Strategic Growth and Physician Engagement Platforms: The Core of Population Health

Transcription

1 Strategic Growth and Physician Engagement Platforms: The Core of Population Health

2 Relevancy in Both a Volume and Value-Based World SHSMD U Sponsored Webcast: The Next Evolution of Business Intelligence June 8, 2016 It s a well-known fact that a patient-centric, population health-based model is the new paradigm in healthcare. Consumers are more tech-savvy than ever, have control over the patient/provider relationship and are focused on wellness. Providing excellent customer service is paramount in order for organizations to thrive in the impending value-based environment. So how do organizations actually improve population health in their communities? How do they identify and track chronic and non-chronic patients to engage with them across the full care continuum? Consumers are seeking a retail experience in healthcare, but the usual approaches that work for retail don t apply to healthcare. Organizations are utilizing marketing automation platforms that rely on web leads, but in the healthcare industry not everyone needs the products or services being offered. Remarketing or retargeting can t be executed the same way. Discounts can t be offered. Hospitals can t provide incentives like buy-one-get-one knee replacements. And there are regulations around privacy to consider. Retail and healthcare simply operate differently 1. Healthcare entities are faced with a dual challenge: staying relevant in both a volume and value-based world. With reimbursements on the line, hospitals and health systems need to remain profitable now, while promoting wellness and making a cognizant effort to keep patients out of the hospital. A new evolution of business intelligence and a strategic growth technology platform with the right data and automation features is required if hospitals, physicians, and other care providers want to stay relevant in the current environment, engage with consumers and persuade them to take a more proactive role in their health. A smarter, more persuasive and efficient 360 outreach approach is needed to drive higher patient engagement and promote population health.

3 Abstract This whitepaper will discuss the business intelligence and technology that exists to succeed in both a fee-for-service and fee-for-value landscape. We will map the patient journey along the healthcare continuum as a person moves from low, to rising, to high-risk over the course of their lifetime and highlight how a healthcare organization can use technology to inform decisions along the way. Data analytics coupled with the right automated outreach approach should be at the core of any healthcare organization s strategy if they are seeking a 360 view of patients. Customer and physician relationship management (CRM and PRM) are essential components in the effort to accurately target the appropriate audience, tailor the message and automate communications to influence behavior at pivotal moments ultimately motivating individuals to be proactive participants in their care. As more and more reimbursements are based on outcomes, organizations are looking to strategic growth and physician engagement solutions to help improve care compliance and strengthen loyalty across the full care continuum 2. CRM and PRM platforms can improve population health management by creating personalized care for better outcomes, managing risk populations, empowering consumers to take control of and manage their care, incite collaboration across the continuum of care, respond to consumers in real-time, at the best time, across any channel, and connect the dots to streamline processes and create efficiencies 3. But which is more important when striving to manage a population s health and wellness? Engaging consumers or physicians? This whitepaper will also touch on the importance of both. Mapping the Wellness Journey One Step at a Time Business intelligence fueled by data and marketing automation should be the foundation of any customer-centric strategy that leverages technology to create stronger relationships with current or prospective patients and physicians. For purposes of this example, we will tell the story of Hospital A, as it uses CRM and PRM to track and manage Patient B and Doctor C while Patient B moves through the various stages of the care continuum. We will identify the key interactions Hospital A has with Patient B and Doctor C throughout the wellness journey and explain how Hospital A uses business intelligence provided by strategic growth and physician engagement solutions to positively affect behavior along the way 4.

4 C Step 1: Data Hospital A s first step in the journey is gathering the necessary business intelligence on both current and prospective patients via a comprehensive database that includes both internal and external data. The strategic growth and physician engagement vendor that built Hospital A s database cleansed, de-duped and appended their data with demographic data and predictive models. All diagnosis and procedural codes (DRG, ICD 9 & 10, CPT) were appended to each existing encounter. In addition, the demographic data was supplemented with other variables that provide a total understanding of consumer needs, preferences and behaviors including health conditions, lifestyle interests, OTC and prescription drug usage, etc. The combination of all these elements provides Hospital A with a complete, 360 view of its target audience to help manage its population s health. LIFESTYLE INTERESTS HEALTH CONDITIONS OTC / RX USAGE TOUCH POINTS ENCOUNTERS

