DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Innovations & Results - What's Working and What
Will it Take? February 23, 2014
Sarah Krüg CEO, CANCER101, Society for Participatory Medicine
Founder, Krug Global Solutions Jan Oldenburg
Principal, JanOldenburg.com
Conflict of Interest Disclosure
Jan Oldenburg, FHIMSS and Sarah Krug have no real or apparent conflicts of interest to report.
© 2014 HIMSS
Learning Objectives
• Explain innovations in the field of patient engagement
• Recognize the hallmarks of successful innovations
• Identify innovations to invest in • Design innovation programs for success .
Key patient engagement trends to watch
Gamification
Interactive care
planning
Personalized education
Personal Health
Analytics Social
engagement
Convenience
Cost transparency
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Innovation in Healthcare
Sarah Krüg
Partners in Healthcare
Patient Advocacy
Orgs
Health Systems
Pharma
Payors
Patients & Caregivers
IT Vendors
Other
Role of Patient Advocacy in Innovation?
Key influencers disrupting the healthcare landscape
Impacting strategies, policies, and setting the stage for patient-centric solutions
Thought leaders influencing the way healthcare systems think about and interact with patients &
caregivers
Patient advocacy organizations are a lifeline to patients and caregivers as they interface with the healthcare system and can serve as a liaison between clinicians and their patients
To fulfill its mission, C101, founded in 2002: − Meets the cancer patient and caregiver on the front line and turns a chaotic
experience into a calm and organized plan of attack − Provides innovative tools and resources patients and caregivers need to
manage chronic condition in partnership with the healthcare team − Creates a comprehensive roadmap for patients by filtering “garbage from
gold”, aggregating best practice content through partnerships − Personalization of the patient experience - one patient at a time-through
tailored education based on personal profile
Empower. Inform. Organize
To empower, inform and engage patients and their caregivers to take control over their diagnoses, navigate
the cancer journey, and partner with their healthcare team to make informed decisions
.
CANCER101 (C101)
Who We Are
Our Mission
'I am so grateful to have such a wonderful asset to help me along my cancer journey. The CANCER101 Planner has kept things neat and orderly. It has helped me know what to expect. It has calmed my anxieties and fears. This truly is a treasure and I can't think of any way to make it any better.'
- Norma W., Breast Cancer, Golden, CO
"...the perfect addition to her Personal Health Record and the hospital's Electronic Health Record since it enables her to document her thoughts and experiences in a way that complements the objective healthcare data gathered during the care process." – – John D. Halamka, MD, MS, CIO at Harvard Medical School & Beth Israel Deaconess Medical Center gives kudos to C101 tool for bringing order to wife's cancer journey http://geekdoctor.blogspot.com/2012/01/cool-technology-of-week.html
Cancer101 has been Featured On:
Empower. Inform. Organize CANCER101 (C101)
Press & Testimonials
C101 Today: Navigator Program Overview
Navigator Distribution
Cancer101’s Navigator guides patients through the cancer journey by: ‒ Igniting a participatory relationship between patient, caregiver and clinician
at the point of care, encouraging partnership that converges a patient’s day to day life expertise with a clinician’s medical expertise. ‒Providing information to understand treatment options ‒Deploying tools to track and manage symptoms and medications ‒Arming patients with a platform to keep it all organized
We distribute approximately 100,000 requests per year and receive over
300,000 requests for navigators.
‒Facilitating coordinated cancer management between patients, caregivers and the medical community ‒Enabling patients to document
experiences in a way that complements objective healthcare data gathered during the care process
C101 Today: Navigator Program
CANCER101 Today Navigator Sections • Tumor Specific Information (22 different Cancer Types) • myMedical History • Questions to Ask Doctor • What is a Clinical Trial? • Symptom & Medication Tracker
We partner with over 1200 cancer centers and community oncology practices to disseminate our materials in all 50 states & Canada. We have also received requests from over 40 countries.
Our Reach • Medical Bills & Insurance Tracker • 10 Year Calendar & Appointment
Tracker • Caregiver Support • Medical Dictionary • National Resources • Understanding the Healthcare System • My Toolbox (Health Summary
Templates, etc) • Managing the Costs of Care
CANCER101 Tomorrow: Addressing Unmet Need
Expansion to more
Diseases
Navigator Program
Research Platform
Medical & Community
Training
Innovation Platform
Expansion to Additional
Groups
Community Building
Personalized Education
Wellness/Prevention
A Case Study: How do we replicate success as we convert to digital?
E-Navigator
• Document and manage symptoms to share with the medical team
• Organize appointments/ task lists and set text /email reminders
• Record medications and associated adverse events/symptoms
Building Technology Based on Evidence Based Needs Cancer navigation is complex. Education and disease management are an important
component of care
Disease management systems can help bridge the gap in patient: clinician communications
Oversaturation of self management technology and very little information on the efficacy of the various tools
Disconnect between explosion of healthcare technology and point of care
Data not collected in a meaningful and standard method for the clinician to integrate seamlessly
Information overload
Most education is one size fits all Based on these needs, which tools work within the cancer community and which
don’t?
•
Research Assessment
Survey educational and tracking mechanisms that are currently being utilized by cancer community
Understand which educational & tracking mechanisms are most
beneficial to the patient and caregiver during treatment Which educational & tracking mechanisms are most beneficial to the patient: provider relationship?
