Executive Summary
At a time when health plan costs for employers and their employees are
spiraling out of control, companies have a new secret weapon at their
disposal: healthcare performance management (HPM). By freeing health
data from silos and fostering sharing and collaboration across platforms
and among patients and healthcare entities, it is easier to achieve the full
promise of Health 2.0 initiatives: lower costs and better patient outcomes.
One key area of innovation in the healthcare arena is the advent of
social media, which is fast becoming a tool for connecting healthcare
consumers and providers. Such online collaborations are at the core of
Health 2.0 strategies and are radically transforming the way patients,
providers and researchers approach healthcare in everything from
wellness programs to chronic disease management.
In this report, we will examine how social media and other
Health 2.0 initiatives are transforming the healthcare marketplace and
how organizations can leverage the power of HPM technology to connect
plan sponsors, members and the provider community in a cost-efficient
interactive healthcare system that promotes better health for employees.
A key area of innovation in the healthcare arena is the advent of
social media, which is fast becoming a tool for connecting healthcare
consumers and providers.Transforming Healthcare With Social Networking
“Internet-enabled communities of patients and providers are coming together to
communicate and collaborate,” explains Brian Klepper, Ph.D., Healthcare Analyst and
Consultant, Health 2.0 Advisors. “In so doing, these virtual communities are reshaping the way
that healthcare is delivered and consumed,” he says.
The numbers back up this bold assertion. According to a report last year by the
Pew Research Center and the California HealthCare Foundation, 61 percent of Americans
are turning to the Internet for health information — particularly for consumer reviews and
comments. “The Social Life of Health Information” found that 59 percent of people did at least
one of the following activities online:
Read someone else’s commentary or experience about health or medical issues on an online
news group, website, or blog;
Consulted rankings or reviews online of doctors or other providers;
Consulted rankings or reviews online of hospitals or other medical facilities;
Signed up to receive updates about health or medical issues;
Listened to a podcast about health or medical issues
“Technology providers and healthcare performance management companies recognize the
transformational capability of these trends and are working to support them,” says Henry Cha,
CEO, Healthcare Interactive.
One example of this is the Point to Point (P2P) Healthcare solution offered by
Healthcare Interactive and WellNet Healthcare Group. That technology combines a repository
for storing and analyzing medical and pharmacy data with an online social network that links a
company’s employees with all of their care providers.
The goal is to promote employee wellness while eliminating waste and reducing excessive
medical-benefit costs. The HPM technology enables plan sponsors to receive and evaluate
medical and pharmacy claims data in a HIPAA-compliant manner, allowing companies to
forecast and manage risk.
This is combined with an online healthcare social network through which employees may
communicate securely with all their care providers, saving employees money and improving
their health outcomes.
This approach has been proven in cases such as the Veterans Administration’s VistA
healthcare system, which enables all its doctors to communicate online in a private, secure
manner to coordinate care for the plan’s three million members. Use of VistA, VA officials say,
has cut per patient healthcare costs by 30 percent because patients are more engaged, care
is provided in a timely manner, and unnecessary tests and procedures are avoided.
“The goals are similar for P2P,” says Cha. “From a social media perspective, doctors are able
to have direct interactions with patients about medication experiences, for example. Their
responses can then be used to better understand what medicines and treatment protocols are
working and which aren’t. Then this kind of collaboration can be used to improve outcomes,”
he explains.
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The HPM technology enables plan sponsors to receive and evaluate medical and pharmacy
claims data in a HIPAA-compliant manner, allowing companies to forecast and manage risk.PatientsLikeMe Blazes New Trail
“Healthcare social networks are springing up everywhere and one of the most
successful is PatientsLikeMe, an online community for people with life-altering
illnesses,” says Klepper.
Healthcare consumers who use the site reported significant benefits in a survey
published by The Journal of Medical Internet Research in June 2010.
Nearly 7,000 members from six of the site’s communities (ALS, Multiple Sclerosis,
Parkinson’s Disease, HIV, fibromyalgia and mood disorders) were sent a survey
invitation. Of the 1,323 respondents to the invitation, 72 percent said that the site
was “very” or “moderately” helpful in informing them about a symptom they were
experiencing, and 57 percent found it helpful for understanding the side effects of
their treatments.
Use of the site was associated with increasing levels of comfort in sharing
personal health information among those who initially had been uncomfortable. Overall,
12 percent of patients changed their physician as a result of using the site; this figure
was nearly double (21 percent) among patients with fibromyalgia.
