Wednesday, December 19, 2007

A Closer View of E-health

When transforming the hospital experience through an enterprise e-health initiative—the greater the convenience a portal offers, the greater the benefits to the organization.

Dealing with a cocktail of changing market dynamics — health consumerism, retail health services, Google health, community benefit, "co-opetition" with physicians, patient safety, pay-for-performance and regulatory pressures — hospitals nationwide are beginning to formulate their strategic plan to tackle these market drivers while delivering on their mission. Savvy health care executives know that the experience their community, patients, physicians and employees have with the organization directly impacts their competitiveness and ultimate success.

Today's information-driven society is changing health care (for good or bad we'll save for another discussion) forever. Consumer expectations are more demanding of our institutions, where access to timely, relevant information is a clear market differentiator. Hospitals that embrace these changing dynamics will thrive in the coming years.

As hospitals begin addressing these new challenges, many are turning to e-health as their foundation for creating a positive, differentiated experience. It's certainly not the only answer, but key to engaging and interacting with an information-driven constituency.

Shifting processes to the Internet
By leveraging the power of the global network to fundamentally transform how they interact with their constituencies — consumers, patients, physicians and employees — and shifting business processes to the Internet, organizations can differentiate themselves in their local hospital market.

Smart, progressive organizations that invest in their constituents' overall experience with the organization will find that their investment will more than pay off in improved patient and physician satisfaction, more effective community advocacy, increased downstream revenue, better employee collaboration and clinical excellence. The investment also will strengthen their ties to consumers, patients and patients. In the past, for example, hospitals built office space within or near their hospital to forge relationships with physicians. Smart organizations will continue to use that tactic, but they also will use Web portals to supplement their physician recruitment and retention initiatives.

Hospitals currently are deploying Web portals that enable doctors to access and direct patient data remotely, sparing them a road trip to the hospital or forcing them to make clinical decisions without the benefit of all the information they need because the patient's paper record is unavailable. Given the choice of selecting a hospital that helps them practice more efficiently versus one that doesn't, physicians will go with the former.

Innovative hospitals also are delivering information online to help patients take better care of themselves and schedule appointments, making it more convenient for existing and prospective patients to interact with and access their services.

Like the banking and travel industries, the health care industry will shift most of its non-clinical business processes to the Internet because it will improve their efficiency. For instance, a hospital that enables patients to find answers to their questions online may find that it needs only 10 customer service representatives to staff its call center instead of 20 or 30 employees.

Portal progress
Given the extraordinary value that the Internet offers, consumers expect everyone with whom they interact to be online. This means that the first exposure a hospital's constituents have to a health care organization will be through its Web site. Thus, it's imperative that the organization strive to make the consumer's first experience a positive one; the organization may not get a second chance if that visitor has a poor experience.

The greater the convenience a portal offers, the greater the benefit to the organization. To help enterprises plan and benchmark progress in their e-health strategy, MEDSEEK developed a model, adapted to the hospital market from Gartner portal research, composed of the following five levels:
Level 1. The hospital or system offers static brochures.
Level 2. Through a Web site, the hospital extends some interactivity.
Level 3. The hospital starts using its site to drive changes in business processes. These include online pre-registration, appointment scheduling, payer transactions and administrative functions. The site also enables physicians to interact via secure messaging with consumers and lets consumers search for disease management and self-care activities.
Level 4. The organization creates new business opportunities and moves a majority of its current business functions online.
Level 5. The portal features advanced collaboration between the hospital and the community, with enhanced integration of capabilities among all hospital departments. Interactions between the hospital and the portal user feel uniquely personalized.

Hospital approaches vary
Hospitals and health care networks understand the need to move toward Level 5 and are actively doing so. These include Edward Hospital & Health Services. In 2006, the Naperville, Ill.-based health system implemented a portal, gearing it toward a non-traditional health care experience to reflect its brand positioning and community identity.

"Our corporate brand — 'For people who don't like hospitals' — is about connecting with our patients, physicians and visitors in ways that reduce the inconvenience and stress typically associated with hospitals. We challenge the status quo, and our market research confirms that the community feels we do things differently here," said Cheryl Eck, director of e-health at Edward Hospital.

"Compared to our past Web site experience, we are not only offering much more flexibility for the community to interact with the hospital, but also to meet people with similar interests and health concerns," Eck noted.

Like Edward Hospital, Munroe Regional Medical Center in Ocala, Fla. embraced the Internet as the cornerstone to marketing its new Bariatric Center of Excellence. Munroe established a partnership with a leading obesity informational Web site and provided detailed, relevant information about its expertise and experience through its consumer portal. Every marketing "call to action" channeled prospects to the hospital's Web site and a dedicated effort developed thought leadership that motivated prospects to take action.

As a result, monthly referrals to the Bariatric Center jumped 50 percent to 60 procedures per month. With each procedure contributing $4,000 in net operating income, the effort contributed approximately $960,000 to net profitability per annum. Hospital executives and physicians were ecstatic with the results — and even more surprised to learn they were pulling patients from as far away as Missouri and other non-traditional service areas.

Approximately a decade ago, Henry Ford Health System (HFHS) in Detroit launched its first enterprise Web site. Like most corporate Web sites of its time, it was a largely a static branding exercise. Since then, HFHS has regularly enhanced the content, functionality and usability of this site so that it is now offers rich patient and physician experience on a highly scalable portal platform. Introduced in 2000, Henry Ford's "MyHealth" patient portal has become an extension of its patient management and clinical systems environment. It began with 100 requests for appointments a month and grew to its current level of around 10,000 a month. MyHealth is now one of the largest patient portals in the country, with 200,000 patients enrolled.

In August 2006, HFHS launched "eVisits" — a Web-based system within the MyHealth portal for conducting virtual consultations with physicians. Plans are to extend eVisits to all primary care physicians by May 2008 and to execute a 3-year quality outcomes research project through the portal. Through and MyHealth, HFHS is achieving its corporate mission of being a leader in the e-health space. HFHS has an evolving portfolio of Web-based solutions that support and enhance its administrative and clinical workflows.

Some hospitals, such as East Jefferson General Hospital in Metairie, La., are seeking to secure a competitive advantage by implementing portals catering to provider needs. "The home page is certainly dynamic and inviting, but what's going on behind the scenes is perhaps even more powerful," said Don Chenoweth, formerly the hospital's CIO and now a senior vice president with Phoenix Health Systems, an IT outsourcing and consulting firm.

"In designing the Web site, we decided that we wanted to attract every qualified physician in the area to get privileges at East Jefferson," Chenoweth explained. "More providers equal more revenue and a greater range of services that we can provide to the community." One key aspect of this goal was loading the Web site with standard forms, such as patient-referral paperwork, that nurses in physician offices can download and securely e-mail to hospital departments.

"The site contains some 300 PDF forms, all indexed, and always the most current version. That's huge," Chenoweth said. "To get physicians working from the hospital, you have to give them the functionality and make things easy for them."

Not an option
In the increasingly competitive landscape of health care, organizations have no choice but to deploy and execute initiatives to improve care, promote patient safety, and enhance the overall experience that patients and physicians have with the organization. It's not a luxury, but an essential part of doing business in today's economy.

Enterprise e-health can play a vital role in helping hospitals achieve their mission and goals by enabling them to engage and interact more meaningfully and cost-effectively with patients, physicians, employees and consumers.

This article was written by Peter Kuhn and originally published by ADVANCE for Health Information Executives (Vol. 11 •Issue 12 • Page 33.) Peter Kuhn is the President of MEDSEEK, a provider of enterprise e-health solutions with 600-plus hospital clients across North America.

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