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GE Healthcare Camden Group Insights Blog

9 Ways to 'Activate' Patient Engagement

Posted by Matthew Smith on Apr 18, 2016 10:53:06 AM

New payment models reward healthcare systems and providers for improving the health of populations. Providers are understandably concerned about the extent to which they can succeed in such models because so much of patient health is beyond their personal control.

Seventy-five percent of our health dollar is spent on chronic conditions that have everything to do with the choices made by patients, notably diabetes and degenerative joint disease as they relate to obesity. Therefore, engaging patients in the management of their own health is vital to achieving population health improvement.

At a recent national health conference I attended, the speaker asked the audience, “What is the least utilized resource in the American healthcare system?” After a few seconds of silence, as thousands scratched their heads for the answer, the speaker called out, “The Patient!”

Accountable systems and providers will increasingly need to learn how to empower and “activate” patients, rather than encouraging their dependence on the system to provide cures. Similarly, providers and care managers will need to reach out proactively to patients, rather than passively waiting for patients to seek care.

Here are nine key approaches to patient “activation:"

1. Charge Patients with the Primary Responsibility for their Own Care

Some patients have never been encouraged to think of their disease as their personal responsibility. Remind them there are some things they can do for themselves that no one else can do for them. For instance, no amount of insulin or other diabetic medication will overcome the effects of excessive eating.

2. Encourage Patients to Monitor their Own Conditions

Provide glucometers and blood pressure devices and ask patients to log their daily readings and progress. Let them know that you expect them to bring their logs (or devices that store results) to visits so you can monitor their progress. Teach them how to adjust their diets or medication to respond to their daily readings.

3. Encourage Use of a Patient Portal If You Have One (And Agitate Your System to Invest in Portal Technology if it Has Not Already Done So)

Make the procedure for signing up for the portal easy and understandable for the patient. Show them how to use the portal to check their own lab results or request appointments. Let them know that you want them to regularly use the portal so it can become a reliable channel of communication between you and them.

4. Plug your Patients Into Community and National Support Groups for their Condition

The local park district may hold free exercise classes, for instance. Many communities have free smoking cessation clinics. National organizations representing almost every major disease have websites that provide educational support materials and may introduce patients to local support groups for their condition.

5. Consider Group Visits

Group visits have several advantages that accrue to the providers (it saves time and enhances revenue) but one of the best outcomes of group visits is that they greatly increase patient engagement. Patients with chronic conditions gain significant emotional support and encouragement from interacting with other people “like them” who share their condition. Social support is one of the most powerful motivators of behavior. Group visits produce surprising improvements in the health of their members.

6. Pull Patients into the Electronic Health Records ("EHR") Screen in the Exam Room

EHRs threaten direct eye contact of health professionals with their patients. Savvy providers have learned to turn this liability into an asset by bringing the patient “into” the EHR as they work, showing them computer-generated charts, for instance, that trend their blood pressure or blood sugar, or to have the patient verify their medications and doses. The EHR becomes an engagement tool, and patient trust is enhanced when they realize the provider is not hiding information from them.

7. Use In-Office Instructional Videos

Some practices run motivational or educational videos in their waiting rooms or have a learning room with a library of instructional videos on a variety of health-related subjects. A well-organized file of printed educational materials is a low-tech way to achieve the same ends. The more information patients can absorb about their conditions, the more engaged they will be with their self-care.

8. Create an Interactive Website

Numerous providers have created their own webpage or blog and write about topics related to the health of their patients. These providers found that this strategy increased the engagement of their patients and generated new business.

9. Convey an Openness to Questions and Support Initiative

Consider the factors that might harm patient engagement and work to reduce them. Be there to support and respond to patients when they attempt engagement. This requires a positive response when the patient asks about their condition and how to improve it. Old-fashioned paternalism, which thwarts patient questioning, kills patient engagement. Patients respond to praise for even modest health improvements they achieve. 


GE Healthcare Camden Group and Prophet recently hosted a webinar discussing their new patient experience study which was conducted to understand the consumer healthcare experience by assessing the gap between patient and providers’ expectations and perceptions. To view this webinar on-demand or stream it to your device, please click the button below.

Webinar, Patient Experience, Patient Satisfaction

Topics: Population Health, Patient Engagement, Patient Activation

Infographic: Engaging Patients Before Their Appointments

Posted by Matthew Smith on Mar 16, 2016 12:55:23 PM

The importance of preparing patients before their appointments has never been stronger. To show why this growing trend is so valuable to any practice, LeadingReach created an infographic with 7 Reasons To Engage With Patients Before Their Appointments. The infographic provides the ten best examples of pre-appointment information that can be sent to patients to ensure satisfaction and engagement before they even step foot in the door. Take a look and find out why and how to send pre-appointment information to patients.

