This rise of consumerism is leading many health care organizations to rethink their information technology strategies. "In the past, decisions about the kinds of technologies to purchase and implement were driven by how they would make our lives easier here," says Jim Beinlich, associate CIO at University of Pennsylvania Health System. "Now the perspective is 'how does this technology support creating the ideal patient experience?'"
To make sure consumers' demands are met, health care organizations must take steps to involve physicians, nurses and marketers, as well as technology experts, in their strategic decisions about I.T., Beinlich says. "If the I.T. department was the only group trying to make these decisions, we wouldn't be as sensitized to the consumer aspect of this as we are," he adds.
"Consumerism is really impacting what patients expect with regard to how they interact with health care providers and payers," says Dan Garrett, health care I.T. practice leader at Price Waterhouse Coopers, a New York-based consulting firm. Consumers want easier access to information as well as better access to clinicians via e-mail, telemedicine and other options, he says.
A Big Step
Once health care organizations offer more online services, they'll need to take an even bigger step, Garrett stresses. That step involves offering what he calls "personalized medicine," supported by robust outcomes research.
Savvy health care shoppers, who increasingly are responsible for more of the cost of treatment, are asking doctors tougher questions about the scientific evidence that supports a proposed treatment plan, the consultant says. "A person with cancer is going to demand facts on what treatments are yielding good results," he points out. "They want to know that their doctor has access to that data or they're going to get nervous and get a second opinion."
As a result, hospitals eventually will have to go far beyond such consumer-oriented offerings as Web portals, e-prescriptions and online bill pay. They will need to conduct meaningful research based on the data in electronic health records, Garrett contends. "Aggregating data on segments of patients with chronic diseases will give clinicians the power to start looking at what works and what doesn't work and when and why," he says. In addition, hospitals ultimately will pair this research with patients' genomic profiles to build truly personalized medicine, he predicts.
"All the players in this industry are making choices right now about how responsive they want to be to the expectations of a new generation of patients," Garrett says. "As they do that, they're going to determine how sustainable they will be."
Responding to consumer expectations is such a high priority for Florida Hospital that it's created a new position called "director of the experience network." The post, held by Jason Wells, oversees the use of technology to support patients before they arrive, during their treatment and after their discharge.
"It's part an overall communication strategy to get to the patient sooner and stay communicating with them longer," Wells says. One important goal of the effort, he explains, is shifting from being an acute care provider to serving as a "wellness partner" to build consumer loyalty.
The effort at Florida Hospital, which owns seven hospitals, started with an interactive patient education system in hospital rooms. But other organizations are taking a wide variety of initial steps, including building patient portals, creating quality scorecards, offering e-mail links to doctors and nurses or accommodating online bill payments.
The ultimate model for chronic care, some say, is the Medical Home, where a primary care physician coordinates care, supported by a personal health record and other technologies (see story, page 75). Some payers also are jumping on the PHR bandwagon in response to consumerism.
Meeting the needs of younger consumers, however, takes some ingenuity. For example, one payer is using text messages to get the word out about its health plans (see story, page 78). And for the sickest of the sick, sometimes an online chat can provide a wealth of relevant information (see story, page 80).
At the Philadelphia-based University of Pennsylvania Health System, all technology acquisitions are weighed on whether they help meet consumer expectations, says Beinlich, associate CIO. One reason this is so important, he says, is that the academic medical center is competing to attract patients to participate in clinical trials. "We don't want to lose patients who are very savvy about their care," he says.
The three-hospital delivery system is developing its own data warehouse, in part, to help it demonstrate the quality of care delivered to consumers. The warehouse, linked to various clinical information systems, enables researchers to conduct massive outcomes studies, Beinlich says. But even individual physicians can query the database to investigate which of their treatments for a condition have yielded the best results.
In addition, the academic medical center has rolled out electronic health records at its outpatient sites. It's also using a patient portal from its records vendor, Epic Systems Corp., Verona, Wis. Patients can use the portal to request medication refills, appointments and referrals. They also can use it to update their problems list and provide other information.
Electronic health records are an integral part of the consumerism trend, Beinlich contends. "We can't push out reminders for flu shots or test or screening unless we have the right data in the electronic record," he notes.
In shopping for a new practice management system for its clinics, the organization is seeking an application that will help it ease scheduling for patients across all its many caregiving sites.
"We're a lot less focused now on how the new practice management system will support our back office functions. We're more focused on how it helps our front offices and how it makes it easier for a patient to book an appointment online or pay bills online," Beinlich says.
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