Monday, March 10, 2014

Measuring patient engagement is a 'science,' not a 'dark art'

A new collaboration announced at HIMSS14 aims to rank all of the nation's hospitals on their patient engagement abilities, much like hospitals are now ranked for their health IT acumen or their beauty.

"The best hospitals realize the patient gets well outside the hospital," said Joanne Rohde, CEO of Axial Exchange. "They've been doing this long before Meaningful Use 1, 2 or 3 … and now it's time for the rest to catch up."
Axial Exchange, a Raleigh, N.C.-based developer of mobile engagement tools for hospitals and their patients, has been creating so-called Patient Engagement Indexes (PEIs) for specific states. At HIMSS14 last month in Orlando, the company announced a partnership with Becker's Hospital Review to expand that system to a national stage, with the rankings set to be released in May.

"Patient engagement is increasingly at the center of healthcare reform, and achieving excellence in clinical outcomes has been proven dependent upon enhanced patient involvement," said Lindsey Dunn, editor-in-chief of Becker's Hospital Review, in a press release. 

Speaking to mHealth News at HIMSS 14, Rohde said many hospitals rely on a patient portal that's nothing more than a "view into a back-office system designed by a vendor for regulatory obligations." Likewise, she said, hospitals often create websites that offer information they want to share with the public, rather than offering a link to information that patients want to see. If that's a mobile version – a huge advantage in this day of mobile consumers and health pricing transparency – the site is often clunky and underwhelming.

Rohde said hospitals need to realize that two-way communications with the patient outside the hospital – no matter where they are or what device they're using – is crucial to ensuring that patients are satisfied with the care they're getting. That translates into better Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, which are used by the Centers for Medicare and Medicaid Services to determine reimbursement for Medicaid patients.

Established in 2013, the Axial Exchange PEI evaluates hospitals using publicly available data in three categories and gives each a score of 1 to 100. For example, while a hospital is expected to offer electronic access to patient health records, it would score extra points for offering resources for disease management support, including mobile tools.

The categories are defined as:

• Personal health resources (representing 50 percent of the score), based on an aggregate score for hospitals that provide any of the following: read-only Internet access to health information, mobile applications or interactive tools for managing ongoing health.

• Social engagement (25 percent of the score), based on a weighted score of hospital ratings on leading social media and consumer ratings sites.

• Patient satisfaction (25 percent of the score), measured by the HCAHPS survey, a standardized instrument for measuring patients' perspectives on hospital care that has been endorsed by the National Quality Forum.

Matt Mattox, Axial's vice president of products and marketing, said in a July 2013 interview with mHealth News that healthcare executives were mindful of the value of patient engagement, but were too busy implementing EMRs to devote the time, money and staff. Now they're feeling pressure and seeing the value.

"Patient engagement is strategic ground that the best health systems will claim in order to thrive in a profit-from-quality world. Mobile devices are quickly making an impact on how patients manage their health," he noted in a May 6, 2013 blog titled "How to Generate a 15X Return on Patient Engagement." "For a health system, not having a mobile engagement offering in 2013 may be similar to not having a corporate website in 2003. Whether healthcare systems and practices are motivated by higher margin patients, professional reputation, payment incentives – or all three – they have everything to gain from enabling superior patient engagement and everything to lose if they do not."
Rohde said healthcare executives have to understand that patient engagement can be measured.
"It's a science, not a dark art," she said. 'There's a real correlation between patient satisfaction and social media, and mHealth plays a big role in this."

Rohde is critical of hospitals and health systems who "make patient engagement the responsibility of the IT department," because that creates a separation between the patient and the clinician. She's also critical of Meaningful Use standards that compel hospitals to "just check things off a list."

She sees a national PEI as a means of shining the spotlight on innovative and successful patient engagement programs, while establishing benchmarks for hospitals and health systems looking to improve.
"At the end of the day, it's all about the patient," she said. And that may be the missing factor in many a health system's path to success.

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