Is this a big surprise? Even during Covid, Pega’s annual 2,000-person Patient Engagement Survey shows that 63% of patients are unhappy with the communication they receive from their payers and providers. Which begs the question… just how bad was it before? (Answer: 86% unhappy– yikes!)
Pega’s VP of Healthcare & Life Sciences, Kelli Bravo, has run this survey three years and counting and drops in to share the highlights (if we can really call them that) of the survey results and how she thinks enterprising young health tech startups can capitalize on the opportunity to help.
For those in the business of trying to talk to patients — which is all of us — let’s look at this as a wake-up call. Let’s stop speaking “health care” and start using language everyone can understand about their care, what it will cost, and what all the options really are. Pega is attempting to do its part in that department, and we get an update on how they’re fairing at helping to make healthcare feel more like retail. The rise of the healthcare consumer is a real thing. Now, with new data to back up claims about what they’re demanding in terms of how they prefer to be talked to and communicated with.
Today on THCB Spotlight, Matthew sits down with Tendo’s CEO, Dan Goldsmith, and President, Jennifer Goldsmith. Tendo is in the patient engagement space, and Jennifer tells us about the vision behind the company – to become that trusted connection between patients, clinicians, and caregivers via software that creates a seamless and consumer-driven experience throughout that care journey. They talk to us about the plethora of point solutions for patient engagement, and how the platform approach that Tendo takes is meant to support a patient’s comprehensive needs without placing the full burden on the patients themselves.
Leaders in hospitals and health systems as well as post-acute care providers such as skilled nursing facilities (SNFs) and Home Health Care (HHC) agencies operate in a complex environment. Currently, the health care reimbursement environment is largely dominated by fee-for-service models. However, acute and post-acute leaders must increasingly position their organizations to prepare for, and participate in, evolving value-based care programs—without losing sight of the current fee-for-service reimbursement structure.
With that said, the call to action for acute and post-acute providers working at both ends of the reimbursement spectrum is real. The time is now to innovate, test and adopt new post-acute care models to support each patient’s transition from hospital to post-acute settings, and eventually home to enable a better care experience for patients and their care teams.
This is especially relevant for Skilled Nursing Facilities (SNFs) and chains that meet the current Medicare requirements for Part A coverage. Increasingly, the SNF industry is under pressure from the Medicare program to improve coordination and outcomes. Medicare’s hospital readmission policy and value-based purchasing program (VBP), bundled payments, and ACOs encourage SNFs, and other post-acute settings, to avoid readmissions. In addition, earlier this year, the Centers for Medicare and Medicaid Services (CMS) finalized a new patient-driven payment model (PDPM) for SNFs, which will go into effect on October 1, 2019. The overhaul of the entire system will require significant staff focus and operational changes.
Last week we attended the big healthcare IT confab HIMSS in that grand city of sin, Las Vegas. While many spoke of how HIMSS hit an all time record of over 37K attendees (an impressive number), HIMSS is still dwarfed by what is arguably the largest US-based healthcare trade show, RSNA, which had a 2011 attendance of just over 57K, (roughly 54% greater than HIMSS). Why such a radical difference you ask? As one colleague put it:
RSNA is where providers come to make money and HIMSS is where they go to lose money.
While that may be the case today, it is unlikely to be so in the future. The healthcare industry is undergoing a massive transformation that will likely take a decade to complete as we transition from a reimbursement model largely based on fee for service to one based on outcomes. Under this new model, providers will be taking on a greater portion of risk. In reward, these providers have an opportunity to receive a significantly higher net reimbursement. This transition is making for some interesting bedfellows as payers and providers join together to create new care delivery models such as Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs). These new models will be increasingly dependent on a robust HIT infrastructure to effectively measure quality, risk and performance, something that simply cannot be done effectively with the antiquated systems that are in place today in many healthcare organizations (HCOs).
Among many healthcare providers, it’s been long-standing conventional wisdom (CW) that hoarding patient data is an effective business strategy to lock-in patients — “He who holds the data, wins”. However…we’ve never seen any evidence that this actually works…have you?
We’re here to challenge CW. In this article we’ll explore the rationale of “hoarding as business strategy”, review evidence suggesting it’s still prevalent, and suggest 7 reasons why we believe it’s a lousy business strategy:
Data Hoarding Doesn’t Work — It Doesn’t Lock-In Patients or Build Affinity
Convenience is King in Patient Selection of Providers
Loyalty is Declining, Shopping is Increasing
Providers Have a Decreasingly Small “Share” of Patient Data
Providers Don’t Want to Become a Lightning Rod in the “Techlash” Backlash
Hoarding Works Against Public Policy and the Law
Providers, Don’t Fly Blind with Value-Based Care
In the video below, Dr. Harlan Krumholz of Yale University School of Medicine capsulizes the rationale of hoarding as business strategy.
