The status quo of in-person verbal care delivery has greatly changed due to COVID-19 and the influx of digital health tools.
In addition to live telehealth videos, one of the most important digital health tools to increase efficiencies and improve patient outcomes is the use of recorded videos as a digital asynchronous care tool.
With recorded video integrated as an operational care delivery tool we are able to save hundreds of hours in expensive staff and clinician time while also saving thousands of dollars.
No more paper pamphlets that end up in the trash. No more verbal education that leaves patients wishing they would have listened better or didn’t forget.
Health Care Transformation supports healthcare organizations to integrate recorded video as a care delivery tool that drives ROI for the organization.
We saved Resolution Care Network over $1000 and 15 hours of busy clinician time with ONE video implemented for TWO weeks for FOUR physicians
Let’s show you how we saved time + $$ with digital video.
THE PROBLEM: Given the urgent nature of COVID-19, the physicians at Resolution Care needed a streamlined process to have advance care planning (ACP) conversations with hundreds of chronically ill patients in a short period of time.
THE SOLUTION: Health Care Transformation supported Resolution Care leadership to streamline this end of life decision-making and documentation with chronically ill patients through the strategy, development, and implementation of recorded video as a digital asynchronous care delivery tool.
We used video analytics, surveys, and focus group feedback to assess performance and ROI. Within 2 weeks of implementation we saved over 15 hours and $1,000 of clinician time. Patients who watched the video were more prepared and physicians were more effective during their appointments.
Our implementation of digital asynchronous video is a 3-step process:
Watch our process video:
Strategize: We documented our goals, desired ROI, and metrics to assess performance of the video, including patient activation and physician efficiency.
Develop: We scripted, filmed, and edited the asynchronous care delivery video. In post-production we added English and Spanish language captions and created Call-To-Action buttons with surveys to assess performance.
Execute: The video was hosted online with analytics, embedded into the Resolution Care website, and integrated into the schedulers’ + physicians’ workflows.
Watch the patient-facing digital video we produced:
ROI for ONE video implemented for TWO weeks for FOUR physicians:
Organizational impact resulted in:
$1,000+ in cost savings
15+ hours in physician time saved
Hundreds of medical records updated
Provider impact resulted in:
Our engagement went more smoothly, briefly, and productively if they [the patient] watched the video.
-Resolution Care Physician
Patient impact resulted in:
It was a nice, clear explanation of covid-19 as a health challenged person and end-of-life decisions I should think about before having the conversation with my doctor.
-Resolution Care Patient
Hear from physician leadership at Resolution Care Network on the use and implementation of digital asynchronous care videos:
I’m very interested in exploring new and different ways to use this asynchronous digital technology to advance the care we give.
Prior to the onset of COVID-19, the U.S. healthcare system was going through a major shift in healthcare delivery and reimbursement. The current structure is unsustainable as healthcare costs continue to rise and more consumers need access to high-quality affordable health outcomes.
Given this necessary shift, massive well-funded self-insured employers, such as Walmart, Amazon, and Berkshire Hathaway, as well as investor-backed healthcare companies, such as Maven, VillageMD, and Iora Health, are pushing U.S. healthcare towards innovative consumer-centric care.
We are also seeing the continued shifts in reimbursement and the management of patients from fee-for-service to value-based care arrangements, such as capitation and Accountable Care Organizations (ACO’s) that drive the need for population and panel management. This requires that healthcare providers have better technology and digital tools to engage in these types of future-forward care delivery models.
This shift was already occurring but has now been dramatically accelerated with the onset of COVID-19, where we are experiencing a drastic shift to digital and virtual healthcare delivery.
Many large healthcare providers had been taking years to integrate live video visits between a physician and patient, but with the onset of the coronavirus and better reimbursement from payers, we saw the shift to telehealth happen instantaneously, going from a few hundred telemedicine visits per year to thousands in one month.
Thankfully for most patients the results from a telehealth visit are largely qualitatively positive. The patient no longer has to drive through traffic, find parking, pay for parking, wait with other sick patients in the waiting room, wait for doctors who are always behind schedule, and interact with care team members who are staring at a computer instead of looking at the patient.