When it comes to patient engament and satisfaction, healthcare providers are scrambling to adapt to changing government regulations, growing consolidation pressures, and the transformation from volume to value-based care. According to the new study from Prophet and GE Healthcare Camden Group,The State of Consumer Healthcare: A Study of Patient Experience," an alarming 81 percent of consumers are unsatisfied with their healthcare experience.

Join thought leaders from Prophet and GE Healthcare Camden Group for a complimentary webinar addressing the new patient experience study. Learn more about the gap between patient and provider expectations and perceptions, and arm yourself with the ability to assess your own organization, define a successful strategy, and deliver on it.

Date and time: Wednesday, March 30, 2016 | 12:00 pm Central Daylight Time (Chicago, GMT-05:00)

Date and time: Wednesday, March 30, 2016 | 10:00 am Pacific Daylight Time (San Francisco, GMT-07:00)

Date and time: Wednesday, March 30, 2016 | 1:00 pm Eastern Daylight Time (New York, GMT-04:00)

Date and time: Wednesday, March 30, 2016 | 6:00 pm GMT Summer Time (London, GMT+01:00)

Panelist(s) info: Jeff Gourdji, Paul Schrimpf, Helen Stewart

Duration: 1 hour

webinar, patient satisfaction, consumer healthcare


PatientEngagement.png

Topics: Infographic, Patient Communication, Patient Engagement, Webinar, Patient Experience, Patient Satisfaction, Healthcare Quality, Prophet

Patient Access Innovations: Integrating Patients Within the System of Care

Posted by Matthew Smith on Dec 1, 2015 3:21:44 PM

Provider coordination is of paramount importance for healthcare organizations preparing for the industry’s shift in focus from volume to value. The most ambitious coordination model that has been developed to date is the clinically integrated network ("CIN")—a contractual collaboration among hospitals, physicians, and other providers to manage patients across the entire continuum of care. A CIN uses population health management tools, including care management techniques, to build value through improving patient outcomes and controlling costs. This innovative model offers providers access to value-based payment contracts and an opportunity to improve quality and reduce costs.

Despite the compelling benefits of clinical integration, this approach also poses risks. Value-based payment contracts hold CIN participants accountable for both clinical and financial outcomes, although the ability to influence these outcomes depends largely on patient choice and patient compliance. Whenever a patient leaves the CIN, even if the patient returns to the network for certain services, network providers lose the opportunity to fully manage the patient’s care and utilization, ultimately undercutting their ability to coordinate the patient’s care and accrue the benefits of improved clinical outcomes and reduced costs.

This risk makes it critically important for CINs to keep patients within their organized systems of care. CINs need to make sure patients can access the network easily and are motivated to stay connected, requiring a strategic focus on patient access and engagement.

Based on the experiences of leading CINs, strategies aimed at improving patient access tend to be most effective when they are focused on three primary objectives: expanding entry points to the network, making access more convenient and inexpensive, and keeping patients engaged in the care they receive from network providers. The following five strategies, in particular, have been proven effective for ensuring in-network access and strengthening patient engagement.

To read the rest of this article in its entirety, please click the button below to immediately access the article on the hfm magazine site:

 Patient Access, Clinically Integrated Networks

Topics: Clinical Integration, Clinically Integrated Networks, Patient Access, Patient Engagement, Daniel J. Marino, Value-Based Payments

Stimulate Patient Engagement with these 9 Ideas for 'Activation' and Empowerment

Posted by Matthew Smith on Oct 13, 2015 9:57:58 AM

New payment models reward healthcare systems and providers for improving the health of populations. Providers are understandably concerned about the extent to which they can succeed in such models because so much of patient health is beyond their personal control.

Seventy-five percent of our health dollar is spent on chronic conditions that have everything to do with the choices made by patients, notably diabetes and degenerative joint disease as they relate to obesity. Therefore, engaging patients in the management of their own health is vital to achieving population health improvement.

At a recent national health conference I attended, the speaker asked the audience, “What is the least utilized resource in the American healthcare system?” After a few seconds of silence, as thousands scratched their heads for the answer, the speaker called out, “The Patient!”

Accountable systems and providers will increasingly need to learn how to empower and “activate” patients, rather than encouraging their dependence on the system to provide cures. Similarly, providers and care managers will need to reach out proactively to patients, rather than passively waiting for patients to seek care.