We encourage you to take a minute to listen to Dr. Krumholz, but if you’re in a hurry we’ve abstracted the most relevant portions of his comments:
“The leader of a very major healthcare system said this to me confidentially on the phone… ‘why would we want to make it easy for people to get their health data…we want to keep the patients with us so why wouldn’t we want to make it just a little more difficult for them to leave.’ …I couldn’t believe it a physician health care provider professional explaining to me the philosophy of that health system.”
By KENNETH D. MANDL, MD; DAN GOTTLIEB MPA; JOSH C. MANDEL, MD
The opportunity has never been greater to, at long last, develop a flourishing health information economy based on apps which have full access to health system data–for both patients and populations–and liquid data that travels to where it is needed for care, management and population and public health. A provision in the 21st Century Cures Act could transform how patients and providers use health information technology. The 2016 law requires that certified health information technology products have an application programming interface (API) that allows health information to be accessed, exchanged, and used “without special effort” and that provides “access to all data elements of a patient’s electronic health record to the extent permissible under applicable privacy laws.”
After nearly two years of regulatory work, an important rule on this issue is now pending at the Office of Management and Budget (OMB), typically a late stop before a proposed rule is issued for public comment. It is our hope that this rule will contain provisions to create capabilities for patients to obtain complete copies of their EHR data and for providers and patients to easily integrate apps (web, iOS and Android) with EHRs and other clinical systems.
Modern software systems use APIs to interact with each other and exchange data. APIs are fundamental to software made familiar to all consumers by Google, Apple, Microsoft, Facebook, and Amazon. APIs could also offer turnkey access to population health data in a standard format, and interoperable approaches to exchange and aggregate data across sites of care.
If you have an innovative solution that addresses Patient Engagement and Remote Monitoring, Bayer’s Dealmaker Challenge wants to hear from you! Apply here for a shot at collaborating with the Bayer G4A Digital Health Team and participating in Dealmaker Day, an exclusive matchmaking event, October 9th in Berlin.
What is healthcare without patients? For decades physicians have been a one-stop shop for diagnosis and treatment, a trusted source. And yet it’s only been in recent years that the entire healthcare industry has woken up to the notion that patients can and should have an active role in their healthcare and the decision making process. Patients may not have a medical education or clinical experience, but they do have a strong asset going for them: intimate knowledge of their bodies and access to information only they can provide. The rise of wearable technologies over the past decade has only increased patients ability to quantify their experiences, health and otherwise. Diet, exercise, daily habits, stress levels, family life, physical environment all contribute to an overall picture of health. Yet too often, clinicians only see a slice of their patients health picture – the picture that is presented during office visits. The increased importance of tracking lifestyle data has clinicians and technologists asking themselves, How do we unlock more information in order to make better decisions and deliver better care?
The field is called Patient Engagement. And while the industry has mutually agreed upon it’s critical importance, the question remains as to what it looks like.Continue reading…
An Irish software expert who’d been helping companies sell on eBay walks into a room with a Slovenian inventor who’d built a world-class company in the “accelerator beam diagnostics market.” (Don’t ask.) What they share is not just foreign birth, but “immigration” to health care from other fields. Both have come to the MedCity Invest conference in Chicago seeking funding for start-ups focused on patient engagement. They’re not alone in their “immigrant” status, and their experience holds some important lessons.
Eamonn Costello, chief executive officer of patientMpower, works out of a rehabbed brick building in Dublin next to the famed Guinness brewery at St. James Gate. An electronic engineer who’s worked at companies like Tellabs, Costello became interested in healthcare in 2012 when his father was in and out of the hospital with pancreatic cancer. What struck him was the lack of any monitoring on how patients fared between doctor appointments or hospitalizations.
When in 2014 a friend working in healthcare approached him, they looked at building an app for different illnesses.Continue reading…
Sure, I’ve always wanted to write a clickbait headline that sounds like a promo for the bastard child of Buzzfeed and the Federal Register. But, seriously: you will not believe what Medicare just did about patient engagement in a draft new rule dramatically changing how doctors are paid.
And, depending upon the reaction of the patient community, you definitely won’t believe what happens next.
Criteria for Stage 3 of meaningful use of EHRs were released recently and there is lots of controversy, as would have been predicted. One set of recommendations that is raising eyebrows is around patient engagement.
The recommendations include three measures of engagement, and providers would have to report on all three of them, but successfully meet thresholds on two.
Following on the Stage 2 measure of getting patients to view, download, and transmit their personal health data, the Office of the National Coordinator (ONC) has proposed an increase from five to 25 percent.
The second measure requires that more than 35 percent of all patients seen by the provider or discharged from the hospital receive a secure message using the electronic health record’s (EHR) electronic messaging function or in response to a secure message sent by the patient (or the patient’s authorized representative).
The third measure calls for more than 15 percent of patients to contribute patient-generated health data or data from a non-clinical setting, to the EHR.