You are currently browsing the category archive for the 'Healthcare' category.
One of the big struggles in healthcare is the difficulty of Master Data Management. A typical regional hospital organization can have upwards of 200+ healthcare applications, multiple versions of systems and, of course, many, many “hidden” departmental applications. In that situation, Master Data Management for the enterprise as a whole can seem like a daunting task. Experience dictates that those who are successful in this effort start with one important weapon: data and application governance.
Data and application governance can often be compared to building police stations, but it is much more than that. Governance in healthcare must begin with an understanding of data as an asset to the enterprise. For example, developing an Enterprise Master Patient Index (EMPI) is creating a key asset for healthcare providers to verify the identity of a patient independent of how they enter the healthcare delivery system. Patients are more than a surgical case, an outpatient visit or pharmacy visit. Master data management in healthcare is the cornerstone of moving to treating patients across the entire continuum of care, independent of applications and location of care. Bringing the ambulatory, acute care and home care settings into one view will provide assurance to patients that a healthcare organization is managing the entire enterprise.
Tracking healthcare providers and their credentials across multiple hospitals, clinics and offices is another master data management challenge. While there are specialized applications for managing doctor’s credentials, there are not enterprise-level views that encompass all types of healthcare professionals in a large healthcare organization and their respective certifications. In addition, this provider provisioning should be closely aligned with security and access to protected healthcare information. A well designed governance program can supervise the creation of this key master data and the integration across the organization.
An enterprise view of Master Data provides a core foundation for exploiting an organizations data to its full potential and offers dividends beyond the required investment. Healthcare organizations are facing many upcoming challenges with reference data as a part of master data management, especially as the mandated change from ICD-9 to ICD-10 codes approaches. Hierarchies are the magic behind business analytics – the ability to define roll-up and drill-downs of information. Core business concepts should be implemented as master data – how does the organization view itself? The benefits of a carefully defined and well governed master data management program are many: Consistent reporting of trusted information, a common enterprise understanding of information, cost efficiencies of reliable data, improved decision making from trusted authoritative sources, and most importantly in healthcare, improved quality of care.
Data and application governance is the key to success with master data management. Just like an inventory, key data elements, tables and reference data must be cataloged and carefully managed. Master data must be guarded by three types of key people: a data owner, a data steward and a data guardian. The data owner must take responsibility for the creation and maintenance of the key asset. The data steward will be the subject matter expert that determines the quality of the master data and its appropriate application and security. Finally, the data guardian is the information technology professional that oversees the database, the proper back-up and recovery of the data assets and manages the delivery of the information. In all three roles, accountability is important and overseen by an enterprise information management (EIM) group that is composed of key data owners and executive IT management.
In summary, master data management provides the thread that ties all other data in the enterprise together. It is worth the challenge to create, maintain and govern properly. For success, pick the right people, understand the process and use a reliable technology.
As the heated debate continues about ways to decrease the costs of our healthcare system while simultaneously improving its quality, it is critical to consider the most appropriate place to start – which depends on who you are. Much has been made about the advantages of clinical alerts especially with their use in areas high on the national radar like quality of care, medication use and allergic reactions, and adverse events. Common sense, though, says walk before you run; in this case its crawl before you run.
Clinical alerts are most often electronic messages sent via email, text, page, and even automated voice to notify a clinician or group of clinicians to conduct a course of action related to their patient care based on data retrieved in a Clinical Decision Support System (CDSS) designed for optimal outcomes. The rules engine that generates alerts is created specifically for various areas of patient safety and quality like administering vaccines to children, core measure compliance, and preventing complications like venous thromboembolism (VTE) (also a core measure). The benefits of using clinical alerts in various care settings are obvious if the right people, processes, and systems are in place to consume and manage the alerts appropriately. Numerous studies have been done highlighting the right and wrong ways of implementing and utilizing alerts. The best criteria I’ve seen used consider 5 major themes when designing alerts: Efficiency, Usefulness, Information Content, User Interface, and Workflow (I’ve personally confirmed each of these from numerous discussions with clinicians ranging from ED nurses to Anesthesiologists in the OR to hospitalists on the floors). And don’t forget one huge piece of the alerting discussion that often gets overlooked…….the patient! While some of these may be obvious, all must be considered as the design and implementation phases of the alerts progress.
