Power to the Patient
by Anthony Chipelo, Director of Portal Development, MedSeek, Inc.
The “New” Informed Patient and the Rise of Consumerism
Consumer behavior in healthcare has undergone significant changes since the emergence of Internet technology allowed consumers to take charge of their health. As such, a “new,” informed, and empowered patient evolved and along with this evolution there were new demands and expectations placed on the healthcare industry.
The “new” informed patient is demanding better customer service in the form of convenience and self-service from an industry that has traditionally resisted this movement. Patient expectations are based on their experiences in banking, financial services, travel, and other personal service industries where various levels of self-service have been made available to them over the past few years. Their reasoning follows a simple logical process and poses a familiar question: If they can pay a utility bill, manage their 401k account, and book a vacation online, why can’t consumers conduct similar types of self-service transactions when they are dealing with their own health? Furthermore, in addition to increased self-service and the convenience that comes with it, the “new” informed patient desires a personalized experience similar to those they receive from other e-commerce sites such as Yahoo, AOL, eBay and Amazon.
The “new” informed patient is also placing more pressure on the physician to play the role of the expert caregiver and provide them with higher levels of expertise and quality of care than in previous years. Patients desire a personal and friendly relationship with their physician. For many years the physician was viewed as the clinical expert and sole owner of healthcare knowledge. However, in the current healthcare environment patients feel that the healthcare industry, specifically Managed Care, encourages physician overbooking to increase revenue. While patients have adjusted to the managed care environment, they do not necessarily like it. With the emergence of Internet technology consumers became empowered and to fill the void resulting from lack of communication and time spent with their physician, took a self-education approach to satisfy their healthcare needs.
As a result of the demands and expectations of the “new” informed patient, we are witnessing the beginnings of a “new” personalized relationship between patients and physicians forming. Within this relationship the patient has easier access to information, the ability to self-educate under the physicians supervision, and electronically communicate with the physician and their staff.
The Importance of Physician Adoption
Patient self-service and secure communication will not be beneficial to patients unless there is adoption from physicians. In order to gain adoption the physician must be sold on the value proposition associated with providing these types of services. As an example, from a benefits perspective research from Healthcast 2010 indicates that an estimated 20% of the 830 million annual office visits per year could be eliminated by online communications between clinicians and patients. With each visit averaging about $63, about $7 billion could be saved each year in clinical messaging.
Furthermore, patient self-service transactions and online communication can increase practice efficiency and productivity through fewer telephone calls, decreased administrative costs, and growth through attraction of new patients. One result of increased practice efficiency would be that more office visits could be reserved for, as well as physicians dedicating more of their time to those patients truly requiring face-to-face care.
As an example, some of the administrative and clinical functions previously handled only by telephone or face-to-face encounter that can now be accomplished through secure communication include:
- Appointment requests
- Update information
- Online bill payment
- Non-clinical patient inquiries
- Rx renewals
- Test results
- Self-monitoring status
- Uploading data from home monitoring devices with clinical feedback
- Non-urgent e-consults
The Role of Technology
The role of technology in the process of providing patient self-service and secure communication can be addressed from both the patients and physicians perspective. The bottom line is that providing patient self-service and secure communications has more to do with financial, organizational and communications factors than it does technology factors. Technology is not the solution, but instead a key enabler. Ideally technology should be translated into a toolset that speaks the user’s language. As a result, benefits realization from patient self-service and secure communication occurs as a result of a process oriented approach that provides a seamless interface between users and technology, while defining the method in which technology gets absorbed into the workflow.
Patient loyalty is at a new low and the “new” informed patient has reached the point where they may actually use new criteria in determining who their physicians will be. The bottom line is that the patient does not feel the physician is listening and they do not revere the physician as past generations did. Where previously patients were content to select a physician based on their credentials or via “word of mouth,” in a March 2003 report from the American College of Physicians, it was mentioned that some patients are now considering selecting their physician based on the availability of Internet systems.
Physician adoption with self-service and online communication processes provides benefits realization in areas such as:
- Reducing unnecessary office visits resulting in patient cost savings.
- Increased efficiency and productivity with lower operating costs such as reduced telephone calls and lower administrative costs.
- Making necessary office visits more productive and less time consuming.
- Ability to monitor patients and provide follow-up care without additional office visits.
The patient also benefits from the convenience of utilizing self-service transactions and online communication by experiencing increased access to information and their physician. The results are higher levels of satisfaction and increased patient loyalty.
While technology plays an important role in the process, it should not be expected to provide the entire solution, but rather enable it. The key is to be very realistic about the capabilities and expected benefits to be realized from technology and to make sure it interacts seamlessly with workflow and offers the least path of resistance. As a result, a process oriented approach should be utilized in which careful and detailed research is conducted to understand the requirements and needs of all users involved in the process.
From the patient’s perspective these requirements and needs include:
- Provide a user friendly interface to access information and perform self-service transactions.
- Understand how patients wish to communicate and develop a relationship with their physician.
- Integrate personalization and a “community” concept to improve overall patient experience.
From the physician’s perspective these requirements and needs include:
- Supporting physicians business needs.
- Understanding how physicians and their staff organize themselves and work.
- Aligning technology with the processes and tasks that make a physician practice successful.
The end result of a patient self-service and secure communication solution should be to develop a community where communication is enhanced, access to information is convenient, the relationship between the patient and physician is improved, and patients can continue to self-educate themselves relative to their health, while still under the physician’s supervision.
To continue a discussion around this topic, feel free to contact the author:
- Bowman, B. (2002). Beyond the telephone: Electronic tools for patient-provider communications. Group Practice Journal. 51(11).
- Gorden, Mark S. and DuMoulin, John P. (March 2003). The Changing Face of Ambulatory Medicine – Reimbursing Physicians for Computer-Based Care: ACP Analysis and Recommendations to Assure Fair Reimbursement for Physician Care Rendered Online. Philadelphia: American College of Physicians.
- Healthcast 2010: Smaller World, Bigger Expectations. (November 1999). Price Waterhouse Coopers.
- McDonald, Keith, Case Joanna, and Metzger, Jane. (November 2001). E-Encounters. iHealth Reports. California Healthcare Foundation.