Bridging the gap: Using technology to maintain patient contact – Medical Economics

As technology shapes and changes the world around us, physicians are wondering what that means for their practice and how they can use it to augment their relationships with patients.

Sarah Bennight, director of product marketing for Stericycle Communications, gave her insights on how technology has changed the landscape and what she hopes to see in the future.

The following has been lightly edited for length and clarity.

Medical Economics: So, what the landscape of patient communications looking like right now?

Sarah Bennight: Sure, I think, you know, patient engagement kind of became a big buzzword about two or three years ago, and a couple years ago, that's the only word he saw on tape. We have patient engagement tools. What does that what does that really mean? Does that mean you're engaging your patient or your patient experience within the walls and organization or does it mean your engagement outside of the organization? And I think where we are now is we've, we've realized that the commercial world does this really well. We just haven't taken the right technology and implemented it in the right way in the healthcare space.

So, for example, online scheduling is pretty dominant in the commercial space. I can get a hair appointment, I can get a dental appointment, I can get my pet in to get groomed. I can do almost anything. I can order Starbucks offline. I can now order my groceries online. I can do everything I need to do on a transactional basis for my phone. But I can't do that in healthcare. So, I think we're at the cusp of, we know we need it. A lot of people are going that way. Not everyone's there. But the people that aren't there yet, the only reason I believe they're still going to exist and continue to do business is because of ratings and social media.

So, for example, I have a doctor that I see, and she's still on paper. I have to call to make an appointment. I can't do it online. I can't even email through a portal. She doesnt have a patient portal, which is, right now almost every doctor has a patient portal. This doctor is an anomaly. But people go and see her because there are groups online that talk about particular health issues, and she's an expert in it. And she treats it in a way that no other doctor in the [Dallas Fort Worth] Metroplex does.

So, social media is keeping her practice alive right now. And you have to wonder, how long is that going to last? How long is that convenience going to still be there? So, I think we're kind of in a in an area where we know we need to implement these commercial technologies with the Amazon, the Uber of health. We know we need to implement AI to help drive and influence patient behavior. We just haven't done it well. And what [doing it] well looks like, I think is the big debate right now.

So, I jokingly on a panel, someone said, Well, we want Amazon and we want Uber for health. And I said, Really? Do you want to log on to a portal and say, you just had a mammogram, you might also like a colonoscopy? And I kind of joked around a little bit about that, but if you think about that, how much more powerful could that be? Right, but we're not there yet.

We don't use AI in a manner to drive and dictate patient behavior, if you will, not yet. If you log into a patient portal today, your patient portal is transactional. It's today and it's yesterday, you had these labs drawn, here were your results, here were your results from this month. You have a new appointment coming up in two weeks. Would you like to cancel that appointment? It's just very small snapshot of your health, which is important, 10 years ago we didn't have that. We have that today, it's great. The future, I think, needs to do much more than that to keep patients engaged, especially as we move into value-based care where the onus is on the patient to drive the outcome, so the physician gets paid.

Medical Economics: Do you see these technological approaches to communicating with patients fitting in well with value-based care?

Bennight: Absolutely. I mean, if you can make it easier for a patient to get an appointment, you're halfway there. Because once you get them in the door, you can talk to them you can say, Hey, you know, you really aren't doing well with your blood sugar, for example, or, you know, We really need to implement a fitness program because you're going to trend towards heart disease if you don't do something about this soon, and then you can put them on the plan.

Youve got to get them in the door, or you have to be able to have an online conversation or telehealth meeting with them in order to do this. So, driving behavior, I think that's where the commercial entities have done it really well. Like Amazon says, You just bought this, you may also like this, and hey, guess what? If you buy these together, we're going to give you a discount. And you're like, Well, that totally makes sense. I'm going to do that. You log on to Netflix, and it says, You just watched x, y, z movie. We think you'd like this. And you believe Netflix, you're like, Yeah, they just put some really great things in front of me. I'm going to do this.

And I think that's where the patient engagement with technology, using AI-driven insight is going to have to drive patient behavior. So, you do log into your portal, and it says, you know, You're due for a mammogram and hey, Sarah, if you come in on Friday morning, I can also get you into your lab work within an hour. That makes it easier for me. I miss less work, less time away from my family. But I'm also taking care of things that are really important to keep my health going on along the right direction.

Preventative care is the name of the game with value-based care. Keeping you healthy so you don't have a readmission, so you don't get sticker and cost more. I think we have the right technology in the commercial space. It's really just about implementing it in the right manner in healthcare to make consumers of health want to interact with it, make it easy, almost make it fun, so they want to engage and take care of their health.

Medical Economics: Can the model your describing lead to widespread up-charging, like having a fast food meal supersized, which could put patients off?

Bennight: No, I don't think so once we get there and it's just the norm, because do you get upset when someone says, Hey, you want a value size that? you just say no thanks you go about your day. Or would you also like fries with that? Hmm I probably shouldn't, but thank you.

I can see where you're going with that though, because we're ultimately paying for it. But if you have a transparency of cost, which is another part of keeping that patient engaged with their care, and they can see the transparency of the cost, that's when it becomes not an upsell, but a Hey you really need to take care of this. And there's great examples everywhere: like you order groceries you can order online now. And you take everything you need, you put it into a cart, you schedule it, maybe two days later, or three days later, and you schedule a time and then pick it up at 6 a.m. and you see before you check out, it's going to cost me $200. And at that point, you have the chance to say, You know what, I didn't want to spend $200 on groceries this week, I'm going to go see if I can have coupons. Or maybe I find a sale deal instead. Or I use a generic instead of this.

