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Is A Patient Instagram Worth A Thousand Words?


Patient Engagement thru Pictures Our 24-7 mobile access world has ignited a growing trend in health care for improving patient experience and engagement thru image sharing. Providers are using digital visuals to educate patients. Telehealth is creating live feed methods for communication. Patients are sharing images with their various forms of mobile devices. Did you see my ultrasound on Instagram?

In a world where it is estimated that the time an online article has to capture a reader is only 15 seconds, according to data from Tony Haile of Chartbeat, the same might be true for health education. With such great opportunity for improving health literacy, patient activation and outcomes, better health visualization must be easily digestible, and must engage the reader’s emotions instantly.

Given how emotional health-related decisions and care can be, it is no wonder that a key way of relating to and communicating with patients is through visuals. Pictures can give a patient a complete concept in seconds, where words alone often fall short. Further, healthcare is built on a relationship of trust, and the best outcomes are achieved when a patient and provider communicate well and treatment is adhered to properly.

Communication experts often note research on personality types or learning styles such as the Myers-Briggs test that describe how people perceive the world and make decisions. Based on analyses such as Myers-Briggs, we know that some people prefer the written word while others will want credible datasets to work through, and yet others will prefer to see visual examples.

Care settings, like a doctor’s office, can use tools that include images, visuals and infographics to tell a better story to their patients. Providers can more easily illustrate the potential of a different lifestyle choice, and the impact of behavioral changes. It further gives the patient choices, options and a picture of incremental benefit rather than standard, massive black-and-white text forms.  

This idea also allows providers to have more meaningful conversations during notoriously short visits and better explain in-person what is happening, as well as send them home with reference material that they can interact with on their device of choice and when they’re ready to learn.

Recently, the Robert Wood Johnson Foundation (RWJF) and the University of Michigan Center for Health Communications Research joined efforts to create “Visualizing Health.” This initiative examines how data visualization for risk behaviors can be applied to learning and patient engagement. Their premise is that people need to be able to understand and respond to multiple types of health risk information, and that by including visuals, the likelihood of interacting and understanding increases.

It’s words vs pictures on the digital front. With more patients sharing photos on Instagram and Pinterest it makes sense that they should be able to share images with their care providers. Visual learning tools and coordination of care are real opportunities for increased patient engagement. Powerful, visually-driven educational materials is one key to improving outcomes in all of our communities.

The Rise of Social and Mobile Apps In Hospital Culture


Social and Mobile in Hospital CultureSocial media utilization has grown significantly in the last few years, not only for patients, but also for employees and hospital leadership. Mobile phones, handheld devices and apps have made the ability to seek and share information easy and necessary for both patients and providers.

Although many patients are eager and willing to leave thoughts and feedback about their hospital experiences and care online, as utilization grows in that demographic so must the interaction and engagement by providers. With one in five Americans downloading a health-related app, the potential is unlimited. Providers can use social media to grow their reach, inform patients and provide rapid feedback with anyone that is interested, all of which improve patient engagement.

According to new statistics, 41% of Americans said that the reviews and information obtained from available online healthcare information was a factor in the decisions that they made about their choice of physician or hospital. Further, 26% of US hospitals are already active on social media sites such as Twitter, YouTube, LinkedIn and Facebook, with Facebook being the most popular. A public relations and marketing firm in Wisconsin even reports that Facebook has become the primary means for hospitals to share health information with current and potential consumers due to its popularity. This is primarily because an estimated 22% of parents and 14% of non-parents are actively using the social media site to seek hospital and medical information.

At present, it is estimated that 87% of doctors use social media for personal reasons, and of those 67% also use social media for professional reasons, indicating that individual providers are really embracing the idea.

Despite that great individual provider utilization, data indicates that 6% of hospitals still put an “intern” in charge of social media, for those that take it seriously the dividends for patient engagement are huge. For example the Mayo Clinic saw a one-month jump in their podcast listeners by 76,000 people just by starting to use social media to promote them.

Patients are also more positive about the hospitals and providers that use social media to interact with them. Not only are 43% of US adults willing to share personal information with a hospital on social media, but 81% of those surveyed said they believed that hospitals with social media sites are more “cutting edge” than those that are not.

As hospital employees and leadership catch on to the importance of using social media and embracing social media programs, not only will patient engagement improve, but so will hospital perception, reputation and branding.

Rethinking Provider Payment Incentives For Improved Outcomes


Provider OutcomesIn a recent post by Rob Lamberts, MD on, the author visited the all-too-familiar scenario that the “root financial arrangement in the health care system is to promote more: more diagnosis, more disease, more tests, more interventions, and more medications, with each of these being rewarded with more revenue.”

