Optum: Patient Expectations vs Reality

It’s difficult to quantify exactly what a perfect healthcare consumer experience looks like. That’s why most coverage of rising patient expectations involves pointing out differences between broken care experiences and Amazon Prime, and why it’s worth taking a closer look when a company like Optum puts out an in-depth report on the topic.

Optum surveyed over 1,000 consumers to explore how payors and providers can adapt their digital on-ramps to healthcare (online portals, websites, mobile apps) to optimize for patient satisfaction.

Highlights from the report centered around the expectation vs. reality gaps for these digital front doors, with the largest rifts found between: finding information about providers (i.e. ethnicity, gender, and licenses), ability to schedule an appointment online, and booking telehealth visits.

  • Scheduling disconnects were most acute for consumers ages 25 to 34, with 45% preferring online scheduling, but only 28% doing so today.
  • The cross-generational divide for engagement preferences has shrunk, with 44% of 55-64 year olds preferring text messages for post-appointment provider communication – just a few percentage points behind phone calls (47%) and email (49%). 
  • 52% of respondents missed a scheduled appointment in the past year, suggesting that there’s plenty of room for payors and providers to improve engagement. The most cited reason for missing an appointment was that they simply forgot (33%).

The Takeaway
The consumerization of care has been one of the biggest themes of digital health for years, and the past few weeks were no exception. Although the core idea is no longer a surprise, Optum did a great job wrapping numbers around areas where healthcare experiences are falling short, and drove home the point that removing friction for those seeking care is one of the best ways to attract and retain new patients.

Happify Health Weaves a New Path as Twill

Happify Health recently re-introduced itself to the world as Twill, the Intelligent Health Company.

While a name change and a shiny new logo probably wouldn’t warrant a full feature story, Twill’s fresh identity was tied to a complete overhaul of its business, and reflects the culmination of its five-year journey from a wellness app to a clinical-grade connected care platform.

Twill’s transformation centers around its three core pillars of a connected care experience. 

  • Untangling the complex digital health ecosystem to make the process of finding the right care more personalized and engaging
  • Weaving together evidence-based digital therapeutics, wellness coaching, and third party solutions into Sequences that help patients navigate their care journey
  • No fabric pun was stitched into the press release for this bullet, but the final pillar is about leveraging AI to intelligently guide patients to appropriate care based on their clinical needs and personal preferences

To accomplish these goals, Twill provides fully-configurable Sequences that combine its digital therapeutics with existing partner solutions to address specific clinical needs. The Sequences employ AI and behavior change techniques to steer patients towards positive outcomes at each step of their journey.

  • To give an example, a patient that joins Twill’s psoriasis Sequence would be onboarded with a questionnaire and given access to a content library for their condition. If their responses indicate that their condition is still being managed by their PCP, Twill might direct them to a dermatologist before presenting them with Almirall’s psoriasis treatment after other milestones have been reached.
  • By the end of 2022, Twill and its partners will offer Sequences for four conditions: mental health (Happify), pregnancy (Elevance), multiple sclerosis (Biogen), and psoriasis (Almirall).

The Takeaway 

Even in its past life as Happify Health, Twill’s biggest strength was its ability to blend AI and intelligent design to create real behavior change. Now, with a new brand and configurable Sequences that can weave together outside solutions as needed, Twill has a much more scalable platform that should let it quickly expand into more clinical areas as it grows beyond its wellness app roots.

Memora Raises $40M to Simplify Care Delivery

Although sky-high private valuations made a slowdown in healthcare venture activity a popular prediction for 2022, it sure doesn’t feel like that’s the case six weeks into the new year. Care automation platform Memora Health recently raised a $40M growth round to help more health systems provide proactive care from any setting.

  • Memora Health builds the technology infrastructure behind “learning health systems,” with an AI-enabled platform that automates complex care workflows and improves them over time by learning from the ongoing behavior of patients and providers.
  • The platform includes SMS-based patient messaging, reminders, and scheduling to create continuous patient touchpoints that allow providers to collaboratively manage care journeys and monitor progress.
  • Data from questionnaires and EHR integrations help triage concerns to appropriate care team members while providing patients with proactive communication about their conditions, ideally improving the efficiency of all parties involved.
  • The funding will help Memora meet commercial demand and drive new partnerships with health systems beyond the organizations it already works with, which include Mayo Clinic, Edward Elmhurst Health, and Penn Medicine.

The Takeaway

Memora is solving one of the most pressing challenges facing health systems by automating components of the care journey and allowing time-constrained providers to practice at the top of their license. In doing so, the company is simultaneously pushing the transition from episodic to continuous and always-on care, which seems like a pretty solid combination of goals to build around in the current healthcare landscape.