You can work that list until the price is right for you and then you can check out. When you go to check out on online grocery, they do the same thing. Hey, I see you normally buy bananas and you don't have bananas in your cart. You want to add them now? No thanks. People are so used to that behavior now. I think it's just a matter of time before it gets into healthcare where it becomes the norm. And we're going to have to navigate that behavior of is putting off. You can start easy with early easy things like flu shots, your health insurance covers flu shot. Hey, I see you're coming in early September. Would you also like to get your flu shot the time? My doctor asks me that every time I'm in there, but I have a feeling some doctors forget to ask, patients leave, they don't get the flu shot, which is covered by the majority of health plans. But if they asked you at the beginning, when you're logging in scheduling the appointment, Would you also like a flu shot? They're prepared, you get your appointment, you dont have to wait.

Medical Economics: These other industries have already adopted a lot of these technologies, what's the holdup with healthcare?

Bennight: I think there's a couple of hold ups. I mean, one of them is cost, like, who's going to do that? Is it going to be the EHR? Does the hospital need to build it? Because, I don't know that that would be the best option. Is it going to be a vendor who becomes like an Amazon because, you know, Amazon is free for me to use, but it's because I'm transacting with Amazon? But who's going to take that on? Healthcare operates in a little bit of a silo where there are multiple health EHRs. There are multiple CRM systems, there's multiple systems that we're dealing with. So, integration and interoperability are key. And, you know, every time you go back to one of the major health IT conferences over the last 10 years we still struggle with this. We have not cracked the interoperability code. And until data can flow freely in and out and share across the patient record, you know, portal to portal, doctor to doctor, hospital to hospital, its really hard to get that one unified view. The doctor I get a certain test from is a different doctor then might be my primary care physician, and they can't see this transactional record from end to end to know what I actually need. Thats a huge barrier to doing what Amazon does.

Medical Economics: Where do you see this patient communication is going 10 years down the road?

Bennight: It's got to all be on demand health and high touch engagement and AI driven and outcome oriented. So, the walls of the organization need to kind of be torn down. So, it's easy to get in and out. We've got to share data. And in the future, if it's going to be value-based care, then patient engagement is going to be the key to its success. And I can see maybe even in five years, being something like, like I said, ordering groceries on an online app, which is literally the best thing ever invented if you're busy. So maybe, in this instance, in healthcare in 10 years from now is the physical and you immediately put in any rewards, benefits, or coupon so maybe that's your insurance card, you scan it right there in your phone, and you see the price before you commit to make that appointment, you say, Hey, Sarah, your insurance covers your well visit but that flu shot, maybe that cost you $5. Okay, I'm okay with this, then I make the transaction schedule my appointment. And my time slot is reserved.

When I know I'm on my way to go to my doctor appointment, I check in. And at that point, my doctor starts using my GPS and tracks me. They know if I'm going to be late. They know if I'm in traffic, they can adjust their schedule still and their timing to make sure they grab another patient that's already in the waiting room. So, they're not wasting people's time so people can get in and out faster. And I know that sounds totally crazy, like a doctor office using my GPS to see where I am. But when I look down the future, if you see the things that are going really well in the commercial industry, I think it's going to eventually translate to healthcare and we do have some privacy issues that we have to navigate, obviously, and interoperability.

But those are the things that are changing the way people do business. We are putting retailers out of business, because people can do business easier and faster online. They don't have to take as much time away from work, away from doing the things they love. We're convenience creatures and we're convenience driven. And so, if it's not within the walls of the physician, if you don't want to go to the doctor, theyre going to have to make it easy to do telehealth. So, I see in the future, the walls of the organization are going to be torn down. Not literally, we're still going to have walls because people want privacy. But we're going to expand that to be healthcare as a participatory thing that happens in every space, in your bedroom, in your office, in your car, in the doctor's office, and the physicians and hospitals that do really well at keeping that person engaged with it are going to be the ones to end up winning in the end, just like the online retailers, right now are getting better than the brick and mortar retailers.

Medical Economics: Is there anything you want to add or anything you think our readers should be aware of?

Bennight: I think that's really important that we really build out the digital, but one thing I will say that everyone's going to have to keep in mind is, we're always going to have a need for human touch in everything we do, and I think that's where healthcare digital, some surely digital companies have gotten it wrong. Because there are times of the day or there are times in your healthcare, where a phone call or a face visit is warranted, and your digital tool has to be able to have a human touch in it, someone picking up the phone for a live chat, because healthcare can be scary. I mean, Im talking about it really commodified like groceries and stuff, but let's be honest, healthcare can be scary. Certain diagnoses, certain treatment plans, you're dealing with people's lives here. So that's the last thing I would add is as we navigate more AI, more digital, more technology, we have to be able to intervene in a human pick up the phone, and that's something Amazon doesn't do. If you ever try to call them for support, it's very difficult. Healthcare has to be able to be better than that.

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Bridging the gap: Using technology to maintain patient contact - Medical Economics