Here are nine key approaches to patient “activation”:

1. Charge Patients with the Primary Responsibility for their Own Care

Some patients have never been encouraged to think of their disease as their personal responsibility. Remind them there are some things they can do for themselves that no one else can do for them. For instance, no amount of insulin or other diabetic medication will overcome the effects of excessive eating.

2. Encourage Patients to Monitor their Own Conditions

Provide glucometers and blood pressure devices and ask patients to log their daily readings and progress. Let them know that you expect them to bring their logs (or devices that store results) to visits so you can monitor their progress. Teach them how to adjust their diets or medication to respond to their daily readings.

3. Encourage Use of a Patient Portal If You Have One (And Agitate Your System to Invest in Portal Technology if it Has Not Already Done So)

Make the procedure for signing up for the portal easy and understandable for the patient. Show them how to use the portal to check their own lab results or request appointments. Let them know that you want them to regularly use the portal so it can become a reliable channel of communication between you and them.

4. Plug your Patients Into Community and National Support Groups for their Condition

The local park district may hold free exercise classes, for instance. Many communities have free smoking cessation clinics. National organizations representing almost every major disease have websites that provide educational support materials and may introduce patients to local support groups for their condition.

5. Consider Group Visits

Group visits have several advantages that accrue to the providers (it saves time and enhances revenue) but one of the best outcomes of group visits is that they greatly increase patient engagement. Patients with chronic conditions gain significant emotional support and encouragement from interacting with other people “like them” who share their condition. Social support is one of the most powerful motivators of behavior. Group visits produce surprising improvements in the health of their members.

6. Pull Patients into the Electronic Health Records ("EHR") Screen in the Exam Room

EHRs threaten direct eye contact of health professionals with their patients. Savvy providers have learned to turn this liability into an asset by bringing the patient “into” the EHR as they work, showing them computer-generated charts, for instance, that trend their blood pressure or blood sugar, or to have the patient verify their medications and doses. The EHR becomes an engagement tool, and patient trust is enhanced when they realize the provider is not hiding information from them.

7. Use In-Office Instructional Videos

Some practices run motivational or educational videos in their waiting rooms or have a learning room with a library of instructional videos on a variety of health-related subjects. A well-organized file of printed educational materials is a low-tech way to achieve the same ends. The more information patients can absorb about their conditions, the more engaged they will be with their self-care.

8. Create an Interactive Website

Numerous providers have created their own webpage or blog and write about topics related to the health of their patients. These providers found that this strategy increased the engagement of their patients and generated new business.

9. Convey an Openness to Questions and Support Initiative

Consider the factors that might harm patient engagement and work to reduce them. Be there to support and respond to patients when they attempt engagement. This requires a positive response when the patient asks about their condition and how to improve it. Old-fashioned paternalism, which thwarts patient questioning, kills patient engagement. Patients respond to praise for even modest health improvements they achieve.  

Topics: Patient Care, Patient Engagement, Patient Service, Patient Activation, Patient Portal

Quick Tips for Improved Patient Access

Posted by Matthew Smith on Jun 9, 2015 12:27:34 PM

By Marc Mertz, MHA, FACMPE, Vice President, GE Healthcare Camden Group

It is hard to have a conversation about healthcare today without mentioning quality. Government and commercial payers are putting increasingly larger portions of providers’ reimbursement at risk for performance on quality measures. Employers are seeking high-quality providers to help maintain a healthy work force. Patients assume that their physicians are high quality. Public reporting sites are introducing a new level of transparency regarding physicians’ quality scores. All of this increased emphasis on quality is justified, and an organization should strive to provide and demonstrate high-quality care. But if patients cannot access your services, it is all for naught.

The Importance of Patient Access

Not only does a lack of patient access impact the ability to provide quality care, but it also impacts your financial performance.

In a fee-for-service environment, poor access means lower volume and lower revenue. In a fee-for-value environment, groups must demonstrate high-quality care and high patient satisfaction--a lack of access will impact both. Regardless of the reimbursement model, a lack of access will drive patients to find other providers. Those other providers are no longer limited to medical groups, as new providers of care are entering the market. Retail providers are rapidly expanding their number of locations and the services that they provide. These locations offer immediate access and low costs, and are often affiliated with health systems or networks. Once patients visit one of these locations they might not return to their original provider.

Getting Started

Evaluate Current Wait Times

Start to address access by evaluating current wait times for appointments in existing care locations. The third next available appointment is a commonly used metric to measure access in a medical group. Best practice is within 24 hours for primary care and three days for specialty services (although some specialties like oncology are increasingly offering same or next-day appointments). Calculate the practice’s patient demand versus practice capacity and implement strategies to increase capacity as needed.

