Perspectives: How enhanced digital communications can improve patient engagement

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today, we have a contribution from Dave O’Shaughnessy, Avaya’s Healthcare Practice Leader for EMEA and APAC. The subject is the hot button of patient engagement–how telehealth and virtual care systems can be used to connect patients to providers, improve patient understanding, and increase both patient and provider satisfaction.

Interested contributors should contact Editor Donna. (We like pictures and graphs too)

For most of us, the term “patient engagement” seems straightforward. Patients who come in for their annual exams or patients with a chronic disease who regularly take their prescribed medications are considered engaged patients. But what about the rest of us who feel reluctant to contact our GP when we have health concerns or don’t take our prescribed medicine when we should. If these people were better engaged, their patient experience and outcomes would be improved.

Communications technology that was once considered cutting-edge is now holding healthcare back and one of the most significant obstacles to building an engaged patient experience is the traditional calling-centric communication model. Today, implementation of virtual care systems (telehealth), especially via cloud-based software-as-a-service (SaaS) applications that can be accessed from smartphones or tablets, improves patient engagement levels, and directly contributes to their overall health and outcomes.

So, what should a healthcare provider look for in a modern cloud communication and customer engagement solution? Here are four vital components for starters:

A unified communications platform

A unified communications and patient engagement platform in the cloud provides seamless connections across modes of communication (voice, messaging, chatbots, online meetings, and video), as well as devices (desktop, mobile, and tablet devices). Because it’s all integrated, patients get to use their communication channel of choice over their device of choice, and providers get the features they need to ensure that patients can engage a suitable person when they get in touch. In addition, self-service capabilities such as automated messages for appointment reminders and confirmations help to dramatically reduce time-wasting no-shows for healthcare organisations.

Real-time communications and collaboration

Provision of care requires constant and intuitive access to clinical information and the ability to effectively and efficiently communicate across dispersed teams to exchange critical information throughout care-coordination workflows. Effective and secure real-time collaboration across all communications channels helps staff reach the right people across the organisation at the right time using the most appropriate mode of communication. Most critically of all, these communication services for clinical staff must be easy-to-use, leveraging features like Single Sign-on authentication across multiple apps on a mobile device and offering intuitive click-to-call or team-calling abilities helping teams collaborate easily and rapidly.

Follow-up Patient Engagement

When patients aren’t engaged, they are less likely to follow instructions, resulting in more frequent readmissions. Cloud-based communications solutions with features such as click-to-chat and click-to-video allow patients to keep informed of what, and when, they need to take action for positive health outcomes. Providers can also add automated outbound patient notifications using SMS or Chatbots to follow up on patient satisfaction surveys, freeing critical staff to focus on in-office patients and higher priority, higher quality services.

A Secure and Flexible Platform

To avoid the security pitfalls of Bring Your Own Device (BYOD), healthcare provider staff need a “one-device, two numbers” experience that enables them to securely use one device for both personal and business. And lastly, a communications solution should be able to seamlessly integrate with the most common digital systems used by healthcare professionals.

With the cloud, communication and collaboration can become integrated into one solution that works the way patients and providers work—across any device, anytime, anywhere. Most importantly, the flexibility of cloud communication—particularly when it comes to solutions with open platforms—means providers can add new capabilities in minutes, with almost immediate access to the latest innovations. Look to partner with a solutions provider that has proven experience in patient engagement and experience solutions.

Zimmer Biomet acquires telehealth company RespondWell

Orthopedic device maker Zimmer Biomet today (27 Oct) announced the acquisition of St Louis-based telerehabilitation + telehealth company RespondWell. RespondWell provides several facets of post-surgical physical therapy: telerehabilitation with clinically prescribed exercise routines, virtual doctor-patient consults, tablet-based personalized care plan delivery and data collection/RPM, and ‘gamified’ patient engagement tools. Up to the acquisition, according to Xconomy, RespondWell had raised $2 million from investors and had been seeking another raise of $8 million. Zimmer’s purchase price was not disclosed, but the changeover was swift, with the RespondWell website already copyrighted and top-bar tagged with Zimmer’s information.