Now that healthcare systems and other providers have gotten a taste of the value of virtual care and digital healthcare delivery tools, it’s important that organizations continue to shift healthcare delivery to achieve what we have termed the Triple Aim + 1, otherwise known as the Quadruple Aim:
Improve health access + outcomes
Reduce healthcare spend
Improve patient experience
Improve provider + staff experience
Given this shift in healthcare delivery we launched a webinar on Digital Care Delivery in the Era of COVID-19 and Beyond.
Digital care is patient care that incorporates technology. In the case of COVID-19, this is largely telemedicine live video visits, phone apps, and remote patient monitoring devices.
We are now hearing the buzz terms The Digital Front Door and The Digital Care Journey.
The Digital Front Door is how we use technology to interface with potential and current patients in order to drive them to get the care they need at your institution. In many situations, such as pregnancy and surgery, the patient does in fact have a choice as to where they would like to receive care.
The Digital Care Journey is how we incorporate digital tools into the patient’s care journey from beginning to end, whether those are digital tools for scheduling, monitoring, or navigation.
Digital care can be provided as a population health tool that reaches the masses or as an individualized care tool that provides precision medicine to one individual patient.
One of the most important population health tools that reaches the masses is DIGITAL RECORDED VIDEO, which has been largely underutilized as a digital health tool in healthcare delivery.
Given the importance of recorded video as a digital care delivery tool, let’s discuss the issue with the status quo and how digital video can improve care, access, and experience while also improving clinician and staff efficiency.
What is wrong with the current status quo? It is:
Whether care is provided in-person or through a telehealth video visit, we know that care is inefficient and it is not fulfilling the needs of your patients, providers, or staff and not achieving your organizational mission.
This causes many problems for PATIENTS:
They may not be listening.
They might not understand.
They may forget.
They may not speak English as their first language.
They might need a caregiver to manage the information.
They might toss the paper in the trash without reading it.
Approximately 65% of the population are visual learners! So how effective are we really being with a one-time verbal communication of information to patients?
There are also many problems for the PROVIDERS:
They don’t have time to convey all the information to their patients in a single appointment.
They have to repeat the same standard information with each patient.
Their patients aren’t prepared for their appointments.
They feel frustrated and view their patients as non-compliant.
There are also problems for the ORGANIZATION overall:
Poor quality outcomes and ratings
Poor patient experience
Provider and staff burnout
Surgery cancellations and appointment no-shows
Wasted $$$ on paper educational and marketing materials that go in the trash
No brand engagement/increase in market share
The list goes on but the overarching theme is this: when we leave patient care to be entirely verbal and on-paper then we are providing inefficient care that wastes time, money, and energy. We are also leaving increased revenue on the table that could be driven from improved patient outcomes and experience as well as increased market share.
How do we make care more efficient using digital tools?
We must implement digital asynchronous video as a care delivery tool.
We use recorded videos in care delivery to drive targeted benefits such as increasing revenue, cutting costs, improving access and outcomes, reducing spending and improving experience. Many organizations are familiar with video libraries. But these are never developed with a targeted ROI and they are never integrated into clinical care. They attempt to check a box for patient education but never check the box for clinical and operational efficiencies.
We follow a three-step process to ensure ROI with recorded videos:
1. The first step in implementing digital asynchronous care is to ‘strategize’.
We work with our clients to lay out the goals we are trying to achieve, the target consumer, topic, and how we will directly measure that we have achieved those goals. We also help our clients to develop a multidisciplinary team customized to the client but often including a clinical leader, an administrative leader, and a marketing lead.
2. The second step is to ‘develop’ the content, operations plan, and marketing plan.
This step is incredibly important because we need to both create high-value videos while also ensuring the videos will be viewed by consumers. We take on every step of video production including scripting, filming, post-production, and post-post production add-on’s that include hosting the video with clickable Calls-To-Action. We simultaneously partner with the marketing and operational leads to build implementation plans using our templates.
3. The last step is to ‘execute’ on our plans.
This includes publishing the video(s), implementing our marketing and operational plans, and analyzing the process and goal metrics to calculate our ROI.
Why is recorded video better and more reliable than verbal and paper clinical operations? Analytics.
With digital marketing tactics we can use analytics to see who watched the video, how much of the video they watched, whether they clicked on our call-to-action buttons, and whether they understood and gained value from the content.
This data can be used to drive performance and action and we can directly correlate time and money saved for your clinicians and staff.
Which content areas benefit the most from digital video as an asynchronous care delivery tool?