Add Providers and/or Access Points

If access is poor and your physicians are highly productive, then consider expanding the group by adding providers or new access points. If your access is poor and productivity is low, consider evaluating processes: are appointment schedule templates structured correctly, are appointments the correct length, and are staff trained appropriately?

Allow Patient Self-Scheduling

Consider allowing patients to schedule their own visits through a patient portal, providing evening and weekend hours, offering e-visits, and communicating by e-mail and text.

Review Office Operations

Inefficient office operations will also create waste and reduce access. Assess the workflows in the office, and redesign processes so that patient flow is efficient.

The Pyramid of Success

The Pyramid of Success (below) identifies the access points that are the highest priority. Health systems and hospitals are adding hospitals, clinics, health plans, direct contracts with employers, physician practices, and ambulatory sites to their continuum of care delivery system/network. Increasing the number of access points listed at the bottom of the pyramid will help a hospital or health system reach a broader population and support the services listed higher up in the pyramid.

Pyramid_of_Success_Gray.png


mertz_headshot

Mr. Mertz is a vice president with GE Healthcare Camden Group and has 20 years of healthcare management experience. He has 17 years of experience in medical group development and management, physician-hospital alignment strategies, physician practice operational improvement, practice mergers and acquisitions, medical group governance and organizational design, clinical integration, and physician compensation plan design. Mr. Mertz has managed private practices, hospital-affiliated practices, and academic physician practices. The Medical Group Management Association (“MGMA”) has identified practices under his management as “Best Performing.” He may be reached at 310-320-3990.    

Topics: Patient Access, Practice Management, Patient Engagement, Marc Mertz, Medical Practice Workflow

10 Emerging Characteristics of High-Performing Hospitals

Posted by Matthew Smith on Jun 8, 2015 9:01:02 AM

For decades, hospitals across the United States have operated within a challenging, rapidly changing, and fragmented healthcare system. Today, this environment is even more complex as healthcare reform and market forces transform the way healthcare is delivered and managed, shifting focus from fee-for-service to value-based care models. While healthcare providers are increasingly pressured to improve clinical quality at a lesser price, many have a long path of improvement to achieve sustainability in this post-healthcare reform era. Here are 10 emerging characteristics of high-performing hospitals in the value-based care environment.

1. Defined Strategic Vision

According to a 2014 global survey commissioned by the American Management Association and administered by the Institute for Corporate Productivity, the single largest gap between high-performing and low-performing organizations is whether organization-wide performance measures matched the overall strategy. The second largest gap between high- and low-performing organizations was due to whether organizations had clear and well thought out strategies to support the strategic plan1.

High-performing healthcare organizations have a strategic plan that sets a clear direction for the organization, and there is proper alignment between the strategies set forth and the organization’s goals, tactics, and measurable outcomes. Further, the strategic plan is hard-wired throughout the organization across all departments, engaging physicians, nurses, and staff in the process and making them accountable for achieving the organization’s overall goals.

2. Consistent Leadership

Leaders in high-performing healthcare organizations consistently demonstrate the mission, vision, and values, and ultimately drive the direction of the organization. These leaders are responsible for thinking strategically, allocating appropriate resources, building engagement, driving accountability, and achieving results – all in collaboration with very different stakeholders (physicians, nurses, staff, board members, and vendors).

Given that the healthcare industry overall faces an aging workforce, high-performing healthcare organizations have developed a pipeline of future leaders whose skills match their future needs. These organizations identify potential leaders, both clinical and non-clinical, and develop skills and competencies needed for the future. According to a survey of more than 5,000 executives conducted by The Boston Consulting Group and the World Federation of People Management Associations, high-performance companies fill 60 percent of top management roles with internal candidates, while low-performance companies fill only 13 percent internally2.

Lastly, high-performing healthcare organizations directly link leadership strategy to the organization’s overall strategic direction. Regardless of who the C-suite may be, operational execution takes place at the mid-level and supervisory levels of the organization, and involves engagement from physicians, nurses, and staff. High-performing healthcare organizations invest in their success, and actively monitor and work to strengthen their engagement and skills3.

