Presentation slides from 3/21/18 webinar.

eHealth Initiative interviewed senior executives at leading healthcare organizations to determine how policies, consumerism, and patient engagement strategies influence provider decisions. In this webinar, we will hear how the decision to acquire and use technology ultimately affects the revenue cycle.

This webinar will dive into:

• Value-based care trends and the impact on technology
• The role of patient engagement in technology decisions
• Adoption of technology
• Pre-Service innovations

Panelists:

Jeff Chester
Senior Vice President and Chief Revenue Officer for Availity

Taya Mohesier
Director of Health Policy & Product Development, H3C

Charlotte Hale
System Director Admission Services and Central Access, Cox Health

eHealth Initiative conducted a series of interviews to gain insight from an industry perspective on the impact of healthcare reimbursement policies on technology. In October and November 2017, twelve executives, primarily from provider organizations and health information networks (HINs), were interviewed for this research project. Executives answered questions that aimed to establish how policies, consumerism, and patient engagement strategies influence provider decisions around the acquisition and usage of technology, while also affecting revenue.

The key themes that emerged in the Workflows to Improve Patient Experience Roundtable were enabling relationships through technology; building relationships between stakeholders; appropriate care in all healthcare settings; navigation and coordination that solicits input from patients; and value across the spectrum (economic, quality of care and life, efficiency in relationships, support groups, self-care, shared decision making, parity).

The group choose three priority areas to address:

• Encourage industry to transform current portals from transaction based towards platforms that co-produce health and maximize relationships.
• Tie patient engagement to the business cases that matter to all healthcare stakeholders—growth, retention, efficiency, and empathy—so that reimbursement is not the only consideration when strategic health information technology (HIT) decisions are made.
• Advise and convene adjacent industries via eHealth Initiative to facilitate access to healthcare thought leaders and inform HIT leadership. These adjacent industries could be strong in personal technologies, platforms, consumer products, consumer services, entering healthcare or wellness (for example Apple, Mint, Amazon, Android), and include companies from areas of healthcare emerging as HIT stakeholders, such as genomic and research platforms (for example Seqster and Verily).

TRANSFORMING CURRENT PORTALS & POLICY PLAN

In the transformation of current portals, roundtable participants want vendors and providers to expand beyond the ‘plumbing’ to enhance methods and to move from one-way transactions to care team exchanges that are respectful and encouraging. Additionally, the meaning of “care team” should be defined by the patient, moving beyond the licensed provider. Transparency around price, quality, and experience is important. This priority requires the addition of patient advocacy groups to the collaborative and in inventory of who the advocacy groups are on a national and regional level.  

The policy plan to transform portals convenes stakeholders to draft policy statements on strategies that allow for innovation and self-care in medical devices and continued diligence and guidance in the following areas:

• Enhance Meaningful Use by liberating the data, adding new stakeholders, and reducing reporting requirements and administrative over-burden
• Create a standardized definition for telehealth and bi-partisan support for the Triple Aim, because telehealth contributes to better outcomes and lower costs
• Co-sponsor The Chronic Care Act
• Create an even playing field for all providers, payers and contract administrators so that paper/faxes can be eliminated and equal communication for both fee for service and value-based payment administration is achieved.

TYING PATIENT ENGAGEMENT TO THE BUSINESS CASES & POLICY PLAN

This priority has a guiding principle that mandates its work relates to a business case and data flow that supports productivity and enhances national growth. It requires new constituents, such as home health services, patient monitoring companies, device manufacturing, and pharma and provides opportunities for these new stakeholders. Policy goals include:

• Policy to consider a quadruple aim — Cost, Quality, Outcomes, and Productivity. Productivity as a measure can counteract “burden” by measuring regulation through this lens, for providers, patients, and all stakeholders
• Improve national productivity by 3%
• Continue with incentives that drive collaboration in care
• Educate policy leaders on the business case for patient engagement
• Connect issues to patient data flow and gaps in care and coordination to improve efficiency

INVITE ADJACENT INDUSTRIES & POLICY PLAN

Goal: Become the go-to organization adjacent industries look to for knowledge about healthcare

• Convene a group of adjacent industries
• Generate a whitepaper and webinars
• Create a journey map and persona for the industries to help inform the ideal engagement and relationship platform
• Prepare a proposal for non-covered entity relationships to patient data, in a secure and patient driven manner, including consent frameworks that are easy for patients to use and encouraging responsible use of patient information
• Encourage universal broadband access
• Educate and encourage industry knowledge and awareness of 5G
• Agreeable framework for data ownership & use

Article from Dunn, Margaritis, and Anderson (2017)

While grounded theory is often cited in the qualitative literature as the methodology, there are few good
examples of publications that follow the principles of grounded theory and result in an actual theory. The
purpose of this paper is to demonstrate how the Corbin and Strauss (2015) method of grounded theory was
used in a study looking at how patients with cardiovascular disease and diabetes develop health literacy skills
that are used to manage their condition. The key principles of grounded theory include theoretical sampling,
constant comparison, open, axial, and selective coding, the use of memoing, and theoretical saturation. Data
collection in this study was in the form of semi-structured interviews of 16 patients with cardiovascular
disease and diabetes, and 19 healthcare professionals that care for or educate these patients. Patients were
recruited from a primary care medical practice, a cardiology medical practice, patient focused programs
provided by the American Heart Association, and social media. Healthcare professionals were recruited from
the medical practices, the American Heart Association, and social media. Each interview was recorded,
transcribed, and coded. Insights from these interviews led to the development of the health literacy
instructional mode, which explores the use of digital tools, instructional approaches, social support, and selfdirected
learning in the development of health literacy skills, and is an example of the use of grounded theory
in cardiovascular research.

Literature review from Dunn and Milheim (2017)

The purpose of this paper is to: a) define how informal patient education manifests itself in healthcare settings, b) identify, through a review of literature, potential issues arising from informal patient education practices, and c) suggest ways nurses can further support and enhance informal patient education to help overcome these issues.