Monday, October 17, 2016

What are some ways payers can use digital to reinvent their business models?

As someone who's been working in healthcare, mainly for health plans, payers and risk-bearing providers for over 20 years, I'm always interested in what others have to say about health plans and those who assume payment risk.

One of the topics in last month's #HealthITChicks tweetchat, held on September 22, 2016, and hosted by Sukanya Soderland @SSoderland, Health & Life Sciences Partner at Oliver Wyman, caught my eye:

T4: What are some ways payers can use digital to reinvent their business models?

The need for healthcare payers to provide succinct, easy-to-understand information about benefits and payment made for member benefits dominated the conversation on Topic #4. Here are all the responses I was able to glean on this topic from those participating in the #HealthITChicks chat:

Stop with the fax machines! Seriously. Because I don't have one, and I'm not going to Kinkos to fax an auth form.
I've loved the fact that our health insurance offers telemed via @MDLIVEInc
Digital = less cryptic re: benefits, coverage, price transparency; easier, more frequent engagement w/ pts
Pretty low bar - nowhere to go but up! Step 1: Access to benefits, $ info, accurate provider directory for a start
Pricing that's easily understood. Tired of calling for preapproval only to be railroaded by some obscure fine print.
I think payers can play in pop health. I don't mind a prevention email. "It's that allergy time of yr again"
Can they work with providers on #pricetransparency? I want to know how much care will cost me up front please.
It's probably more like a billion $ question. The answer is the billions of $ hidden in those EOBs.
Online scheduling, for goodness sake!! I'm a working mom with 2 young kids. I don't have time to wait on the phone.
Yes! They often have the data needed to facilitate effective #PopulationHealth programs.
Payors lag behind. Need to invest in IT infrastructure to improve partnerships with providers and consumers
And payers, stop making the discounts not disclosable to patients until the bill. That's NOT transparent, it's misleading
Step 2 payers: getting care summary, plans, alerts to Mobile - NOT another portal (not to beat the portal prob to death)
Payers really don't have the trust of their members, because their business model focuses too much on $$, not enough on care
A story in Participatory Healthcare describes patient trying to get a cost estimate. Req 15 phone calls+web visits + emails
How about eliminating EOBs? What about providers/payers reconciling bills without patient in the middle? 1 process,…
What, do away with a whole "cottage" industry of healthcare bill navigators?! đŸ˜‰ agreed - let's make EOBs way better
Yes! Neither doctor nor patient know how much the insurance will pay and how much will be "denied" and why

So thanks to all those who regularly share their knowledge, expertise and opinions about healthcare and healthcare IT - via tweetchats like #HealthITChicks and via Twitter and other social media channels. You can follow me on Twitter where I regularly share information about healthcare data, technology and services.

Tuesday, October 11, 2016

Guidewell Interviews Iodine’s Thomas Goetz at Singularity University’s Exponential University

This week, the GuideWell Insight Lounge was at the Singularity UniversityExponential Medicine conference. Jessica DaMassa of GuideWell interviewed Thomas Goetz of Iodine.

Jessica posed questions about his experience with engaging consumers, what providers think and need from apps that serve patients, and what thinks has the most potential to impact the consumer experience moving forward.

Here's a transcript of the interview from GuideWell's channel for the Exponential Medicine event:

Jessica DaMassa: Hi this is Jessica DaMassa; I'm here at the Guidewell Insights Lounge at Singularity University in Exponential Medicine. I'm joined by Thomas Goetz; he's the CEO of Iodine. So Thomas, tell me a little bit about Iodine. What is that?

Thomas Goetz: Well thanks for having me. Iodine is a consumer technology company. We develop tools, for both web and mobile, for people to make better decisions about their medications; find out what's going to work for them better. Kind of like a Yelp for medicine.

Jessica DaMassa: Yelp for medicine. I love that. That's a great little buzz phrase.

Thomas Goetz: Time magazine said that, not me.

Jessica DaMassa: Really. Well there you go. So what are you seeing so far in terms of consumer engagement with the technology? Are you having good uptake?