OK, Now Back to Reality
A discussion about how clinical alerting can improve the quality of care is one limited to the very few provider organizations that already have the infrastructure setup and resources to implement such an initiative. This means that if you are seriously considering such a task, you should already have:
- an Enterprise Data Strategy and Roadmap that tells you how alerts tie into the broader mission;
- Data Governance to assign ownership and accountability for the quality of your data and implement standards (especially when it comes to clinical documentation and data entry);
- standardized process flows that identify points for consistent, discrete data collection;
- surgeon, physician, anesthesiology, nursing, researcher, and hospitalist champions to gather support from various constituencies and facilitate education and buy-in; and
- oh yeah, the technology and skilled staff to support a multi-system, highly integrated, complex rules-based environment that will likely change over time and be more scrutinized………
◊◊Or a strong relationship with an experienced consulting partner capable of handling all of these requirements and transferring the necessary knowledge along the way.◊◊
I must emphasize the second bullet for just a moment; data governance is critical to ensure that the quality of the data being collected passes the highest level of scrutiny, from doctors to administrators. This is of the utmost importance because the data is what forms the basis of the information that decision makers act on. The quickest way to lose momentum and buy in to any project is by putting bad data in front of a group of doctors and clinicians; trust me when I say it is infinitely more difficult to win their trust back once you’ve made that mistake. On the other hand, if they trust the data and understand the value of it in near real time across their spectrum of care, you turn them quickly into leaders willing to champion your efforts. And now you have a solid foundation for any healthcare analytics program.
If you are like the majority of healthcare organizations in this country, you may have some pieces to this puzzle in various stages of design, development, deployment or implementation. In all likelihood, though, you are at the early stages of the Clinical Alerts Maturity Model
and with all things considered, should have alerting functionality in the later years of your strategic roadmap. Though, there are many projects with low cost, fast implementations, quick ROIs, and ample examples to glean lessons learned from like, Computerized Physician Order Entry (CPOE), electronic nursing and physician documentation, Picture Archiving System (PACS), and a clinical data repository (CDR) to use alerting as a prototype or proof of concept to demonstrate the broader value proposition. Clinical alerting, to start, should be incorporated alongside projects that have proven impact across the Clinical Alerts Maturity Model before they are rolled out as stand-alone initiatives.
Hey healthcare providers! Yeah you the “little guy”, the rural community hospital; or you the “average Joe”, the few-hundred bed hub hospital with outpatient clinics, an ED, and some sub-
specialties; or you the “behemoth”, the one with the health plan, physician group, outpatient, inpatient, and multi-discipline, multi-care setting institution. Is your EMR really just an electronic filing cabinet? Do nursing and physician notes, standard lab and imaging orders, registration and other critical documents just get scanned into a central system that can’t be referenced later on to meet your analytic needs? Don’t worry, you’re not alone…
Recently, I blogged about some of the advantages of Microsoft’s new Amalga platform; I want to emphasize a capability of Amalga Life Sciences that I hope finds its way into the range of healthcare provider organizations mentioned above, and quick! That is, the ability to create a
standard ontology for displaying and navigating the unstructured information collected by providers across care settings and patient visits (see my response to a comment about Amalga Life Science utilization of UMLS for a model of standardized terminology). I don’t have to make this case to the huge group of clinicians already too familiar with this process in hospitals across the country; but the argument (and likely ROI) clearly needs to be articulated for those individuals responsible for transitioning from paper to digital records at the organizations who are dragging their feet (>90%). The question I have for these individuals is, “why is this taking so long? Why haven’t you been able to identify the clear cut benefits from moving from paper-laden manual processes to automated, digital interfaces and streamlined workflows?” These folks should ask the Corporate Executives at hospitals in New Orleans after Hurricane Katrina whether they had hoped to have this debate long before their entire patient population medical records’ drowned; just one reason why “all paper” is a strategy of the past.
