the test (e.g. dramatically reducing the chances of suffering from flu symptoms.)  And each message is branded to the physician office (rather than a 3rd party), so the patient feels the communication is with the doctor’s staff.

In addition, CareCognitics supplies a “Care Ally,” a Certified Medical Assistant (CMA) who can respond to requests for additional details, schedule changes, etc., on behalf of the physician’s office, further enhancing the personal VIP touch, similar to a VIP host in the casino industry.  All patients who enroll in the program get instant benefits like “VIP phone” access (a special priority access phone line that physician offices aren’t responsible to run), next day appointments, and interactive personalized care.

All these perks help to reinforce the relationship between the patient/customer and the physician’s office.  The patient feels “special” because there is a pervasive sense of being uniquely cared about by doctors. Many of these principles of VIP service overlap with the principles of concierge medicine, but in this program, there is no large monthly fee to the patient!  All the patient has to do is be an active participant in his or her own healthcare.

Hey, let’s not forget about the docs!

Yes, the focus of all these activities is on the patient, but physician acceptance is critical for the program to be sustainable and incorporated as an essential feature of medical treatment, and not just a fancy add-on. Physicians’ feedback has pointed out at least 4 features of this chronic care management program which are particularly attractive to physicians: engaging dialogue with patients, natively documents in the EMR, improved PQRS scores, and incremental revenue. 

According to Dr. Cliff Molin, a family practitioner with PHG, physicians like the fact that patients are engaging in a dialogue with representatives of the physician practice, without taking time out away from the daily workings of the practice. The key elements of interaction are embedded into the EMR, so physicians can oversee the progress without having to access a different website. Because the program encourages completion of positive health behaviors, all the practices are reporting improved results on PQRS quality reports.  And finally, the program has brought in incremental revenue since all the care coordination activities are reimbursed by CMS at ~$42 pmpm.

Carecognitics improves physician’s ability to compete with large health systems and provide excellent care while improving payment for the work they do. Technology is leveling the playing field in improving patient care without increasing costs for physician practices.

Note: John Lynn, Founder of Healthcare Scene, is an advisor to CareCognitics.

How to Text PHI with Patients and Stay Compliant

Posted on September 19, 2018 I Written By

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

Did you know that 73 percent of Americans say it is difficult to reach them by phone? In fact, Americans ignore 337 calls each year and that number is rising. Even if you leave a message, chances are high no one will ever hear it—80 percent of people report that they don’t even bother leaving a voicemail anymore because they don’t believe it will get listened to. More and more, phone calls are seen as invasive, outdated, or ineffective. Instead, people prefer to communicate via modern methods such as text message.

Texting Reigns as Favorite Communication Tool

We all know that pretty much everyone with a cell phone texts friends and family regularly. What is less well-known is that people would like to extend their texting habits to their healthcare provider. According to the 2017 Patient-Provider Relationship Study, 60 percent of patients want text reminders. Seven out of ten patients say they would like text communication beyond just reminders as well. It’s not just millennials. Around half of baby boomers also prefer text messages.

Unfortunately, many practices have shied away from texting or emailing patients through unsecured channels, wary of running into compliance issues. This is especially true when it comes to texting patients when those messages may include protected health information (PHI).

In fact, I suspect that if you were to poll a group of healthcare workers concerning the legality of sending PHI through unsecured text message, you would probably get answers all along the spectrum. Yes, no, maybe so? Many just don’t know.

Last March, at the HIMSS health IT conference Roger Severino, Director of the US Department of Health and Human Services Office for Civil Rights (OCR), the HIPAA enforcement agency, clarified the confusion.  According to Severino, providers may share PHI with patients through unsecure text messages as long as they have informed their patient that texting is not secure, asked for permission, and documented that consent.

“I think it’s empowering the patient, making sure that their data is as accessible as possible in the way they want to receive it, and that’s what we want to do.” Severino said.

Implementing Texting in a Compliant Way

This announcement was a big deal. Patients want to text you…and they want you to text them back. You significantly increase the value you offer to patients simply by giving them this option. So how does the implementation of Severino’s suggestions look in practice? Let’s say that you receive a text message from a patient named Mary asking you for some health-related information. In response, you can send something like this: “Hi Mary. I would love to chat with you more about your health. Text message is not a secure way to do that. Would you still like to continue this conversation?” If you are the one to initiate the conversation, you can send a similar message requesting permission before continuing.

Once Mary agrees and you document that permission, you are then allowed to continue the conversation without concern of violation. A key piece to remember here is that it is important that you make sure your patients are aware that texting is not secure. Then, if the patient feels uncomfortable communicating via that channel, you should move the conversation to a secure method such as a phone call, secure patient portal, or in-office visit. Remember—you are required to make patients aware of unsecured communication and receive authorization before discussing PHI on an unsecured channel.

As one final best practice, always include an opt-out message. Even if a patient has given consent in the past, you must always offer the option to discontinue the communication. This means that it is best to include a message such as “Reply STOP to opt-out” in your text messages.

In summary, if a healthcare provider would like to share PHI with a patient through regular, unsecured text messages, they must first:

  • Inform the patient that texting is not secure
  • Receive permission from the patient to continue
  • Document the patients’ consent
  • Offer an opt-out option

If you are not yet texting with patients (or only sending basic text reminders), this is a critical time to make a change. There is no other form of communication that has such a high level of adoption and engagement. Texting improves the health outcomes for patients as well as the financial outcomes for practices. With this recent clarification of policy by compliance officials, we can expect that the use of text will continue to grow dramatically as we move into the future.

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.

Walgreen’s Perspectives on Patient Engagement at #DHIS18

Posted on August 15, 2018 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.

The past 2 days I’ve been attending the Digital Health Investor Summit that’s hosted by KLAS. It was a classy event and the people they had in attendance were phenomenal. I’ll be offering up a number of insights I got from the event across the Healthcare Scene network of blogs, but a couple slides from Chet Robson really stood out for me today. Chet is the Medical Director, Clinical Programs & Quality at Walgreens.

The slides that Chet Robson shared were around some views on patient engagement. Or as he framed it: patient engagement, patient activation, patient involvement, patient participation, patient adherence, patient compliance, patient empowerment, or patient experience. I love that we have so many terms for the same concept.

Here’s the first chart he shared for patient engagement:

The 3 dimensions in the chart listed above seemed like a good framework for patient engagement. So, I was glad when Chet then shared this slide:

I think that more things could be added to the above expectations. However, it’s a really good start. Imagine if all of healthcare implemented these principles.

As timing would have it, I’ve actually done 3 appointments at Walgreens in the last month. Without going into all the details of why, I’m happy to say that Walgreens delivered on these expectations. The visits were easy to schedule, quick and painless, and the experience was great. My only complaint was that the appointment process wasn’t clear. I wasn’t sure if you could only schedule certain appointments or if you could also do walk-ins. The answer is that it’s best to have an appointment. Otherwise, when you walk in, the computer will have you schedule an appointment and unless you’re lucky, you’ll likely be waiting for a bit. However, this is a minor learned thing that can easily be fixed.

What do you think of looking at patient experience from a behavioral, cognitive, and emotional dimension?