Babylon Acquires Patient Engagement Platform DayToDay

Value-based care enabler Babylon is wasting no time making M&A moves in 2022, announcing patient engagement platform DayToDay as its second acquisition in as many weeks. 

Just days after kicking off its US expansion by acquiring health kiosk manufacturer Higi, Babylon is bolstering its remote care capabilities with DayToDay’s digital-first programs supporting patients through major health events such as surgeries, childbirth, and the diagnosis of chronic conditions.

  • DayToDay supports patients during crucial recovery periods that often extend beyond a hospital stay. It provides targeted education resources and clinical support from a personal care team, a strategy that it reports is able to keep rehospitalization rates below 4% (vs. a 15% industry average).
  • Babylon works with providers, employers, and payors to offer members digital-first healthcare through the devices they already own. Its AI platform powers its Babylon 360 value-based solution as well its Babylon Cloud Services data analytics suite.
  • The combination of DayToDay’s patient engagement services with Babylon’s existing offerings should enable better care delivery for both the hospital setting and the home, widening the impact that Babylon can have across the care continuum.

The Takeaway

Babylon’s goal is to “make high-quality healthcare accessible and affordable for every person on Earth,” a mission that’s as big as the company’s appetite for acquisitions that could help make it happen. The Higi acquisition was a strong entry point into US healthcare, and DayToDay’s patient engagement services strengthen Babylon’s value-based care portfolio as it establishes itself internationally.

Phreesia Acquires Insignia Health

Patient engagement company Phreesia recently announced its acquisition of Insignia Health to help patients become more active participants in their care journeys.

  • Phreesia provides services focused on “putting tools in the hands of patients to take on tasks,” ranging from scheduling to self-reporting social determinants of health. Each service is designed to make care more efficient through patient activation.
  • Insignia Health holds the worldwide license for the PAM patient activation measure, which allows clinicians to quickly understand a patient’s ability to self-manage their healthcare. PAM is backed by over 700 peer-review studies and is the only measure of patient activation used by the NHS and CMS.
  • PAM levels include “disengaged and overwhelmed,” “becoming aware but still struggling,” “taking action and gaining control,” and “maintaining behaviors and pushing forward.” Knowing a patient’s level allows care teams to cater treatment plans to individual needs.
  • The acquisition expands PAM’s reach through Phreesia’s existing partner network. Insignia Health founder Chris Delaney stated that “the number of patients we can reach in a single week through Phreesia’s platform would otherwise take us months.”  

The Takeaway

Improving outcomes through individualized care is a top priority for any patient engagement company, and the Insignia Health acquisition gives Phreesia the license to the “gold-standard” of patient activation measures.

Owning PAM could generate additional revenue for Phreesia through licensing, but might also lead to Phreesia cutting back on the number of competitors that have access to PAM in order to strengthen its competitive positioning.

Suki Raises $55M to Bring Voice to Visits

Although some physicians might love the time-consuming administrative tasks that help make a successful patient visit, Suki recently raised a $55M Series C round to help develop AI-enabled voice tools for those that don’t.

As of the latest funding, the company has raised a total of $95M to support the development of Suki Assistant, its voice-first digital assistant, and Suki Speech Service, its platform designed to improve the accuracy and experience of voice solutions.

  • Suki uses natural language processing to create patient notes and streamline administrative tasks, such as retrieving information from the EHR or ICD-10 coding. 
  • The digital assistant supports doctors “in any clinical setting, as well as any specialty,”  and can be configured with personalized commands to adapt to unique workflows.
  • Early research shows that the assistant lowers average time per note by 76%, while decreasing claim denials by 19% through the creation of detailed documentation.
  • Voice is quickly entering the healthcare spotlight, with Notable raising a $100M Series B in September and Microsoft acquiring Nuance for nearly $20B earlier this year.

The Takeaway

The accuracy of voice recognition has crossed a threshold that allows it to be effective in a growing number of consumer products, as well as in healthcare. These tools can now understand a speaker’s intent regardless of most accents or phrasing, leading to wider adoption within previously difficult use cases.

In a roundabout way, Suki is taking a tech-heavy approach to making technology less visible, removing it from between the doctor and the patient so that more attention can be given to providing clinical care. Taking advantage of voice is a natural way to accomplish this, giving Suki a good shot at reducing burnout by allowing more time for physicians to actually practice medicine.

Digital Experience Key to Patient Acquisition

The digital patient experience and online provider reviews continue to see a growing role in both acquiring and retaining patients, according to Press Ganey’s 2021 Consumer Experience Trends in Healthcare.