Let’s take one example most provider organizations can conceptualize: a pneumonia patient flow through the Emergency Department. There are numerous points throughout this process that could be considered “data collection points”. These, collectively and over time, paint a vivid picture of the patient experience from registration to triage to physical exam and diagnostic testing to possible admission or discharge. With this data you can do things like real or near-real time clinical alerting that would improve patient outcomes and compliance with regulations like CMS Core Measures; you can identify weak points or bottlenecks in the process to allocate additional resources; you can model best practices identified over time to improve clinical and operational efficiencies. Individually, though, with this data written on a piece of paper (and remember 1 piece of paper for registration, a separate piece for the “Core Measure Checklist”, another for the physician exam, another for the lab/X-ray report, etc.) and maybe scanned into a central system, this information tells you very little. You are also, then, at the mercy of the ability to actually read a physicians handwriting and analyze scanned documents of information vs. delineated data fields that can be trended over time, summarized, visualized, drilled down to, and so on.
Vulnerabilities and Liabilities from Poor Documentation
Relying on poor documentation like illegible penmanship, incomplete charting and unapproved abbreviations burdens nurses and creates a huge liability. With all of the requirements and suggestions for the proper way to document, it’s no wonder why this area is so prone to errors. There are a variety of consequences from performing patient care based on “best guesses” when reading clinical documentation. Fortunately, improving documentation directly correlates with reduced medical errors. The value proposition for improved data collection and standardized terminology for that data makes sense operationally, financially, and clinically.
So Let’s Get On With It, Shall We?
Advancing clinical care through the use of technology is seemingly one component of the larger healthcare debate in this country centered on “how do we improve the system?” Unfortunately, too many providers want to sprint before they can crawl. Moving off of paper helps you crawl first; it is a valuable, achievable goal across that the majority of organizations burdened with manual processes and their costs and if done properly, the ROI can be realized in a short amount of time with manageable effort. Having said this, the question quickly then becomes, “are we prepared to do what it takes to actually make the system improve?” Are you?
Why does my health insurance cost so much?
It’s that time of the year again. No, I am not talking about the holidays. It’s the time of the year, when you figure out how much more money you need to make, in order to afford the rise in your healthcare costs. It’s Annual Enrollment time! But as most folks have already realized, there probably won’t be any raises, bonuses, etc., this year to help off-set the rise in healthcare premiums. The economy is experiencing its biggest downturn since the Great Depression and yet our quoted health insurance cost for next year is rising at a double-digit pace. How is that possible?
“Over the last decade, employer-sponsored health insurance premiums have increased 131 percent”.
My wife and I calculated that pre-tax, she would need to earn another $ 1,200 a year this year to off-set the rise in the monthly premiums being charged for an HMO plan with family coverage. Currently, we belong to the #1 ranked Health Plan in the country, which is increasing its rates to the tune of $100 a month for the same level of coverage as last year. Unfortunately, we have been experiencing this trend for more than the past 20 years.
I realize its not a simple answer, and there are several external factors including rising pharmacy costs, inflation, etc. However, one could argue that since the economy is in a tail-spin, unemployment is sitting just under 10%, and the federal government is wasting time and my tax dollars trying to create a new public option for health coverage, that the best option for insurers is to hold premiums steady and to finally get a handle on what are the true drivers of cost and utilization. Thus, they would not risk losing its most important constituents, their employer groups and members, who every year are now faced with the idea of reducing their level of healthcare coverage just to make ends meet.