On community-specific questions, 41 percent of HIV patients reported having reduced
their risky behaviors and 22 percent of mood disorder patients said they needed less
inpatient care as a result of using the site.
But PatientsLikeMe is more than just a social community for patients.
“It enables greater collaboration throughout the healthcare industry where that
information is needed most.” says Klepper.
The web site itself takes information gained and shares it back to the research
community to produce new kinds of protocols and benefits. And that value-added
sharing of information doesn’t typically occur between healthcare providers and
researchers, so there is significant benefit to such an application. Overall, the
PatientsLikeMe survey is important because it quantifies some of the vast potential that
exists with online data-sharing platforms. And the industry is only beginning to scratch
the surface of that opportunity. A robust HPM-enabled technology platform can broaden
the ways that information is shared in the context of social media.
And the value proposition doesn’t stop there. New applications will enable patients
to interact with one another in an anonymous methodology and accept a corporate
wellness challenge — receiving various incentives for adopting healthier behaviors and
sharing best practices with one another.
In addition to engaging patients on a behavioral level, there are two other levels of
engagement that also apply to providers: the incentive level and the collaborative level.
“Just as patients can receive incentives to engage in better health practices, so can
providers be offered incentives to collaborate on patients, develop new protocols,
comment on and create information, etc.,” says Cha.
In such an arrangement, physicians could be compensated for answering messages
in secure email or by following up with patients online; extending patient encounters
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A robust HPM-enabled
technology platform can
broaden the ways that
information is shared in the
context of social media.beyond traditional face-to-face appointments. They also can be compensated for
keeping up to date on the latest developments in healthcare by accessing new
research, obtaining information on clinical trials and seamlessly enrolling their patients
in those clinical trials.
Streamlining Healthcare Delivery With Health 2.0
While most players in the healthcare industry readily admit collaboration is a worthy
goal that can drive down costs while improving patient outcomes, current information
infrastructures make that task challenging. Healthcare data traditionally has been stuck
in an information silo, making it difficult for providers to collaborate with one another and
for patients to access data and information.
“The ultimate solution will require robust systems that can allow for very flexible data to
be shared, and accomplishing that goal will require business leadership,” says Cha.
“A linchpin of this strategy is the empowerment of primary care physicians as part of
on-site employer health clinics and medical “homes” on the web,” he says.
In that web environment, doctors can utilize analytical tools and resources to identify
“at risk” patients among a company’s pool of employees.
“By collaborating on data with other physicians it is possible to not only identify which
patients have risk factors and need to be focused on, but also which doctors and
hospital services have the best outcomes and which need to be avoided,” says Klepper.
One example of how such a system would work is the case of the Toms River School
District in New Jersey, which opened an employee health clinic in October 2009. In the
first three months of operation, the average health care cost per employee dropped
by $1,950 — a premium reduction of 19 percent. At that rate, the school system is
poised to save $2 million in its first year.
Creating an HPM system that could deliver metrics to empower the clinic’s primary
care physicians was a big part of the success. By using that data, leaders were able to
create incentives to increase the average clinic visit time from seven-and-a-half minutes
to 20 minutes.
“This approach enables the physician to more actively monitor a patient’s health, which
results in fewer visits to specialists and fewer medical tests and procedures, because
doctors have more time to investigate medical issues,” says Klepper.
Compared with the standard 25 to 30 percent referral rate to specialists, the
Toms River clinic’s referral rate is between 10 and 11 percent. And when a patient is
referred to a specialist, the approach is more collaborative because the doctors are
actively communicating with one another about the overall treatment plan of the patient.
Specifically, the data and analytics make it possible for providers to identify — and
better manage — two types of patients: those with chronic diseases and those likely to
develop an acute condition over the course of the next year. Of all the money employers
spend on health benefits, 60 to 65 percent will be spent on the first category of patient.
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By using HPM data,
leaders created incentives
to increase the average
clinic visit time from
seven-and-a-half minutes
to twenty minutes.When a chronic patient is identified, the provider can immediately pair them with a clinic
nurse. This on-site disease management nurse (who also can perform wellness and
prevention duties) has regular, face-to-face interventions with the chronic patient that are
aimed at producing a behavioral change and improving health.