Based on the release, RespondWell will be integrated into Zimmer Biomet Signature Solutions, using the brands Therapy@Home and presumably their original Fitness@Home. RespondWell’s former CEO Ted Spooner has been named VP of Connected Health at Zimmer Biomet; in his interview with MedCityNews, he was pleased at the exit and the acquisition by a company which wants to scale his solution.

Signature Solutions was formed from related Zimmer programs a few months ago as essentially a specialized value-based care consultancy and service provider. The combination of the two–VBC consultancy integrating with a health tech service provider–appears to be a nascent trend–and perhaps finally a path for telehealth providers. Hat tip to reader David Lee Scher MD via Twitter

Patient engagement: a digital divide in health technology accessibility

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/earthquake.jpg” thumb_width=”150″ /]Guest editor Sarianne Gruber (@subtleimpact) scopes the ‘digital divide’ separating those who need health services the most from the patient engagement and other tools they need in this article. The studies are US, but the lessons apply anywhere in the world. This Editor notes that many patient engagement tools are over-designed and over-complicated for users, even if they are fairly competent and frequently use online and mobile. (I entered a ‘pilot’ of a stress reduction program which proved to be anything but–and quitting because it is invasive and the reporting is ludicrously burdensome.)

To developers: Imagine your patient engagement platform being used by a person on the less sophisticated, less educated and disconnected end of the spectrum–or by someone less able due to physical (vision, touch) or cognitive impairment. Put on bad glasses and gloves–and start. Better yet, find a few people and put it in front of them. If we can make the mental shift in developing mobile apps for Africa or India, certainly we can do so for Americans, Britons and Europeans.

What the Studies are Showing

Hallmarked as a solution to improve healthcare quality, cost and safety, studies are showing health technology is up against a “digital divide” when it comes to patient engagement. At the Internet Governance Forum, Pew Research Center’s Lee Rainie, Director of Internet, Science and Technology Research presented the Fact Tank Report discussing the “digital divide” that exists in 2016. The report documents that lower income, less educated, non-white, seniors and rural communities are the least likely to have home internet, home broadband, mobile connectors and smartphones. This summer’s medical publications, the Journal of the American Medical Association and the Journal of the American Board of Family Medicine, released studies where demographic and socioeconomic data marked the root causes to limited or no access to digital technology, thus hindering the benefits and improved outcomes it can bring to the neediest and most costly populations. Here are the highlights from each study.

Trends in Seniors’ Use of Digital Health Technology in the United States, 2011-2014, a research letter submitted from Harvard Medical School’s Brigham and Women’s Hospital, appeared in the August 2, 2016, JAMA. Authors, David M. Levine, MD, MA, Stuart Lipsitz, ScD, and Jeffrey A. Linder, MD, MPH,FACP made mention that this study, based on the National Health and Aging Trends survey (NHATS), was exempted from the Partners HealthCare Human Research/IRB Committee. The research team included participates to the longitudinal NHATS survey in 2011. The participants were re-surveyed annually on everyday (nonhealth) and digital health use until 2014. The research team acknowledged that this may be the first nationally representative study to examine trends in the adoption of digital health technology by seniors age 65 years and older who are community-dwelling Medicare beneficiaries.

Here are some the reported statistics from the study: (more…)

IBM Watson Health adds 5 partners, 2 solutions

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/pillar.jpg” thumb_width=”150″ /]Breaking News  IBM Watson Health not only cut the ribbon on their new global HQ on Kendall Square in Cambridge, Massachusetts (and on their new General Manager Deborah DeSanzo), they also announced two more data crunching power platforms and five new partners.

  • The IBM Watson Health Cloud for Life Sciences is designed to help life science companies fast track the deployment of a GxP compliant infrastructure and applications while adhering to stringent requirements for hosting, accessing and sharing regulated data.
  • The IBM Watson Care Manager is a population health solution that integrates Watson Health, Apple ResearchKit and Apple HealthKit into a personalized patient engagement program to improve individual health outcomes.