Thomas Goetz: Yeah so the whole the whole trick or riddle for us is: how can we get people to share their experience of different medications, right? Because, you know, what we know about medications is really based on randomized control trials; clinical trials which are highly artificial, highly kind of managed. And then, the drugs going to the real world and the effect of them can be quite different. So we wanted to understand what happens to real people in the real world of medicines and how do we use that data to provide more guidance for other people.

Well in order to make that happen, you need people to share. So getting, building tools and resources that people not only find useful but are willing to donate and and basically share their own experience is really the trick of the trade.

Jessica DaMassa: So we've been hearing a lot about obviously data here I mean collection of big data and the opportunity for it. From a patient engagement standpoint, can you talk a little bit about maybe some of the challenges that you guys are having getting patients to engage, to contribute their data. I know security is an issue and all those things so talk a little bit about what you're encountering.

Thomas Goetz: Yeah so it definitely is the main challenge and I think one of the things that the healthcare industry in general is not very good at understanding is who the end user of consumer technology is; the end user being the patient. But it's really difficult to get that person, that patient to really contribute, to share, to participate in these patient engagement programs that are patient portals, it’s all, honestly it's not some very well designed in terms of human experience. So we really try...

Jessica DaMassa: To make it better!

Thomas Goetz: Yeah, exactly. What, well first of all, designing it as consumer software instead of healthcare software. That was really the first insight that we had. So my co-founder is a developer from Google and we really put a lot of emphasis on things like speed; how quickly can somebody get through a process; how can you develop meaningful insights from the least amount of data. So it's really understanding what consumer technology has spent years and billions of dollars getting right and bringing that to healthcare.

Jessica DaMassa: How does your solution interact with the traditional health system? How's the update going?

Thomas Goetz: Yeah so our mobile strategy, basically, is to have people use a mobile app that, when they started medication, they use the app and they're able to check in, share their experience. But out of that data, we start to create a loop or what we generate a progress report. And those reports can be really powerful for not just the person in understanding their experience on the medication but also for the doctor.

Jessica DaMassa: Sure

Thomas Goetz: Because oftentimes the patient is largely chronic care outpatient setting so the person leaves the doctor's office with a prescription and the doctor has no sense of whether it's working or not, for months. So we basically create a real-time awareness of what's happening with that patient.

Jessica DaMassa: And what kind of feedback are you getting from providers?

Thomas Goetz: So we thought - actually it's been very positive - we thought it was going to be more suspicious; more concerned that we were in effect replicating what the doctor is supposed to be doing. But frankly, doctors are outmatched in the amount of expectations that we have around what they're doing and how closely they’re monitoring patients. And so building software that can actually automate those processes that are typically manual, that's what software is for.

Jessica DaMassa: Right. So as far as some of these other exponential technologies that we are seeing, you know, and talking about here xMed, what do you think has the most potential to impact the consumer experience moving forward?

Thomas Goetz: So the thing that I think is cool about what, I mean it's all very cool, but for many years I've talked about the future of medicine and the third feature medicine but what I think is actually changing and very promising is the ideas around artificial intelligence, machine learning and bringing, basically, some sense of predictive intelligence to help guide patient, the patient journey so to speak.

What is the best course of action for a patient? And I think that's a lot of what you see, is thinking about okay what is the layer of artificial intelligence that we can bring into care that makes for not only more informed patient but also a faster kind of movement through the trial-and-error process.

Jessica DaMassa: So what, in your opinion, what area of health care needs to be disrupted next?

Thomas Goetz: Oh…goodness. Well, all of it. Ok I'm excited about the changes that are coming to the insurance industry. I mean not what we're doing but I'm just excited about it generally. I think the insurance, you know, there's some pressure from the ACA that is moving from top-down systems but also some bottom-up innovation that I think would be really dynamic and really changed what we expect as people as consumers out of our insurer relationship.

Providers, I think providers are going to have more. They need more time there. I mean that the rate of physician burnout is exorbitant.

Jessica DaMassa: You hear a lot about that.

