3PHealth Blog

Insanity vs. Results in Healthcare Delivery

Wednesday, December 14th, 2016

As we embark on this new era of virtual care delivery, it is important to examine how we got here and why we are all working so diligently to transform healthcare into something better and more affordable than it is today.  And what better to honor that commitment to progress, then to remember the sage words of Albert Einstein:

 

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So you might be saying, huh?!  What we are doing IS different.  It’s video services, and apps, and secure messaging.  It’s way more efficient than it’s ever been.  While this may be true from one perspective, it is important to stand back and look at the bigger picture.

We have patient portals.  We have apps for diabetes, fertility, asthma and Parkinson’s. We have services for scheduling appointments and social media sites for peer support and discovery.  We have a whole constellation of apps and services – most in their own delivery and data silos.  Sounds a lot like the digital equivalent of our current health system of speciality physicians, clinics and hospitals.

So, we must ask ourselves are we doing the same thing over again? Are we simply shifting the “place” of care delivery, without addressing the root cause of the problem?

As your care delivery organization determines its virtual or digital care delivery strategy, it’s worth heeding the good Professor’s words.  Think beyond the disease or condition. Think beyond improving access to care.   Think beyond the app or service.  Remember to include a means to unify, individualize and connect your patients or members with their care support team in a meaningful way.  Consider strategies that build and reinforce good health behaviors on a daily basis, rather than simply making it easier to access care when you are sick.  Consider what tools, data and resources are required to facilitate that active collaboration and engagement, and who will need access to them – and when.

If we don’t change our behavior, how can expect a different result?


Pulling the Plug on Old-School Care Delivery Strategies – Lessons from Marketing

Tuesday, December 6th, 2016

Many years ago, when Mac computers were little smiling boxes, I accidentally pressed the “yes” button when asked if I wanted to reformat my hard drive.  A nanosecond later, my error sunk in, and I dove across my office to pull the plug before years worth of  my company’s data was erased from this earth.  Later, I became a product manager for a tape backup company.  Because I had experienced the panic of data loss at such a personal level, I understood why preventative measures were so important.   I was now marketing insurance for a possible future event.  Not an easy sell. Nobody wants to pay for something that might happen, and even if they do, it doesn’t mean they’ll back up their computer everyday.  Just as in health insurance, the consequences of taking, or not taking an action are so far removed from the decision point, itself, it’s like trying to get an 8-year old child to understand why regularly drinking soda, which tastes good and makes them feel good, may cause diabetes some day.  Good luck with that.

pull-plug

We have become used to marketing and education on illness instead of health. Forget the “happy” ads promoting the benefits of a healthy lifestyle if you only eat well, exercise and live a balanced life with your perfectly happy family. Seriously?  This is not our reality.  What I see on TV is not what I hear in the doctor’s office or when I search for a health policy online.  This disease is covered, that disease is not.  This provider, not that one.  Yes you can have a mammogram, but oh, not that kind.  What is marketed vs. what is delivered are inconsistent – misaligned.  Add to that, when you go to the doctor’s and hear things like, lose weight, quit smoking, or cut back on salt – without a specific, mutually agreed upon plan to get there – chances are, we won’t succeed. Changing lifestyle behaviors are not easy, even with help.

If we want people to change their behavior we must engage them in a way that matters to them.  We must make the consequences of their decisions relevant to their life – RIGHT NOW – not what might happen 30 years from now.  Recently I saw one video, sponsored by Stride Health, which is taking this long-overdue approach to health marketing by telling a young person’s story about the lifestyle choices he makes and why.  Now, good marketing won’t solve healthcare’s problems, but it does provide instructive insights on how to reach different populations, build aligned health ecosystems, and how we might repackage healthcare delivery to better achieve the Triple Aim.

People demand convenience, choice and relevance.  We now have the tools to deliver the individualized content consumers need, and connect them to the people, devices and community resources that can help them make real and sustainable lifestyle changes.  We have the means to support them in their daily decision making.  Buying insurance doesn’t make someone healthy, nor does getting an annual “wellness” exam ensure you or I will magically start managing a chronic health condition.  It’s only the first step.  We’re focusing on the wrong the problem.  Engaging people on their terms, in their communities, and on a regular basis is the key to improving health outcomes and reducing the cost of care delivery.

 


To Control Costs You Must Control Claims

Thursday, November 17th, 2016

In today’s ColoradoBiz digital magazine, Andrew Neary wrote this thoughtful article on self-insured businesses.  He discusses what companies can do to ensure that their goals for lower insurance costs and healthier, more productive employees are actually achieved.

My blog title is a quote from his post.  It gets to the heart of what many of us can do, right now, to help solve the problem of rising healthcare costs:

 

WE CAN MAKE IT EASIER FOR PEOPLE

TO STAY HEALTHY OR KEEP EXISTING CONDITIONS FROM WORSENING

 

In this time of regulatory uncertainty, it’s easy to simply wait and see what happens next year.  But that doesn’t help anyone. There are things we can do right now that can improve the health of our citizens.  As businesses and care delivery organizations, we have the ability to align our interactions and incentives with the behavioral changes and outcomes.  While, we have begun this process, but still have a long way to go.

