Healthcare organizations and providers are still largely confused, or at least slow, when it comes to effective patient portals and other technologies that may help spur better patient engagement, according to a recent report from Chilmark Research.
“…We found a marketplace long on potential, but short on results to date,” lead author Naveen Rao wrote in describing the findings of the report, which first started tracking patient engagement in 2008.
Healthcare organizations are “still doing the bare minimum when it comes to digital,” the report said, particularly when it comes to between-visit or post-discharge interactions with patients.
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One of the key reasons is that providers have largely identified other, bigger priorities when it comes to matters of health IT, including data analytics, integrating clinical networks, risk-based contracting and other preparations for population-based health management, according to the report.
“Even among the innovative delivery systems out there, it is clear that patient engagement is taking a backseat to other enterprise priorities,” the report said.
The findings echoed similar sentiments elsewhere in the industry, as recently as today during a Google Hangout hosted by Xerox that featured health IT experts Dr. Eric Topol, director of Scripps Translational Science Institute; Dr. Geeta Nayyar, chief healthcare advisor for Femwell; and Tamara St. Claire, chief innovation officer of commercial healthcare for Xerox.
“The whole paradigm needs to shift,” Nayyar said. “How are we making sure we have personalized experiences through the technology? It’s not about meaningful use, it’s not about a portal, it’s really about a cultural shift and outcomes.”
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While separate, both the report and the online panel touched on the broader theme of patient engagement and the use of technology to improve it, with consensus emerging that healthcare on the whole has not yet solved the problem.
“This is running counter to broader market dynamics – such as consumer advances in mobile and cloud technologies, federal incentives like the Meaningful Use program, shift to value-based reimbursement, and greater consumerization of care delivery through retail clinics and pricing transparency,” the Chilmark report said.
Topol, an evangelist for wearables and patient-generated data, similarly said the market isn’t yet there.
“Part of the problem is hospitals and doctors own the information, and it really doesn’t make sense,” he said. “There’s a lot of new information coming through smart phones and devices,” and other sources of data like sensors and lab information. “All sorts of things,” including EMRs.
Another factor for providers, the Chilmark report said, is that vendors of EHRs or EMRs and patient portals themselves have not yet adequately addressed the demand.
“When it comes to patient engagement, EHR vendors have displayed a tendency to build ‘in’ towards the clinical user rather than ‘out’ toward the patient,” Rao of Chilmark said. “This is simply what they know best, what the market and opportunity, including Meaningful Use 2, incentivizes them towards, and what their end users and customers — clinicians and administrators — will nod their heads at.”
And it’s going to take more than just a web portal, he added.
“‘Innovative portals’ is becoming an oxymoron. Established vendors tend to build what they know their customers will buy from them next. EHR vendors have not asked themselves ‘what is the real future of a web-driven login model?’ Mobile tools are barely available in these portal-centric platforms, design remains primitive, and integration — data, longitudinal PHR, portal sprawl — remains pretty much non-existent.”
Topol touched on this point often, saying: “The patient is the most unused entity in all of healthcare. There are ways to do this, but it isn’t going to be fixed with a patient portal. It’s a challenge of autonomy in the medical community.”
Still, provider organizations likely want to tailor their patient engagement efforts to generational attitudes, with Millennials likely more apt to embrace digital technology and wearables, while aging Boomers are more “transactional” in their approach to patient technologies, according to St. Claire, of Xerox.
“Different patients want different levels of engagements,” she said, pointing to another survey by Xerox.
Yet there is progress, according to Chilmark and the Xerox panel, and 2015 looks to be more promising, particularly in the realm of telemedicine, which has potential to aid patient engagement.
“Despite the signs of unreadiness and immaturity, progress in this market is undeniable – though advanced engagement (smart care plans, telemonitoring use cases, and several others) remain limited to pilots today,” the Chilmark report said.
“…Adoption will happen in an emerging best-of-breed approach, where (healthcare organizations) will pick and choose multiple vendors in an effort to meet the diverse clinical and business needs across different departments and patient populations. We anticipate a busy 18-36 months, full of acquisitions, partnerships, pilots, and of course, new entrants.”
Speaking to telemedicine, St. Claire likewise said there will be a mix of adoption, and that big health systems will likely look to either new startups in the field like TelaDoc or Doctor on Demand or established vendors who develop workable solutions. Few big hospital systems have the dexterity to pivot quickly into the space, she said.
“Sometimes it’s very difficult for big health systems to change their business models, so in the beginning it will come from more small startups,” she said, adding that as traction picks up, integrated systems will likely enter the fray.” And I think it will be an interesting mix,” she said.
Ultimately, when it comes to patient engagement, Rao said the technology has a ways to go.
“Our take is the vendors really ought to be leading the way on the tech tools front,” he said. “Bottom line is, neither vendors nor providers have prioritized the patient’s needs or considerations with the how, what and why of between and post-visit interaction.”
This story has been updated to include comments from Naveen Rao, lead author of the Chilmark report.