Thomas Goetz: Yeah. So creating tools that not only make them more efficient but also more happy and fulfilled in the care that they provide; I think that's going to be a huge. There's basically, it's aligning incentives, right? We want better care. But unless you get physicians to want to use a new tool and something that works into the workflow and benefits them in a day-to-day basis, you're not going to kind of foist the tool on them. So those are, those are kind of the tricks of disruption in health care and medicine - are unique.

Jessica DaMassa: Excellent! Thomas, thank you so much for joining and...

Thomas Goetz: Yeah, yeah it was fun.

Jessica DaMassa: We appreciate your input especially on the consumer engagement side of things and hearing how technology is really making a difference in that experience for the patient. This is Jessica Demassa reporting from the Guidewell Insights Lounge.

Saturday, October 8, 2016

GuideWell CEO Dr. René Lerer Talks About Innovation in Population Health

source: GuideWell Insights Lounge - YouTube Channel
The GuideWell Insight Lounge was at the Oliver Wyman Health Innovation Summit two weeks ago. Kate Warnock of GuideWell interviewed about two dozen executives and other thought leaders in the healthcare space; one of them was Dr. René Lerer, GuideWell's president.

Kate posed questions about population health, the social needs of the senior population and the recent Greater Than Cancer Immersion Event. Here's a transcript of that interview.

Kate: Hi everyone and welcome back to the GuideWell Insights Lounge. We're here at the Oliver Wyman Health Innovation Summit. My name is Kate Warnock and I have with us right now GuideWell’s president, Dr. RenĂ© Lerer. RenĂ©…Welcome.

Dr. RenĂ©: Thank you. It’s a pleasure to be here.

Kate: We're happy to have you here with us every day. Let's start with your first question. You're going to be talking on the summit you're going to be on a panel talking about ‘Beyond The Checklist’ and how do you really improve population health. RenĂ©, what are some of the things that we really do need to address the population health so that we began to transform that experience?

Dr. RenĂ©: So population health, first off, is what it says: it’s understanding your population. One of the things we'll talk about tomorrow is how we identify the population that we're dealing with. Who are those patients? What are their needs? What kind of experiences have they had in the past? Not just medical experience, not just clinical experiences but experiences in dealing with the challenges of life. We want to know who they are. This is primarily in the discussion related to Medicare; so they're seniors.

What have their experiences been? What's their health history then? Know who they are and then identify who we can focus on and then put together programs that really meet their needs: clinically, socially, and psychologically. All aspects of it, in a different methodology, supporting their primary care doctors, supporting the specialist, supporting the community of healthcare; surrounding them in a way that we really get to know who they're, what they need and when we can have the greatest impact.

You know, it really just seemed to be a manifestation of one of the themes here; the biggest theme for the Oliver Wyman Health Innovation Summit which is the Consumer Imperative and how it’s transforming healthcare. So clearly you’re a step ahead already in addressing that consumer in such a holistic way.

Kate: René, I just came across an article, our next question, from a New York Times article that said that loneliness in the senior population is a greater indicator of early morbidity than obesity.

What is it that GuideWell is doing with its partner Wyman Healthcare that is addressing the social needs of this population?

Dr. RenĂ©: So the lack of social interaction in this population is an incredible challenge for these folks. They're totally isolated. So not only are their medical problems a challenge because of their age or because of medical history that they've had; they’re on their own. They're often living alone, they’re by themselves. They don't feel that they are being cared for; that someone cares about them.

So one of our goals, again, is to understand holistically who these patients are. What are their needs? How do we bring all their needs to them so that we can improve their livelihood? Not just from a clinical perspective because the reality is it's not about managing their healthcare. It's about giving them a supportive environment so that they can have some enjoyment in life which goes well beyond writing prescriptions. We’re seeing clinicians. It really has to do with their lifestyle getting out, appropriate nutrition, appropriate even drinking, opening up a refrigerator seeing some food in there. And constant interaction with people.

So that we now have dashboards with companies were working with that we follow. We know what they're (members) doing. We know if they're leaving their house. We know who they're interacting with. We will be able to tell: are they on the phone or they truly isolated; so we can target them.

