patient engagement: key factors for success
TRANSCRIPT
January, 2015
As pressure mounts to include patients in improving their health outcomes, patient engagement strategies have
become a priority for many healthcare companies. However, there has been no clear vision of what patient
engagement looks like in today’s world of value-based care.
Overwhelmed by the requirement to implement an EHR systems, patient engagement has been a lower priority for
IT. Some organizations have anointed a patient advocate. Others launched pilot programs that, without focus and
commitment, delivered marginal improvements. Only a few have made patient engagement a strategic initiative
core to the company’s long-term success.
In the midst of this chaos there is tremendous opportunity for organizations to transform patient relationships.
People will only use one system to manage their health. If it is your system, you own a deep, direct patient
relationship – for life. Customer relationship software has improved relationships and reduced costs in most
industries. Similar technology will work for patient engagement in healthcare as well.
Organizations that get it right will improve outcomes, reduce costs, and gain a strategic advantage.
This report charts a path through the chaos. Discover key factors for success including:
• What is patient engagement, and why does success come from taking the patient’s perspective?
• How to identify, capture and report on outcome data that is the foundation of value-based care.
• Build, buy or partner? Questions to consider for building a single, integrated solution.
• An implementation plan of how to bridge the gap between chaos and the rewards of better patient outcomes.
• How to build sticky patient relationships that quickly improve behavior.
• Finally, how to get started; now.
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―Patient Engagement
Market Expected to Reach
$13.7B by 2019‖
-- ReportsnReports
―Patients with the lowest
engagement generate 21%
more health costs.‖
– Commonwealth Funds
―Many expect real-world evidence
to become increasingly
significant over time — for
instance, to incorporate real-time
data and information about the
patient experience.‖
-- E&Y, Progressions, 2014
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Quantified Self & e-Patient Movement
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100%
80%
60%
40%
20%
0%
2014 2016 2018
% o
f P
aym
en
ts tied
to
qu
alit
y o
r v
alu
e 85%
90%
30%
50%
20%
Medicare fee-for-service
payments.
Medicare payments
through alternative
payment models (ACOs
and bundled-payment
arrangements.)
HHS historic announcement sets goals and timeline for value-based reimbursements. (1/26/2015)
$362 B
HHS will intensify its work with states and private payers to support
adoption of alternative payments models through their own aligned
work, sometimes even exceeding the goals set for Medicare.“
“
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$290B Opportunity
Closing the
Patient Engagement Gap
• Improved outcomes.• Real-time insights into patient
behavior.• Optimal medication
compliance. • Early intervention.• Increased patient loyalty.• Clinical trial recruiting.• Inexpensive direct patient
communications.• Improved care coordination.• Readmission reductions.• Easier disease management.• Reduced care costs.• Motivate patients towards
healthier behavior.
Today’s Confusion
• Is it really necessary?• Build, buy, partner?• Where, when, how to start?• How to measure ROI?• How to comply with
regulations.• What features matter most?• Core strategy or marketing
program?• Which patient populations
can benefit the most?• What will it cost? Now, and
in the future?• Why will it work when
other programs have failed? • What outcome data matters,
and how to collect it.
Bridge the gap with a patient relationship management platform.
Tomorrow’s Rewards
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In the midst of chaos, there is
also opportunity.
― Sun Tzu, A Arte da Guerra
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4. AgilityThe rate of both technological and health care system change is unprecedented. Staying agile, open to new partner, technology, patient expectations and regulations is integral to success.
> Invest in a patient engagement platform that can grow in many directions.
5. ConnectedConnect stakeholders through data to improve outcomes, reduce care costs, and reward patients.
6. Corporate CommitmentPatient engagement requires strategic commitment from the highest level. Set a vision, pick partners carefully, start small.
> Questions to consider> Implementation plan> Partner resources> Internal resource commitment
1. User-centeredDesign to solve problems your patients have, and you will build exclusive patient relationships for life.
> Engagement begins with patient needs.> Best practices for sticky relationships.
2. Outcome MeasurementsThe ultimate benefit of patient engagement is the ability to capture outcome data. Discover the five steps to outcome data for success, including sample reports.
> Quantitative Reports> Qualitative Reports> Partner Management Reports> Reports for Patients> Solution Engagement Measurements
3. Compliant and SecureHealthcare regulations increase the challenge of patient engagement IT. We show you how to succeed in spite of compliance barriers.
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Patient Desires
Single
Solution PortableConnected
Secure
Personalized
Accessible
AnywhereSimple
Flexible
My
Control
Your patient engagement strategy must fit the needs of the patient. In the end, the solution is about them, not you. No matter how beautiful, technical, or medically sophisticated your application is, if patients don’t use it, your investment is wasted. To increase stickiness take into consideration:
• Value to the user. Does it solve a problem they have? To be adopted, your solution must enhance the life of the user.
• Ease of use. Follow the KISS (keep-it-simple-stupid) principle. From sign-up, to access, data export, integration and cancellation, create a seamless process.
• Flexibility. One size does not fit all.
• Start Now. Patients will only use one patient engagement platform. Make it yours and you own the relationship for life.