3. Talent Management (don’t tolerate the low performers)

High-performing healthcare organizations focus on the development of their talent, managing people in the challenges of healthcare reform, strategic initiatives, and operational and performance improvement initiatives. These organizations are proactive in managing their talent and are quick to identify individuals that are not meeting performance targets, implementing necessary measures (e.g., talent replacement, mentoring, among others) to ensure that the organization’s performance remains on the projected path. According to a 2014 report published by the Project Management Institute (“PMI”), only nine percent of organizations surveyed rated themselves as excellent on successfully executing initiatives to deliver strategic results. Further, the PMI found that high-performing organizations successfully complete 89 percent of their projects, while low performers complete only 36 percent; high-performing organizations wasted nearly 12 times fewer resources than low performers4. Thus, high-performing healthcare organizations have more successful operations and waste fewer resources because they effectively align talent management to strategy.

4. Culture of Accountability

High-performing healthcare organizations are constantly looking for ways to improve the quality of care provided in order to achieve the Institute for Healthcare Improvement’s (“IHI”) Triple AimTM of: 1) improving the patient experience of care (including quality and satisfaction); 2) improving the health of populations; and 3) reducing the per capita cost of healthcare. In order to achieve these objectives, high-performing healthcare organizations have adopted and hard-wired a culture of accountability throughout the organization. A culture of accountability serves as a vehicle to reduce inappropriate utilization of healthcare resources; increase utilization of, and adherence to, clinical practice guidelines and evidence-based medicine; improve patient care outcomes; and ultimately create a continuous learning environment. As healthcare organizations seek to create a culture of accountability, it is critical that the following key factors become integral to the organization’s culture:

  • Provide consistent leadership and involve physicians
  • Focus on quality and the underlying processes required to sustain high levels of performance
  • Ensure customer service and patient satisfaction are forefront priorities across the organization
  • Regularly measure and monitor performance
  • Adopt and implement an infrastructure to support achievement of the organization’s objectives

5. Change Management and Adaptability

In this era of healthcare reform, high-performing healthcare organizations have the ability to rapidly adapt to changes in the marketplace and engage key stakeholders in the process. These changes include shifts in demographics, health status, and patient care needs; technological advancements; reimbursement changes; and transitions to emerging value-based care models. Not only are these organizations able to quickly adapt, but they have a disciplined approach to drive shifts in focus, strategy, direction, structure, and culture throughout the organization through innovation and by developing alternative approaches that maximize impact – usually through more cost-effective, higher quality of care. Further, high-performing healthcare organizations are prepared to respond to failures, and continually find new solutions, and their resilience and quick problem-solving prevents disasters.

6. Transparency

High-performing healthcare organizations drive organizational awareness and quality performance through improved communication and data sharing. These organizations provide sufficient, easy-to-access information to the right person at the right time for the right patient, facilitating evidence-based decision-making, and appropriate and timely measurement of quality and key performance indicators. Further, high-performing healthcare organizations are able to successfully align governance with the use of data and information to drive performance improvement. Comprehensive sharing of information and best practices means alignment between leadership and physicians, nurses, other clinicians and staff around strategic goals, data-driven decisions, transparent metric analysis, and timely reporting. This helps to ensure that patients receive consistent care while improving overall quality outcomes at lower costs.

7. Outcomes

The healthcare industry is becoming increasingly consumer-driven. Patients have greater decision-making power in managing their healthcare budgets, and the increased transparency of healthcare outcomes data allows patients to compare and select providers based on published reports. As competition intensifies, patient satisfaction, service quality, and efficient resource management have become the basis to measure patient, clinician, and organizational outcomes. High-performing healthcare organizations have developed a strategic quality plan that sets the direction for quality improvement by creating a strong patient focus and demonstrate continuous commitment to achieving the organization’s quality improvement goals. Further, these organizations have hard-wired evidence-based practices throughout the organization to ensure performance targets are met, and have engaged physicians, nurses, and staff in this process. This is particularly important, as shifts in payment models link reimbursement to quality outcomes. Thus, the benefits of high-performance are recognized in multiple areas:

  • Financial outcomes, through higher revenues and lower costs
  • Clinical outcomes, through higher quality of care and more efficient clinical resource utilization
  • Operational outcomes, through healthier patients at reduced costs and improved processes and workflows to manage information and enhance patient experience

8. Alignment with Physicians Through Clinical Integration

Healthcare reform initiatives are forcing all providers to reevaluate current partnership models in light of future accountability mandates. As reimbursement systems evolve, hospitals and physicians will share an increasing amount of joint accountability for the care they deliver, which will require a defined infrastructure to evaluate costs while delivering higher quality care. High-performing healthcare organizations have adopted a clinical integration strategy that allows both the hospital and its physicians to achieve these goals by jointly participating in value-based contracting models. This provides opportunities for both parties to collaborate through coordinated patient interventions, management of quality across the continuum of care, movement towards population health management, and pursuit of value-based contracting – all of which are key critical success factors in today’s age of healthcare reform.  