Kate: You and I, in previous conversations with you René, I know that you've talked about this: it's very high-tech but also very high touch. So you're really enabling technology to come into the home in a very non-invasive way. Again to make sure that that there are doing those behaviors that you want to see and making sure that if they're not, that you're able to intercept, maybe, some negative situation.

Dr. René: So you think of technology as an introduction to interaction. Technology gives us the opportunity to interact with the member and pick the members that need it. The technology is great from a clinical perspective but the social interaction is really what the member wants.

Kate: Right. One final question for you: René, so just last month we had a really exciting event at the GuideWell UST Global Innovation Center. And that was the Greater Than Cancer Immersion Event. A two day event and you were a member and inside of the audience. We got to interview you there.

I was hoping you could, maybe, connect for us, you know, here we are at the Summit; what would the audience here want to know about this immersion experience so that we can have this, the folks that are here at the Summit, maybe kind of join where we are with this Immersion Event; which is a six-month journey. Why don’t you tell us a little?

Dr. René: So the immersion event was it was a first of its class, first of its kind of program where we really not just had lectures about patients with cancer - this was about cancer - but saw cancer from the perspective of everyone involved. From the family member, to the patient themselves, to the doctors, to the community leaders, to groups that were just being support groups. It was really an opportunity for people to contribute and add; it was not an environment where people just lecture. So as we now move into the next environment, if you think about what's happening here with consumer engagement, consumer engagement is the ultimate for the cancer patients.

Again, if anyone feels isolated, feels alone in their journey, often it's a cancer patient. If we can take what we're learning here to further the immersion event over the next few months so that we can truly understand the experience of all the caregivers and all the patients, what we learned at the immersion event was it was almost more difficult for the caregivers as they experience the pain of their patients. If we can identify ways to communicate, interact and engage members and all of those involved in the management of cancer patients, we’ll move a long way. So hopefully, what we learn here over the next few days, we can adopt, bring some of the skill sets, bring some of the people, and emerge them into this immersion event.

Kate: Perfect! Well that's an open invitation for anyone who hears this interview. Please find out more about this event at

Dr. René Lerer, thank you so much for joining under here at the GuideWell Insights Lounge. My name is Kate Warnock. Thank you so much for watching!

Dr. René: Thank you

Thursday, October 6, 2016

How Can Your Healthcare Organization Do Social Media Like the Mayo Clinic?

Has your healthcare company been thinking about getting its employees ‘up to date’ on the benefits social media can bring to your company? Well, the esteemed lead and team at Mayo Clinic have been advancing leaders in the area of ‘Healthcare Social Media’ for a while now.

Yesterday the Mayo Clinic posted a video titled ‘Social Media at Mayo.’ It presented some key considerations healthcare 'providers' wanting to leverage social media need to consider. The video was targeted to Mayo employees but it's apparently available to others. (See here and the end of this post.)

Who Started All of This?

While I’m not 100% sure, my take is that the video can be 'attributed' to a fellow named Lee Aase - someone I know was the spark that started the 'social media' a fire at the Mayo Clinic some 5, 6 or 7 years ago. 

Leverage This Professional Audio!

This blog post is a transcript of the video – obviously produced by people well-versed in producing professional media. The narrator voice is classic! It's a short, but good, resource intended to attract those interested in learning how to use social digital media. 

The following is a verbatim transcript. I've done my best to add punctuation based on YouTube's voice to text translation. 

== Transcript Starts ==

Social media are having a revolutionary impact in society; enabling users to share information ideas, personal messages and to create communities. Some of the most popular social media platforms include Facebook, Twitter, YouTube, LinkedIn, Pinterest & Instagram - with new sites launching continuously.

Mayo Clinic’s leaders understand the power and potential of social media tools and healthcare; and also believe professionals need proper training to use them well. I’m proud to say that Mayo Clinic has been, and intends to be, among the leaders in using social media in medicine. This one is not about competitive advantage. This message is as it should be. It’s s all about the patient and how these tools can help us all serve them better and work together with the patients and their families for their health.