• Continual Enhancements. The current rate of technology change, especially in healthcare, is unprecedented. As soon as your platform is launched it will be outdated. Plan in advance for new features, new devices, new competitors.
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Rewards
Health
Record
Education
Community
MessagingMed
Management
Health
Reports
Promotions
Patient
Best Practices
Desktop
Tablet
There is a strong correlation between feature adoption and customer loyalty. To build sticky relationships:
• Provide engagement options. When it comes to changing patient behaviors there is no silver bullet.
• Allow users to begin engagement with features that matter the most to them. Add additional features over time.
• Bridge the knowledge gap and cultivate deeper engagement through continual, multi-channel education/ marketing.
• Promote functionality that delivers the greatest ROI for you. For example, medication compliance.
• Support leading platforms and technologies.
• Follow the KISS principal. Integrate all features/functionality into a single platform with single sign-on for a seamless experience.
• Listen and add functionality based on user feedback.
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Aggregate in Database
Identify/Anticipate
Stakeholder
Requirements
Simplify Data
Capture for
Patient
Build a Patient
Engagement Platform
To Support:
<view samples>
• Create an advisory board.
• Who needs outcome data?
• What metrics matter most to each stakeholder?
• How should it look?• Where to focus
resources?
• Data specific to a condition(s).
• Begins at patient onboarding.
• Ongoing marketing.• Adoption incentives.• Opt-in, always.
• Digital connection.• 2-way mobile
messaging.• Multiple platforms.• Smart device
integration.• Integration with
blood results.
<view samples>
Patient Reports
<view samples>
Management ReportsQualitative
Outcome Reports
<view samples>
Quantitative
Outcome Reports
Connect
Outcomes to
Value
• Patient incentives/penalties.
• Healthcare partner selection/compensation.
• Documentation for reimbursement.
• Early clinical intervention.
Step 1 Step 2 Step 3 Step 4
Dynamic Reports
Step 5
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General Wellness Trend(Region 2 “East Coast”, rolling 12 months)
Self Reported Wellness
Scale of 1-5 Stars, “How well do you feel”
Recorded daily
Number of Days Missed Worked/School(all patients, rolling 12 months)
Self Reported Absence
# No of days missed, “How many days of school or work
did you miss last month due to illness?”
Surveyed monthly
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Self Reported Hospital Visits
Weekly survey, “Did you visit the hospital this week/How long did you stay”
CD4 Cell Count(all patients, rolling 12 month)
Self Reported CD4 Cell Counts
Monthly survey, “What is your most recent CD4 count”
Number of Hospital Visits per 1,000 Patients(Q1-Q3 2014)
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Average CD4 Cell Counts(by provider, 1.1.2013 – 12.31.2013)
Number of Hospitalizations per 100 Patients(by provider, January 2014)
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Most Frequent Medications(all patients, Q1 2014)
Average Medication Compliance Rates(all patients, rolling 12 month)
Self Reported Medication Compliance
“Yes, skipped, no response”
Recorded at time of text/email reminder
―Low T‖ Medications(all male patients, Q1 2014)
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Data provided by www.rememberitnow.com
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On Demand Engagement Reports
Number of New Users/Month Number of Metrics Tracked/Month
Medications ManagedNumber of Medication
Reminders/Month
Data provided by www.rememberitnow.com
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Include all
Stakeholders from
Day 1
• If not already in place, establish consensus on what compliance means for your organization.
• Utilize a formal approval process.
• Establish quarterly review.
• Plan for internal and external training.
• Anticipate change, and proactive response.
Select a Flexible,
Knowledgeable
Partner
• Choose a partner that understands your regulatory environment (ieHIPAA, FDA, OIG)
• Technology must be able to adjust to established standards, unique corporate requirements.
• Find a partner that can creatively balance compliance with usability.
• Document all processes.
Build in Plenty
of Extra Time
• Regulations add time and expense to a project. Plan accordingly.
• Batch project for routine regulatory review. The typical agile development does not work.
• Plan for 3x the resources of other industries
• Start small, learn, grow.
How to Work Within
Your Regulatory
Environment
• First do a concept review with the Regulatory Team.
• Set up weekly meetings with your Compliance lead. Talk through project ideas, steps – this will breed familiarity and provides a less formal space to prepare for more formal meetings.
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Initiative How Implementers Worked with Internal Compliance Teams
Sanofi Community
Health Partnership
Description: Enterprise wide, 90% unbranded, multi-channeled, field-driven, community-based patient centered initiative. Therapeutic areas – hypertension, diabetes, deep vein thrombosis, insomnia, and peripheral vascular disease
Issues and SolutionsApplication of health literacy principals . Existing OPDP approved marketing materials, product branding elements and language are usually not patient-friendly. The branded materials were redone with health literacy in mind. The brand and compliance teams were taught the principles and rationale and, eventually, understood the value. Of changing fonts, use of white space, etc.
How close can the field team get to patients? The two issues here are how to handle adverse events reporting and how to adhere to HIPAA regulations. AEs are discussed in the example below. The field based team was eventually allowed to speak directly to patients once a training program was designed to help manage questions from patient groups ,ie – do not discuss any treatments at all, company-owned drugs.
