September 17, 2012 
I got a call today from a consultant who was researching the topic of patient engagement in healthcare. I found their questions interesting and really got me thinking about the topic. I’m going to turn my thoughts into a few blog posts this week.
The first one was to look at how different constituents think about engaging the consumer and why. This is changing a lot with the shift to Patient Centered Medical Homes (PCMH) and ACOs, but in general, companies were very transactional about this in the past where it was something to be done. Now, everyone is tracking this and cares about:
- How successful are you at engaging patients?
- How successful are you at changing their behavior?
- What insights about the population can you provide me?
The ultimate strategy is one that:
- Predicts who to target (the at risk patients)
- Focuses only on the patients that are likely to change behavior
- Segments the population
- Delivers personalized communications to them
- Delivers the messages at the best time to engage them
- Tracks key metrics
- Dynamically adjusts the process
- Captures learnings
- And…does this in a cost effective and scalable manner
With that set-up, here’s my someone skeptical view of who cares by constituent.
|
Group |
Traditionally |
Emerging |
|
Patient |
Someone will tell me what to do – physician, employer, insurance company |
I need to be more responsible for my care and spend my dollars wisely (driving transparency tools and e-patient efforts) |
|
Physician |
My job is to diagnose, write a prescription, and/or provide immediate care…I assume the patient is compliant with everything I tell them |
I need to understand the patient, how to change their behavior, and what’s most likely to drive their best outcome (but I still don’t have the time to do it) |
|
Hospital |
People come to us because they have to and it’s all about location |
Chronically ill patients use resources disproportionately and should be catered to; plus we have to improve outcomes (or get penalized by CMS or get low quality rankings) |
|
Employer |
I evaluate the options from my managed care company and select a program; they really cater to me |
I want something better and customized to my employees; I can probably improve engagement and need to as I shift first dollar responsibility to them |
|
Managed Care |
Consumers don’t pay the bills; the best model is a gatekeeper model; regardless, engagement is only important to avoid losing money |
Employers want to see results which requires patient engagement; how can I do this cost effectively? |
|
Pharmacy |
We have to increase productivity at the counter to make money; patients will buy other front end goods |
There’s a big opportunity for me to collaborate with managed care and employers to improve outcomes |
|
PBM |
I’m in the B2B business; just make sure consumers know what they’re supposed to do |
No one really wants to use hard blocks all the time; they want to drive behavior change through information and interventions |
|
Pharmaceutical Manufacturers |
Convince the physicians and the patients will follow; if not, advertise on TV |
I really need to understand the consumer’s experience with the disease and my drugs so I can influence outcomes |
|
Technology Companies |
Can I make money off consumer health apps? Enterprise software is the focus |
Everyone is jumping into this space; how do I make myself relevant and improve satisfaction and use of my apps |
Enabling Healthy Decisions 
Dave Lavinsky @growthink blogged about ensuring one’s product or service is an “aspirin” that cures pain.
You have identified in the table a number of headaches looming on the horizon. Healthcare and HIT entrepreneurs now have a list of “symptoms” for which they can develop “aspirins.” Those headaches will grow stronger and more numerous as attesting “meaningful use” deadlines approach and converge with headaches due to transiting to ICD-10 and HIPAA 5010. Migraines will erupt when wresting with PHI security and interoperability problems.
Fertile entrepreneurial fields abound.
Thanks for the insights, George!