If you have the strategy, processes, and analytics in place you can make videos on any content area: women’s health, surgery, cancer, transitions of care…the list is endless!
Just be sure when implementing that you are targeting ROI.
The ROI calculation will be different based on the organization, your target audience, and content area. It will range from cost cutting, i.e. replacing paper and lost expensive clinician/staff time, to increased value, i.e. improved patient outcomes, experience, and market share.
It is recommended that you start small with the clear and crafted ROI you are seeking and then grow and expand to other content areas.
In order to become the leaders and achieve ROI in virtual care through digital asynchronous care, there are some decisions you will have to make:
The first question to ask yourself is: Where are your low hanging fruit?
To determine the low-hanging fruit areas you should target, ask yourself the following questions:
Where are my providers/staff having redundant standardized conversations with patients that we could put on video?
Where would it be better and more effective for the patient to know the information BEFORE the appointment?
Where is it critical that the patient has access to the information (along with a caregiver) in order to ensure the patient complies with their care, i.e. we can’t risk them forgetting or not understanding?
The second question to ask yourself is: Will you build digital asynchronous video in-house or work with a partner to achieve success?
If you decide to work with a partner, you need to know what to look for in a partner. They should have the following background and expertise:
Because it is a partnership you need to focus on partnering with someone who knows:
How to develop your strategy
How to develop ROI and metrics
How to film including set design, editing, post production, CTA’s, etc.
How to market and operationalize
How to PDSA (Plan-Do-Study-Act)
So, what do you need to think about in order to start your digital care journey and be the best-in-class in virtual care? Ask yourself the following questions:
Where are your low-hanging fruit?
What are your barriers to incorporating digital asynchronous care?
How can those barriers be overcome?
How would you establish the ROI of digital video at your organization?
Who do you need to engage to ensure buy-in for your first pilot?
With digital asynchronous care you can move a 1:1 redundant unstandardized conversation into a standardized impactful conversation that can reach millions of patients with one click and drive operational efficiencies.
We have worked with clients across different spheres of healthcare topics to integrate digital recorded video as an asynchronous care delivery tool.
With Resolution Care Network physicians, we were able to save over 15 hours and over $1,000 in clinician time in just two weeks of implementation.
Our goal is to support healthcare organizations across the country to optimally integrate digital asynchronous video into their care delivery operations. With asynchronous video we can improve access, outcomes, and efficiency that is a win-win-win for patients, providers, and organizations.
Ready to chat about digital asynchronous care delivery at your organization?
As healthcare costs continue to rise and health outcomes
lack improvement, consumers are growing increasingly frustrated, confused, and
In fact, 9 out of every 10 individuals are considered healthcare illiterate, which is not surprising given the complexity of the healthcare system in addition to language barriers- not only due to medical jargon but also for the 25 million+ individuals who are limited English proficient. In no other industry is communication as important but as difficult as it is in the health care system.
Every other industry has defined their business model around
the consumer. This has not been the case in health care. Health care has
evolved to lack the infrastructure needed to understand their consumers and
their true needs, wishes, and desires.
This is all changing as health care moves from a
fee-for-service reimbursement structure that incentives volume to a value-based
care reimbursement structure including two-sided risk Accountable Care Organizations
(ACOs), bundled payments, and capitation. The future payment system will
require an overhaul of healthcare delivery as we know it.
In value-based care, the goal is improved outcomes at reduced systemic costs. And there is no way a health system can achieve success in the future of value-based payments without better empowering and engaging the most important component of the equation, the consumer.
“We are shifting to a model of payment where outcomes, quality, utilization, and cost matter more and more. In that market, how our customers behave and what they choose to do is going to be reflected in healthcare outcomes, and will matter to the viability of healthcare organizations far more than it has in the past. Patients will also increasingly act like consumers and will be voting with their wallets and their feet.”
-Dr. Zeev Neuwirth, Author of Reframing Health Care
We can no longer engage consumers by handing them pieces of
paper filled with medical jargon and hoping that Google will communicate on
behalf of the provider for anything that was misunderstood.
Consumers will need clear, concise, targeted, and curated information and tools that tell them exactly what they need to know. And this information will both improve the consumer’s experience with the healthcare system but will also drive appropriate consumer behavior. In doing so, this will allow your organization to not only survive the future of at-risk payments but to thrive in them.
The future of health care is video.