Using his logic, it seems obvious that the cause of our out-of-control health spending does not in fact lead to better health, but simply more costs and more focus of providers on sickness rather than health.

Dr. Lamberts contends that instead of thinking of our system as a provider of health, we should instead come to think of our payer system as one that actually encourages sickness, by giving more payment incentives to providers for the more “care” they provide each patient.  

With this in mind, it is necessary to reflect on whom exactly we are primarily thinking of as care decisions are made. It is not until we are certain that the patient is once again at the center of care, that all incentives can be aligned properly.

In the fourth column of the StayWell Patient Engagement Framework solutions table, there are a number of eTools and information about the ways that patient engagement can improve drastically when the patient is properly interacting and empowered by the interactions and information obtained by their care team.

As Dr. Lamberts claims, the patient-centered way of thinking and practicing isn’t a problem that increased access to care, repealing of SGR or forestalling ICD-10 can help. Focusing on the patient’s needs, wants, questions and involvement has to be at the core of all good provider strategies, and engagement tools and strategies are the provider’s surefire way.

This can be done in tandem with a number of other high and low level strategies. For example, at the government level Americans could focus on changing reimbursements and financial incentives from payer to provider. At the hospital level we can all work on using technology and community outreach to better empower health consumers. And further, at the education level we can work to train care teams to be cost-effective teams that concentrate specifically on patient-centered care and care coordination.

When the tools that StayWell provides for patient engagement are coupled with the right mix of aligning our system as a whole to put the patient first, the potential for empowering the patients is unlimited.

As we move away from the fee-for-service model that incentivizes more diagnosis, more tests, more treatments, more drugs and devices and more unnecessary expenses, the value of the patient-physician relationship will reemerge, as will the emphasis on patient health, not sickness.

We once again have to make the health care system about health.   

Welcome to the new StayWell


By StayWell CEO Trent Sterling

The world of health care is changing: it’s undisputed. And, while there are still many moving targets in this changing landscape, there are also many positive developments, such as the coming intersection of health care delivery and population health management. I’m personally thrilled to be at the epicenter of this movement as the CEO of StayWell.

Many of you may know the StayWell name from past experiences with Krames StayWell and StayWell Health Management. These organizations had been sister companies for years and collaborated often over that time. And on March 31, the two organizations became one company that will be known simply as StayWell.

The merger took place at an auspicious time because, as health care and our economy evolve, care collaboration, population health management and consumer health engagement are becoming increasingly important as strategic imperatives to reduce costs, increase revenue and improve health and health outcomes. At the same time, the boundaries between industry and consumer lines in health care have blurred, and trends in the industry have aligned to create a perfect opportunity for StayWell to deliver a completely new approach.

What’s changing? Industry reform and other market trends are changing the way we think about care delivery and how consumers interact with the health care system. Value-based incentive programs focused on improving the health and well-being of consumers and improving quality present an opportunity for StayWell to drive significant value to a broad spectrum of segments.

What can the new StayWell deliver? In short, a tremendous amount of value and a whole new approach to health improvement and consumer engagement. More specifically, by combining the assets of StayWell Health Management and Krames StayWell, we are better positioned to help clients navigate health reform and empower consumers to make positive health decisions. Access to information and a seemingly endless supply of communication channels are changing the way consumers make decisions about products, solutions and services. This evolution will impact the health care industry, particularly as it evolves into a more consumer-driven market. The modern consumer will seek immediate, personalized and relevant health information through a variety of channels—and StayWell will be poised to deliver.

The vision for StayWell is to change the game in health engagement by providing a comprehensive portfolio of solutions that engages consumers throughout their interaction with the health care system, whether it is choosing a health plan or provider, making an informed decision about a procedure, managing a chronic condition or participating in a health and wellness program.

Improving health care and health outcomes will require sustained engagement throughout a consumer’s interactions with the health care system. In the new age of StayWell, the solutions we deliver will leverage the latest technology, analytics and consumer engagement expertise to help clients attract and engage health consumers, educate patients and members to improve health outcomes and enhance the health and productivity of populations—all of which drive long-term engagement and, ultimately, health improvement.

The merger will allow us to harmonize technology and product development plans, redeploy features across platforms and share best practices—all of which will enhance innovation and accelerate the delivery of new health care solutions. I invite you to join us on this exciting journey and look forward to collaborating with you in the future.