Leading pharma
manufacturer
Description: Global, enterprise-wide patient support program includes co-pay card, nurse/customer service center, branded & unbranded patient engagement digital platform. Therapeutic areas – plaque psoriasis, actinic keratosis
Issues and SolutionsDigital platform approval. Best to break down into small chunks to appear on approval team agenda weekly. This helped the review team to digest the information and get comfortable with the digital space.
How to manage adverse events reporting . Ensure your partner is trained in your company’s AE reporting process.. Historically, according to a recent Neilson report, the actual incidence AEs mentioned in social media is rare.
Patient engagement is not just for rare diseases or those treated with specialty drugs. Below are two programs developed to support common and chronic diseases.
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Healthcare
Providers
Value Mining
Pharmacy
PHR
Education
Bio-Metrics
Adherence
Community
Patient
Information
Rewards
Devices/
Apps
Desktop
Add new integration
partners
Enhance functionality
Support new platforms
Store data for outcome
analysis – anticipating
future needs
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Patient
Drug
Manufacturer
Payer
Government
Pharmacy
Provider
Accountable care success.
• Simplified disease management.• Accessible and affordable care.• Get well and stay well.
• Coverage by payers.• Patient compliance.• Clinical trial recruiting.• Direct relationship with clients.• Efficacy.
• Medication compliance.• Reduced clinical costs.• Competitive advantage.• Recommended provider of
Specialty drugs.
• Treatment compliance.• Improved outcomes.• Larger reimbursements
• Reduced care costs.• Behavior modifications.• Score cards.
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Function New Skills and Processes – Pharma Manufacturer Example
R&D• Identify potential participants from database of patients actively managing disease.
• Continuous, proactive clinical trial recruiting via multiple online channels.
• Platform serves to help compliance with clinical trial disclosure requirements.Business
Development• Capture patient and market data that reveals potential "hidden gem" opportunities.• Attract, screen, and engage undiagnosed patients for new treatments.• Attract proactive, healthier plan members.
Medical
Affairs
• Identify and manage multiple medical advisory boards.• Aggregation of validated usage and publishable outcomes data down to the individual.• Provision of early warning system for prompt investigation.• Collection of adverse events (AEs) from patient and broader support group .
Patient
Engagement
• Open patient dialogue through peer-to-peer community, bio-metrics monitoring, AE reporting, surveys and patient reported outcomes (PROs).
• Identify and capture meaningful patient outcomes data.• Break down barriers to treatment with early compliance alerts.• Open multi-channeled communication – however the patient wants to communicate (email,
newsletters, 2-way text messaging, etc) .• Via social community, foster and monitor open, peer-to-peer dialogue.• Dynamic analysis and reporting.• Identify diagnosed as well as undiagnosed patients.• Manage regulatory approval.
Marketing/
Sales
• Create direct relationships with branded and unbranded patients.• Customer segmentation/analysis.• User adoption campaigns.• Increase medication compliance/consumption through chronic disease management tools.• Capture real-time data on compliance rates, market share and patient concerns.
IT• Hosting or oversight.• Integration facilitation.• Vendor management – one vendor solution is ideal.
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Business Model Technology Support Services
• What determines the
solution price?
• Is the proposed technology
scalable?
• Branding options?
• What percent of the project
requires customization?
• Exclusive patient access?
• Exclusive ownership of
disease state?
• Critical partners?
• Senior management team
background?
• Data access & ownership?
• What happens to patients if
partnership dissolves?
• Patient-centric philosophy?
• Hosting location and
security?
• Service license agreement?
• HIPAA compliant?
• Certification process?
• What is included in
maintenance?
• Platforms and browsers
supported?
• Product roadmap?
• Critical partners?
• Integration options?
• Development
process/timeline?
• Enhancement process?
• Ease of customization?
• Project manager roles and
responsibilities?
• How does support operate?
• HIPAA training?
• How to drive patient
adoption?
• Marketing campaign
support?
• Train the trainer?
• Ad hoc reporting?
• Report definition and
design?
• Strategic vision?
Factors for consideration when building patient engagement solutions.
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External
Design
Adoption Marketing
Quality
Assurance
Distribution Campaigns
Partner Integration
Internal External
Platform
CustomizationEnhancements
Data Mining and Reports
MONTH 1 2 3 4 6 9
Launch
Rewards Tied to
Outcomes
Clinical
Intervention
Internal
AssessmentAdvisory
Team
Compliance Review
5 7 8
Launch varies by 3-16 months based on requirements, corporate commitment, etc.
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c
Account Manager
Engineering
Desktop Engineer
Mobile Engineer
Database
Engineer
InfrastructureEngineer
DigitalMarketing
Product Development
Testing
UI Designer
Support
Report Development
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Size of team and skill set depends on project requirements.
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+ConsultingPre-built
PlatformCustomization Real-Time
AnalyticsMarketing
Innovative state-of-the-art desktop and mobile patient engagement
technology and services matched to your objectives.
+ +
All-in-One Patient Engagement
+
Learn More
Contact expert patient engagement
advisors today.
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