Many young adults do not have healthcare coverage because they feel they are less likely to need it. They're not invincible, though, so it's important that they make safe decisions that could impact them later.
Most of what health insurers send to physicians winds up in the trash. Who can blame doctors for hitting the delete button or finding the nearest wastepaper basket when an insurer, pharmacy benefit manager, or assorted vendor sends out yet another message about saving money?
The problem is two-fold: Doctors trust their own knowledge over a health insurer or vendor's software and physicians are inundated with so many communications that are either cost-driven or simply junk.
Dana-Farber Cancer Institute recently studied medication alerts in ambulatory care. The study found that electronic prescribing systems with decision support may well improve patient safety and protect patients against drug interactions, but physicians ignored most of the clinical alerts. Dana-Farber researchers suggested the current medication safety alert system is inadequate to protect patient safety.
Aetna's ActiveHealth Management has come up with a possible solution. ActiveHealth's Care Engine is a clinical decision support technology that gathers the medical, pharmacy, and laboratory claims data for members and compares it against the latest findings in evidence-based literature. The system sends clinical alerts, called Care Considerations, to physicians about potential issues, such as drug interactions, vaccinations, adding or intensifying therapy, and condition or drug monitoring.
The alerts are divided into three levels depending on severity. This means an e-mail alert is sent to physicians whose patients are in jeopardy while snail mail is the route for the patients with monitoring or preventive issues.
But, as I mentioned earlier, physicians often ignore messages. With that in mind, ActiveHealth recently tested whether sending the alerts to patients as well as physicians would improve overall compliance.
ActiveHealth found that informing both the physician and patient improved compliance to Care Considerations recommendations by 12.5%. They saw the greatest compliance increase in recommended screenings, diagnostics, and monitoring tests.
ActiveHealth gave three possible reasons why sending clinical alerts to patients as well as physicians benefitted results:
Messages reminded patients and reinforced physician instructions.
Patients who received the alerts brought information to the physician and reminded the doctor to write prescriptions or order tests.
The physician alert was sent to the wrong physician, but the alerted patient brought the message to the correct caregiver.
Stephen Rosenberg, MD, MPH, senior vice president of outcomes research at ActiveHealth, says a patient notification system is one way to get patients more involved in their care.
"This in a way empowers the consumer. We are not just telling the doctor 'you ought to do this for the patient.' We are telling the patient 'this is in your best interest,'" says Rosenberg.
As ActiveHealth's study showed, involving patients in their care is beneficial, but engaging the physician is equally important. How does a health insurer do that? Here are two avenues:
Stop sending self-serving junk that doctors don't trust or care about.
Help doctors create electronic handshakes by donating/help fund technology upgrades.
ActiveHealth expects that all of its physician alerts will be conducted via e-mail within three years, but most doctors don't have the technology to communicate with health insurers in real-time. Given the increasingly grim economic picture, health insurers will need to help physicians acquire the technology necessary for real-time communication and reimburse doctors for participating and following suggestions.
That's a way to get the doctors to pay more attention to your communications. However, there is still the question as to doctors receiving too much information (most of it worthless). ActiveHealth is exploring ways to distinguish the company's correspondence from others and integrate the messages into physician workflow that doctors will know is worthwhile. This also means limiting communication to truly important outreach and focusing on evidence-based, quality care in addition to cost savings.
Providing only worthwhile communication coupled with proper payments creates a program that could win physician approval.
Effectively reaching physicians is difficult, but a combination of patient activation and creating a valuable message that stands out from the pack is a combination that could just work.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.Note: You can sign up to receiveHealth Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
Reaching your target audience is difficult enough. But when your target audience includes all of the residents of New York City—who speak more than 88 different languages, difficult is an understatement.
New York City's Health & Hospitals Corporation (HHC) had challenging business goals that seemed, at first, at odds: To create a campaign that could reach out to the increasing at-risk, multi-cultural, New York City population and also lower the costs of bad debt, caring for the uninsured, and providing charity care.
Working with its agency, Princeton Partners Health in Princeton, NJ, the team started by integrating two of HHC's major healthcare plans: the Child Health Plan and the Family Health Plus plan.
"We really wanted to support the health and well-being of New York residents," says Gabrielle DeTora, vice president of health strategy for Princeton Partners. "So we worked with clinical and administrative leadership at HHC as well as plan leadership to tweak and make something that would really be useful, powerful, and applicable."
