Getting to the Point: A Multifaced Approach to Avoiding App Overload

By | October 23, 2018

Elaine Goodman, MD, Medical Director, Massachusetts General Hospital, and Associate CMO, Wellframe

As more emphasis is placed on value-based care, health plans are looking to devote more resources toward lowering costs and improving outcomes. Adopting new technology-enabled approaches that help patients take control of their own well-being can be a win for the patient, physician and health plan, helping to achieve quality and cost goals without requiring significant increases in human resources.

This is perhaps why we’ve observed an uptick in the investment of “point solutions,” each of which purports to address some subset of patient needs, support physicians, and meet the demands of health plans’ different business lines. In fact, according to a survey conducted by Wellframe, 50 percent of organizations manage anywhere from four to nine different digital point solutions such as disease-specific apps, wellness programs, technology solutions like texting, or customer service tools.

As a result, physicians, patients, health plans, and their care teams are suffering from a condition known as “point solution fatigue” where they’re overwhelmed by managing multiple apps, and health plans are left without measurable results.

Instead of implementing a suite of different point solutions, our experience has shown that a single comprehensive approach to health management better supports patients beyond the walls of care facilities. To combat point solution fatigue, organizations should adhere to the following principles.

  1. Support the whole person

By 2030, nearly one in two Americans will be living with one or more chronic conditions, according to a RAND Health report. But when it comes to helping this high-risk population improve their health, we must also keep in mind that 80 percent of outcomes are determined by non-clinical factors such as behavior, environment, and socioeconomics.

Rather than offering condition-specific apps or wellness point solutions, plans must be able to deliver comprehensive, personalized, and holistic support by doing the following:

Meet both clinical and social needs

  • Address lifestyle and socioeconomic factors that are critical to improving health
  • Utilize interactive surveys to screen for social determinant needs such as transportation, financial concerns, social support, and safety
  • Deliver personalized health education tailored to those social needs, within the context of their clinical needs, so the member can visualize how therapeutic lifestyle changes have can have positive, direct impact on health

Address comorbidities with comprehensive clinical programs

  • Address overlapping symptoms and the challenges of polypharmacy by supporting conditions simultaneously (one in four Americans have multiple chronic diseases, according to the CDC)
  • Offer a broad range of clinical programs in a single solution to support multiple chronic conditions like diabetes, COPD, and asthma, as well as transitional care and behavioral health

Utilize multiple channels

  • Deliver health management support through a combination of phone calls, messaging, apps, web, and video chat so members can choose the method that meets their needs
  • Provide more frequent support and guidance than intermittent calls

Meet health literacy standards

  • Deliver health education content at a fourth-grade reading level (using short sentences with basic structure and simple words) for broad accessibility
  • Use creative solutions such as videos, bullet points, highlighting, bolding, colors, and images to deliver education to members with a variety of learning needs
  • Provide definitions for medical terminology
  • Break complex concepts into digestible pieces

Finally, it’s important to empower team members to determine what information to send, depending on the individual needs of each individual.

  1. Unify engagement

As anyone with clinical experience can attest, care can suffer when it is not coordinated across the various specialties involved with a patient’s care plan. Digital engagement point solutions are often delivered in a siloed fashion, which can not only cause point solution fatigue, but also result in a lack of insight into patient needs, inefficient outreach, and, ultimately, poor care.

To break down these barriers and unify engagement, it is advisable to follow these best practices:

  • Unite technology and human services. To better support patients, care teams need real-time insights into patients’ day-to-day health. But typical point solutions, such as patient education or texting apps, don’t inform or integrate with care management workflows. When human services and member engagement technology are unified, care teams can get the insights they need to provide the right intervention to the right patient at the right time. Successful programs will be able to capture and analyze patient-reported data, automatically prioritize patients based on clinical need, and respond via two-way messaging with timely, personalized support.
  • Integrate administrative and clinical services. One patient may get as many as 20 different outbound touch points in a year. Rather than overwhelm patients with outreach, engagement efforts can be unified across healthcare services and point solutions to support the broader needs of patients and engage them through their preferred communication channels. Often referred to as a concierge model, this approach gives the patient one point of contact to help understand claims, answer questions, and more.
  1. Enable Collaboration between Providers and Payers

Providers and plans must be able to work together to improve quality, reduce costs, and succeed with performance measures. Siloed point solutions, however, often act as barriers. By offering solutions that facilitate collaboration, providers and plans can leverage one another’s key competencies to more effectively deliver screenings, measure and improve patient satisfaction, improve primary care utilization, and decrease hospital readmissions.

  1. Measure Rigorously

For many health plans, the issue that arises with point solutions is an inability to properly evaluate their collective impact, due to a lack of standardization across the data that have been collected from each solution. To avoid this problem, it is best to measure the outcomes that matter in a consistent way across your health management interventions, and avoid point solutions that fail to meet this standard. Some of the key outcomes that should be consistently measured include:

  • Patient insights for real-time intervention. Gathering continuous information from individuals’ activity via digital care management tools can provide meaningful data on patient engagement, health status, gaps in care, and more. In aggregate, this data provides valuable insight into population preferences, engagement, and satisfaction.
  • Care team reports for workflow evolution. Data from care managers’ interactions with patients reflects individual productivity based on operational metrics such as recruitment volume, engagement rates, efficiency, and capacity. Measuring this can empower supervisors to make data-driven decisions to optimize resource allocation around staff needs and strengths.
  • Program reports for impact evaluation. Based on large-scale, program-wide indicators, these data points measure the cumulative impact of health management on the population it serves. Data from medical and pharmacy claims combined with data from patients and care teams as described above can enable new comparisons of cost and value that can demonstrate a clear return on investment.

Point solution fatigue is prevalent within healthcare organizations and systems. But through a comprehensive health management strategy that supports the whole person, unifies engagement, and delivers measurable results, it doesn’t have to be.

This piece was written by Elaine Goodman, MD, who serves as both Medical Director at Massachusetts General Hospital, and Associate Chief Medical Officer for Wellframe. A primary care physician, Dr. Goodman holds an MBA from Harvard Business School. Her research, publications, and editorial work focus on patient safety, patient-centered care, and primary care innovation.

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