The five new partners are Boston Children’s Hospital (pediatrics), Columbia University (Pathology & Cell Biology and Systems Biology), ICON plc (pharma clinical trial matching–Ireland), Sage Bionetworks (Open Biomedical Research Platform) and Teva Pharmaceuticals (treatments for chronic conditions–Israel). They join CVS Health, Medtronic and Yale University. On opening day, the new headquarters also hosted demonstrations by health ecosystem partners Best Doctors, Modernizing Medicine, Pathway Genomics, Socrates and Welltok. Release (PDF)

Previously in TTA on IBM Watson Health: their big announcement at HIMSS 15 and we do wonder about their work with the VA on clinical reasoning and mental health.

The potential of engaging ‘safety net’ patients via mHealth: study (US)

The Commonwealth Fund‘s just-published study on mHealth usage in a national sample of urban and rural community health centers and clinics (in US termed ‘safety net providers’ for low-income and uninsured) indicates the potential of mobile health for patient engagement in care, but yet to be achieved. Their patient population has high levels of mobile phone adoption, including text and internet. About 27 percent of the 181 providers who participated currently use mHealth in care delivery, but in basic applications such as appointment reminders. The potential observed is in chronic disease management support, health education and specific programs such as smoking cessation, weight management and medication adherence. Mobile Health and Patient Engagement in the Safety Net: A Survey of Community Health Centers and Clinics    Also FierceMobileHealthcare.

HIMSS Monday highlights

HIMSS is the largest US healthcare conference in the world, and Neil Versel, who has just joined the staff of MedCityNews, reported that registrations in this year’s event in Chicago were in excess of 40,000. He has a 37 minute interview with HIMSS Executive Vice President Carla Smith where they touch on CMS, Meaningful Use, EHR interoperability, data security, patient engagement and the empowered patient such as E-Patient Dave deBronkart (who will also be at The King’s Fund Digital Health conference in June). HIMSS is also showcasing on the show floor mobile health, interoperability, cybersecurity, disaster preparedness, intelligent health and the connected patient….Another sign that the Wild West days of digital health are over is the increasing oversight of the Federal Trade Commission (FTC) on non-HIPAA regulated health data collected by fitness and wellness devices. This is in addition to health apps making unsupported claims (see today’s and previous articles on melanoma detection apps) and the PaymentsMD patient billing software that was collecting a little extra patient data. This is both extra- and in addition to FDA. Mobihealthnews….. The Venture+Forum on Sunday discussed doctor burnout particularly in acute care and to ease this, focusing on the Holy Grail of proactive rather than reactive care and results rather than ‘shiny new objects’ (what this Editor has called Whiz-Bang Tech) “Doctors want clinical decision execution. Don’t give me any more tools.” Healthcare IT News….A survey by Accenture released today on doctors and EHR usage headlines good news–79 percent US doctors feel more proficient in their EHR usage than in their 2012 survey. The bad news is that other numbers are plummeting: fewer believe that EMR has improved treatment decisions (46 percent in 2015 vs. 62 percent in 2012), reduced medical errors (64 vs. 72 percent) and improved health outcomes for patients (46 vs. 58 percent). Familiarity breeds contempt? Buried way down in the release is that US physicians offering telehealth monitoring to patients has tripled since the last survey, from just 8 percent in 2012 to 24 percent now. Accenture surveyed over 2,600 physicians in six countries….HIMSS goes to Thursday, so more to come!

Integrating mobile apps between clinicians and patients

Your Editors have noted many well-funded companies working in the wings to link up and find meaning in the hugeness of Big Data generated by a gazillion medical systems and devices (Validic, the recently seen QpidHealth at HealthIMPACT East). However what’s been scarce on the ground are companies that are front-end, point of service, integrating mobile communications between clinicians, then with consumers/patients, then with EHRs, operations and patient portals. We noted ZynxHealth at HealthImpact, interestingly part of media giant Hearst, but they confine their secure messaging to clinicians. Now spanning both worlds is an early-stage company, Practice Unite, out of New Jersey Institute of Technology’s (NJIT–metro NY-ers of a certain age remember it as Newark College of Engineering!) NJ Innovation Institute accelerator. Inspira Health Network, located in southern NJ, is adopting their single clinician/patient platform. In conjunction with Futura Mobility, this will facilitate clinician/patient secure texting, voice communications, patient-directed communications and delivery of EHR data. Practice Unite has previously developed apps for at least ten health systems and home care providers. Their three-minute demo here illustrates a very wide span among clinicians, hospital operations, home care operations and patient engagement. (This Editor will be finding out more on Friday when visiting their offices at the NJIT Enterprise Development Center in Newark.) Release.

