"It’s a constant theme we'll be talking about continuously," Hart says. "Patients are saying "we need this support" and yet very few providers are delivering it. "
In an interview conducted at HIMSS 2017, Allison Hart (left) of West Corporation spoke with HCA News about the results of a pair of patient engagement studies that the company announced at the conference.
The surveys, which featured over 500 respondents with chronic conditions including diabetes and obesity in the first and over 400 healthcare providers in the second, emphasize the uneasiness many patients feel about management of their health. One in five patients in the survey rated their ability to manage their conditions as poor or fair at best.
“We know that a lot of organizations are really focused on improving chronic care at this point because of its close tie to readmissions and the penalties that are being assigned,” said Hart, who is vice president of marketing for TeleVox Solutions at West Corp. The study data points out that readmissions represent an estimated $17 billion in Medicare expenditures annually, in addition to an expected $528 million in associated penalties in 2017. About half of hospitals were assigned penalties under the Hospital Readmission Reduction Program in 2016.
The surveys were designed to find ways to mitigate such financial burdens, according to Hart: “We really felt it was important to get that patient perspective on chronic care management: what did patients want, what did they need, so that we could provide that feedback back to providers to help them as they’re investigating opportunities to put engagement programs in place.”
Over 90% of patients surveyed indicated that they needed more help managing their chronic conditions, with 75% of them desiring increased monitoring and check-ins from their healthcare providers.
“Patients are saying “we need this support” and yet very few providers are delivering it. Specifically, they’re saying they need these remote check-ins regularly, but 5% of providers are actually doing that. I think the reason is that they see patient engagement or chronic care management programs as a very large undertaking and something to approach very strategically, that they need to staff up with clinical bodies or open a call center to make this outreach,” Hart explains, before mentioning that some of the interventions are simpler than they may seem. The same automated phone systems that almost all hospitals use for appointment reminders can very easily be set up to check in on patients.
“For example, an [interactive voice response] administered phone call, a patient gets a phone call and they’re asked to complete a short question survey, it could be one question, it could be three questions. For example, you have a patient with congestive heart failure. We know weight is a big indicator of if that condition is getting worse, so an example there might be they receive the phone call, they’re asked to press ‘1’ if their weight is the same, press ‘2’ if their weight has gone up by two pounds, press ‘3’ if it has gone up four pounds…”
“When we say surveys, we don’t mean a lengthy thing, it’s as simple as a one-question, interactive connection that we’re making there, a symptom check. Phone, email, and text.” She says even systems as simple as these can help to personalize care by logging changes in the symptoms or metrics of individual patients with certain conditions. “If I’m a diabetic patient, and you’re a diabetic patient, we’re going to have different goals just based on our physiology…so they want to make sure providers are speaking specifically to them and not simply doing the equivalent of handing out a pamphlet of diabetes and sending them on their way.”
The survey of healthcare providers found over 60% of them are optimistic about two-way devices that can monitor patient health in the home and transmit such data to the clinical team, a “connected care loop” as Hart calls it: “We really advocate for interventions and notifications and this kind of communication that focuses on education, information, and support, encouraging and then reminding to do the behaviors. I think a good combination of those for any disease or any patient would really be optimal.”
Patient engagement, she believes, is essential to the future of medicine, and any providers that are not focused on it specifically are “focusing in the wrong place.”
The report issued recently, titled “Strengthening Chronic Care: Patient Engagement Strategies for Better Management of Chronic Conditions,” is the first of five such reports West plans to issue in 2017. The others will hone in on care quality, patient satisfaction, readmissions, and revenue cycle optimization for the healthcare organization. “It’s a constant theme we’ll be talking about continuously,” Hart says.