5 Step 2: Outreach Hospital A s next step is to use the intelligence within the database to make initial contact with a pure prospect. Hospital A s goal is to reach prospects who need care and appeal to their feelings, provide relevant information that answers their questions and motivate them to engage with the organization. Hospital A decides to execute a New Movers acquisition campaign to inform individuals that have recently moved to the area about their services. The team turns to their strategic growth platform. The pre-written queries within the platform contain criteria, codes and predictive models that identify the most valuable and eligible consumers in the market for the campaign. The queries can target the individuals who have moved into Hospital A s service area over the past 30, 60, 90 days or more. These people who are new to the area will be in search of primary care services. Hospital A can use the mailing list generated by the query to then reach those individuals with a variety of automated digital and traditional tactics. Hospital A can keep their services top-of-mind and remind recipients that Hospital A and its clinics are conveniently located nearby. From there, Hospital A can introduce recipients to their new PCP, inform them of the nurse line, promote their ED services or redirect them from the ED to their closest urgent care clinic based on need. WELCOME SOLD

6 Step 3: Acquisition Hospital A uses the campaign engine within their strategic growth platform to automatically send out a campaign to these New Movers. It includes a direct mail piece, s and social media tactics that are all coordinated to touch the recipients with repeated messages at various times. Enter Patient B. Patient B receives Hospital A s campaign welcoming her to the neighborhood and reminding her that a Hospital A clinic is located right down the street from her home. Since Patient B needs a new primary care doctor, she calls the number on the communication and makes an appointment with one of the clinic physicians for a routine annual wellness exam. Hospital A has acquired Patient B. Patient B comes in to the clinic and meets with Doctor C for her physical. Patent B begins her relationship with Hospital A in overall good health, or low-risk. The physical exam reveals one issue: a concerning mole on Patient B s shoulder that Doctor C thinks should be examined at by a dermatologist. Doctor C refers Patient B to a dermatologist within Hospital A s network. Patient B makes the appointment with the dermatologist and has the mole biopsied. The test reveals that the mole is benign, but the dermatologist recommends it be removed. Patient B schedules and completes the procedure to get the mole removed. After this transaction takes place, Hospital A can use the data from this encounter in a variety of ways. First, it knows Patient B may be at risk for skin cancer, so she can be included on future communications about skin cancer awareness and proactive prevention. Also, Hospital A s physician liaisons can see the referral patterns of Doctor C and know he is referring within network. The liaisons can then use this information in future interactions with Doctor C to ensure he stays satisfied, maintains that loyalty and continues to refer within network. C

7 C Step 4: Engagement Now that Hospital A has acquired Patient B, the organization s new goal becomes keeping her well and out of the hospital while still engaging with her on a regular basis. Hospital A wants to promote services that help keep Patient B proactive in terms of her health, and keep Hospital A profitable. Since her initial visit didn t reveal any immediate concerns aside from the mole, Hospital A turns back to its strategic growth platform to find out her age and birthdate. They create an automated, triggered campaign that will reach Patient B on her next birthday. This particular campaign will have a friendly Happy Birthday message, will promote preventative screenings and remind her of any vaccinations she may be due for based on her age and birthdate. Patient B receives that automated direct mail communication and its follow-up reminding her of wellness screenings, and she comes back to Doctor C to get a flu shot and have her cholesterol checked. Patient B receives her flu shot and the necessary bloodwork for the cholesterol tests and departs, understanding she will be contacted with the results. Her lipid panel comes back revealing that her total cholesterol numbers are higher than desired. She receives information from Doctor C explaining that she should try lowering her cholesterol through diet and exercise and should be screened again in another year. She decides it is time to change her lifestyle a bit and begin eating healthier foods to both lower her numbers and lose weight. The information gathered at this visit and her test results all go back into her encounter file, and can then be accessed via the business intelligence database. Now that Patient B has high cholesterol and is slightly overweight, she is considered rising-risk and has a higher propensity to need cardiac services. The business intelligence platform and the data within it from health records can identify Patient B as risking-risk and include her in queries related to heart issues.