The result was the start of HHC's campaign and program: Take Care New York. "They really wanted to take care of their own," says DeTora, "they wanted to take care of New Yorkers regardless of their citizenship or their ability to pay . . . that's really where this idea was born."
The program enrolled uninsured patients into the integrated plans at low or no cost to the patient or their families. The plan also included comprehensive wellness health screenings to allow HHC to capture market share of the uninsured population as well as to catch health issues in the early stages.
The campaign used TV, radio, print, and local events at HHC facilities. To be sure word reached the target audiences, marketing pieces were produced in 23 of New York's most frequently spoken languages. NYC's "big apple" image appeared on each of the marketing pieces to establish continuity between the various elements and increase recognition.
Overall, 65,000 New Yorkers responded to the screenings. More than 12% required follow up care. HHC had also enrolled thousands into its health plans, which provided it with a 2–1 return on its investment.
Though meeting both business goals was an important part of the campaign, equally important was the way the campaign's execution allowed each resident, no matter their language or cultural background, to be informed of their health options and feel included.
Kandace McLaughlin Doyle is an editor with HealthLeaders magazine. Send her Campaign Spotlight ideas at kdoyle@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
Rob Lester, director of food and nutrition services at HCA's two-hospital Ocala (FL) Health system, was looking over his cafeteria spreadsheets in early 2008 when he had an epiphany. "I saw where in 2007 we had used 400 cases of disposable plastic spoons that come in cases of 1,000. When you think about those in real pieces going to a landfill, it's disgusting," Lester says. "I stared at those notes for a couple of days. I felt like there had to be a way we could make an impact."
So Lester looked into switching the utensils and to-go containers in the cafeterias at 200-bed Ocala Regional Medical Center and nearby 70-bed West Marion Community Hospital away from plastic and Styrofoam and toward recyclable and biodegradable alternatives. To gauge staff support for the idea, Lester sent out a notice to the hospital's 1,500 employees about a special Earth Day event on April 22, 2008, telling them about the plans to go green. He asked vendors to provide a one-day supply of biodegradable and recycled food service containers and utensils. Staff tasted food served in containers made of bamboo, a biodegradable material that resembles Styrofoam, and shredded paper, using utensils made from a biodegradable polymer and sipping drinks from cups made of corn starch.
The overwhelming response he got from employees surprised him. "People were crazy about it," he says. "I felt like we had to do something with this. I met with the administration and asked if I could try to put together a green program. They said fine as long as I kept the costs in line."
That's when he looked at the high cost of biodegradable food containers and had a second epiphany. It turns out being earth-friendly isn't always budget-friendly. The lidded white Styrofoam to-go boxes that sell for 7 cents apiece were a bargain compared with the biodegradable to-go boxes that cost between 15 cents and 20 cents each. A 12-ounce Styrofoam cup costs 3 cents, while a biodegradable corn starch cup costs 20 cents. "When you think about how many thousands of those we hand out each month, it really adds up," Lester says.
With earth-friendly products costing about three times as much as the standard disposable containers and utensils, Lester knew the switch to green wasn't doable. That's when he had a third epiphany. "We use real plates and bowls and silverware on our patient tray line. I got to thinking, what if we go back in time and see if we can bring china plates and stainless utensils back to the cafeteria." Lester says. "They aren't that expensive and you can use them over and over again. We put it all together and crunched the numbers and figured out that if we could get staff and cafeteria customers motivated to use the real china and stainless when dining in, we might be able to pull this thing off."
When some staff asked if the plates and silverware were sanitary, Lester invited them to inspect the hospital's dishwasher. "I've got a serious dishwasher," he says. "Our machine hits it with steam and kills everything. That helped."
Lester couldn't find a reasonably priced biodegradable cup. So, he bought 500 reusable 20-ounce insulated travel mugs, each carrying the Ocala Health logo. He sold them to employees at cost, along with a 25% discount on drinks. The travel mugs quickly sold out. He ordered 500 more. They sold out. He's awaiting a third shipment. "The mugs were made with recycled materials. I didn't plan that, but it helped to sell them a little bit more," he says.
