Guest Column | April 6, 2015

Patient Engagement Solutions Are Here. Now.

Kathleen Fowler

By Kathleen Fowler

Crisis Communication Is Turning To IT Solutions

A five-year roadmap to a patient engagement platform might be five years too long.

Next month, hospitals, providers, and other healthcare organizations (HCOs) from across the country will venture to Chicago for the annual HIMSS conference, where many will look for tech solutions to improve patient care, reduce costs – and meet Meaningful Use (MU) requirements. More often than not, these organizations will arrive with a five-year roadmap in hand, looking for tech tools to meet three main criteria:

  1. true interoperability
  2. full patient engagement
  3. full provider engagement

This is no easy task. Despite the MU requirement that vendor solutions achieve these goals, the reality is, many MU-certified IT offerings fall short. Chilmark Research, an independent global research and advisory firm that evaluates healthcare IT solutions, recently released a report ranking the major competitors in this industry, and found the market lacking. As the report notes, “The bulk of clinical IT solutions are supplied by electronic health record (EHR) vendors, who have spent the last five years designing products to enable short-term compliance with federal incentives rather than long-term success.”

Yet, according to the report, the healthcare organizations (HCOs) contracting with these vendors are part of the problem. “The majority of middle market HCOs have stuck tightly to MU guidelines and are not ready to make investments in any ad­vanced tools at this stage,” the report states. “While some of these HCOs are moving slowly along the maturity curve, they are cautiously backing into their IT purchasing, choosing to lean on their existing infrastructure or work with their preferred incumbent vendors on building new features.”

The result? Insufficient EHR products that may check the box of MU requirements, but don’t go beyond and provide a true patient engagement solution that accomplishes what MU set out to accomplish: more streamlined operations, healthier patients, and reduced costs.

Despite all this, there is good news. Many healthcare IT vendors are developing products that go beyond simply meeting the MU requirements to provide fully developed patient engagement solutions for HCOs. “This trend is likely to intensify as health reform yields new payment models that reward HCOs for better outcomes of care as opposed to a greater volume of care,” said Lygeia Ricciardi, former head of the ONC’s Office of Consumer eHealth. “If you want to get better outcomes, you have to engage patients and families, who have a greater impact on health than anyone else, and technology provides many opportunities to do so. And the great thing is there are products on the market today that are effective in that regard – we just need to make sure more people know about them.”

The patient engagement solution that came out on top in the Chilmark report was Get Real Health. With an overall grade of A-, it beat out all of the other 13 competitors, including Allscripts, Cerner and WebMD. The report stated that Get Real Health was “the product standout” with its “highly configurable platform and product vision, and understanding of end-user needs.” It added that Get Real Health’s patient engagement platform – InstantPHR® - is “a complete engagement offering” that goes “beyond standard VDT [view, download, transmit] and communication features.”

Because Get Real Health is an untethered platform, it can integrate with existing systems, achieving true interoperability. In many cases, EHR vendors are offering clients MU-certified products that don’t actually conform to interoperability. Some vendors are working to close those gaps to make sure providers have a fully integrated patient engagement platform.

The other untethered patient engagement platforms ranked in the Chilmark Report are: Dossia (which received an overall grade of C+), Influence Health/MedSeek (a grade of B), Medusion (a grade of C), and NoMoreClipboard (a grade of B-). “In general,” the report states, “untethered portals have demonstrated success in integrating with native HIS, incorporating data from different sources, and forming longitudinal records.” But they also tend to be “less deep on clinical functionality than their tethered counterparts.”

Beyond interoperability, HCOs need patient engagement platforms that truly engage patients. This was the challenge of Stage 2 MU requirements – with its VDT mandate – and many healthcare providers made great strides, but there’s still work to be done. Getting patients to sign up for a patient portal is one thing; getting them to actually use it is another.

Fortunately, according the Chilmark report, a wealth of innovative vendor technologies to engage patients are emerging, including smart care plans (a digital list of tasks sent home with patients), discharge plans, health monitoring (such as weight, glucose readings, blood pressure, etc.), medication adherence, shared decision making among the provider, patient and/or family members, video-based virtual visits, and network management that steers patients to seek care within the boundaries of a specific network. “These typically involve a far greater degree of collaboration between clinicians and patients and often result in the production of patient-generated health data that can serve as a valuable piece of the patients’ overall longitudinal record,” the report states.

But perhaps the biggest challenge to creating a successful patient portal is engaging providers. In a recent op-ed in the New York Times, Dr. Robert M. Wachter, a professor of medicine at UCSF, wrote about the resistance among modern hospitals to EHRs, citing a 2013 RAND survey of physicians that found “mixed reactions” to EHRs, including widespread dissatisfaction. “Whopping errors and maddening changes in work flow have even led some physicians to argue that we should exhume our three-ring binders and return to a world of pen and paper,” he writes. While he adds that “this argument is utterly unpersuasive,” it highlights the resistance among providers to MU requirements.

“We see a lot of healthcare organizations using their patient portals to check a box and not taking the time to look and see what’s ahead,” said Christina Caraballo, Senior Healthcare Strategist for Get Real Health. “This forces them to rethink everything when new MU requirements are released. It’s a huge setback. What hospital systems and providers need to do is look ahead and start implementing healthcare IT solutions now for what’s coming down the pike in one, two or three years.”

There’s no question that interoperability and patient and provider engagement are all critical to ensuring the success of any patient engagement solution. How to go about achieving those goals, however, is a matter of choice. As hospitals and healthcare organizations head to Chicago for the HIMSS conference, they should be thinking of what questions to ask the health IT vendors to ensure that their tools go beyond checking a box, and instead provide a real, comprehensive patient engagement solution for now and the years to come.