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Patient Engagement
Jessica Sweeney-Platt
Executive Director,
Physician Performance Research
75 8580 9590 0500 1510
PATIENTS
PROVIDER
S
• Health record
• Care plan and health tracking
• Appointments and preventive care
• Decision making
• Patient-specific education
• Prescription management
Patient engagement is active collaboration between
patients and providers
2
Patient engagement drives outcomes
3
Unengaged patients are…
3X
more likely to have
unmet medical needs.
2X
more likely to defer care.
http://technologyadvice.com/medical/blog/study-patient-portal-communication-
2014/
75 8580 9590 0500 1510
BY 2018most Medicare payments
will be tied to
QUALITY CARE
Engagement is critical to reimbursement
4
Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to-
gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
Patient Engagement
Digital landscape continues to grow
6
63%
of adult cell owners
use their phones to
go online
• Has doubled since
2009
• 34% mostly go online
using their cell phone
• 21% do most of their
online browsing using
their mobile phone—
and not some other
device such as a
desktop or laptop
computer
69%
of U.S. adults track
a health indicator
like weight, diet,
exercise routine, or
symptom
• Half track “in their
heads”
• One-third keep notes
on paper
• One in five use
technology to keep
tabs on their health
status
35%
of U.S. adults have
gone online to
figure out a medical
condition
• Of these, half followed
up with a visit to a
medical professional
35%
of U.S. adults have
gone online to
figure out a medical
condition
• Up from 30% in 2010
• Many navigate health
care with the help of
technology
Source: The Pew Research Center
People want access…
7
75 8580 9590 0500 1510of U.S. patients
WANT ELECTRONIC ACCESS
TO THEIR HEALTH
RECORDS.
37%HAVE
ACCESS.
>40%
ARE WILLING TO SWITCH
providers to get access.
84%
Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to-
gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
75 8580 9590 0500 1510
If you could securely connect with your doctor online,
which services would you use most?
Other Schedule an
appointment
Get lab
results
Request
prescription
refills
Fill out
medical
forms
Ask care-
related/admini
strative
questions
Review and
pay your bills
90
80
70
60
50
40
30
20
10
0
68%
62%
81%
59%
51% 53%
3%
Source: Intuit Health Survey by Decipher Research, January 2011
Patients will use all the tools in a portal
8
75 8580 9590 0500 1510
83%of U.S. seniors want access to medical
records.
91%of Medicare patients
use internet.
…including seniors
9
Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to-
gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
The Business Case
for Portal Adoption
75 8580 9590 0500 1510
$25,000*
Annual Savings
From electronic
delivery of
lab results
$17,000*
Annual Savings
From online
billing inquiries
$35,000*
Annual Savings
From self-
scheduled visits
* Based on a 10-MD practice.
Portal adoption pays off
11
Portal adoption a potential
competitive differentiator
12
Portal adopters
13 percentage points more
likely to return
for second visit
18 Month Retention Rates
Non-Portal Adopters 67%
Portal Adopters 80%
Portal Adopters More Loyal to
Their Primary Care Providers
1 “More than Forty Percent of U.S. Consumers Willing to Switch Physicians to Gain Online Access to
Electronic Medical Records, According to Accenture Survey,” Accenture, September 16, 2013.
