Patient Engagement Innovation to Drive Improved Population Health
Patient Engagement Innovation to Drive Improved Population Health
A panel hosted by DataArt
A recent Patient Engagement Innovation panel discussion hosted by DataArt on June 9th, 2016 at the Harvard Club of New York City brought together top technology executives from major hospitals and healthtech companies in an enticing dialogue on patient engagement innovation. The event was attended by 80 healthcare industry professionals.
Daniel Piekarz, VP & Partner, Healthcare & Life Sciences, DataArt moderated the discussion and was joined by Chaim Indig, CEO, Phreesia, Dr. Barry Goetz, Director of Clinical Informatics, Population Health and Ambulatory Care, Northwell Health, Dr. Ashish Atreja, Chief Technology Innovation and Engagement Officer, Department of Medicine, Mount Sinai Health System, Mony Weschler, Chief Technology & Innovation Strategist, Montefiore Medical Center and John Donohue, Associate CIO, University of PA Health System.
Piekarz started the conversation by asking the panelists about the meaning of patient engagement. Indig proposed that patient engagement is ‘getting the patient to either do more or learn more or become more active in the entire ecosystem, which is their health.’ Dr. Atreja, in turn, explained that patient engagement entails identifying the points of patients’ contact with the health system and providing relevant and quality experiences at those points.
Discussing the extent to which patients are engaged today and how used are patient engagement tools, Dr. Goetz felt that ‘while there is a small number of very engaged patients, overall engagement with health is quite low.’ Weschler mentioned that there is a gap between available technology and provider’s ability to use it productively. ‘While there are many gadgets that measure one’s heart rate and sleep patterns, that data is not coming to the healthcare provider because the skills and resources needed to get insights from that data are lagging behind’. Closing that gap will allow us to ‘change ourselves from what we are today, which is an acute care reactive system, to a partner that helps to avoid disease, not just treat disease.’
Another area where technology is becoming available but skills are lagging is Telehealth ‘We are not teaching medical students how to do a virtual examination. The technology is becoming available to do that’ said Weschler. ‘A $150 device that can be put in the patient’s home guides one through a self examination, captures the heart sounds, the lung sounds, the temperature, even images of the ear canal, so the clinicians on the other end have real data. When those components become available and clinicians will start learning how to practice in that discipline, then telemedicine will revolutionize everything and will be something that averts the right ED visits.’ Dr. Atreja mentioned a Kaiser report finding that even using current technology, 60% of face to face visits can be changed to virtual visits, if the incentives are lined up.
Donohue noted a change of direction in patient engagement where early generation patient engagement technologies, like patient portals, were ‘pushed’ out, and now patients’ expectations are ‘pulling’ and driving the new functionality. Weschler also noted that patients are becoming more engaged, as higher co pays mean they are more vested in healthcare, more educated and expect more than just excellent care: ‘They want an experience, they want to get an appointment by going to an app, they want to be able to talk to their clinician in an e - visit by pushing a button and they want all that data to flow seamlessly, and when they go between systems they expect you to know about that, not just come again and start from scratch.’
Many interesting insights were shared about the barriers to a widespread adoption of patient engagement innovation and possible future scenarios.
Dr. Atreja said that ultimately we will have a few mainstream technologies but at the moment there is a big evidence gap. Many health systems are doing closed pilot studies to understand which patient engagement technologies are effective, yet the process could go much faster if they could share and learn from each other. This sparked a lively and humorous dialogue between the panelists with Piekarz’s brief but successful campaign for the panelists to agree to share information and insights which was well summarized by Dr. Goetz – ‘there is almost a necessity of sharing because we are all doing the same thing and it’s also a wide enough space so there is a lot of opportunity. There are core systems, that we want to be better than anybody else, but there are also many opportunities for clinical engagement where I take care of patients that actually go to practices that are part of Mt. Sinai and vice versa and my obligation to my patients is to share.’
Donohue said that innovation requires a shift in culture and a different skill set and approach to that of building legacy systems: ‘The struggle that we have as a core IT group is typically you stand up large legacy systems that should be resilient and they have to be supported 24/7. Innovation is completely different, you’ve got to be able to stand up ten and expect eight to fail.’
Piekarz inquired whether we can expect to get significant impact through patient engagement technology and to what extent there is a need for human input. Dr. Atreja highlighted the importance of segmentation and advised mapping the population on the scale of digital adoption to reserve in-person, concierge kind of services for technology averse people. ‘We have to think what population is coming but we don’t want to leave anyone behind. While we can create technology which has emotions built into it there always needs to be a back up of human element.’
Weschler agreed that there needs to be a hybrid model where the machine does the initial inquiry and hands the case over to the clinical individual ‘we are far far away from automation and the system just doing it from end to end, hopefully we won’t get there. We want physicians in the mix at the right point.’
The panel left no doubts that we are living in the age of empowered and ready-to-be-engaged patients and numerous health benefits are to follow. As the panelists discussed the concept of patient engagement, the scope of its current implementation, the barriers to adoption, success factors and scenarios for its future development, it became apparent that this is only the beginning of the conversation… to be continued by DataArt’s future events.