9. Patient Engagement

To build and maintain patient loyalty and engagement during a time when consumers can shop for the best value, healthcare organizations must not only provide quality care but also exceed patient expectations. Patient experience and emotional engagement have become critical factors to achieve improved health outcomes and lower costs, and research conducted by Gallup suggests that high levels of engagement among physicians, nurses, and staff are key to developing and maintaining these critical patient relationships. For example, engaged employees are enthusiastic and willing to go above and beyond the basic standards of performance, which makes them more likely to anticipate patients’ needs and create a positive patient experience5. High-performing healthcare organizations cultivate provider-patient relationships and apply strategies to build patient engagement, allowing patients to become more active participants in their care. These strategies include empowering employees to problem-solve down to the front-line levels, as well as deploying behavioral interviewing techniques to hire the right people for the right positions.

10. Innovation and Care Redesign

High-performing healthcare organizations adapting to transformational payment systems and payment reform have determined it is not business as usual. Many organizations cannot afford sophisticated benchmarking or best practice comparisons. A beginning strategy in care redesign for bundled payment and other payment reform initiatives includes comparisons to internal best practices in both cost and quality. Additionally, high-performing healthcare organizations have implemented systems such as Lean and Six Sigma to involve frontline staff and physicians in identifying unnecessary, non-value added testing and processes.  Competency in care redesign is a critical skill in an organization’s efforts to reduce costs, eliminate variation, and streamline transitions in care. High-performing healthcare organizations have learned how to enhance care transitions and move outside the walls of acute care hospitals and into post-acute settings to reduce readmission rates and potential complications.


  1.  American Management Association. “The Essentials of High Performance Organizations.” October 6, 2014. http://www.amanet.org/training/articles/The-Essentials-of-High-Performance-Organizations.aspx
  2. The Boston Consulting Group. “High-Performance Organizations: The Secrets of Their Success.” September 2011.
  3. The Boston Consulting Group. “High-Performance Organizations: The Secrets of Their Success.” September 2011.
  4. Project Management Institute. “The High Cost of Low Performance.” February 2014.
  5. Burger, Jeff. “Why Hospitals Must Surpass Patient Expectations.” Gallup Business Journal. May 1, 2014.

Topics: Clinical Integration, Hospitals, Patient Engagement, Strategy, Care Redesign, Hospital Pricing Transparency, Hospital Performance, Performance Improvement

Optimize EHRs to Engage Patients and Providers

Posted by Matthew Smith on Jun 4, 2015 10:41:00 AM

Once medical practices have familiarized themselves with and utilized their Electronic Health Record (“EHR”), they develop a basic understanding of its functionalities and generate ideas on how to improve its efficiency. In order to do so, it is necessary to conduct an assessment of overall practice performance. Optimizing an EHR too soon after an implementation may lead to additional worries and confusion, so administrative and clinical staff should spend the first two-to-three months getting comfortable working through the EHR. You can’t improve on what you don’t know. Below are some thoughts on how to proceed with optimizing an EHR and the reasons behind the recommendations:

Engage Patients in their Care

In recent months, The Camden Group has been written several articles about Patient Access.  Just as patients need access to local care, they also need access to their EHR. Choosing not to provide patients the ability to view their EHR puts practices at a disadvantage. To provide better care and achieve desirable outcomes, practices need to provide patients the ability to become engaged in their medical care. Patients will soon expect this. If practices don’t provide it, patients may look elsewhere for a practice that does offer these conveniences. 

For example, a colleague who recently moved into the community was evaluating multiple family practitioners. After much research, she narrowed her decision to two equally qualified physicians and chose the one that had a fully implemented patient portal.

Enable Patient Reminders

Patient reminders are another way to provide better care for patients. This feature allows for reminders to be sent to patients in advance of important preventive care testing as well as follow-up care to manage their chronic conditions. Patients must be reminded to follow up on their healthcare. Providers who have not optimized the patient reminder functionality waste valuable time and staff resources to accomplish this task.   

Promote Provider Communication

Electronic provider-to-provider communication is often neglected during the initial implementation of an EHR. Optimizing the full functionality of this portion of the EHR will allow real-time health information exchange about a patient’s condition among providers and other care team members. If providers and care team members do not communicate in a timely manner, unnecessary repeat testing may occur or important patient information may be delayed. Without proper communication, patients are often referred to specialists who do not receive any of the test results from the primary care physician. The specialists re-order all of the tests—including expensive radiological exams. Ultimately, the insurance companies may deny payment for the duplicated procedures or tests..