Patients of all ages use the portal
0-9 yrs
10-19 yrs
20-29 yrs
30-39 yrs
40-49 yrs
50-59 yrs
60-69 yrs
70-79 yrs
80+ yrs
0% 5% 10% 15% 20% 25% 30% 35% 40%
35%
32%
30%
28%
27%
20%
10%
17%
21%
Portal Adoption Rate
13
Higher adoption with commercial patients than
Medicare, Medicaid
14
32%
29%
14% 14%
19%
16%
0%
5%
10%
15%
20%
25%
30%
35%
Blue Commercial Other Medicaid Medicare Self-Pay
0% 5% 10% 15% 20% 25% 30%
1-2
3-5
6-10
11-50
51-80
81+
24%
27%
24%
25%
26%
Practices of all sizes can be successful
Portal Adoption Rate
Median Portal Adoption Rate
by Number of Providers
25%
NumberofProviders
15
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Adoption,Past30Days
6 12 18 24 30 36 42
Practices can achieve very high
adoption rates very quickly
16
Months Since Introducing Portal
91%
85%
66%
57% 55%
40%
34%
OB/GYN Practice A
OB/GYN Practice B
Orthopedic Group
Multispecialty Group A
Multispecialty Group B
Family Practice
Pediatric Network
Higher portal adoption
means greater engagement
17
n = 1,612 practices
Metric
Procrastinators
(0-10%
Penetration)
Beginners
(10-30%
Penetration)
Aspiring
(30-60% Penetration)
Pioneers
(60-100%
Penetration)
Proportion of Practices 30% 40% 22% 8%
Portal Penetration Rate 5% 18% 43% 75%
Logins / Visit 0.54 0.80 1.03 1.81
Patient Msgs Sent / Visit 0.15 0.18 0.21 0.38
Provider Resp.s Sent / Visit 0.05 0.09 0.13 0.25
% messages responded to 33% 50% 62% 67%
Blueprint for Portal
Adoption
Patient Engagement
Top performers do five things differently
20
1
2
3
4
5
Develop a portal adoption policy
Ensure the portal delivers value to patients
Implement a streamlined portal training program
Craft a compelling portal marketing message
Support in-office portal registration
Consciously articulate a strategy for adoption,
moving from opt-in to opt-out
Portal
Adoption
Policy
Description
Adoption
Target
Default to Portal
Registration
Portal use is assumed by default: registrars actively encourage patient
registration in the office. The practice will see patients without portal
accounts.
70%
Tying Portal Use
to Care Plan
Adherence
Clinicians incorporate use of a portal a central part of a patient’s care plan
and discuss portal use with patients directly. Not using the portal is
considered a failure to adhere to clinical recommendations.
80%
Strict Portal-Only
Policy
Patients are required to register for portal accounts except in a limited
number of cases Practices may choose not to accept new patients who
decline to use the portal.
90%
1. Develop a portal adoption policy
21
2. Ensure portal delivers value to patients
Lab Results
Delivery
Service Required Practice Activity
• Develop policy for pushing normal/abnormal
results to patients through portal
• Ensure that providers routinely provide
appropriate lab results to patients
Secure
Messaging
• Encourage patients to send secure messages
• Respond to secure messages in a
timely fashion
General
Support
• Should be able to answer basic questions
about using the portal in the office
1
2
3
22
3. Provide streamlined staff training
DO SAY:
Would you like to have access
to your health records online?
DON’T SAY:
May I have your email address?
DO SAY:
You may go online at your
convenience to view lab results.
DON’T SAY:
I’ll mail you the lab results.
DO SAY:
Would you prefer not to be called at
night (dinner time)?
DON’T SAY:
We’ll call you in a few days.
23
4. Develop a compelling marketing message
Craft a compelling portal
marketing message
• Provide physicians, other clinical
team members, and registrars with
scripting to convey benefits of
portal
• Take advantage of athena
marketing collateral
• Staff should be able to teach
patients how to view lab results,
send messages, pay bills, and
request or schedule an
appointment
24
Expert on-site
On premise portal experts for
more complicated questions
and reluctant patients
• Can demonstrate portal use
while patients are in-office
• Provide limited phone support
to patients
• Serve as trainer / portal
evangelist to staff
• Eventually, they need to work
themselves out of a fulltime job
(as adoption reaches critical
mass)
25
5. Promote in-office registration
athenaCommunicator allows patients to register for the
portal in the practice through one of three methods:
1. Using a staff member’s laptop or tablet directly.
2. Using a kiosk in the waiting room or lobby.
3. Texting the patient’s smartphone while they are in the office.
26
Alternative kiosk solutions:
AN OLD
LAPTOP.
AN
iPAD
OR
TABLET
AN OLD
DESKTOP
COMPUTER.