In good health,

Trent Sterling
CEO StayWell 

Twitter, Healthcare Professionals and Patient Engagement


Twitter and Healthcare ProfessionalsThere is no doubt that social media is continuously changing the way knowledge about health and care is consumed by the entire world. Real-time access to data, information and people, as well as public sharing and outreach by providers and payors, changes the way that patients engage in their care and view the US healthcare system.

According to new research from Creation Healthcare in London, there are more than 75,000 healthcare professionals on Twitter. Of those, more than 30% are US-based professionals such as doctors, nurses, pharmacists and health-related consultants.

The Creation Healthcare’s “Creation Pinpoint” Global HCP Profiles Engine was used to determine the social media statistics. This engine is quite large and growing in real time as it collects intelligence on how healthcare payers, providers and experts use social media such as Twitter to pass along information.

According to the most recent study, here in the US, professionals using Twitter for health-related dissemination of news and opinions are:

1.     Health Consultants

2.     Nurses

3.     Pharmacists

4.     Physicians

According to collected statistics, of those healthcare professionals that post on Twitter, they collectively produce about 152,000 tweets per day, with a total – since the website’s launch in 2006 – of more than 208 million health tweets.

For Twitter users, most professionals appear to use the site to spread information about health policy, research, medicine and treatments. Given that the Patient Protection and Affordable Care Act (ACA) encourages the use of patient engagement strategies through its policies and regulatory shifts, it is no wonder that policy and research are gaining as much social media traction as medicine and treatments.   

Further, social media such as Twitter, Facebook and Google searches can drive worldwide knowledge about illness, spreading of diseases and how people are feeling about the access and quality of care they are receiving in their areas. Social media has provided a new means for patients, payors, providers and policymakers to share their thoughts and ideas.

In past posts, we have discussed the methods by which StayWell clients can use public sharing of information and outreach strategies to improve patient engagement. We believe that using health communication strategies that include social media can vastly improve patient engagement, literacy and outcomes.

However, it is also important for providers to think about new ways to use social media to not only learn more about patients, but to improve health communication throughout all facets of the system. Consumers use social media to gain additional resources such as when they are choosing a hospital, clinic or provider, as well as posting about their experiences and using gained information to share with others what they learned. Providers and payors also have an opportunity to share new ways to interact with the care system that can encourage patients to be more compliant with medications or follow-up with therapy when needed.  

Better Patient Engagement In An Uncertain World


Patient Engagement FrameworkWhen confronted with a health system that is expansive beyond comprehension, very complex and severely flawed it is no wonder patients are often passive observers. Providers and administrators often do not know how to navigate the environment themselves, let alone a patient who infrequently touches the system.

This is further complicated by the ever-changing world of health care practices. While adoption rates are often very slow in the clinical setting – taking on average 17 years between research findings and clinical adoption – the transition for consumers is never-ending, often leaving those administering care and those needing care on very different paths.  

Despite this, we know that when a patient is involved in their own health, better outcomes are experienced. Provided with the right tools, we know that many patients will use those tools to their advantage. We also know that new ACA policy efforts target the creation of better engagement and satisfaction methods and metrics for patients.  

In previous weeks we have discussed the Patient Engagement Framework and have been using that as a guide to highlight real world examples and planning methods for patient engagement strategies. The Framework serves as the backbone for Staywell eHealth tools and resources for implementing successful engagement efforts.

With that model in mind, how does a provider get a patient to be “engaged” in their own care and stay on course with their prescribed care? Perhaps it is exercising regularly, taking medications properly, or something interactive and different. While no one answer exists according to Altarum's Center for Consumer Choice in Health Care, there are steps that can be taken to improve engagement that lead to patients feeling informed enough to take positive action in their own care.

In the third Staywell column that addresses patient Empowerment in the Framework, we see that providing basic information and ways to seek and find the answers patients need is addressed at length. Virtual coaching, online nursing and secure plan management are easy to use eTools that can be employed immediately WITH patients.

By working to improve personal behaviors through reaching out and continuing educational communication, common goals and pathways to get there are shared by the providers and the patients. Even simple to use Staywell tools such as converting forms to Spanish or using guidebooks for understanding accountable care improve engagement.  

When only 10% of consumers are estimated to be “very confident” in their own abilities to find high-quality care and 6% to “affect the cost of care,” it speaks volume about the distance US-based systems need to go to empower those we care for.

Beyond electronic health records and coordination of care, Staywell believes patient engagement is necessary for making more informed and empowered patients. Outcomes are a reflection of the pathway that the patient takes, and it is necessary to understand that each person has a different level of understanding, set of resources and faith in their own knowledge. However, patients want to be involved; they want to help.