If the #1 health plan in the country is raising their premiums by $100 a month for a basic HMO plan, can you imagine what the lower ranking health plans will charge to their members? There are no quick-fix-it solutions for the healthcare industry. However, with so many inefficient processes, fraud, overhead, flawed reimbursement methodologies, expensive compliance and technology projects, etc., the industry is ripe for opportunities to become more analytics focused. With today’s business intelligence and data warehousing technologies available, health plans now have the ability to create high-value metrics that involve integration of disparate data sources from key areas such as: sales & marketing, operations (ex. Claims processing), and cost and utilization across members, providers, and employer groups.
Despite the quoted savings achieved by health plans from a variety of medical management programs, disease management, formularies, network discounts, etc., why is it never passed onto a subscriber’s premium? Are health plans not evaluating the right metrics? Pushing the boundaries for increasing the use of payer analytics will allow health plans to truly understand the drivers of cost and utilization and thus to migrate their business model to become more predictive in nature. Maybe this is wishful thinking, but a health plan could actually reduce their monthly premiums if they can drive out the unknown costs and inefficiencies. A futuristic but intriguing thought would be to have benefit plans that are created and priced for each member, which is based on both historical utilization and predictive analytics to determine the monthly premiums.
At a minimum, can we stop the double-digit price increases?
Microsoft recently purchased Rosetta Biosoftware from Merck & Co. for its Amalga Life Science platform; with this move, Microsoft is starting to differentiate itself from its competition by offering its integrated information solutions, which include HealthVault, Amalga UIS and Amalga Life Sciences, to both providers and producers. In its crosshairs are huge budgets available from Pharma for infrastructure solutions for drug R&D and clinical trials. Microsoft is posed to attract a whole new audience of customers from Pharma to integrated health systems that have their own research entities. If done correctly, Microsoft’s new strategy could become a model for improving the efficiency of clinical research, by drastically reducing the most costly resource needed for clinical trials, time.
The current Amalga UIS is fundamentally what I like to call a PDA (no not Public Display of Affection, rather a Patient Data Aggregator). There are three core components that include:
- Data Aggregation and Distribution Engine (DADE) – sits on top of healthcare provider sources and listens for HL7 messages; then puts them through transformation and parsing scripts in preparation to be stored in Amalga and sends them to a data store;
- Data Store – receives the messages from DADE; is a basic core storage engine and is a database with a set of tables specific to segments within the HL7 messages; and
- Front End – a web-based presentation layer that was originally designed for patient level data viewing and has plug in capability to provide more appropriate tools for analysis.
The current needs of data integration seem to be met by this solution, and the high degree of customization that can accommodate an implementation makes it even more attractive. Microsoft’s footprint in healthcare is getting bigger; they must understand, though, that this space has many stakeholders. While addressing all their needs is nearly impossible (just ask our hard working politicians’ trying to pass healthcare reform legislation), the last people they want to alienate are those they’ve already convinced that Amalga is the healthcare platform of the future, most notably some high profile integrated health systems across the country.
Integrated health systems (IHS) often provide a combination of services including care delivery, research, education, and even their own health plan (think KP, John Hopkins, Geisinger, and Sentara). These entities have a unique opportunity to leverage the MS offerings by creating a continuous feedback loop of information from patient to provider to researcher that improves the quality and accuracy of the data throughout the process. Let’s start with the patient:
- Patient information in HealthVault – As patient’s progress from being baby boomers (less tech-savvy) to Generation X & Yer’s (tech-hungry), clinical information will no longer be in the sole possession of the doctors. Rather, the demand will be for online, mobile, 24×7 access that is shared and can be updated real-time as health data is gathered by both patients and their doctors. Patients, thus, become a stand-alone data quality tool as they become more comfortable verifying, updating, and changing the information in their medical records.
- Research information in Amalga Life Sciences – Researchers are all too familiar with the tedious, error-prone process of identifying patients with the correct diagnosis and conditions as candidates for clinical trials. As patients become more empowered with their medical records, they make the segmentation of populations a much simpler process.