That’s why we have the Mayo Clinic Social Media Network, a professional social network for Mayo Clinic employees and colleagues worldwide who want to learn and share ways to use social media tools in their work. On the Mayo Clinic Social Media Network, you’ll find social media guidelines from Mayo Clinic employees as well as an explanation for each guideline. You also have access to a unique training program in the basics of social media for healthcare professionals.

Our colleagues outside of Mayo Clinic pay for this training; but for Mayo employees and students its are. Here’s how to get started:

Use your email address to create your Mayo Clinic social media account. Your Mayo Clinic Social Media account lets you participate in other Mayo social sites too, including Mayo Clinic News Network, sharing Mayo Clinic, Mayo Clinic Connect and the Social Media Champions Program.

Note from @ShimCode: Mayo has a free membership option for anyone to use.

Here’s What You Get - If You Take The Next Step

As a Mayo Clinic Social Media Champion, you get access to news and health information you can easily share on Facebook, Twitter, and Linkedin. 
  • Will you make it to the top of the leader board? 
  • Ready to take the next step?

Review the Social Media Guidelines for Mayo Clinic Employees. Join the Mayo Clinic social media network. become a champion! 
== Transcript Ends ==

That's It

That's a straight translation with punctuation I think is in the ball park. Be sure to check out the links I've provided in the above transcript and get more details about social media resources at the Mayo Clinic Social Media Network site here.

Disclaimer! Why did I just Share This?

Because I know that the content the Mayo Clinic provides is generally good info for those interested in health care social media. Mayo's been a leader in using social media and digital media to make a positive contribution to health care at large for a while now.

And it's not rocket science. In many ways, the stuff Mayo is sharing are table stakes to compete in healthcare today. Even other healthcare providers and healthcare-related organizations not as well known and esteemed as the Mayo Clinic can do well like Mayo with some moderate focus and guidance; if leadership and staff alike are involved.

Want More?

For more information on how to do learn about social media, digital health strategy and other healthcare data, technology and services topics, consider following me on Twitter where I share as @ShimCode. If you'd like some guidance and help with leveraging social media at your organizations, feel free to reach out to me and I can point you to some good people and resources.

Saturday, October 1, 2016

The Four P’s of Hosting a Tweetchat: Preparing, Promoting, Performing & Pursuing

stwittertips, social media tips, tweetchats
Over the past few years, the number of healthcare-related tweetchats have grown; both in the number of chats and the number of people participating in the chat. Some of the most popular healthcare tweetchats include #HITsm, #hcsm and #hcldr. For those who don’t know, a Twitter tweetchat is a pre-arranged chat that happens on Twitter through the use of Twitter updates (called tweets) that include a predefined hashtag to link those tweets together in a virtual conversation.

Are Tweetchat's Hard to Do?

Monitoring a tweetchat without actually participating in the chat (i.e. lurking) is as easy as searching for the hashtag associated with the chat. Participating in a tweetchat is also easy; you just have to tweet something with the chat’s hashtag during the time the chat is scheduled. But hosting a tweetchat, while still pretty simple, takes a bit more planning and effort. If you’re interested in hosting a tweetchat, I’d like to propose The Four P’s of Hosting a Tweetchat: Preparing, Promoting, Performing and Pursuing.

‘P’ #1 – Prepare for the Chat

Define Your Goal

First of all you must define the goals for the chat. What is the ‘theme’ of your chat? And do you want to share information, collect information from others or both share and collect?

Define the Topics

Chats typically have anywhere from three to eight topics shared, typically shared over a 30 or 60 minute period. You should allow about 4-8 minutes per topic.

Select a Time for the Chat

You’ll want to try to schedule your chat to maximize attendance by your target audience. You should consider the impact of time zones and whether your target audience may be at work or home. You also need to consider whether any other tweetchats are scheduled at the same time.

Select and Register a Hashtag

A pre-requisite for hosting a chat is that you’ll need a unique hashtag to identify the chat. Hashtags should be easily remembered and as short as possible. For healthcare chats, I recommend that you should register your hashtag at @Symplur. This will add your chat to Symplur’s directory, allow you to easily pull a transcript of the chat, and provide you with useful statistics on the chat including the number of mentions, tweets and overall impressions.