Individuals want information conveyed in a clear, concise, and entertaining manner. Gone are the days of reading packets of paper.
Here at Health Care Transformation, we are combining our
expertise to develop, create, and produce curated video content and tools that
help you achieve consumer-centric care. This curated content will improve the
patient experience and build a positive relationship with your brand.
Our content ranges from:
What to Expect as First-Time Patients
What to Do When You Experience an Urgent Health
How to Navigate Health Insurance
Planning Your Pregnancy Journey
Navigating a Hospitalization
Medical Decision-Making For Your Loved Ones
In addition to our content library, we love working with our partners to create custom content to achieve their specific goals. Regardless of whether we license or custom-create the content, we provide top support every step of the way as we partner to ensure success in rolling out the content at your organization and create a positive ROI.
How is our content + partnership consulting so impactful?
Removes the burden of developing standardized
patient education materials
Available in multiple languages
High-quality Los Angeles video production
A/B testing of all content + communications
Communication + marketing strategy
Analytics partnership to determine impact and
To quote leading healthcare expert Dr. Zeev Neuwirth, host of Creating a New Health Care podcast and author of Reframing Health Care, one more time:
“Our collective job is to educate, influence, and engage patients so that they have the best chance of becoming active participants in their own care…It is our job to make engaging in health care appealing, even enticing and entertaining, so that healthcare customers want and choose to participate. It is our job to make it easier, more convenient, and more dignified.”
-DR. ZEEV NEUWIRTH, AUTHOR OF REFRAMING HEALTH CARE
If you are a healthcare provider who is innovative and ready to thrive in the future of value-based care, contact us today. We are looking forward to supporting you and your efforts to integrate video content into the delivery of care and truly become a consumer-centric healthcare provider.
Wait… you didn’t know it was today?? And you don’t even know what that means??
Well then let me explain because this is really important and this is an area of health care I’m very passionate about!
The goal of National Healthcare Decisions Day is to educate and empower all individuals and doctors to complete their advance care planning.
So what is advance care planning?
Advance Care Planning means planning in advance for medical decisions just in case you are so sick that someone else has to make the decisions for you. These are your decisions to make based on your values, preferences, and conversations with loved ones.
Advance care planning is really important for the following reasons:
We are all mortal but prior to our time on this earth ending, we have incredible feelings, goals, and preferences on how we want our final time to play out. Some people would be happy never being able to taste food or walk again as long as they are alive. Other people would rather die than be stuck in a home in front of a TV with tubes for eating and going to the bathroom. Since you are an individual human you have your own desires and we need to make sure your family and doctors are aware of these.
The default of our medical society, unfortunately, is NOT to proactively have these conversations with you and your loved ones (although this is slowly changing). And then when the time comes when there is an urgent issue and no medical professional is aware of your wishes, they provide really aggressive medical care. Think surgeries and rib-breaking chest compressions and electrical shocks and tubes down throats. Now sometimes that saves a life but sometimes it actually can hurt an individual who is elderly or can be quite a shock and disappointment for those who want to die peacefully at home at the end of their life.
So what should you do? Follow the checklist below that’s taken directly from My Health Care Transformation Handbook (available for purchase soon!) You might be the individual who needs to complete these steps or you might need to support your parents and grandparents in completing these steps. Either way, we can’t predict the future so we want to be sure that the family is as prepared as possible for whatever may come our way.
Advance Care Planning Medical Checklist:
Self-reflect on My Goals of Care
Discuss My Goals of Care with my family and friends
Discuss My Goals of Care with my Primary Care Provider (PCP)
Discuss My Goals of Care with the rest of my Care Team
Complete my Non-Temporary Advance Directive
Complete my Physician Order for Life-Sustaining Treatment (POLST) Form
Have my doctor scan copies of my documentation into my medical record
To learn more about Advance Care Planning, the Navigating the U.S. Health Care System 101 course has two lessons on this topic! And like I mentioned, My Health Care Transformation Handbook will be coming soon with an entire chapter to support you and your loved ones with advance care planning so stay tuned for more info!
In the meantime, check out this comprehensive list of more resources on advance care planning.
I hope today you take this opportunity to have open honest conversations with your family and other loved ones about your goals, wishes, and preferences in the face of an unforeseen event.