Registration
In-Office Registration Methods Have Vastly Higher Yield
57% 53%
23%
12%
4% 0.4%
In-Office
Kiosk or Tablet
Via Registrar
Computer
Text
Message
Email at
Check-In
Automated
Monthly Email
Campaign
Invitations
In-Office Registration Methods At-home Registration Methods
27
28
The athenahealth
Solution
29
Reminder
Calls
Payment
Estimator
Credit Card
Processing
Text Message
Reminders
Live
Operator
Patient
Portal
Bill on
EOB
30
Thank You
Jessica Sweeney-Platt

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Patient Engagement

  • 1. Patient Engagement Jessica Sweeney-Platt Executive Director, Physician Performance Research
  • 2. 75 8580 9590 0500 1510 PATIENTS PROVIDER S • Health record • Care plan and health tracking • Appointments and preventive care • Decision making • Patient-specific education • Prescription management Patient engagement is active collaboration between patients and providers 2
  • 3. Patient engagement drives outcomes 3 Unengaged patients are… 3X more likely to have unmet medical needs. 2X more likely to defer care. http://technologyadvice.com/medical/blog/study-patient-portal-communication- 2014/
  • 4. 75 8580 9590 0500 1510 BY 2018most Medicare payments will be tied to QUALITY CARE Engagement is critical to reimbursement 4 Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to- gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
  • 6. Digital landscape continues to grow 6 63% of adult cell owners use their phones to go online • Has doubled since 2009 • 34% mostly go online using their cell phone • 21% do most of their online browsing using their mobile phone— and not some other device such as a desktop or laptop computer 69% of U.S. adults track a health indicator like weight, diet, exercise routine, or symptom • Half track “in their heads” • One-third keep notes on paper • One in five use technology to keep tabs on their health status 35% of U.S. adults have gone online to figure out a medical condition • Of these, half followed up with a visit to a medical professional 35% of U.S. adults have gone online to figure out a medical condition • Up from 30% in 2010 • Many navigate health care with the help of technology Source: The Pew Research Center
  • 7. People want access… 7 75 8580 9590 0500 1510of U.S. patients WANT ELECTRONIC ACCESS TO THEIR HEALTH RECORDS. 37%HAVE ACCESS. >40% ARE WILLING TO SWITCH providers to get access. 84% Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to- gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
  • 8. 75 8580 9590 0500 1510 If you could securely connect with your doctor online, which services would you use most? Other Schedule an appointment Get lab results Request prescription refills Fill out medical forms Ask care- related/admini strative questions Review and pay your bills 90 80 70 60 50 40 30 20 10 0 68% 62% 81% 59% 51% 53% 3% Source: Intuit Health Survey by Decipher Research, January 2011 Patients will use all the tools in a portal 8
  • 9. 75 8580 9590 0500 1510 83%of U.S. seniors want access to medical records. 91%of Medicare patients use internet. …including seniors 9 Source: http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to- gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm
  • 10. The Business Case for Portal Adoption
  • 11. 75 8580 9590 0500 1510 $25,000* Annual Savings From electronic delivery of lab results $17,000* Annual Savings From online billing inquiries $35,000* Annual Savings From self- scheduled visits * Based on a 10-MD practice. Portal adoption pays off 11
  • 12. Portal adoption a potential competitive differentiator 12 Portal adopters 13 percentage points more likely to return for second visit 18 Month Retention Rates Non-Portal Adopters 67% Portal Adopters 80% Portal Adopters More Loyal to Their Primary Care Providers 1 “More than Forty Percent of U.S. Consumers Willing to Switch Physicians to Gain Online Access to Electronic Medical Records, According to Accenture Survey,” Accenture, September 16, 2013.