- Clinical information in Amalga UIS – Amalga UIS is a mechanism for driving continuous improvement in clinical care by integrating data across the enterprise. One way to improve care is by incorporating best practices identified through clinical research. The information learned from improved research methods are then implemented directly into the standard delivery of patient care offered by provider institutions.
The Amalga UIS is currently operational in 12 domestic organizations. Because most of these clients are IHS’ and have research entities, they are in the best position to capitalize on the Amalga Life Sciences offering. These will also be the locations where the ROI MS is hoping will be formulated for less prestigious organizations to eventually imitate. It begs the following question, though, that some of the current customers will ask, “How can the existing components of Amalga Unified Intelligence System (UIS) be leveraged in this new offering to make it attractive to the widest audience possible and more importantly, be affordable?” Well, if you can articulate the argument above, and identify the huge benefits that can come from the Microsoft Feedback Loop, your argument might be easier to make than you think. And don’t forget, this feedback mechanism is built on the fundamental principle that all stakeholders must have the collective groups’ best interest in mind; so don’t forget to share what you find with your neighbor.
“I want it all.” This sentiment is shared by nearly all of the clinicians we’ve met with, from the largest integrated health systems (IHS) to the smallest physician practices, in reference to what data they want access to once an aggregation solution like a data warehouse is implemented. From discussions with organizations throughout the country and across care settings, we understand a problem that plagues many of these solutions: the disparity between what clinical users would like and what technical support staff can provide.
For instance, when building a Surgical Data Mart, an IHS can collect standard patient demographics from a number of its transactional systems. When asked, “which ‘patient weight’ would you like to keep, the one from your OR system (Picis), your registration system (HBOC) or your EMR (Epic)?” and sure enough, the doctors will respond, “all 3”. Unfortunately, the doctors often do not consider the cost and effort associated with providing three versions of the same data element to end consumers before answering, “I want it all”. And therein lies our theory for accommodating this request: Leave No Data Behind. In support of this principle, we are not alone.
By now you’ve all heard that Microsoft is making a play in healthcare with its Amalga platform. MS will continue its strategy of integrating expertise through acquisition and so far, it seems to be working. MS claims an advantage of Amalga is its ability to store and manage an infinite amount of data associated with a patient encounter, across care settings and over time, for a truly horizontal and vertical view of the patient experience. Simply put, No Data Left Behind. The other major players (GE, Siemens, Google) are shoring up their offerings through partnerships that highlight the importance of access to and management of huge volumes of clinical and patient data.
Why is the concept of No Data Left Behind important? Clinicians have stated emphatically, “we do not know what questions we’ll be expected to answer in 3-5 years, either based on new quality initiatives or regulatory compliance, and therefore we’d like all the raw and unfiltered data we can get.” Additionally, the recent popularity of using clinical dashboards and alerts (or “interventional informatics”) in clinical settings further supports this claim. While alerts can be useful and help prevent errors, decrease cost and improve quality, studies suggest that the accuracy of alerts is critical for clinician acceptance; the type of alert and its placement and integration in the clinical workflow is also very important in determining its usefulness. As mentioned above, many organizations understand the need to accommodate the “I want it all” claim, but few combine this with expertise of the aggregation, presentation, and appropriate distribution of this information for improved decision making and tangible quality, compliance, and bottom-line impacts. Fortunately, there are a few of us who’ve witnessed and collaborated with institutions to help evolve from theory to strategy to solution.
Providers must formulate a strategy to capitalize on the mountains of data that will come once the healthcare industry figures out how to integrate technology across its outdated, paper-laden landscape. Producers and payers must implement the proper technology and processes to consume this data via enterprise performance management front-ends so that the entire value chain becomes more seamless. The emphasis on data presentation (think BI, alerting, and predictive analytics) continues to dominate the headlines and budget requests. Healthcare institutions, though, understand these kinds of advanced analytics require the appropriate clinical and technical expertise for implementation. Organizations, now more than ever, are embarking on this journey. We’ve had the opportunity to help overcome the challenges of siloed systems, latent data, and an incomplete view of the patient experience to help institutions realize the promise of an EMR, the benefits of integrated data sets, and the decision making power of consolidated, timely reporting. None of these initiatives will be successful, though, with incomplete data sets; a successful enterprise data strategy, therefore, always embraces the principle of “No Data Left Behind”.