These are just a few benefits of optimized EHRs. Best practices suggest that a medical practice establish specific goals it wants to achieve and then start with an assessment to identify and address the gaps in order to meet those goals. Once a direction is determined, practices should seek advice from the EHR vendor, peers, and consultants to develop an implementation work plan with realistic expectations. A successful optimization will result in increased satisfaction among both administrative and clinical staff as well as patients. The medical practice will also experience improved revenue, reduced cost, and compliance with government incentive programs.


This is the first of a three-part blog series surrounding Electronic Health Record optimization. Part 1 focuses on engagement, Part 2 on build-out, and Part 3 on maintenance.

Topics: EHR, EMR, Patient Engagement, EHR Optimization, EMR Optimization

9 Ways to Stimulate Patient Engagement Via 'Activation' & Empowerment

Posted by Matthew Smith on Aug 28, 2014 12:30:00 PM
By William K. Faber, MD, MHCM
Chief Medical Officer
Health Directions

Patient Engagement, Patient Activation, Accountable CareNew payment models reward health care systems and providers for improving the health of populations. Providers are understandably concerned about whether they can succeed in such models, because so much of patient health is beyond their personal control. Seventy-five percent of our health dollar is spent on chronic conditions that have everything to do with the choices made by patients, notably diabetes and degenerative joint disease as they relate to obesity. Therefore, engaging patients in the management of their own health is vital to achieving population health improvement.

At a recent national health conference, the speaker asked the audience “What is the least utilized resource in the American health care system?” After a few seconds of silence, as thousands scratched their heads for the answer, the speaker called out “The Patient!”

Accountable systems and providers will increasingly need to learn how to empower and “activate” patients, rather than encouraging their dependence on the system to provide cures. Similarly, providers and care managers will need to reach out proactively to patients, rather than passively waiting for patients to seek care.

Here are several approaches to patient “activation”:

Charge Patients with the Primary Responsibility for their Own Care

Some patients have never been encouraged to think of their disease as their personal responsibility. Remind them there are some things they can do for themselves that no one else can do for them. For instance, no amount of insulin or other diabetic medication will overcome the effects of excessive eating.

Have Patients Monitor their Own Conditions

Provide glucometers and blood pressure devices and ask patients to log their daily readings and progress. Let them know that you expect them to bring their logs (or devices that store results) to visits so you can monitor their progress. Teach them how to adjust their diets or medication to respond to their daily readings.

Encourage Use of a Patient Portal If You Have One (And Agitate Your System to Invest in Portal Technology if it Has Not Already Done So)

Make the procedure for signing up for the portal easy and understandable for the patient. Show them how to use the portal to check their own lab results or request appointments. Let them know that you want them to regularly use the portal so it can become a reliable channel of communication between you and them.

Plug your Patients Into Community and National Support Groups for their Condition

The local park district may hold free exercise classes, for instance. Many communities have free smoking cessation clinics. National organizations representing almost every major disease have websites that provide educational support materials and may introduce patients to local support groups for their condition.

Consider Group Visits

Group visits have several advantages that accrue to the providers (it saves time and enhances revenue) but one of the best outcomes of group visits is that they greatly increase patient engagement. Patients with chronic conditions gain significant emotional support and encouragement from interacting with other people “like them” who share their condition. Social support is one of the most powerful motivators of behavior. Group visits produce surprising improvements in the health of their members.

Pull Patients into the EHR Screen in the Exam Room

Electronic health records threaten the direct eye contact of health professionals with their patients. Savvy providers have learned to turn this liability into an asset by bringing the patient “into” the EHR as they work, showing them computer generated charts, for instance, that trend their blood pressure or blood sugar, or to have the patient verify their medications and doses. The EHR becomes an engagement tool and patient trust is enhanced they realize the provider is not hiding information from them.

Use In-Office Instructional Videos

Some practices run motivational or educational videos in their waiting rooms or have a learning room with a library of instructional videos on a variety of health related subjects. A well-organized file of printed educational materials is a low-tech way to achieve the same ends. The more information a patient can absorb about their condition, the more engaged they will be with their self care.

Create an Interactive Website

We know of numerous providers who have created their own webpage and blog on topics related to the health of their patients. These providers found that this strategy increased the engagement of their patients and generated new business.

Convey an Openness to Questions and Support Initiative

Consider the factors that might harm patient engagement and work to reduce them. Be there to support and respond to patients when they attempt engagement. This requires a positive response when the patient asks about their condition and how to improve it. Old-fashioned paternalism, which thwarts patient questioning, kills patient engagement. Patients respond to praise for even modest health improvements they achieve. 