Create Graphics

While not a requirement, using images to convey your topics adds a little pizzazz to your chat and makes the topics stand out.

Create Content & Tweets 

Since you’ll have your hands full running the chat, be sure to pre-define any tweets you want to share during the chat. Then during the chat all you have to do is copy and share the tweet without rushing to type out your tweet.

Prep Your Script

You may want to outline a recipe for the chat including when you will move from topic to topic.

Background Material

In order to help people understand the theme of your chat and better prepare, many people will share background materials prior to the chat. A blog post is a good way to do this and you can reference that post in your promotions of the chat. Here's an example.

‘P’ #2 – Promote the Tweetchat

Timing of Promotion

Announce your chat via all your social media channels about a week before the chat. Then repeat those announcements every day leading up to the chat. On the day of the chat, you may want to promote the chat two hours, one hour and 15 minutes before the scheduled start time of the chat.

Clarity and Graphics

As noted above, using graphics is a powerful way to attract attention to you tweetchat. You can also provide more information in an image than you can in Twitter’s 140 character limit.

Reach Out to Influencers and Others

Consider reaching out to individual influencers and others via a tweet, Twitter direct message, email or other ‘direct’ means. Ask them to share information on your chat – just be sure to make it as easy as possible for others to share that information.

Get Creative

There are all kinds of ways to promote your chat so get creative. Some ideas include mentioning your chat at the end of similar tweetchats. Some people will even ‘hijack’ a popular hashtag to promote their own chat. Not that I recommend that or would ever do that! :)

‘P’ #3 - Perform the Tweetchat

Be sure to start the chat at the designated time. You may want to consider scheduling certain of your tweets – especially the initial announcement, welcome tweets and the chat topics - so that you have more time for other tasks during the chat.

Welcome Chat Attendees

Be sure to extend a welcome to those attending your chat, especially any influencers or other Twitter ‘luminaries.’ Depending on how many people attend, you may not be able to do acknowledge everyone individually so a tweet to the effect of “Welcome, everybody, to the #FourPsTweetchat – we’re glad you’re here” will suffice.

Engage with Everyone!

Besides welcoming those who attend, you should answer all questions posed by chat participants. And you should strive to engage with everyone. Even a “+1” or a retweet of tweets you like or agree with is a good way to engage.

Thank Everybody!

If people note that they have leave thank them for participating in your chat. At the end of the chat, thank everyone for attending and/or participating, especially those who shared a lot of tweets. As with welcoming participants, a ‘group thank’ you can be ok. But, unlike at the start of the chat when you are somewhat time limited since you’re focusing on managing the chat, you’ll have more time once the chat ends so you should strive to thank all key participants individually.

‘P’ #4 - Pursue

Just because the chat has ended doesn’t mean it’s over. After going through all the effort to prepare, promote and perform the tweetchat, be sure to reap the rewards of your effort. If you had a good chat, you’ll have all kinds interesting and valuable information that can be re-purposed and shared via your social channels. Share the curated information with your co-workers and network.

Curate Select Tweets

Many people who host tweetchats will “Storify” select tweets and share the Storify via their social channels. Here is an example of a tweetchat that was ‘Storified.” If you’ve registered your chat hashtag via Symplur, you can share tweets from the chat by sharing the ‘Symplur query’ for the chat’s time period.

Blog Posts

You can also create a blog post that recaps key bits of information shared during the tweetchat; and include additional commentary and analysis. Here’s one example of how I’ve recapped a tweetchat I hosted.

You can also use Symplur to download a transcript of the tweetchat into your favorite data manipulation tool and then sort, group and categorize the tweets to create additional value.

Share and Use the Tweets

After going through all the effort to prepare, promote and perform the tweetchat, be sure to reap the rewards of your effort. Share the curated information with your co-workers and network.

Now Go Host a Tweetchat!

So there you have it, the Four P’s of Hosting a Tweetchat: Prepare, Promote, Perform and Pursue! For more information like this post and more on healthcare data, technology and services, feel free to follow me on Twitter where I share as @ShimCode.

For additional information on promoting and hosting tweetchats, see this earlier blog post of mine.