What is co-browsing?
Co-browsing lets multiple users work together in their respective browsers through what look like shared screens and communicate via telepresence including video and audio. The impact of this technology is enormous as companies become more virtual and the need for serious collaboration increases to be competitive in tough times. To be able to share, interact and see the body language of your collaborator in real-time without extraordinary downloads to your PC or expensive third party solutions could simply change the way we work. This innovation comes from not Google, or Yahoo but from IBM in a proof of concept project called Blue Spruce, a Web browser application platform that IBM is working on to allow simultaneous multiuser interactions enabled by AJAX and other standard technologies through the Web browser.
The Blue Spruce project is IBM’s solution to the classic one-window, one-user limitation of current Web browsers. The application is a mash-up that combines Web conferencing with voice and video and other data forms to let people share content including existing Web widgets – at the same time. Two different users, possibly anywhere, are able to move their respective mouse pointers around the screen in the browser to click and make changes on the shared application, with the platform enabling concurrent interactions through the browser without disruptions. Despite the appearance, the co-browsers aren’t actually sharing content. Both collaborators obtained a Web page through the Blue Spruce client, but the “events” enabled by the mouse are what is being sent to the Blue Spruce Co-Web Server. The idea is that no matter where the two users are in the Internet world, they pick up the general data caches on both personal computers and react to the events.
The applications for co-browsing collaboration are numerous, especially for knowledge workers. In healthcare, IBM has used Blue Spruce to create an online “radiology theatre” product, currently at the prototype stage, which allows teams of medical experts to “simultaneously discuss and review patients’ medical test data using a Web browser.” The project is being run in collaboration with the Brigham and Women’s Hospital of Boston. According to IBM, it has created a secure Web site that allows select medical experts at Brigham and Women’s Hospital to access and collaborate on data such as CT scans, MRIs, EKGs and other medical tests. Each medical expert can “talk and be seen through live streaming audio/video through their standard web connection, and have the ability to whiteboard over the Web page as well as input information to the patient’s record.” Basically it is a secure multimedia experience running inside a single browser window, using Blue Spruce as the platform.
It is important to note that Blue Spruce is not your typical “fat client” or downloaded application, but it is a fully browser-based application development platform, currently in development, which is being built on open Web standards. The main feature of Blue Spruce is that it allows for a combination of different Web components – data mashups, high-definition video, audio and graphics – to run simultaneously on the same browser page. It’s important to note that the Radiology Theatre app only requires a standard Web browser – so there’s nothing to download for the end user, in this case, doctors.
This is how IBM described how the new online radiology theatre will work:
”A group of doctors can log into a secure Web site at the same time to review and analyze a patient’s recent battery of tests. For instance, a radiologist could use her mouse to circle an area on the CT scan of a lung that needs a closer look. Then using the mouse she could zoom into that scan to enlarge the view for all to see. An expert on lung cancer could use his mouse to show how the spot had changed from the last scan. And then, a pathologist could talk about patient treatments based on spots of that size depending on age and prior health history, paging through clinical data accessible on the site.”
“The theatre allows all these experts to discuss, tag and share information simultaneously, rather than paging through stacks of papers, calling physicians to discuss scan results and then charting the results. This collaborative consultation brings together the personal data, the experts and the clinical data in one physical, visual theatre.”
The impact on rural medicine and the need for telemedicine for key healthcare experts is significantly advanced with this technology.