The report includes key drivers behind current healthcare consumer behaviors based on a survey of over 1,000 adult patients. Several themes emerged from the responses, each highlighting the fact that healthcare consumerism is on the rise, and here to stay.

Digital drives choice. Patients utilize digital resources 2.2x more than provider referrals

when choosing a healthcare provider.

  • Ratings and reviews are the top influence on a consumer’s decision to book an appointment, followed by referrals from a current doctor.
  • The average patient looks at 5.5 online reviews before selecting a new provider.
  • 61% report that poor-quality reviews would discourage them from choosing a provider.

Search engines are just the start. While search engines are the most used online resource during care-seeking (65%), consumers use an average of 2.7 different sites for research.

  • Since 2019, there has been a 54% increase in the usage of healthcare review sites (e.g. Healthgrades and Vitals). 
  • By contrast, there’s been a 23% decline in the search engine use over the same period.
  • 47% of patients search for the type of doctor they’re looking for and “near me,” while only 16% search for their condition or treatment needed

Customer service is the new bedside manner. Patients rate “customer service” (71%) and “communication” (63%) as more important than “bedside manner” when it comes to a five-star experience.  

The Takeaway

The above trends indicate a steady convergence between healthcare and retail behavior. Consumers use similar criteria to book a hotel or dinner reservation as they do to find a doctor, and they’re growing accustomed to using online reviews to share and research the experience.

While the need to have a “digital mindset” is getting to the point of being a healthcare platitude, the Press Ganey report does a great job emphasizing the fact that a digital strategy involves not only the online patient experience, but also the cultivation of a good online reputation.

CHIME: Patient Engagement on the Rise in 2021

CHIME’s recently released 2021 Digital Health Most Wired Survey explores how the pandemic and regulatory changes have fueled a surge in adoption for patient engagement technology over the past year.

The survey of nearly 750 healthcare organizations offering acute, ambulatory, and long-term post-acute care (LTPAC) assesses the progress these providers are making on their digital transformations, offering insight into the adoption of several new technologies.

Patient Telehealth Use Stabilizes

  • Telehealth use has stabilized as a hybrid care option for most organizations
  • 77% reported that >10% of patients used telehealth in 2021 (up from 67% in 2020)
  • 26% reported that >25% of patients used telehealth in 2021 (down from 32% in 2020)

Patient Portals Expand Capabilities

  • 88% of ambulatory care organizations report that >25% of patients accessed their portal in the last year, vs. 83% for acute and 82% for LTPAC
  • Many portal capabilities are now considered standard, with test results and secure messaging all adopted by >90% of organizations
  • OpenNotes access saw the most dramatic growth, up to 89% adoption in 2021 (vs. 65% in 2020)

Mobile Apps Gain Functionality

  • Most common mobile app capabilities are text reminders (86%), EHR access (84%), prescription renewal (84%), and visit scheduling (80%)
  • Service pricing lists saw the most growth in 2021, up 22% in 2021 (50% adoption)
  • LTPAC organization apps have a wide feature gap, with text appointment reminders and wayfinding functionality each 18% less common than in acute and ambulatory care apps

The Takeaway

The rising adoption of new patient portal and mobile app features underscores the fact that most healthcare organizations have been fairly agile in their response to the pandemic, aiming to provide patients with greater transparency into their own care.

Telehealth’s continued climb in utilization is balanced by the fact that fewer providers are using it as their only way to offer care like during the pandemic, and instead viewing it as a core component of a modern patient experience.

Unsatisfied Patients Turn to the Internet

According to a new study from the AHIMA Foundation and Kelton Global, there is a large disconnect between the information shared by doctors and their patients’ understanding of it.

This communication breakdown leaves patients confused about how to proceed, prompting many to turn to other resources to feel more in control of their health.

  • The survey was distributed to a nationally representative sample of US adults in August 2021 (n=1,059), finding that 76% of Americans “do not leave their doctor’s office on a positive note,” due in part to lacking clear answers to questions (24%) or not having the chance to ask any questions (17%). 
  • After these visits, 62% of Americans are “not extremely confident” in their understanding of information discussed with their doctor, while 15% admit feeling more confused about their health than they did before their appointment.
  • As a result, 80% of Americans research medical recommendations online following an appointment, reporting that they are confident the information on the internet is credible (86%) and that it allows them to feel more confident in their doctor’s recommendations (35%).

The Solution

The researchers conclude that having access to a complete picture of your own health, whether through a doctor’s visit or internet research, is the key to seeing better health outcomes. Most Americans seem to agree, with 81% of survey respondents saying that if they had access to all their health information, such as medical records and test results, they’d see at least one improvement in their health management.

