Top health industry issues of 2018

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Patient experience as a priority and not just a portal

Healthcare providers have succeeded in making administrative tasks easier and more convenient for patients.1 Patients can pay bills online, and they get appointment reminders by email or text. But 2018 will be about making significant strategic investments in patient experience so it changes behavior and improves outcomes—a critical goal as the industry turns toward paying more for value, not volume.2

Some healthcare organizations also will begin to use patient experience to differentiate themselves in the market.

Forty-nine percent of provider executives said revamping the patient experience is one of their organization’s top three priorities over the next five years. Many already have or are building the role of chief patient experience officer. In a few organizations, including Texas Health Resources (THR) in Dallas-Fort Worth, this position reports directly to the CEO.

Delivering a better experience pays in CMS’ new value-based payment scheme under the Medicare Access and CHIP Reauthorization Act (MACRA). Provider reimbursements will be based in part on patient engagement efforts such as promoting self-management and coaching patients between visits.3 But organizations have traditionally built patient experience efforts around the industry’s satisfaction surveys and measured performance based on satisfaction scores, service volume and revenue. Though they’re important, these measurements don’t get to the root of what patients value most or what motivates them to get and stay healthy.4

Just as retailers have harnessed data’s power to understand consumer behavior, healthcare organizations must obtain a 360-degree view of patients to engage them—and get a return on their investments. “An ability to derive meaningful information from linking disparate data about patients becomes a differentiator for an organization in a competitive market,” said Winjie Miao, executive vice president and chief experience officer at THR, who also is handling THR’s systems integration efforts.

Measures that can help organizations understand patients more completely include supplementing demographic profiles with information on the preferences and social circumstances that shape patients’ everyday health decisions. These include cultural values, work and home commitments and neighborhood dynamics. Accolade, a company that helps employees and health plan members navigate the health system, uses machine learning to find patterns in the information patients provide and use that knowledge to predict behaviors.

Eighty-eight percent of insurers are investing in technology to improve the member experience. Humana’s analytics, for example, can predict a member’s fall risk and help create interventions. “These members might not have ventured outside of their home independently before, because they feared they would have a fall,” said Vipin Gopal, Ph.D., enterprise vice president of clinical analytics at Humana. “But now they go out because they have the confidence that someone will be alerted immediately if they do fall, giving them mobility and much needed sense of security.”

Patients generate reams of data about their lives through wearables, pharmaceutical apps and spending habits. But providers say they lack the data to understand different patient segments and struggle to aggregate data from multiple sources. 2018 could be the year the health sectors rally around the patient experience by filling each other’s missing links.

Implications

Make every interaction count

Connect data points across and beyond the organization to understand how the patient’s experience fits into your business. “Improving overall patient experience will require strong organizational strategies around bringing in disparate data sets, governing them, establishing ownership, and utilizing them to provide real-time, actionable information about the patient,” THR’s Miao told HRI. This includes connecting experience measures to utilization data to help organizations bring dissatisfied patients back, and to help focus investments on services that will increase patient satisfaction. 

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Invest in patient experience tools with operating models

Educate patients and clinicians on how to use the tools; integrate them into care; and manage the data they generate. “As a physician, I need a framework so that I’m not putting more burden on my patient to use yet another device or take yet another action,” said Dr. Ivor Horn, chief medical officer at Accolade. “We have to consider how we can use tools that fit into the life flow of the consumer, in a way that works for them and creates an experience they want. It shouldn’t be about how the consumer fits into our process.”

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Marry workforce and patient experience

Seventy-three percent of provider executives say balancing patient satisfaction and employee job satisfaction is a barrier to efforts to improve the patient experience. But the two have the potential to go hand in hand. The Cleveland Clinic saw major improvements in patient experience measures after conducting programs to engage employees in the mission of caregiving.[5]

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1 Adam Cherrington and Colin Buckley, “Patient engagement 2016 – No silver bullet; strategic approach needed,” KLAS, January 2017, https://klasresearch.com/report/patient-engagement-2016/978

2 Thomas H. Lee, "How U.S. Health Care Got Safer by Focusing on the Patient Experience." Harvard Business Review, May 31, 2017.https://hbr.org/2017/05/how-u-s-health-care-got-safer-by-focusing-on-the-patient-experience

3 Centers for Medicare and Medicaid Services, “MIPS Improvement Activities – QPP,” accessed Oct. 17, 2017, https://qpp.cms.gov/mips/improvement-activities

4 Paul Roemer, “Three fatal flaws of relying on HCAHPS,” Aug. 6, 2014, http://healthsystemcio.com/2014/08/06/three-fatal-flaws-relying-hcahps/

5 James I. Merlino and Ananth Raman, “Health Care’s Service Fanatics,” Harvard Business Review, May 2013, https://hbr.org/2013/05/health-cares-service-fanatics

 

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