Last week, the Surgeon General Dr. Jerome Adams made an official announcement with recommendations to address the opioid epidemic in the U.S. He recommends more individuals keep the opioid antagonist, Naxolone, on hand in order to save someone from dying who is currently overdosing as well as provides recommendations to the general public and health providers about Naxolone and how to identify an overdose.
Let me give a quick recap on the epidemic and then I’ll give you my two-cents on the announcement along with some recommendations for you to follow in order to protect yourself and your loved ones.
Opioid Epidemic: Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, etc. Opioids have killed more than 250,000 people in the last decade, including more than 42,000 people in 2016 alone. That equates to one person dying every 12.5 minutes due to opioid overdose. Opioids kill an individual by depressing their respiratory function so the individual literally chokes to death because they cannot get enough oxygen to their brain and other organs.
Sadly enough, this problem is very unique to the U.S. in comparison to other countries:
Now you might notice a really interesting fact: many opioids, which lead to addiction and death, are actually prescribed to a patient by a doctor. The data show that most physicians lack confidence in their ability to prescribe opioids safely and to predict and discuss potential future drug abuse with their patients. And, in fact, large proportions of doctors are actually very concerned about opioid addiction and death.
My disappointment with the announcement is that there is such a focus on Naxolone, which is an expensive and often not readily available solution that doesn’t actually get at the root cause of the problem. The root cause of the problem is that doctors are prescribing high dosage and frequency of opioids to patients who unknowingly will get addicted and could have otherwise received a different pain intervention such as exercise, massage, acupuncture, physical therapy, etc. Unfortunately, once addicted patients turn to pill-seeking amongst different doctors to game the system and ultimately turn to getting heroin off the streets.
Therefore, it’s important that we stress the importance of educating physicians and patients on how to navigate this drug altogether to gain any potential benefit without wreaking havoc on an individual and their family.
The documentary will shake you to your bones but it will visualize for you how opioids can kill anyone from good kids to good mothers.
Doctors can prescribe opioids on anything from knee surgery to a c-section. So how can you protect yourself and your loved ones?
When prescribed a pain-relieving medication, ask the following questions:
Is this medication an opioid?
Is there another option instead of taking a drug?
Is there a non-opioid pain-relieving drug I can take instead?
Is this the lowest possible dose I can take?
Can I have fewer pills?
How is it best to taper off the drug?
Be sure to discuss your health history, family history, and risk of addiction.
For the healthcare professionals, I recommend the following:
Pull your analytics on prescribing patterns of doctors so you can intervene on high prescribers.
Pull your data on dosage by patient so you know which patients are at risk of addiction and overdose.
Use these guidelines to establish protocols and procedures for your institution in order to intervene where possible.
Yes, Naxolone has the potential to save an individual who is overdosing and going into respiratory failure, but we need to start addressing the root of the problem, which begins with developing clear guidelines and operational support to physician prescribers and patients.
As a final send-off before we head into 2018, I’m going to spend today giving a brief overview of the large risk pools or insurance options that we have here in the U.S. If you haven’t already checked out my prior video explaining risk pools and how they work- be sure that you do!
So to recap: the three major ways to get health insurance in the U.S. is through:
Medicare– insurance run by the federal government for all individuals overage65, those with disabilities, and those with two specific diseases: End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
Medicaid– insurance run by the government for eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by the state governments according to federal requirements.
Private Insurance:insurance run by private companies.
We can get private insurance in a few different ways:
Through your employer
Through the health insurance marketplaces, or exchanges (healthcare.gov)
By staying on your parent’s insurance until age 26
As you can see that leaves us with a hodgepodge of insurance options which inevitably means some people fall through the cracks and don’t have health insurance in any given year.
The current estimate of uninsured individuals in the U.S. is around 30,000,000 people.
Thankfully that is much lower than in prior years because after the health insurance exchanges were built, this allowed people who own their own businesses, work freelance, or aren’t offered insurance through their employer to be able to be a part of a risk pool and purchase health insurance.
That’s all for this week, folks!
If you still haven’t purchased health insurance for 2018 be sure to check your open enrollment dates and purchase insurance.
And keep your eyes peeled in the new year because The Health Care Transformation Academy will be launching in January! I’m incredibly excited to be offering very concrete easy-to-understand lessons through The Academy that will really give you the confidence and peace of mind to understand and navigate the U.S. health care system.
Wishing you and yours the happiest of holidays and I’m so excited for all that 2018 will bring! xoxo