Using mHealth to enhance population health management
The success of hospitals today requires innovative thinking, the ability to respond to new situations quickly and increasingly novel approaches to how they deliver quality patient care. Population health management is one of the key strategies required to thrive in this new world.
The goal of PHM, whether for a health system or an individual practice, is to keep patient populations as healthy as possible. Doing so reduces the need for expensive interventions such as emergency department visits and/or inpatient admissions. This not only lowers costs, but also redefines healthcare as ongoing, patient-centered and beyond just facility-based care.
A key component of PHM is patient engagement, or getting whole groups of individuals actively involved in and responsible for their care. Providing timely, relevant information that keeps patients aligned with their healthcare has been shown to reduce a hospital’s cost of unnecessary care by 30 percent. However, it requires physicians to rethink how they deliver information and the tools they use for proactively offering care. New enterprise communications technologies, when combined with clinical best practices, can help address the challenge of patient engagement by facilitating education, goal attainment and accountability while empowering providers with important information about each individual’s health status outside the clinical setting.
Achieving and maintaining optimal health involves more than medical care – it also encompasses the context of people’s lives, such as where they live and work, what they value and whether they have access to resources. Patients can face many challenges, including:
Language and health literacy;
Readiness to change; and
Other social determinants of health, such as education, occupation and environment.
The first step to patient engagement begins with understanding the social, physical and individual barriers that can interfere with outcomes. Once these obstacles are understood, providers can leverage technologies such as improved direct communications and mHealth applications to deliver appropriate and targeted information, including care plans, based on an individual’s priorities, interests and unique situation to improve compliance and bring about behavioral change.
A patient's recollection of medical information at the point of care is limited. Whether due to age, stress, anxiety, lack of understanding of medical terminology or other factors, studies indicate that they immediately forget as much as 80 percent of what they are told at a doctor’s office. Moreover, what little they do remember is frequently incorrect. Therefore, communicating the right information in the right way – so that it’s timely, relevant and easily retrievable – is an important piece of the patient engagement puzzle. Mobile health tools offer several ways to help patients make the shift from passive observers to active users of resources that support self-management:
The most successful patient engagement programs rely on multichannel communication—strategies that provide information and feedback according to the participant’s preferred method of contact. This may include telephone, mail, e-mail or text messages. Automated messaging to all discharged hospital patients, for example, can be used to urge them to see their providers, fill their prescriptions, monitor potential complications or call the hospital if they have questions about their care plans. It can also remind them of appointments, alert them to the availability of test results or provide discharge notifications and instructions.
The traditional means of informing patients about their conditions, either by talking to them during a medical encounter or handing them a brochure, largely have proven ineffective. This type of passive communication can be easily forgotten, lost or ignored. With the advent of mobile phones, however, has come a convenient and highly interactive way to push information to patients. Physicians can take advantage of this opportunity by sending out customized content, such as educational materials, tips, links and other information that the patient can use to make better healthcare decisions. Using communications platforms with a programmable rules engine enables physicians to engage patients around health, display health-related information at the right time and in the right context and reach patients with contextually relevant, motivating messages.
Physicians and healthcare facilities can use surveys to help them refine information-sharing techniques and uncover any additional needs within patient populations through assessments and other touch points. Post-visit questionnaires, for example, can make sure patients understand discharge instructions to greatly improve compliance, as well as return accurate, actionable data needed to improve satisfaction.
According to the Pew Research Center, more than 90 percent of American adults have a cellphone and are therefore equipped with a powerful tool for engagement and health tracking. Medicaid patient populations, which have been hard to reach using traditional communications techniques, are more accessible via cellphone. Across the board, mobile health devices make it easier for patients and providers to communicate, which is the first step in strengthening the provider relationship and keeping patients on track and accountable for their health. Mobile technology also gives patients a sense of control through shared decision-making and goal setting, and helps them to understand the importance of adhering to treatment plans. Perhaps most importantly, engaged patients express greater satisfaction with the care they’ve received.
These technologies not only better connect with patients but also improve provider engagement. They enable physicians to close gaps in care with secure, HIPAA-compliant communications. According to Marc Mitchell, a lecturer on global health at the Harvard School of Public Health, mHealth monitoring reduces the number of adverse events, shortens the length of inpatient stays and reduces hospital readmissions. Greater compliance can also help providers meet meaningful use measures and lead to better reimbursements. Furthermore, mobile technologies can help bring about additional financial savings by reducing waste. Automating routine, time-consuming tasks such as appointment reminders streamlines administrative workflows and conserves human resources.
The healthcare industry is undergoing rapid, wholesale changes in the way it transacts business, administers care, reimburses physicians and approaches the patient. Mobile technologies play a vital role in helping providers meet the triple aim of improving care and enhancing the patient experience while lowering costs. By facilitating the delivery of medical care, these devices allow organizations to engage individual patients and efficiently manage the health of entire patient populations – thereby improving outcomes. In sum, they enable provider organizations to make the transition from fee-for-service to accountable care while enhancing financial and organizational sustainability.
Patrick Clarkin is vice president of engineering at HIT Application Solutions.