‘Grizzled pioneer’ VRI receives major investment from Pamlico Capital (US)

US telehealth monitoring and medical alert provider VRI (Valued Relationships, Inc.) of Franklin, Ohio earlier this month received a majority investment/recapitalization from Pamlico Capital, a Charlotte, North Carolina-based private equity firm. Terms of the transaction were not disclosed. Current lead executives CEO Chris Hendriksen and President Andy Schoonover will remain in active management and retain significant ownership in VRI, which they founded in 1989. Regarding the investment, Mr. Schoonover to this Editor stated that the funds will be used for expansion purposes. “It is another vote of confidence (alongside the Cardiocom acquisition) that telehealth is getting great results and is here to stay. The capital will support VRI’s growth objectives, particularly in executing a couple of large projects with health plans that VRI has booked for 2014, and the hiring of additional sales talent.” 

Despite being in a rather ‘non-buzzy’ area of telehealth, the investment attracted the interest of some major players. VRI was assisted in evaluating its options by well-known digital health financial advisor Triple Tree; legal counsels were McDermott Will & Emery for VRI and Alston & Bird LLP for Pamlico. Pamlico specializes in the ‘middle market’ and has previously invested selectively in mid-sized healthcare providers such as Greenway (EHR), Healthcare First (home health software) and Physicians Endoscopy (surgical centers). Overall, and interestingly, this appears to be a positive, long-term vote for telehealth and medication monitoring, as well as for the viability of traditional medical alerts and some of the patient engagement/hospital readmission reduction models VRI has been developing with major payers such as Humana. Pamlico Capital release, Triple Tree release.

WebMD’s Avado acquisition and meaning (US)

Early-stage company Avado’s acquisition by content Goliath WebMD has rocked the small world of New York health tech, with both companies being located (or co-located) here. First is the acquisition price estimated by TechCrunch in the $20-30 million range. Co-founded by Dave Chase (whose Forbes articles we’ve occasionally commented on here), Avado developed its patient portal PRM (Patient Relationship Management) system, including direct messaging and the highly touted Blue Button, on relatively limited funding with a $1 million raise in March plus an earlier $300,000 from New York Digital Health Accelerator in addition to angel funding. Second, for WebMD, it is their first foray into anything that bridges from the patient to their physicians for messaging, reminders, and appointment scheduling. (more…)

Engaging patients from the top down

Neil Versel’s first major national magazine story just appeared in US News & World Report on the always engaging topic of…patient engagement. He explains to a general audience how healthcare reform might not change individuals’ behavior right away, but surely it is changing providers’ behaviors in relating to and engaging their patients. It covers EHRs, PHRs, online communications, aging in place, social networking and even doctors speaking with patients in understandable language. Well, Neil certainly does get it….it’s a clear article which we hope will be one of many written by Neil for a general audience. He is also speaking Tuesday at ATA’s Fall Forum in Toronto. Helping Patients Stay Engaged in their Own Care

Engaging patients (sideways?) is a new partnership announced by Bosch Healthcare and New York-based Remedy Health Media to add web-based solutions to its current health management programs delivered through their Health Buddy and T400 devices. The release and coverage (Mass Device, mHealth News)  implies that monitoring will part of the patient engagement with “a suite of innovative web-based products for remote patient monitoring” available later this year. Does it mean that the hubs are on their way to the scrapheap? Hat tip to reader Bob Pyke.

Why HIT CIOs breakfast on aspirin

CIO has an excellent summary of how HIT is attempting to cope with the tidal wave of mHealth. Moving away from the ‘look up, receive alerts’ passive mode versus being able to enter data on that mobile device (whether BYOD or hospital issue) means having to focus on architecture, infrastructure and governance priorities (rather than one-offs), fitting mobile into workflows (field discovery of clinical needs), alignment of IT with line-of-business departments and figuring out how patient engagement really works plus how it fits into the previous (and it’s not the hype of what developers would like to see and sell.) Healthcare IT Struggles to Keep Up With Mobile Health Demands