So far the program has been cost neutral, but the reduction in nonrecyclable waste has been impressive. In January 2008, before the green initiative, Ocala Regional used 243 cases of disposable products representing 206,530 pieces at a cost of $6,338. In January 2009, Ocala Regional used 127,000 pieces at a cost of approximately $6,500. About 55% of those 127,000 pieces were recyclable or biodegradable.
To-go containers remain a big expense. In January 2008 Ocala Regional used 7,600 Styrofoam to-go containers at a cost of $636. In January 2009 the hospital used 8,400 biodegradable to-go containers at a cost of $1,943. "The cost is just crazy," Lester says. "That just shows how expensive that biodegradable stuff is. But we did reduce the non-recyclables by almost 100,000 pieces so we feel pretty good about that."
Ocala's emphasis on earth-friendly practices has not gone unnoticed. Last month, the Ocala Chamber of Commerce awarded Ocala Health its Environmentalist of the Year award. Lester says the only reason the program works is because the staff is committed to the idea. "You have to sell it to your staff. If they aren't committed it's not going to work," he says.
John Commins is the human resources and community and rural hospitals editor withHealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Community and Rural Hospital Weekly, a free weekly e-newsletter that provides news and information tailored to the specific needs of community hospitals.
Everybody's talking about social media, but it's hard to find examples of how, exactly, hospitals can use it to build their brand, create buzz, connect with physicians, and educate patients. One hospital that's getting it right: Henry Ford Health System in Detroit. Most recently, the hospital gained national attention when it performed a surgery and posted 140-character updates live on the micro-blogging site Twitter.
I asked William Ferris, Web manager at Henry Ford Health System (he also twitters about the Detroit Tigers), about the organization's social media efforts.
Gienna Shaw: So, why did your organization decide to describe the surgery live on Twitter?
William Ferris: We did the first one (the robotic cystectomy) in conjunction with the IRUS conference [the International Robotic Urological Symposium]. It was an opportunity to both try a new way to interact with patients and other physicians, and promote the IRUS conference. The feedback we received was generally favorable, so it became another way to share an innovative surgery with people, and it can be done in an interactive way.
GS: What were the benefits of this event—both for the audience and for Henry Ford?
WF: It gives patients and other physicians access into an OR to ask questions (even if it is only 140 characters at a time). We also were able to highlight a treatment option that isn't widely known, and in this case it saved the patient's kidney.
GS: What other social mediums does Henry Ford employ? In what ways do you use them?
Primarily these media are currently being used as distribution channels, but my goal is for them to be additional patient touchpoints.
GS: Are people paying attention? What kind of response do you get from patients and physicians?
WF: The response has generally been favorable. In the case of the surgeries we've been aided by the fact that Dr. Rajesh Laungani has turned out to be an excellent Twitterer, in my opinion. [Look for posts on Henry Ford's Twitter feed] He's a chief resident urologist and does a nice job balancing complex medical information physicians can use while answering questions in a way that non-clinical people can understand.
GS: How would you describe the state of social media in healthcare?
WF: Emerging. Many institutions (including Henry Ford) are trying to find out how to best leverage these tools. It provides another mechanism to interact with patients and outside physicians while also another channel to communicate your message. And it can be done at a relatively low cost. But understanding the right balance points for transparency and privacy are important considerations that we're still exploring.
So what can healthcare marketers learn from Henry Ford?
First, participate in multiple social media sites to strengthen your online presence. Remember that many of your customers are still just dipping their toes into social media, too. You have to reach them where they are, and that means cross-promotion on multiple platforms.
Second, don't just use Twitter or other sites as glorified press release feeds. You might not be ready to take as dramatic a step as twittering surgery live, but you can focus on your own strengths and tell your unique story.
Third, make sure the conversation is two-way. During the surgery (and for some time afterward) viewers posted questions about the event, engaging with the surgeons who were in the OR (and no, the surgeons did not twitter while they were performing the surgery—another doc was there to monitor the computer screen, post updates, and answer questions).
What can you offer to online audiences that other hospitals cannot? What can you do that is different, that will help your organization stand out? Henry Ford wanted to promote its surgeons and its technology. Decide what you want to be known for before launching an online persona. And then ask yourself how you can communicate that in new and buzz-worthy ways.
The process of creating your brand is the engine that will ultimately drive your ability to deliver and sustain it. Often marketers focus first on developing a campaign to define and communicate the brand without developing the relationships that bring the brand to life. Here are 10 steps to take.