DHW Q&A: Humanizing Healthcare With Accenture

With Darryl Gibbings-Isaac, MD
Accenture, Senior Manager – Strategy

Consumer expectations are rising for healthcare experiences, and technology is playing a key role in meeting the demand for convenient and accessible care.

In this Digital Health Wire Q&A we sat down with Accenture’s Darryl Gibbings-Isaac, MD, to discuss the future of digital health and the importance of keeping patients at the center of the conversation.

The US healthcare system is under a lot of pressure from an aging population and a shortage of healthcare workers. What does it take to ease this burden and where does technology fit into the picture?

Technology has to play a role in augmenting what humans can do. Traditionally, healthcare has been a very human-centric system. Technology is going to be important in lowering the cost-to-serve, which will help increase access, by augmenting what clinicians can do. It will also help with healthcare worker burnout by offloading more tasks.

Technology’s relationship with humans is going to be the key thing. We’re talking about augmenting clinicians, not substituting clinicians. The conversation isn’t about doing more with less. 

We can also use technology to augment humans on the patient side. The question is about how we can enable patients to take care of themselves in situations where that’s appropriate. As an example we already see this with different symptom checkers, which help provide a guided, structured way to reach the best care.

What are some of the tools that you believe show the most promise in augmenting patients?

There are a lot of tools that take into account behavior change and behavioral science techniques to really go beyond the nudge and actually put a message in context of that patient and their daily lives. This enables a better response from that patient and allows them to manage their care in a better way. 

There’s also the data coming in. We’ve seen wearables on the consumer level where health information can be fed to patients outside of a clinical interaction and they can see if there’s something they need to do about it. As long as you pair the data with a simple and easy to understand action, that is cognizant of behavior change, you can have an effective result.

The other realm is virtual health, which enables more of the diagnosis to happen on the patient side. One way this happens is to empower patients with remote examination devices. The other way involves the “care anywhere” model and guiding patients through retail-based settings where they can get blood draws, or even imaging. Having more data generated on the patient side allows clinicians to make a decision fairly quickly when they actually see it.

Do you think we’re going to continue seeing a shift to remote care and a hospital-at-home setting?

We definitely believe that shift is going to happen for a number of reasons. The first is around experience. We’ve seen during the pandemic that experience matters and that convenience matters. We believe the tools that can bring care to where the patient is are going to be quite successful.

You also have to look at the model for centralized care, where you absolutely have to have specialized resources, and the hospital will still make sense. However, that’s the most expensive form of care in the way that it’s configured, and in a world where we need to reduce the cost of care to improve access and keep up with demand, we’ll almost have no choice but to configure other spaces to meet those same needs.

Accenture recently released a Patient Experience Survey where you found that two thirds of consumers have had a poor patient experience with a provider. How can providers improve the patient experience to meet rising expectations?

Consumers have liquid expectations from their other experiences outside of healthcare, and in order for providers to keep up with those, I think they have to understand a couple of things.

One is that experience matters, and we’re seeing that shift more and more. But it’s not just understanding that experience matters, it’s understanding which experiences matter, and asking “what are the moments that matter most to the patient.”

When we’re talking about providers, we’re not just talking about clinicians, but also the whole organization that’s managing the experience. It’s not a one-and-done situation, but something that needs continuous monitoring, so metrics are needed on the other side of it.

You have to measure consumer experience levels to have a foundation for improvement. If you recognize that the levels are going down, you need to understand why they’re going down to make adjustments.

What are Accenture’s current top priorities in the healthcare industry?

Improving the consumer experience is definitely one of them. We’re often using human-centered design to solve these problems, and placing the patient at the center of the solutions. We’re also looking at how you can unbundle care and the components around it to create a location agnostic care model. 

The first part of the equation is more design-centric, while the other side of the equation is more operation-centric. I think you need to be able to do both of these things, as a health system, to really be at the top level in today’s world.

What are the biggest challenges when focusing on human-centered design and changing healthcare?

There have been many different approaches to changing healthcare, each with varying degrees of success. We’ve seen entities come from outside of healthcare and try to disrupt it. Changing healthcare from the outside is a tall order.

Where we’ve seen this be most successful is with true partnerships that are not only inspired by the health system, but also instigated by it. Both sides have to want change before an outside partner can come in and reimagine how care is delivered.

We also need to keep putting the patient at the center of these conversations, and I’d go even further and say that we need to put humans at the center, because it’s not going to work just designing for the consumer. You have to design for everyone within the ecosystem.

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-- The Digital Health Wire team