About the Author

William K. Faber, MD Health DirectionsDr. William K. Faber, Chief Medical Officer for Health Directions, is a physician executive with progressive senior leadership experience. He most recently served as Senior Vice President of the Rochester General Health System in New York, where he guided the development of the system’s Clinical Integration program and assisted more than 150 providers at 44 sites through the conversion process from paper records to an Electronic Health Records system (Epic). Dr. Faber formerly participated in the governance of the Advocate Physician Partners (APP) Clinical Integration program and directed APP’s Quality Improvement Collaborative.
 

 Patient Engagement, Patient Service

Topics: William K. Faber MD, Patient Engagement, Patient Service, Patient Activation

NCQA: Health IT Can Be Tapped To Support Patient Engagement

Posted by Matthew Smith on Apr 28, 2014 3:58:00 PM

NCQA, National Committee for Quality Assurance

Successful integration of patient engagement tools into health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system," according to a new report from the National Committee for Quality Assurance (NCQA), EHR Intelligence reports. 

However, the report noted that there is not yet a complete framework for boosting patient engagement through health IT systems.

Details of Report

In a survey, the report authors identified six common themes of "opportunities and challenges" related to patient engagement through health IT:

  • Patient engagement is an untapped opportunity with major potential, especially among marginalized groups;
  • Health IT should adopt a user-based model that originates from the needs and preferences of patients;
  • There is a dearth of evidence on the effectiveness of such tools;
  • Patient-engagement tools should be integrated into overall health care IT systems;
  • Patient and consumer trust needs to be fostered; and
  • Leadership and collaboration among stakeholders are necessary to realize the full potential.

The report also detailed four activities that will help the industry identify and develop a cohesive strategy for patient engagement through health IT, including:

  • Developing joint principles that will facilitate the design, creation and adoption of health IT tools that boost patient care, improve overall population health and lower health care costs;
  • Creating and implementing an evaluation framework that focuses on investment and prioritizes consumer choice;
  • Facilitating the creation of a unified health data integration strategy focused on patient engagement; and
  • Demonstrating innovative ways to use IT tools for patient engagement.

Comments

In the report, the authors wrote that "[h]ealth IT tools for patient engagement are often disconnected from the health care system and in need of full integration across all opportunities for engagement." However, the report added that successful integration of patient engagement in health IT systems has "the potential to improve inefficient communication methods and change the dynamic of the relationship between the patient and health care system."

NCQA President Margaret O'Kane said the "core idea" of the report is that health IT "should be designed around the needs and preferences of patients." She added that "the question of how to link [health IT] and patient engagement is an area where a unified strategy is most needed" (Murphy,EHR Intelligence, 4/23).

Patient Engagement, Patient Service

Topics: HIT, Health IT, HealthIT, Patient Engagement, Health Information Technology

Don’t Miss the Chance to Earn EHR Incentive Payments

Posted by Matthew Smith on Apr 16, 2014 11:46:00 AM
EHR, EMR, Electronic Health Record, Meaningful UseEligible Professionals Must Start Medicare EHR Participation in 2014 to Earn Incentives

If you are an eligible professional for the Medicare EHR Incentive Program, 2014 is the last year you can start participation in the Medicare EHR Incentive Program in order to receive incentive payments.

Eligible professionals who begin participation in the Medicare EHR Incentive Program after 2014 will not be able to earn an incentive payment for that year or any subsequent year of participation.

If you choose to participate in the Medicare EHR Incentive Program for the first time in 2014, you should begin your 90-day reporting period no later than July 1, 2014 and submit attestation by October 1, 2014 in order to avoid the payment adjustment in 2015.

Note: October 1 is the attestation deadline for eligible professionals in their first year of participation to avoid the payment adjustment. However, eligible professionals who miss this deadline can still demonstrate meaningful use during the last 90-day reporting period of the year (October - December 2014) and earn an incentive payment for 2014.

Providers Who First Begin Participation in 2014 must:

To Earn Your Maximum Medicare Incentive

  • Demonstrate 90 days of Stage 1 of meaningful use in 2014 to earn up to $11,760.
  • Demonstrate a full year of Stage 1 of meaningful use in 2015 to earn up to $7,840.
  • Demonstrate a full year of Stage 2 of meaningful use in 2016 to earn up to $3,920.

If you successfully demonstrate meaningful use each year beginning in 2014, your total payment amount could be as much as $23,520.

Additional Resources

The EHR Incentive Program website offers several helpful tools and resources so you can successfully begin participation:

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Meaningful Use, CMS, Electronic Health Record, Stage 1, Patient Engagement, Stage 2

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