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The first step on our journey to physical and fiscal behavior change is to acknowledge the current state of healthcare:

  • The majority of reimbursement is not tied to health outcomes
  • Lack of pricing transparency is counter to consumer decision processes
  • It’s easier to manage symptoms than change the causal lifestyle behaviors
  • Some stakeholders make more money managing conditions vs. curing them
  • PCPs do not have enough time to actively engage patients in lifestyle changes
  • Leisure and work time is increasingly tied to screens, instead of balls and boots
  • Our food choices are driven by convenience and profits over health and nutrition

 
While these issues are too big for any one organization to solve, we can all consider them as we define our strategies, products and services.  We can focus on what we can do, instead of what we cannot, or may not be able to do in the future:

  1. Technology dramatically improves our ability to help patients navigate the health system and make better choices.
  2. We can partner and engage in ways that support the alignment of incentives and the desired health and financial outcomes for all the stakeholders.
  3. We can enable new ways to engage people on their terms, and then analyze the data from these interactions, to adjust and adapt our policies, processes and care delivery strategies.

Let’s focus and take action on what we know works.  We can’t afford to wait any longer. People who engage in their health make better health decision and reduce the cost of healthcare – for everyone.  So let’s make it easier for that to happen.


IT as a Strategic Partner in Clinical Outcomes

Wednesday, November 2nd, 2016

Over the past 18 months, there have been numerous articles by the big consulting firms touting the importance of IT partnering with business units to play a more strategic role in the organization.  With technology becoming integral to everyday business processes and to creating a differentiating user experience, common sense tells us this is true.

But what about healthcare?  Can IT actually impact clinical outcomes?  We believe it can, and it was nice to see this article from Health Data Management talk about the changing roles of healthcare CIOs and CMIOs.

I have spent my life working with brilliant, creative and driven IT professionals.  The best of them have helped me to think bigger and see what is possible, not avoid what is hard or uncomfortable.  So, when I enthusiastically dove headfirst into healthcare, I was surprised to run into passive IT organizations.  They looked to their EHR vendors to tell them what their strategic IT “roadmap” would be for the coming year.  No other industry would let a vendor dictate their strategy.

So why is healthcare different, particularly when the health and financial costs associated with this approach are staggering?

Historically, health IT (outside of the OR, ER and imaging) was about billing.  Then came the EHR.  Adoption has been difficult and all consuming.  We got tunnel vision. We were overwhelmed with compliance and penalty avoidance and lost clear sight of how our customers (patients and providers) want to engage with us.

More recently many health systems jumped on the mobile band wagon, but sustained use is limited and clinical impact is rarely measured.  For most organization, it was a reactive tactic vs. a strategic initiative.  So now, IT finds itself resetting its strategic course.  Which means it’s a great time to partner with the rest of the organization to improve the user experience, health outcomes and financial health.

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It’s time to strategically transform care delivery systems.  Systems that improve health outcomes, profits and sustainability.   Be it virtual care or virtual reality.  Remote monitoring or remote access.  Connecting doctors, connecting patients, connecting information.   CIOs and CMIOs are in the unique position to help clinicians explore the myriad ways to simplify connections between people, and between people and content.  They can also guide EHR vendors towards more open, modular solutions that can adapt to their strategies, and not the other way around.

IT is filled with creative people and strategic thinkers.  They are also in the unique position to help envision and deploy care delivery systems that make it easy for patients to comply with their care plans and collaborate with doctors and peers in support of improved health outcomes.  Outcomes that can directly impact your organization’s bottom line.

Help your teams leverage the hundreds of innovative new m-health and e-health products and services that can make interacting in their health more effective and pleasurable.  Weave in solutions that can help analyze, diagnose, remotely monitor, and engage patients in their care.  Strategies that can simplify collaboration and virtually extend care teams.  Give patients access to the “right” care and information, just when they need it – making it easier and more convenient to reach a doctor, nurse or mental health professional.

It’s time to view compliance and privacy as opportunities and not barriers.  The offer new ways to connect people and share information within a rich digital health ecosystem.  We are only limited by our imagination and willingness to do what is right for all of our stakeholders – the patient, the provider and the payer.


Inclusivity Leads to Innovation

Wednesday, August 10th, 2016

While this post does not directly speak to digital care issues, it is relevant to the topic of innovation.  I am actively involved with Prime Health community here in Colorado.  As a co-chair of the Inclusivity working group, we are always searching for information and resources to help our members maximize creativity, innovation and productivity through inclusive business practices.

Health Innovation

 

This recent Massachusetts employment legislation, as reported by the NY Times, highlights one way in which we can all  contribute to innovation by becoming more conscious of our cultural biases.  From the article:

By barring companies from asking prospective employees how much they earned at their last jobs, Massachusetts will ensure that the historically lower wages and salaries assigned to women and minorities do not follow them for their entire careers. Companies tend to set salaries for new hires using their previous pay as a base line.

“I think very few businesses consciously discriminate, but they need to become aware of it,” said State Senator Pat Jehlen, a Democrat and one of the bill’s co-sponsors. “These are things that don’t just affect one job; it keeps women’s wages down over their entire lifetime.”

Is your company asking your job applicants to share previous salary information as part of your hiring process? If so, you may be perpetuating the pay equity problem. Remember that minorities must be put in the context of the industry or job function – which could be men in positions such as nursing or early childhood education.  This data does not just apply to women, age and ethnicity.

Let’s not wait for Colorado to pass a law in order to stop the cycle and do the right thing. It’s up to us to build Colorado’s digital health ecosystem based upon respect and equality. Simple changes in process or policy can go a long way to increasing our innovation and competitive edge as companies, health organizations and a digital health community.



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