Social Technologies: Meeting the Challenges of Population Health

November/December 2013
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Social Technologies

Meeting the Challenges of Population Health

 

Social technologies offer powerful tools that can be applied in healthcare settings to improve the quality of care and patient safety, especially as the U.S. healthcare delivery system transforms to accommodate changes brought about by the Affordable Care Act and aging baby boomers.

The anticipated shortage of healthcare providers, along with significant increases in numbers of individuals accessing care, mean we must significantly transform how we approach and deliver healthcare services. Airlines, banking, and retail have had to re-envision their customer experiences and radically change business processes to accommodate evolving attitudes, expectations, and behaviors. In each of these industries, technology and online tools have played a major role in the transformation.

The shift away from a focus on treating episodes of illness to improving the health of populations highlights the need for automation of processes and more self-service options. Population health involves three fundamental components, each of which can be accommodated by social technologies (Care Continuum Alliance).

The first component is central care delivery and leadership role of primary care. It makes sense to offer consumers and patients an integrated approach to the presentation of the health information and access to trusted resources for self-management of their conditions. Too often, providers offer their patients access to their electronic health information through a patient portal without any guidance or tools that can help them take action.

The second component is the critical importance of patient activation, involvement, and personal responsibility. Social technologies that have patient-centric design features are engaging, present information in a way that patients can understand, and facilitate closed-loop communications.

The final component is patient focus and capacity expansion of care coordination through wellness, disease, and chronic care management. Social technologies are user directed and scalable. They can accommodate intimate groups or large pools of individuals in public or private conversations. They bring individuals together, even those who are graphically dispersed or have transportation challenges. Users self-select those in their network and can join as few or many communities as they like. The tools also facilitate the tracking of communications between a few or many.

Consider some of the goals and activities (see list) that are required to effectively manage the health of a population and the potential efficiencies offered by use of social technologies, especially for those with multiple chronic conditions or complex needs.

  • Assessing risks
  • Tracking patients on population basis
  • Confirming completion of preventative screenings
  • Monitoring adherence to care guidelines and treatment plans
  • Coordinating care across different settings
  • Intervening with individuals, as needed

For those who have difficulty envisioning the use of social and online tools in care processes, it is important to consider the entire care continuum and the fact that 98% of the time our patients are not standing in front of us. Visits to providers make up a relatively small portion of a patient’s life. That means that population health can’t happen if we only focus on those processes when the patient is in our facility. It requires that we maintain contact and find ways to engage patients and their family caregivers before, during, and between encounters with the healthcare system.

Examples of organizations that are well positioned for population health activities by their demonstrated use of innovative social technologies include:

  • Boston Medical Center’s use of an avatar to conduct a pre-conception assessment of teens at risk for poor reproductive health and family planning outcomes.
  • United Health Centers of San Joaquin’s use of a social networking platform to help safety-net providers and patients manage chronic disease.
  • Partners HealthCare’s use of texting for reminders and prevention messaging with multiple populations to realize improvements in adherence to care plans, decreases in “no show” rates and sustained behavior change.
  • Boston Children’s use of social media to augment traditional surveillance methods of hypoglycemia in diabetes to expand knowledge of complications and impact behaviors.
  • Children’s Hospital Dallas’s secure online social networking community for patient and family peer support.
  • Nemours/Alfred I DuPont Hospital for Children’s using a secure social enterprise network to collect real-time feedback from family advisors.
  • Aetna’s use of a social networking platform to support beneficiaries recovering from addiction and to help prioritize case manager outreach activities.

Healthcare leaders are expected to seek out and apply best practices, as well as adopt those information systems that support patient safety and quality. As we look toward a transformed healthcare delivery system, we can expect to see the most effective leaders leveraging what social technologies have to offer.

Christina Thielst is vice president of TOWER, a patient experience consulting group based in Playa Vista, California. She blogs at http://thielst.typepad.com and is a fellow of the American College of Healthcare Executives. She may be contacted at christina@cthielst.com or on Twitter @cthielst.

Reference
Care Continuum Alliance. Advancing the population health improvement model. Available at http://www.carecontinuumalliance.org/phi_definition.asp