Test disease management tools with patient/caregiver population Health literacy assessment Analyze & evaluate effectiveness Incorporate assessment into personalized solutions Build platform based on evidence
What is Missing? Code of Ethics
Science of Education
Innovation
Personal-ization
Participatory Education
Meaningful Data
Literacy
What is Missing?
How do we account for health literacy needs?
Health Literacy Assessment I. Assembled Health Literacy Committee: Message Content, Text
Appearance, Visuals, Layout & Design, Understandability, Numeracy, Measurement Systems & Graphs, Readability
II. Patient Focus Groups made up of varied patient profiles accounting for different age ranges, Ethnicities, Education level, Literacy Levels, Phase in Journey, Activation Level
III. Caregiver Focus Groups to address specific needs IV. Analyzed assessment data from patients, caregivers and health literacy
experts V. New Content & Redesign based on unmet need & feedback VI. Health Literacy Guidelines on Multi-Media
Planner-Next Edition
Personalized Education Dashboard
Personalization of the patient experience …one patient at a time
Interactive disease management system
Tailored education provided to patient based on personal profile, symptoms and medications entered
Customized education that builds a relationship with the learner based on entry points, symptoms & medications
Recommendation engine provides useful resources, and emerging research based on personal patient profile and usage trends
Sensory Mapping
• Track prescriptions and over the counter medications
• Manage expectations and understand medication and potential side effects by receiving information tailored to treatment pathway and specific side effects
• Set text or email reminders to remember to take medications
• Obtain alerts if there are any drug interactions or adverse events
The Patient Shark Tank®: If you build it, they will come? The Patient
How do you incorporate the voice of patient into the design, development or enhancement of innovation being developed by the healthcare community and move away from the notion: "If you build it they will come”? As each innovator pitches their concept, technology, or initiative, patient panelists will ask targeted questions based on their experiences to understand how the innovation will reach and uniquely respond to patient needs.
Patient Shark Tank® Scorecard
How do we address the patient: clinician communication gap using technology?
How do we solve for information overload, ensuring the patient has access to credible resources at relevant phase in journey?
Right information at the Right Time
Prescription to Learn TM
Prevention
Diagnosis
Treatment
CT Awareness
Long Term Survivorship
• Overwhelming amount of trackers, applications, brochures, books, websites, videos, tools, support communities that a patient has to navigate across cancer journey.
• Recommendation engine will provide other useful resources as a phase II based on search criteria
• Code of Ethics • Criteria • Matchmaking • Request for Solution
Prescription to Learn™ A learning platform that facilitates
connections by allowing the clinician to assess specific needs of the patient and personalize the education experience through a selection of educational interventions specific to phase in journey Emphasizes the need to
prescribe learning at the point of care-right resource, for the right patient at the right time Anchored on patient needs
promoting the inclusion of patients as vital partners in a continuously learning care team
How do we integrate explosion of healthcare innovation into point of care?
MATCHMAKING
Key patient engagement trends to watch
Gamification
Interactive care
planning
Personalized education
Personal Health
Analytics Social
engagement
Convenience
Cost transparency
Gamification Providers and payers experimenting with gaming:
Dr. Joseph Cafazzo using BANT to encourage children to manage diabetes: 49% improvements in adherence and 87% satisfaction rate
Kids using Zamzee showed 59% increase in moderate-to-vigorous physical activity, reduced LDL cholesterol levels, and improved blood sugar
DietBet and StickK enable people to bet on meeting their weight loss goals
Gamification
32
Insurers investing in gaming for behavior change:
Aetna: “Get active Aetna” and Mindbloom
Cigna links to “Daily Feats” to reward healthy behaviors
United, “Optimize Me” encourages earning digital badges with rewards
Wellpoint using Kinect to get kids to exercise
Interactive Care Planning
Done with, not to, patients
Incorporates patient goals
Incorporates family/caregiver
s
Connected devices and
trackers
Updated in real time
Trends and alerting
Personalized education
• Directly linked to patient’s conditions and issues
• Tailored to patient: – Learning style – Education level – Stage of disease – Activation level
Personalized education and activation Resistant Passive Informed Empowered Self-
Actualized
Extrinsic Intrinsic Motivation
Partners
Advisors
Authorities
Atti
tude
tow
ard
doct
ors
Personal health analytics
• Quantified self data informing clinical practice
• Recommended treatment plan incorporating:
– Personal genome profile – Critical triggers or disease
characteristics – Personal values and goals – Previous history
Social engagement
• Opportunity to engage with or compete against family and friends
• Opportunity to exchange data with patients like me
• Opportunity to enlist community in supporting achievement of health goals
Convenience as loyalty strategy
• Move to self-service • Investment in moving back office operations into patient hands
• Focus on location and nature of consumer/patient needs
• Even convenient billing can generate loyalty
• Strategy increases satisfaction while reducing costs
Cost transparency as differentiating factor
• Incorporating ways to simplify link between cost estimation, provider bill, insurance claims information
• Incorporating cost into shared decision-making discussion
• Recognizing cost as an “unmentionable” that affects patient actions
Patient engagement affects all dimensions of the triple aim
http://www.himss.org/ValueSuite
40 40
Engagement impacts experience and satisfaction
Engaged consumers have better
outcomes
Self-service strategies reduce costs
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