  • 13. Patients of all ages use the portal 0-9 yrs 10-19 yrs 20-29 yrs 30-39 yrs 40-49 yrs 50-59 yrs 60-69 yrs 70-79 yrs 80+ yrs 0% 5% 10% 15% 20% 25% 30% 35% 40% 35% 32% 30% 28% 27% 20% 10% 17% 21% Portal Adoption Rate 13
  • 14. Higher adoption with commercial patients than Medicare, Medicaid 14 32% 29% 14% 14% 19% 16% 0% 5% 10% 15% 20% 25% 30% 35% Blue Commercial Other Medicaid Medicare Self-Pay
  • 15. 0% 5% 10% 15% 20% 25% 30% 1-2 3-5 6-10 11-50 51-80 81+ 24% 27% 24% 25% 26% Practices of all sizes can be successful Portal Adoption Rate Median Portal Adoption Rate by Number of Providers 25% NumberofProviders 15
  • 16. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Adoption,Past30Days 6 12 18 24 30 36 42 Practices can achieve very high adoption rates very quickly 16 Months Since Introducing Portal 91% 85% 66% 57% 55% 40% 34% OB/GYN Practice A OB/GYN Practice B Orthopedic Group Multispecialty Group A Multispecialty Group B Family Practice Pediatric Network
  • 17. Higher portal adoption means greater engagement 17 n = 1,612 practices Metric Procrastinators (0-10% Penetration) Beginners (10-30% Penetration) Aspiring (30-60% Penetration) Pioneers (60-100% Penetration) Proportion of Practices 30% 40% 22% 8% Portal Penetration Rate 5% 18% 43% 75% Logins / Visit 0.54 0.80 1.03 1.81 Patient Msgs Sent / Visit 0.15 0.18 0.21 0.38 Provider Resp.s Sent / Visit 0.05 0.09 0.13 0.25 % messages responded to 33% 50% 62% 67%
  • 20. Top performers do five things differently 20 1 2 3 4 5 Develop a portal adoption policy Ensure the portal delivers value to patients Implement a streamlined portal training program Craft a compelling portal marketing message Support in-office portal registration
  • 21. Consciously articulate a strategy for adoption, moving from opt-in to opt-out Portal Adoption Policy Description Adoption Target Default to Portal Registration Portal use is assumed by default: registrars actively encourage patient registration in the office. The practice will see patients without portal accounts. 70% Tying Portal Use to Care Plan Adherence Clinicians incorporate use of a portal a central part of a patient’s care plan and discuss portal use with patients directly. Not using the portal is considered a failure to adhere to clinical recommendations. 80% Strict Portal-Only Policy Patients are required to register for portal accounts except in a limited number of cases Practices may choose not to accept new patients who decline to use the portal. 90% 1. Develop a portal adoption policy 21
  • 22. 2. Ensure portal delivers value to patients Lab Results Delivery Service Required Practice Activity • Develop policy for pushing normal/abnormal results to patients through portal • Ensure that providers routinely provide appropriate lab results to patients Secure Messaging • Encourage patients to send secure messages • Respond to secure messages in a timely fashion General Support • Should be able to answer basic questions about using the portal in the office 1 2 3 22
  • 23. 3. Provide streamlined staff training DO SAY: Would you like to have access to your health records online? DON’T SAY: May I have your email address? DO SAY: You may go online at your convenience to view lab results. DON’T SAY: I’ll mail you the lab results. DO SAY: Would you prefer not to be called at night (dinner time)? DON’T SAY: We’ll call you in a few days. 23
  • 24. 4. Develop a compelling marketing message Craft a compelling portal marketing message • Provide physicians, other clinical team members, and registrars with scripting to convey benefits of portal • Take advantage of athena marketing collateral • Staff should be able to teach patients how to view lab results, send messages, pay bills, and request or schedule an appointment 24
  • 25. Expert on-site On premise portal experts for more complicated questions and reluctant patients • Can demonstrate portal use while patients are in-office • Provide limited phone support to patients • Serve as trainer / portal evangelist to staff • Eventually, they need to work themselves out of a fulltime job (as adoption reaches critical mass) 25
  • 26. 5. Promote in-office registration athenaCommunicator allows patients to register for the portal in the practice through one of three methods: 1. Using a staff member’s laptop or tablet directly. 2. Using a kiosk in the waiting room or lobby. 3. Texting the patient’s smartphone while they are in the office. 26 Alternative kiosk solutions: AN OLD LAPTOP. AN iPAD OR TABLET AN OLD DESKTOP COMPUTER.
  • 27. Registration In-Office Registration Methods Have Vastly Higher Yield 57% 53% 23% 12% 4% 0.4% In-Office Kiosk or Tablet Via Registrar Computer Text Message Email at Check-In Automated Monthly Email Campaign Invitations In-Office Registration Methods At-home Registration Methods 27
  • 28. 28
  • 29. The athenahealth Solution 29 Reminder Calls Payment Estimator Credit Card Processing Text Message Reminders Live Operator Patient Portal Bill on EOB
  • 30. 30

Editor's Notes

  1. “Patient engagement” has become a bit of a buzzword. True patient engagement is the knowledge, skills, ability, and willingness of patients to manage their own health care. It is also the culture of the health care practice that prioritizes and supports patient engagement. And finally it is the active collaboration between patients and providers to design, manage, and achieve health outcomes.