Patients in the second group are paired up with the doctor, who is instructed
to do whatever is necessary to diagnose the patient and prevent a major — and
expensive — health care crisis. The key to being able to support this kind of healthcare
management is end-to-end, web-based health care information technology. This
enables the consolidation of analytics with claims data; electronic health records (EHR),
drug and lab data to deliver a comprehensive, actionable picture of what’s going on
with each individual patient.
“The bottom line is that when patient information is more transparent, it enhances the
delivery of healthcare, reduces costs and improves quality,” says Cha. “The information
also is valuable for measuring what forms of treatment work well and achieve the most
successful outcomes,” he says.
In other cases, social media can make great strides in promoting wellness. Blogs such
as The Health Sensei, for example, empower consumers to take more responsibility
for their health by providing resources for wellness and fitness. Another example
of paradigm-shifting tools is the WellCentive Patient Registry, which combines the
capabilities of a Web-based, community-wide, point-of-care all-patient registry system
with custom interfacing, customizable alerts, targeted patient outreach, comprehensive
reporting tools, secure messaging features and direct reporting of outcomes to a variety
of payors. The system also incorporates patient outreach tools, including an integrated
automated telephone appointment and care reminder system.
In the same vein as WellCentive, HCI’s Point to Point Healthcare program also leverages
digital technologies and social networks to align employee health imperatives with
organizational productivity objectives. For instance, it provides employers with a
workflow engine that automates the launch and ongoing management of different types
of member-based programs.
Conclusion
Social networking and Health 2.0 initiatives are transforming healthcare in many different
ways. The new collaborative technologies and Twitter-like internet connectivity tools
foster a cooperative environment that allows organizations — and the people who
work in them — to gain much greater control over many important healthcare factors.
In helping people work together to achieve better healthcare outcomes (i.e. healthier
lifestyles), organizations reap the benefits of improved productivity.
These Health 2.0 initiatives also create benefits for physicians, because communication
and collaboration with their patients and peers enables better treatment outcomes.
Additionally, that information can be shared with the research community in a manner
that increases the efficiency of drugs by providing real-time input on side effects and
performance.
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The advent of social
media is changing
the way millions of
consumers and patients
manage their own health.Ultimately, however, the pay-off from these initiatives will manifest themselves by driving
down healthcare-related costs while improving the quality of care. This is a task that
becomes far easier once health data is broken out of legacy silos and shared securely
across platforms. That is one of the biggest lessons — and benefits — that have come
from the advent of social networks. It is why social media is changing the way millions
of consumers and patients manage their own health. It represents a tremendous
opportunity for organizations that want take control of an exploding line item in their
annual operational budgets and reverse the cost curve while improving the health of
employees.
6About the HPM Institute
The Healthcare Performance Management Institute (HPM Institute) is a research and
education organization dedicated to promoting the use of business technology and
management principles that deliver better and more cost-effective healthcare benefits for
employers who cover their employees. The Institute’s mission is to introduce and develop
the new corporate discipline, HPM, a technology-enabled business strategy that tackles the
challenge of controlling healthcare costs and quality in much the same way that enterprises
have optimized customer relations, supply chain management and enterprise resource
management. HPM provides C-level executives with visibility and control over company
healthcare benefits spending trends and risk-management postures, while protecting
individual employee privacy.
For more information, visit www.hpminstitute.org.
HPM Institute Board of Advisors
About BizTechReports.com
BizTechReports.com is an independent reporting agency with offices in Washington, D.C.,
and the San Francisco Bay area that analyzes user trends in business technology. The
editors explore the role that technology products and services play in the overall economy
and/or in specific vertical industries. For more BizTechReports.com white papers, case
studies and research reports, visit www.biztechreports.com.
Henry Cha
President
Healthcare Interactive
Paul Chang
Global Business Strategy Lead, Emerging Technologies
IBM Software Group
Scott Haas
Vice President
Wells Fargo Insurance Services
Stuart Hersch
President/CEO
Cantor Insurance Group
Bill Lavis
Partner
Sitzmann Morris & Lavis
Keith Lemer
President
WellNet Healthcare Group
Sabrina Orque
Vice President of Human Resources
Charlie Palmer Group
George Pantos
Executive Director
Healthcare Performance Management Institute
Deanna Scott
Vice President of Human Resources & Corporate Operations
The SCOOTER Store
Todd Thompson
Chief Technology Officer
Lockheed Martin Federal
Kirk Warren
Vice President of Benefits & Corporate Giving
The Men’s Wearhouse
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