Report from HIM: Why aren t your digital patient engagement tools being adopted? by Shahid N. Shah
15/03/2016
Hundreds of startups and other digital health companies are busy building patient engagement solutions for hospitals, insurance plans, physician practices, and other healthcare stakeholders. Last week at HIMSS's Annual Conference in Las Vegas I got to see many of these innovators under one roof and compare (mostly subjectively rather than objectively) many of their capabilities and roadmaps. While the desire for patient engagement is nothing new, the allure of tiny internet connected touch-screen computers (also known as smartphones) in patients' hands has innovators and care providers racing to put new apps in into those little computers.
There's no definition for patient engagement (PE) that will please everyone but I don't think I will get much pushback if I said the PE tools I saw last week generally fall into these categories:
Provide some self-service capabilities by allow patients to choose symptoms and then inform them how and where to get treatment for ailments. These are mostly educational in nature and insurance companies often employ these kinds of tools to help patients navigate to the proper care settings.
Push some sort of educational or informational therapy to patients and help encourage behavior change. This behavior change (getting patients to do something they wouldn't have otherwise done without a PE tool) is central to many solutions.
Ask the patient to collect or provide data about their health or wellness state to allow them to see it later or share with healthcare professionals or care givers. Fitness tracker apps and wearables data aggregators are major opportunities in this subject area.
Give the patient an inexpensive medical diagnostic device or software that can replace expensive special-purpose medical devices. We saw everything from connected thermometers for babies to blood pressure cuffs. Allow two-way messaging through video, audio, text chat, images, SMS, and related tools - often called telehealth, I think these are PE tools, too
As I talked to the innovators (vendors of the tools) I kept hearing that the PE tools weren't being adopted fast enough and that the buyers were too risk averse . I tried to remind innovators that you cannot blame the buyers when someone doesn't buy your products - you try and figure out what's lacking in the product/market fit. I think that there's not enough thought being given to how hard it is to sell PE tools in a fee-for-service (FFS) payment model.
Let's review the way money flows in healthcare to see why:
Ultimately PE tools will be used by patients, but many vendors haven't given enough thought to the multiple intermediaries that they would need to convince in order to get their tools installed and paid for. In healthcare, funding institutions provide money to insurers (payers) and those payers reimburse care institutions and care providers (except for family members). When you look at this intermediated model, as innovators you have to ask yourself who's going to pay me for my PE tool? If the answer isn't the patient then things get pretty difficult.
The reason why many patient engagement tools were not being adoped and PE approaches aren't working is because we havent aligned the funding, payments, and usage of those tools to specific workflows that the intermediaries would find easy to fund.
Do you agree? How are PE tools impacting your health system?
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On March 17th at 9:00 PT/12:00 pm ET, @IronMtnHealth is hosting a Twitter chat using #InfoTalk to further the dialog on transformational strategies that are enabled through Health IT and Health Information Governance. If you have been involved in Health IT and information governance-related projects, we'd love to have you join.
See more at: http://blogs.ironmountain.com/2016/industry/healthcare-information-management/pressures-behind-enterprise-information-governance/#sthash.whpRY8rL.dpuf
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