  2. While patient engagement has always been known to be a great addition to practices and health care organizations, it is now vital to the business of delivering care. Disengagement only causes more of the same issues that are seen over and over again in healthcare.
  3. The shifting technology environment has created a response from the government. Updated standards now dictate health care organizations and individual providers will be paid partially based on how patients rate their care experience. Practices must also meet new industry standards based on better cost and clinical outcomes as with programs such as Meaningful Use, Patient-Centered Medical Homes, and Accountable Care Organizations. In short, patient engagement now has a reward-based outcome in a time where the mass market is more than ready to embrace technology updates in the personal management of their health.
  4. The world is obviously a different place. Products such as personal drones, iPhone app virtual realty sets, and watches that are only watches as a secondhand function not only exist but were top items on children’s holiday gift wish lists last year. Consumer technology and sophisticated gadgets have comprehensively permeated our society and the forecast for 2016 predicts this trend will build exponentially. Image source: http://www.businessinsider.com/vatican-square-2005-and-2013-2013-3
  5. Recent surveys indicate that a majority of U.S. adults use technology to engage in their health care. One in five of adults in this country digitally track a health indicator. With health tracking tech products evolving so quickly in the consumer sector it is little wonder why so many then turn to expect the rest of healthcare to pander to these new technological expectations.
  6. 84% of the population wishes to have access to an electronic version of their healthcare records. On top of that, close to half of the population would even be willing to switch providers if it allowed them access their records electronically.
  7. Adopting a strategy for portal adoption in your improves upon population health, helps to enhance patients’ experience of care, and it reduces overall costs. And with the consumer demand for more technology from all sectors, a portal is the perfect place to start as your patients will make full use of it.
  8. It is also important not to discount the older portion of patients as seniors are shown in many recent studies to have the same desire to view medical records online as well as having the ability to capably navigate any electronic tools.
  9. Portal adoption is one great way to achieve patient engagement.
  10. Patient demographics should not be a limiting factor for many practices. Across athenaNet, we see consistent adoption rates for adults aged 30-70. Patients in their 60s use the portal at a higher rate than patients in their 20s—who are only slightly more likely than patients in their 70s to have portal accounts.
  11. Medicaid patients are roughly 70% less likely than commercially insured patients to use a patient portal. However, some clients have succeeded in bucking the trend. For example, one OB/GYN practice in Texas with a heavy Medicaid case mix has enrolled 43% of patients on the portal.
  12. Patient demographics should not be a limiting factor for many practices. Across athenaNet, we see consistent adoption rates for adults aged 30-70. Patients in their 60s use the portal at a higher rate than patients in their 20s—who are only slightly more likely than patients in their 70s to have portal accounts.
  13. Let’s step back from the data now: What truly makes up patient engagement?
  14. Oftentimes, just communicating with the patient is thought to be the defining component but it really is active collaboration between patients and providers. Simply implementing new technology or educating patients with healthcare materials, while not a hindrance, is not nearly cohesive enough.
  15. Taking a look at what the top performers on athenaNet do, we have come up with a comprehensive guidebook that we suggest you follow, no matter what portal you use.
  16. Patients are more likely to register for the portal when you get them to do it during the office visit. Once they have headed home, their likelihood to register on their own drops measurably.
  17. But portals are just the gateway to patient engagement, not the end solution. A practice must be willing to invest in training and education otherwise the product will be a waste.
  18. We provide you the tools you need to make running your practice easier and more efficient. A comprehensive patient engagement strategy requires a patient-centric approach to all aspects of your business. Having a well-functioning patient portal is one of the main keys to connecting providers to patients outside the office so they can better manage their own health. Digitally connecting patients and providers improves the patient experience, boosts retention and improves health outcomes. It also caters to a growing trend of the patient as consumer and the penetration of the internet into every facet of our lives.
  19. At the end of the day, all the work we do is to improve the way care is delivered and unburden the skilled physician of tedious, time-consuming and unfulfilling administrative work. It’s all to get you back to doing what you want to be doing, what you were trained to do, managing patient health through great care.