Perhaps the biggest potential benefit of the online radiology theatre is that it will enable experts from all over the world to consult on cases. The ability for multiple users to “co-browse” means they can interact in the browser in real-time and see each other’s changes. Of course, since this is medical data, there are significant privacy implications involved in using the Internet to collaborate. The time and cost savings from collaboration is important, but better and faster decision making is the key.
The need for inexpensive and minimally invasive techniques for real collaboration over the Internet is real and the backlog of potential applications is fun to consider. Imagine reviewing your health care or insurance claims with a live person (and their reactions) at the insurance company to reduce cycle time, or collaborating on new product engineering drawings from the U.S. with your Chinese manufacturer. Imagine the potential for teaching or training with key experts and a worldwide audience using a live whiteboard. Finally, imagine not paying big monthly fees for basic meeting collaboration needs on a daily basis. Blue Spruce is really a technology to keep an eye on.
In a recent article released by IBM, an argument is made for a transition in the U.S. healthcare system to a team-based approach based on the Patient Centered Medical Home (PCMH) model. A strong case is made from a description of the model, its’ players, technology, and benefits. The critical change that must be established first, though, is the healthcare systems’ evolution to a data-driven system. The access to, higher quality and integration of data, across disparate silos of information, will provide the foundation for this change. Only then can the position of Dr. Douglas Henley, EVP and CEO of the American Academy of Family Physicians, “ A smarter health system is one based in comprehensive patient centered primary care which improves patient/physician communication, the coordination and integration of care, and the quality and cost efficiency of care” be achieved.
The quality and cost of care is what we hear the most about in news headlines. However, the success of each piece of Dr. Henley’s statement is based on the ability of a team of providers to access accurate and updated patient data across care settings and over time in order to proactively suggest lifestyle improvements and reactively diagnose and recommend appropriate treatments. Fundamentally, each decision maker and operating entity needs a data strategy for how it will achieve the ambitious and often ambiguous goals it likes to claim.
I’ll recite a popular management mantra I’ve heard numerous times, “you can’t manage what you can’t measure.” The healthcare system is a data rich environment. Cleaning, manipulating, and leveraging the huge volume of data available will become the critical success factors that will enable the linkage between education, research, the delivery of care and its outcomes, to benchmark and monitor the performance of the continuous improvements necessary to bring costs down and quality up.
Players in the healthcare world will soon find out (if they haven’t already) a principle all those in the data world already know:
- Good data, appropriately aggregated and manipulated, drives accurate information;
- Accurate information is not a luxury that most decision makers have;
- The executives, managers, physicians, nurses, nurse practitioners, educators, pharmacists, researchers, and other stakeholders that do have access to accurate information are in a position to leverage and evolve this data and information from satisfying compliance and regulatory requirements to enabling an organizational knowledge-based asset.
Actionable data will drive the improvements that you see scattered across headlines and mentioned in political speeches in the past and no doubt, in the future.
Image courtesy of Texas Family Physician
Thanks for all those who attended our webinar on implementing web 2.0 strategies last week. If you missed it, the recorded webinar is available on our site. Enjoy.
As I promised, here are some of the questions asked during the session that I have not had time to address:
Q1: Using Facebook and Twitter – how do I get started? How can we monitor it?
Getting started is ridiculously easy. Facebook has a good starter guide . Setting up Twitter is even simpler as there is not much to do other than selecting a name. You have only 15 characters so it is not always an easy task. Twitip has a good guide to best practices in twitting and a list of useful services to track and monitor twitter conversations.
Q2: Why would people want to follow a healthcare organization? How do I promote it without spending money? is it really worth the effort and Investment?
So setting up profiles and pages is easy. The hard part is getting people to follow you on a regular basis. The good news is that you just need to get users to act once and add you to their friends list or follow you on twitter. From that point forward you are just one in a stream of many others.
Spreading the word is done in every way possible, but not through direct advertising. Put it on your website, emails, blog and any other marketing communication form. The best promotion methods are viral. If you have something interesting to say, people will spread the word.