Whether it is drug adherence, follow-up rehabilitation or making initial care decisions, improving individual perceptions, understanding and abilities is a key component of improving outcomes and creating a strong foundation of patient engagement.

It’s True: Patients Can Be Engaged, Informed And Take Charge


Patient Engagement Spurs Questions for DoctorsWith increasing frequency, patient engagement fosters situations where patients are questioning their doctors, and some physicians are embracing the shift. Let’s address the changes we can hope to and expect to see as more and more patients become engaged, empowered and really active in their care.

According to the Robert Wood Johnson Foundation, “patient activation” refers to a patient’s knowledge, skills, ability, and willingness to manage his or her own health and care. On the other hand, “patient engagement” is a broader concept that combines patient activation with interventions designed to increase activation and promote positive patient behavior.

In some cases, engagement leads individuals to monitor their own health and make decisions based on research and knowledge of the world around them. With these cases, we can see proactive changes such as accessing better care regimens online, improving food and dietary choices or working out more. In other cases it can be greater extremes such as forgoing advice from doctors and seeking either additional opinions or non-traditional methods of care and research.  

For example, one controversial patient test gaining traction is the use of self-administered cognitive testing for individuals to look for signs of early dementia before diagnosis from a physician. While some physicians are fearful of false positives, others are happy to see patients using resources available to them at lower costs and easily accessible sites to take care into their own hands.

“What we found was that this self-administered test correlated very well with detailed cognitive testing,” said Dr. Douglas Scharre, who developed the test with his team at Ohio State University, and therefore, it can take the place of expensive and disruptive tests at a later period of life by practitioners.

In cases like those and for the patients who do their own research and get more than one opinion, so long as relevant, detailed and appropriate information is assessable, real patient activation can be seen and providers are happy. These patients are the hopeful future of medicine; those individuals, families and communities that regard health outcomes and care as a collaboration between themselves and their care providers are the ones that the providers should look to.

While opportunities and challenges are both present as patients become more engaged and proactive, it is important to remember that as solutions from the StayWell framework are applied, positive results can and will be seen. And, despite the lengthy journey to improve community and population health through such methods, there are small but important results noticeable every day.

With increasing frequency patients are becoming more engaged, more demanding and more active in their care. So long as providers are making sure the right information is available in the right forums, continued positive results from patient engagement are unlimited.

As we continue to outline and address various ways providers can engage patients using thePatient Engagement Framework – and the associated StayWell solutions – it is important to remember that although the journey is tough, improved outcomes are possible.

Patient Activation: A TEDMED Great Challenge


Highlights from Google Plus and TEDMED HangoutOn April 22nd, a Google+ hangout was conducted by TEDMED to address the need for Patient Activation Measures. During this online meeting, which was held in tandem with the primary sponsor Robert Wood Johnson Foundation, individuals from around the world joined together on one space to discuss the issues with the topic.

As part of a broader series, the TEDMED Great Challenges of Health and Medicine are tough issues that cannot be fixed with a simple cure and require a deeper understanding to truly resolve. In pursuit of this understanding, individuals and organizations are asked to join in a multidisciplinary community in a year-round conversation exploring the complexities of each Challenge.

In the case of the Patient Activation Great Challenge, the conversation was based on the premise that “activated” patients are less likely to have an ER visit, be obese or smoke (among other health measures), and more likely to save providers money.

In 2004, researchers from the University of Oregon developed a scale called the Patient Activation Measure (PAM) to determine how likely patients were to know about and to confidently take a role in their own care. In the last decade, subsequent research has estimated that the more active a patient is and the more engaged a provider is the lower the costs and the better the outcomes, broadly speaking.

The TEDMED platform allowed those who are leaders in the patient engagement field to interact and answer questions from individuals and care system teams about the progress to date. It also presented opportunities for StayWell to revisit the Patient Engagement Framework that has been presented throughout 2014, and the online tools and strategies StayWell has created as solutions to engagement challenges.

One TEDMED Great Challenge participant addressed exactly those same kinds of measures noting that data, “is just data if the provider is not interested, or not engaged in collaboration,” with patients. He continued that he, “would be interested to hear from the guests on how we can get providers trained in techniques such as visit agenda setting, and open up collaborative dialogue during the visit,” all of which are addressed in the StayWell Framework Solutions.

Other participant questions included, “Are there other ways to measure likely care plan adherence? What are the benefits and the drawbacks of measuring patient skills and cooperation? How can patients improve scores?”

