A research-based analysis published in the March issue of Health Affairs has identified significant advances in leveraging information technology to help patients navigate the healthcare delivery system, focusing on advances taking place at four well-known patient care organizations. A team of researchers—Ming Tai-Seale, Ph.D., N. Lance Downing, M.D., Veena Goel Jones, M.D., Richard V. Milani, M.D., Beiqun Zhao, M.D., Brian Clay, M.D., Christopher Demuth Sharp, M.D., Albert Solomon Chan, M.D., and Christopher A. Longhurst, M.D.—describe their findings, in the article, entitled “Technology-Enabled Consumer Engagement: Promising Practices At Four Health Care Delivery Organizations.”
“Patients’ journeys across the care continuum can be improved with patient-centered technology integrated into the care process,” the researchers write. “Misaligned financial incentives, change management challenges, and privacy concerns are some of the hurdles that have prevented health systems from deploying technology that engages patients along the care continuum. Despite these sociotechnical challenges, some health care organizations have developed innovative approaches to engaging patients. We describe promising technology-enabled consumer engagement practices at two community-based delivery organizations and two academic medical centers to demonstrate the approaches, sociotechnical challenges, and outcomes associated with their implementation. Leadership commitment and payer policies that align with the quadruple aim—enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers—would encourage further deployment and lead to greater consumer engagement along the care continuum.”
Referencing the patient portals that hospitals participating in the Medicare program were required to create, in the context of the meaningful use program under the HITECH (Health Information Technology for Economic and Clinical Health) Act, the researchers note that, “While most portals are optimized for outpatients, an increasing number of healthcare organizations are implementing these solutions in the inpatient setting, where patients have unmet information and communication needs9,10 and also value having some control over their physical environment. Patient-centered technology deployed in this setting,” they write, “can help meet those patient needs by identifying the care team and providing real-time access to test results, medication information, and hospitality amenities. The literature is relatively silent, however, on how health care organizations can improve hospitality features of inpatient care while enhancing patient and family engagement in the care process.”
Further, they note, “Hospitals have been encouraged to bridge the digital divide (the differences in use of digital technology between patients of different ages, races, incomes, and education levels)14 by providing technological solutions to all patients. However, it is relatively unknown how patients and families may use hospital-provisioned mobile devices to control their inpatient rooms and access the inpatient patient health portal.”
In the article, the researchers look at developments at the Ochsner Health System (based in New Orleans), Sutter Health (based in San Francisco), Stanford Health Care (based in the San Francisco suburb of Palo Alto), and UC San Diego (Calif.) Health—four organizations at which all the authors practice or work.
At Ochsner, the researchers examined that health system’s focus on “reengineering care between office visits for ambulatory care patients with chronic disease,” particularly with regard to patients with hypertension, in order to “develop a new model for delivering chronic disease care to patients by leveraging technology and sharing information with the goal of improving hypertension control rates.” At Sutter, they looked at that integrated health system’s concerted push to optimize patients’ use of their organization’s portal for scheduling and for messaging with clinicians. And at UC San Diego Health, the researchers concentrated on that organization’s effort to optimize inpatients’ use of tablets and other devices to engage with clinicians, and the change management work needed to integrate such engagement with clinician workflow.
Looking at the federal healthcare policy implications of all these efforts, the authors note that, while federal resources “have facilitated consumer engagement by health care delivery organizations…. The long-term sustainability and scalability of these initiatives depend on payers’ commitment to the quadruple aim—enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers. Organizations may lack incentives to scale virtual visits, for example, in a fee-for-service environment—despite recognized benefits of virtual visits in preventing avoidable emergency department visits and hospital admissions, increasing the capacity of mental health care providers, and allowing for telemonitoring after hospital discharge,” they note.