Social media communication tools are just one more way to reach an audience in a fragmented media world but health is something people really care about. If you are a regional hospital, publish daily information your community will want to know. Allergy report, flu alerts, flu vaccine reminders, etc. The cost is usually limited to a resource that will write and maintain all these social media properties. We’ll go into ROI in the next answer but first and foremost the benefit is relevancy. Hospitals that will engage and communicate will be relevant and top of mind. Others will be there when the appendix burst.
Q3: What type of investment is required? What is the ROI
We usually see 2 main areas of investment. The first is Strategy. With so many options, tools, opportunities and risks large organization usually do not just jump in but take some time to look at the landscape, their audience, their revenue centers and their media assets and capabilities to form a cohesive strategy. This is the main area we help clients in as they often lack internal expertise. We usually recommend forming a broader web strategy as these social activities are not isolated from the needs to have an attractive and interactive website than engages users and effective e-marketing programs. The strategy part also looks at the organizational ability to support these types of programs, the skills required and can help in building a cost and ROI structure. The cost of a comprehensive web strategy can range from five to low six figure depending on the size of the organization and scope.
The second area of investment is in the program operations. This usually translates to people who dedicate some of their time to writing content and managing user interactions. It can range from a few hours a week for a small program to a full time position.
The returns: like in any marketing program, these activities are judged by their ability to generate increase in profitable patients and donations. Since they provide a great way to reach an audience without a cost per unit (as you have in email, banners or paid search) the ROI increases as the size of your audience.
Mashable.com has a good overview for the qualitative and qualitative measurements for ROI. I think it goes back to relevancy and the need to be part of your audience daily life.
Illustration: Monica Parra / Newsweek
We recently looked into ways that companies can leverage web 2.0 and monetize social networks.
We got a lot of questions regarding the applicability of these principles and methods to different industries and specifically for hospitals and other health providers. As organizations with a strong social purpose and educational / outreach focus, how can they remake themselves and their services to provide innovative and effective web-based information and health?
We envision the Hospital as the center of regional health, building a community of patients, caregivers and healthcare professionals that work online and offline providing care, support and prevention.
It is an overall shift in strategy that transforms the organization to be more Open, Collaborative, Transparent, Interactive, and Social. Organizations that have successfully executed Web 2.0 initiatives: share data and information securely and seamlessly with their health care partners, provide platforms for patients, doctors, and hospitals to collaborate on improving the effectiveness of services and communications, foster community patient support networks, and empower patients to gain access to the best health care services and providers.
There have been some interesting efforts but most providers are just in the initial experimentation mode. Ed Bennett maintains a great list on his blog of all the hospitals and their social activities. According to his findings, Twitter has just become the most popular social media channel among hospitals
Paul Levy, Beth Israel Deaconess CEO has been a trail blazer in his blog, sharing thoughts, ideals, goals, results and experiences, promoting true transparency. The hospital has recently launched the first web 2.0 oriented site with a special section dedicated to interactive features such as blogs, videos, podcasts chat etc.
St. Jude Children Research Hospital has close to 35,000 fans in their facebook group and have extensive social media program on their site. Cedars Sinai in LA is using YouTube for staff recruitment purposes.
These are great examples for a few health providers that seem to have a cohesive strategy for this new interactive age. For most hospitals, just being on facebook or Twitter without setting measurable goals and defining a strategy will not yield the anticipated results.
The following diagram shows the different areas where hospitals can consider collaboration and use of social media and interactivity:
Some of the interesting opportunities we are seeing for hospitals:
- Use of social media and communities to create an active health community around their health facilities that will involve patients, physicians and hospitals
- Enhance educational activities to include online courses and support groups
- Use blogs and actual access to quality and performance data to promote transparency and trust with the community
- Use advanced web analytics to capture interests and trends and improve content and services accordingly
- Build a stronger relationship with Affiliated Health Professionals and allow them to collaborate and exchange knowledge
- Reduce the customer support functions by moving self service functions to the web
