A New Day — And New Technology — Has Emerged For Patient Education And Safety
By Nicole Latimer, CEO, The StayWell Company, LLC
Healthcare delivery is undergoing a transformation driven in large part by healthcare regulations such as MACRA and MIPS, not to mention the heightened focus on patient-centered care and value-based care that is central to the ACA. In the new world of healthcare, clinicians will be required to report on steps they’re taking to educate patients, how they’re engaging with patients, and their use of secure messaging. That kind of information, collected under the Advancing Care Information component of MIPS, accounts for 25 percent of a healthcare organization’s score, and that score can affect reimbursement.
But educating patients and ensuring they are compliant with care plans can be a challenge. A 2015 study published in the journal Risk Management and Healthcare Policy found the percentage of patients who are not compliant with their healthcare treatment ranged from 25 to 50 percent. Meanwhile, the Journal of Patient Safety reported in 2013 there were between 210,000 and 440,000 preventable deaths in the U.S.
There are tools that can help improve those numbers. Now that most patients have access to a computer or carry a smartphone, healthcare providers have opportunities to involve patients in their own care, around the clock. Secure emails and text messages enable the delivery of information — such as instructions for surgery prep, appointment reminders or discharge instructions — that is both timely and targeted.
This level of personalization and targeting is important, especially when considering discharge instructions can sound very similar to patients. Take, for example, discharge instructions for a hip replacement and those for a heart transplant. In both situations, patients used to receive several pages of printed instructions that were often generic, pertaining to things like signs of surgical-site infections. The only resource a patient had for questions or concerns was to follow up with their physicians, but little else enabled them to take an active role in their own recovery.
How much more effective would it be if every patient got a list of instructions specific to his or her treatment? How much more powerful if patients were given the opportunity to become engaged in preparing for an important procedure by following an electronic checklist, rather than an easily-discarded paper list?
Fortunately, new technology now allows physicians to share patient information across departments, as well as keep patients in the loop and up to date on their recovery and care management. Some systems based on clinical checklists have been transformed using digital technology into tools that benefit both clinical outcomes, as well as patient satisfaction and engagement.
Patient engagement has become increasingly important in light of health reform and industry changes such as the Partnership for Patients Initiative, introduced by the Centers for Medicare and Medicaid Services in 2012, which has established a goal of reducing patient harm by 20 percent, and making care safer and reducing preventable hospital-acquired conditions by 40 percent.
One way to achieve this is through tools that enable physicians to connect with patients in a personalized, yet prescriptive way, and integrate communication into existing EHRs. The Krames CareEngage Platform powered by Doctella is one such tool, operating on the belief patients, if kept properly informed, can play an important role in their own safety and health outcomes.
The platform works both online and via a dedicated smartphone app and can be customized by providers to meet both clinical needs and patient preferences. It provides patients and their caregivers with digital checklists to follow while facilitating open communication with their healthcare providers. And, because the platform captures data about when or if patients complete certain tasks, healthcare providers can track compliance and intervene when needed to prevent unnecessary treatments. Ultimately, this can decrease costs and improve quality.
To ensure successful and broad adoption, patient engagement and checklist technology should have the capability to record patient-reported outcomes and to share those data with physicians across a system. Facilitating information sharing with family and caregivers is also an important feature, as many patients have an extended circle of people who are part of their recovery and support team. It’s like an always-on window into the treatment process.
Improved communication with clinical staff is another appealing element of patient engagement technology, because it increases the likelihood patients will get the correct information about their medication and details about their treatment. Such technology can also bridge the gap between office visits and allow patients access to more information than they might have time to address in a typical medical appointment. The ability to communicate with clinical staff can also contribute to higher patient satisfaction scores on important surveys like HCAPS.
Benefits of interactive patient engagement platforms for physicians include the ability to monitor patient progress based on completion of checklist activities such as fasting or stopping blood thinners before a surgical procedure, and making it easy for providers to send reminders to patients. Ultimately, this can mean fewer last-minute surgical cancellations.
In recent health system experience with interactive checklist platforms, providers have reported a 60 percent decrease in same-day surgery cancellations, a 57 percent decrease in emergency department visits and readmissions, and a 15 percent decrease in calls to the physician’s offices. Infection rates have also decreased, and patient satisfaction scores have improved.
As health systems increasingly look to patient education to improve outcomes and ROI, reduce costs, and increase patient satisfaction, they will look at new ways to keep patients informed. Meanwhile, importance will be given to the way in which information is delivered with the focus remaining on delivering the right information to patients, at the right time, in a format they can understand and follow. EHR vendors now offer solutions using open standards like FHIR and SMART that make it possible for patient education to be triggered from within the EHR and that log compliance with patient education into individual records.
About The Author
Nicole Latimer is CEO of The StayWell Company, LLC, a health engagement company that helps its clients engage and educate people to improve health and business results. StayWell develops interactive patient education and engagement solutions that are in use at hospitals and health systems across the country. StayWell is a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA (“Merck”). Contact Nicole at nlatimer@staywell.com.