Payer Support Needed to Push Patient Engagement through Health IT

Patient expectations, attitudes, and perceptions are changing as fast as access to information and social media are changing the fabric of society.

Conversely, while the U.S. healthcare system leads in technology, our delivery system is hamstrung by reimbursement, regulatory, and institutional policies that have not only failed to keep pace, the dysfunction between the three has become a key problem.

A press release citing an August 2012 survey conducted by Wakefield Research for Varolii, which provides consumer communication applications platforms, stated that “80 percent of Americans believe it’s their doctor’s job to keep them healthy, not just treat them when they’re sick.” The study included more than 1,000 American adults over the age of 18.

But while the argument can be made that physicians should do more to keep patients healthy, often times the responsibility falls on the patient, whether it’s to eat fewer carbs or to purchase apps that remind them to take their medications, eat a salad, or make some other healthy change.

The problem is that our system not only fails to invest in educating and treating people before it is too late, it disenfranchises those who cannot afford to purchase those services commercially.

Making changes is hard for people to do and to sustain. I know firsthand, and I am equipped with everything I need to get the job done … except, like most people, willpower.

How many of us have heard this from our own doctors? “You need to lose some weight,” or “You need to exercise more,” or “You need to go on a low cholesterol /salt /gluten /carbohydrate /et al diet.” You may or may not get a few pieces of paper with some recommendations, and, more often than not, that is the end of it.

Varolii makes the obvious case that patient care must include preventative care and wellness programs to get and keep people healthy. I’ll vote early and often for that.

They also sell automated, multi-channel communications tools to remind people to take their medications, exercise, eat a salad, and a multitude of other messages in their vehicle of choice - text, e-mail, smartphone apps, even automated phone calls. These are the same programs that they and similar companies provide to the banking, airline, and other industries to communicate with their customers, improve efficiency and to provide better, more seamless customer service.

It's a great program for almost every segment of the healthcare industry, except for one thing: If the folks who have to pay the bills when people get sick won’t invest in these types of programs to keep them from getting sick, why should it be up to the folks that only get paid when people get sick?

This is not only a question for private insurers, but also one for CMS.

I did not know of Varolii, who they are or what they do until they contacted me with the results of their survey and an invitation to ask questions, so I have no dog in this hunt.

The following excerpt from their press release makes perfect sense to the business world, and those of us in the business of healthcare should be doing more than wondering why the same logic does not apply in our world: “…50 percent of respondents believe that texts, e-mails or smartphone apps with tips, reminders and encouragement could have helped them avoid a health problem in the past. Despite this eagerness for more interaction, healthcare providers aren’t delivering. One in four Americans does not feel that their healthcare provider is accessible to them when they have questions or concerns. And, 68 percent of consumers say their doctor has never sent them a text message or e-mail for things like upcoming appointment reminders, discharge information, electronic health resources, etc.

“As an example, our survey found that 25 percent of people forget to take their medications on a regular basis. This is a huge problem for the healthcare industry, costing an estimated $300 billion annually. Healthcare providers have an opportunity to positively impact health and reduce costs with something as simple as a text message,” said Vance Clipson, healthcare market manager for Varolii.

For those who have invested in these types of technologies out of concern for their patients and communities, or as a marketing technique or a public relations strategy or just because, good for you. For those who are wondering where the money is going to come from - it’s a good question begging an answer from insurers.