Should we really be working on person(al) health engagement?
We hear a lot about patient engagement strategies and innovations as a result of Meaningful Use measures; however, innovation appears to remain focused on sick care and the 2-10% of the patient population that currently drive 80% of the cost of healthcare. What are we doing to engage the people who have opted out of the healthcare delivery system unless they require acute or urgent care? These will become the future 2-10% driving 80% of costs if we do not address this now. Most have no primary care physician; and do not know their health status, may have underlying hidden conditions, and do not know the steps to take to lead a healthier life. We each know people (perhaps even ourselves) who use Google as their health care provider.
Sixty (60) million Americans lack adequate access to primary care. Fifty-four percent (54%) of Americans that have scheduled a doctor visit, admit they have postponed or cancelled it.
Add to this equation the prevalence of high deductible health plans becoming the coverage of choice, and the growing number of Millennials in the workforce (75% by 2020); we are on the brink of the obsolescence of healthcare delivery as we know it today.
It is time to invent something new.
What Millennials seek gives us a lot of clues to what we can accomplish for the non-participating person in healthcare delivery. Millennials want:
- To maintain a healthy life and avoid healthcare
- Access to Health anywhere and anytime:
- Digital first and throughout their healthy lifetime with active utilization of personally accessible technology
- Avoid areas of sick care – physician practice waiting rooms.
- Strong social interaction that support a need to help others while helping self.
The time is now for healthcare delivery systems to transform to health engagement systems. This requires a new approach, organized to focus on the health of the person at whatever stage, and to engage proactively -and virtually on an ongoing basis- to support steps toward healthy lifestyle. It means meeting the person in community rather than waiting for the urgent condition to bring them into the system.
It means, with the shortage of primary care providers, that a new team approach will emerge; one that is led by nurse practitioners and other members of the team that can comprehensively and cost effectively engage with the person to assess, guide, coach and virtually connect the person to healthier living….and when necessary to warmly refer the individual to treatment facilities when more specialized services are needed. This team must remain maniacally focused on the delivery of health services without being pulled into sick care services. To be even more specific, Health Services needs to be redefined.
What do I mean about health services?
- Annual wellness physicals…but WITH the missing “follow-up and engagement” that the typical primary care providers just do not have the time to deliver
- Lifestyle assessments and coaching
- Weight loss and weight management services with focus on health for the long run
- Sustained community engagement through social networking, wearables, virtual groups that support positive reinforcement of healthy living
- In-person and group education
And by the way, while it is outlined above as proactively engaging the person not participating in the current healthcare delivery system, it appears that this new team and approach can provide care coordination management needed to help those with chronic conditions remain in control of their condition.
None of this is new news, as they say. The concept just does not broadly exist today…despite much experimentation.
Efforts by large health (and academic) systems will fail to make a significant impact to health improvement across the population. Why?
- They blur urgent care with wellness population management, thus creating the environment that patients are avoiding for interactions other than treatment
- Do not appear to be crafted to appeal to Millennials (a growing percentage of population as Boomers die off)
- Expensive capital infrastructures prevent scaling to multiple locations, especially non-urban
- Appear to lack the social network & wearables integration to forge effective virtual support to health improvement initiatives
- Rely on local reputation and institutional presence difficult to expand to a national market
Healthcare delivery organizations are actively seeking ways to improve outcomes but have to prioritize sick care- which is the historical foundation upon which they have built their operations. Retail clinics provide urgent care, episodic health interaction, and the sale of health related goods; but lack the sustained engagement with the person and naturally, are reluctant to trade retail shelf space for lifestyle coaching.
What new careers does this create?
Implementing a model for person(al) health engagement offers the opportunity to create new careers across this new care team. First is the potential to grow and retain nurse practitioners who seek team care involvement, will provide wellness physicals and have the opportunity to collaborate with the extended team on a plan for ongoing health improvement for life. In addition, nurses can expand their skills through mastering health and lifestyle coaching. This represents a strong alternative to the current nursing environment and returns nurses to nurturing engagement with the person.
Next, innovation around a person(al) health engagement model as illustrated above relies heavily on technology savvy professionals who are knowledgeable about social network systems, the dynamic array of wearables and virtual collaboration technologies.
A vital job requirement will be creative invention and problem solving to change the status quo.
It is time for healthcare delivery to become health person engagement. By engaging with the person as an individual, as part of a family, and as a member of a community, HEALTH organizations can improve the overall health of our population. It’s time to partner to accomplish this.
Sandra Lillie is a client and former candidate of Skinner & Associates. Sandra is the founder of Mead Advisory services providing advanced strategy, and consulting expertise, to enable clients to leverage their organization to improve market alignment, collaboration, support and better results. She is a partner with David Joiner, Founder, of USA CareStore.