The acting administrator of the Centers for Medicare & Medicaid Services (CMS), Andy Slavitt, has called for more conversations in Congress and among providers on how to increase patient engagement in accountable care organizations (ACOs). His premise is simply stated: the more patients who are engaged in their healthcare, the more successful ACOs will be.
Conversing through automated tools
To deepen engagement, ACOs are increasingly turning to automated technology that gives patients access to care, regardless of location or health status – enabling providers to care for more patients, more efficiently and more economically. “These automated tools require engaging the patient remotely through whatever means are appropriate for that person – from fully managed kits to bring your own device (BYOD) consumer electronics,” says Eric Rock, founder and CEO of Vivify Health, a fast-growing international digital health company. “With built-in intelligence, the technology can send patients self-management recommendations or other educational content based on their responses to interactive survey questions. This creates a seamless, continuous conversation between patient and provider that engages the patient, informs the provider, and leads to better health management overall.”
Catalyzing the provider-patient relationship
“The increased use of these technologies doesn’t mean hospitals and physician offices are going away,” adds Dunnie Norman, Vivify’s senior vice president of sales. “Providers still deliver the initial episode of care that patients trust. Digital health tools serve as relationship extenders, bringing the interaction from the provider setting into the home – or wherever the patient happens to be.” Norman points out that the successful health systems of the future will adopt a new “front door” to their integrated systems through continual engagement, rather than waiting for unplanned events that land patients in the emergency room.
Customizing content for continual care
It’s a process of ongoing education, customized pathways, and continual care, Norman notes. First, the patient is introduced to the services available through remote care. Then, when the patient begins to use these tools, providers can automatically tailor pathways to patient needs. “With customized content and daily interaction, the patient develops a steady relationship with the care provider. The net effect is continuous engagement and greater care efficiency at a much lower cost. Eventually, we move from providing episodic care to delivering truly continual care, with the hands-on care experience reserved for when it’s truly needed.”
Carrying consumerism into healthcare
As patients assume more financial responsibility for sharing in the cost of the healthcare services they use, they’re looking to have more control over their experience with providers and insurers, Rock says. “They’re seeking the same high level of service other industries are offering, demanding rapid responsiveness to whatever they need, and expecting an easy-to-understand electronic interaction with their service provider.” Remote continual care technology, he notes, is accelerating their move from being passive patients to becoming proactive, empowered consumers.
Curtailing costs and driving revenue
Not only does this technology save time, it saves money, Norman says. “It’s a simple calculation. If we’re reducing visits to costly episodic settings such as hospitals and clinics and delivering care in brief moments before a problem escalates, we’re saving dollars for whoever is responsible for the cost of that care, from ACOs to health plans and employers.” Before the advent of these tools, he explains, a provider needed to invest dozens of hours reaching out to the patient from a call center. Now, providers can check in with the patient without a phone call or a site visit, increasing efficiency, achieving more rapid interventions, and improving patient outcomes. These tools also enable providers in risk-based arrangements to drive revenue by keeping patients healthy, Norman explains.
Collecting the evidence that it works
CMS Acting Administrator Slavitt has noted the need for discussions not only on how to better engage patients in ACOs, but also on how to demonstrate this engagement is working. According to Rock, the engagement metrics for these tools are compelling. Overall, for the thousands of patients Vivify serves, compliance is 90 percent with patients who use the managed kit and 80 percent with those who use BYOD technology. Readmission statistics also reflect the power of patient engagement – with near single-digit readmission rates for some hospitals using remote care technology. “Reducing or eliminating preventable hospitalizations is a core goal of every ACO, and it is achievable through remote care and engagement programs,” Rock says.
Caring for the healthy
The ultimate goal, Rock explains, is a solution that can scale massively to an entire population and keep patients connected to their caregiver teams. “If you’re a patient visiting a specific provider organization, whether a physician’s office or a hospital, we want you to walk out with a solution on your phone or tablet that brings you continual care. We want every health care consumer – not only high-risk patients with multiple chronic illnesses but also those who are healthy – to have an ongoing relationship with their provider. Then, when they experience a change in their health status, the connected experience is already in place that will help them achieve the best possible outcomes through continuous provider oversight.”