8 Step 5: Loyalty Now, Hospital A has continued to engage with Patient B and she has visited the facility on several separate occasions. She now sees Hospital A as her provider of choice and even recommends it to her friends and family members. Hospital A decides to further this loyalty by sending her other types of population health campaigns, such as information on heart healthy cooking seminars or Heart Month events. Since Patient B is motivated to lose weight and eat healthier, she attends the seminars to learn more about what foods to eat and others to avoid. Then, when a year goes by and Patient B hasn t come in to have her cholesterol re-checked, this becomes another pivotal time when Hospital A can reach out to her with an influential touch point. This time, Hospital A decides to execute an automated trigger campaign for lapsed patients so Patient B receives a communication 18 months after her initial cholesterol screening was completed. Six months have gone by since she was due to come in, and Hospital A is reminding her to have her cholesterol checked. She receives the lapsed patient mailer from Hospital A and decides to go back in to have her numbers re-assessed. This time, Doctor C informs Patient B that the clinic is going to be doing a heart screening next month that Patient B is qualified for. Given her age and numbers, he recommends she attend the screening. Patient B decides to do so, and during the screening they find a blockage in a major artery. Now, she may be considered more high-risk. Patient B needs a procedure done to have a stent put in. This time, Doctor C decides to refer Patient B to a doctor who is out of network. Hospital A s physician engagement platform can show its physician liaisons this leakage, so they can investigate why Doctor C is referring out of network and create an Action Plan to prevent this referral pattern from happening in the future, keeping the volume with the organization. Patient B decides to have the procedure done by a doctor within network so her insurance will cover it, and the procedure is a success. The various touch points that Patient B has received from Hospital A have helped the organization stay profitable, while also meeting their fee-for-value goals of preventing her from needing to be in the hospital for a longer stay. Hospital A, Patient B and Doctor C together have proactively managed Patient B s health to prevent a more severe outcome, such as a heart attack, from occurring. C

9 C The Next Evolution of Business Intelligence To succeed in the future of healthcare, organizations must embrace a strategy that will address today s fee-for-service challenges, while also providing the scalable foundation needed for the fee-for-value landscape. TOUCH POINTS HEALTH CONDITIONS LIFESTYLE INTERESTS OTC / RX USAGE ENCOUNTERS Patient / Loyalty Identify / Engage C Response / Action To build that strategy, healthcare organizations will need technology and solutions that provide a complete understanding of business needs, including intelligence on how both physicians and patients contribute to the success of an organization. Healthcare organizations will need to use the wealth of information at their disposal to deliver data-driven care in real-time, while tracking and managing the behaviors of both the patient and the physician in order to achieve strategic growth 5. With federal and state programs offering incentives to providers for health IT adoption, five areas of technology cloud, data exchange platforms, wearable technologies, data analytics and artificial intelligence will have the greatest effect on healthcare providers in the next five years, states Reda Chouffani of TechTarget & SearchHealthIT 6. Having the ability to apply analytics to healthcare data will give organizations the opportunity to increase care quality and achieve cost savings. The future direction of business intelligence will be driven by data from wearable technology, which will further catapult the amount of information organizations will have to examine as health information can be tracked outside the four walls of the hospital. This information will then feed back into data exchange platforms. Strategic growth platforms will be able to examine the raw data from these devices and develop new predictive models that will help organizations reach their population health goals by identifying a person s likelihood to stay well so they can be kept out of the hospital.

10 Summary Strategic growth and physician engagement solutions are vital to organizations seeking to meet both current fee-for-service and future population health goals. These platforms allow organizations to gather the proper intelligence needed to identify the most valuable consumers, communicate to, acquire and engage them, and ultimately create lasting loyalty among them. Both for patients and providers, the healthcare journey has completely changed as technology has evolved. As healthcare shifts from episodic to customer-centric care, organizations need to thrive in both realms. People are still getting sick and coming in for treatment, while more reimbursements are hinging on encouraging proactive care to keep people out of the hospital. With the right business intelligence platform, hospitals can achieve all of their goals by having a comprehensive understanding of their audience s habits, lifestyles, prescription choices, etc. and using that information to engage with them in a personalized manner. Strategic growth platforms and physician engagement solutions, like the Tea Leaves Health ONE Platform TM, will be necessary for organizations to obtain the business intelligence they need to help them know and grow their business now and into the foreseeable future. References 1. Molly Gamble. (2013, February 28). Hospitals They Don t Market Like They Used To. Retrieved from 2. Emily Zuehlke. Building Loyalty and Managing Population Health with CRM. Retrieved from Innovation-Center/events/webconferences/2014/building-loyalty-and-managing-population-health-with-crm. 3. Eric Demers. (2015, February 11). 6 Ways CRMs can Improve Population Health and Clinical Integration. Retrieved from 4. Paul Boag. (2016, January 8). All You Need to Know About Customer Journey Mapping. Retrieved from com/2016/01/08/need-know-customer-journey-mapping/?utm_content=buffer587be&utm_medium=social&utm_source=linkedin.com&utm_ campaign=buffer. 5. Yulan Egan. (2013, August 29). Why Your Population Health IT Should Function Like CRM. Retrieved from 6. Reda Chouffani. Wearable Technologies, Cloud Guide the Future of Healthcare. Retrieved from Wearable-technologies-cloud-guide-the-future-of-healthcare.

11 To learn about the Tea Leaves Health team and services, visit tealeaveshealth.com