Patient Heal Thyself

By Scott Zimmerman

As the healthcare reform bill leaves Washington and makes its way into the American health system, the rhetoric is over and the task of implementation begins. To say that the bill is far-reaching is like saying the 1985 Bears played a decent game of football.

From the greater regulation of private healthcare insurance, to the coordination of chronic disease management and care compliance, and removal of barriers to preventative services in Medicare – the next five years or so will see the healthcare industry struggle with now ‘mandated’ expectations to do more with less.  As a result, there is the potential addition of 16 million people to the Medicaid roll, making the need for preventive medicine and flawlessly managed care a critical tool in the management of cost. Patient communication will not be sufficient; it will be patient engagement that is key. Increasing patients’ proactive engagement in their own healthcare will play an essential role in cost management. The healthcare industry needs to take greater measures to create scenarios that help a patient “heal thyself.”

Politics Aside: Regardless of the politics, one thing is certain; managed and preventive care will play an ever more critical role in the long-term health of healthcare – and Americans. The role of technology will be thrust to the foreground in this regard. Its role in managed care “compliance” in terms of provider/patient service and HEDIS scores is nothing new, and outbound notifications and communications to patients reminding of health visits and check-ups are pretty much standard across all healthcare providers now. But it is technology’s potential to truly enable and positively affect preventive care and advance the outcomes of managed care, rather than simply being deployed as an administrative tick box, that the healthcare industry should be paying attention to.

New Ways to Communicate: A new category of patient engagement communications technologies – one that combines the advances in communications with a human touch – will benefit Medicaid, Medicare, and commercial healthcare both in service delivery and cost of service. These technologies are poised to play an important role in the shifts of ownership and accountability for preventive and managed care compliance, such as increasing patient accountability in proactive healthcare management. Why? Because at the bottom of all this is people. Funny, fickle, flawed people. People who forget to take medication, who don’t show up for appointments, who prefer to ignore a call for a mammogram rather than deal with the procedure. People who avoid pain in everything they do – even if it has catastrophic long-term implications.

The need here is to change behavior and to influence knowledge. It requires campaigns. Multimedia, multi-touchpoint, multi-month campaigns. Connecting, engaging, and educating – and then connecting some more. Repeating a message again and again. Yes, it does take people ten, twenty, and more messages and discussions before they finally accept and understand that a plan to address obesity is a priority, that engaging in a smoking cessation program is a necessity, or that taking medication on time in the right dosage will improve their overall quality of life.

Engagement communications that automate and create a two-way dialogue between patient and provider through online, mobile, digital, and good old snail mail methods offer transformational benefits in managed and preventive care, in service delivery improvements, and in better outcomes and cost management.

For Example: Imagine a scenario where an alert notifies both the primary care physician and a caregiver when an early stage Alzheimer’s sufferer doesn’t text or call in from a remote location to confirm they have taken their medication. Imagine a scenario where a pharma company that requires patients to complete a series of three vaccines to prevent future disease and is presently only at 80% compliance rate can send out multiple reminders through email, text message, and voicemail to increase compliance to near 100%. Imagine a scenario where preventive screening for osteoporosis, which is about .05% of the cost of managing the disease over five years, results in a 10% improvement in the compliance rate.

Imagine being able to find out at a moment’s notice the level of proactive and preventive steps patients are making in their own healthcare – and having the ability to share tailored one-to-one marketing messages and campaigns in an instant to increase their involvement, campaigns which enable patients to respond and engage in the dialogue. And imagine all these scenarios where outbound and inbound communications are not only personalized to the individual patient but can be massively scaled to millions of outbound connections and engagements a day.

Investment Considerations: An unpleasant truth is that “for profit” enterprises have to look very closely at the actuaries in investing in proactive medicine and preventive care. The more likely a condition is to materialize until after a patient is handed off to Medicare, the lower the interest in making the investment.

However, with greater government regulation in private health plans and the provision of services, the issue of investment becomes one of “how and where” rather than “if.”  The increase in investment will, of course, contribute to the rising cost of healthcare plans – both company and individual. While health providers will undoubtedly step up education and outreach efforts to ensure patients take proactive steps in the healthcare, employers too, who will be bearing much of the impact of increased costs, will expect and put measurements in place for employees to show proactive ownership and accountability in taking preventive steps to ensure their quality of health.

Advances in technology and communications, including voicemail, Facebook, SMS, and email, mean that people are reachable most anywhere.  Connecting and engaging them with timely, relevant, and impactful touch points, and leveraging these advanced communication tools will provide the healthcare industry with a compelling, high impact, and cost-effective channel to engage and empower people to take a greater and more proactive role in their own healthcare. Everyone wins.

Scott Zimmerman is president of TeleVox Software, Inc.

[From the December 2010/January 2011 issue of AnswerStat magazine]