Great Challenge sessions in 2014 range from health costs in the US to addressing poverty to childhood obesity in food deserts. However, one could argue that all of those other sessions lead to the greater role of engaging patients and communities, and further, the function those pieces serve in activating patients in responsible and informed ways to take more interest in their own care and outcomes.

To follow the conversation that occurred between the experts and the participants, visit TEDMED on Google+ or twitter via #GreatChallenges.

Patient Engagement Recognized In John Q. Sherman Award


2014 The Year of Patient EngagementThis is definitely the year of Patient Engagement. On April 4th nominations closed for the John Q. Sherman Award, created by Engaging Patients to “recognize and inspire people and organizations to share their work” that focuses on engaging patients and families to improve care and patient outcomes.

In this first year of the Sherman Award, 36 nominations were submitted, spanning coast to coast and included 22 different states. According to those involved there was a nice mix of submissions that ranged from large, integrated networks to small hospitals to advocacy groups.

This week seven judges will gather to determine the first year winners, with the final announcement of awardees coming on Monday, April 21. The expert panelists include Pamela Greenhouse, the Executive Director of the PFCC Innovation Center of UPMC and Arvind Kumar, Senior Vice President of Technology & Alliances for the Risk Management Foundation of the Harvard Medical Institutions.

Knowing that one person, a small health clinic or a large hospital system can all have unparalleled impact on the quality of a patient’s experience, it was the goal of those behind the award to give a platform to disruptors who are improving the patient experience through the engagement they have when touching the system. The Sherman Award was aimed to recognize those that rise above the daily routine and truly engage and inspire patients in ways that shift the outcomes in great ways or promote better health for the entire population, especially those that are most vulnerable.

The Patient Engagement work nominated had to fall into one of the six primary categories of interest: Innovation, Transformation, Collaboration, Communication, Inspiration or Systems Change. Ideal candidates have transformed the patient experience through one of those categories while also demonstrating real gains in their ROI.

Winners will be announced next week and then flown to accept awards and present their work at the National Patient Safety Foundation (NPSF) Conference in Orlando May 14-16. During that time they will be recognized during a special plenary session.

In a previous StayWell blog post we highlighted that there is no bigger potential impact in health care than that of a provider on a patient. And, it was for that reason that providers were selected to be recipients of the new award, “spotlighting best practices in patient and family engagement.”

Make sure to check back with StayWell to find out more about the winners, their innovative approaches to using patient engagement to improve outcomes and learn more about the importance of patient engagement.

Patient Engagement Critical thru all stages of Meaningful Use


Patient Engagement FrameworkThe Patient Engagement Framework is a model created to guide healthcare organizations in developing and strengthening their patient engagement strategies through the use of eHealth tools and resources. It was developed by the National eHealth Collaborative, in conjunction with nearly a year of collaboration and vetting by over 150 top experts in healthcare, technology and human behavior.

Former ONC Head Dr. Farzad Mostashari says that patient engagement is “the blockbuster drug of the century,” and we at StayWell agree. Not only is there great potential for health improvements for individuals and communities, but great support and investment from the federal government mean the mission has support.

What the Framework itself does, is align the upcoming Meaningful Use Stages to Patient Engagement Milestones. For each phase of this Framework StayWell will be providing insights, case studies and product recommendations relative to the Framework in a series of blog posts ranging from discussions on the stages of Meaningful Use to best practice strategies for communicating with patients to how to efficiently utilize electronic health records.

When an estimated 50% of patients do not take medications as prescribed and up to 30% of prescriptions never get filled, we know that new best practices for patient engagement are necessary. We also know that the current methods have not been effective enough. We all know that examples like this are rampant in the health sector, and set the table for all kinds of potential changes to patient engagement by providers and payers. Using specific examples, previous outcomes and potential new strategies for improving care, StayWell will guide readers through what if scenarios and help generate new ways of measuring, accessing and utilizing patient outcomes to generate best-case results.   

This Framework can help your organization navigate the path toward more efficient and effective models of care that treat patients as partners instead of just customers, focusing specifically on communication, health literacy, and therefore empowerment. It is specifically designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies, and we will cover all of those bases.

Thru new best practices, in-field examples and step-by-step assistance, StayWell has the unique opportunity to assist clients in moving through Stage 2 and beyond as the focus shifts more heavily to patient empowerment. This is where the framework will have its greatest value, aligning the demands of clinicians with the needs of the patients and the escalating requirements of MU.

Stay tuned!

As StayWell grows its advisory role, there will be a series of blog posts devoted to helping you and your company through the patient engagement and health record transition. By learning and strategizing together, both patients and providers can make the best of the new health landscape and empower patients to seek better outcomes.

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