About This Blog

 

Sherri Dorfman, CEO, Stepping Stone Partners, Health Technology Innovation & Patient Experience Strategist

My blog is designed to spotlight healthcare organizations with innovative uses of technology & data to drive Care Coordination, Collaboration, Patient Engagement & Experience.

These patient centric approaches may influence your product & service roadmap, experiences, partnerships and marketing strategies.

MY EXPERTISE:

While consulting, I leverage my extensive healthcare landscape knowledge (acute, ambulatory, virtual, home), patient data expertise and patient experience skills to help companies make the right strategic business, product and marketing decisions. Services include:

1. Strategic Business Planning: Conducts market assessment to guide business, product and marketing strategies. Identifies and evaluates digital health solutions across categories to drive mergers, acquisitions and partnerships.  Defines and validates new business models, data-driven solutions and services. 

2. Patient Experience Strategy: Evaluates current patient experience through best practices framework. Plans, conducts and analyzes stakeholder research and devises journey maps highlighting experience enhancement opportunities, encompassing people, process and technology. 

3. Product & Marketing Strategy:  Co-creates with cohorts (e.g. patient, caregiver and care team) on AI driven health tech solutions. Develops differentiated value proposition story with outside- in view (VOC insights), for marketing, sales and investors.

Find out how I can help you. Email me at SDorfman@Stepping-Stone.net to set up an exploratory discussion.

Learn more about Me 

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Aetna Successfully Uses Social & Personalization to Engage Consumers Managing Metabolic Syndrome

Aetna's Lifestyle Social Community on CaféWell

According to CDC research, over 30% of U.S. adults have Metabolic Syndrome, a set of five risk factors including high blood pressure, high blood sugar, large waist size, high triglycerides and low (good) cholesterol.

Aetna has developed several new initiatives to empower and engage members with Metabolic Syndrome. Aetna has designed each program to support members at their stage of readiness. 

1. Alex, a Virtual Health Assistant, interacts with each member in a friendly, conversational way. Alex asks the member questions to personalize the interaction using content from Aetna Medical Directors, Nurses, health coaches & dieticians. Alex informs the member about the benefits of screenings and how to interpret test results.

Alex helps the member to relate their results to what’s happening in their own bodies through entertaining and informative animated videos. Then Alex directs the member to where they can find resources andsupport to start making lifestyle changes to help reduce their risk.

“We created Alex for members as a starting place since Virtual  Health Assistants are less threatening”, explains Paul Coppola, Head of Wellness Program Strategy & Development at Aetna. “Alex enables members to guide the conversation and explains this health issue to you personally based on your combination of risk factors”.

Alex personalizes the experience based upon what the member inputs into the virtual health advisor from their metabolic screening results report.

Members have given positive feedback using Alex:
"This was the best explanation of these issues that I have ever seen."
"Love this type of learning module. Great!"

2. Lifestyle Social Community is an online monitored area where members share personal experiences, successes and support. Aetna has a Coach serve as the community moderator, sharing information, as well as, guiding individuals to resources when needed.

Members with Metabolic Syndrome participate in the Aetna Healthy Community on the Lifestyle Social Community platform. Coaches are trained and specialize in areas such as weight management and Metabolic Syndrome.
 
“Within our Lifestyle Social Community which on the Café Well platform, we have a private log-in area where members participate in online group coaching and communicate with others in their support group”, adds Coppola.

“This becomes an access point for health education, wellness coaching which focuses on individual success, goal setting, removal of barriers, and building in a support system to help each individual to be successful. Typically each coach supports approximately 15-20 members".

Aetna members can participate in the main social community regardless of whether they are in the coaching program. "It's available 24/7 and we hope to engage more members through this channel who may not have otherwise engaged in the face-to-face or phone coaching modules. It is  another resource with peer to peer support for our Aetna members" Coppola explains.

3. Virtual Classroom for “Metabolic Health in Small Bytes” Program, an evidence-based online program is designed to help consumers (i.e. members, employer’s employees) learn mindfulness techniques to address Obesity and learn about the emotional, nutrition, exercise and motivation elements.

Metabolic Health in Small Bytes uses a virtual online classroom setting, conducted via the Internet - in real time. Participants access the classroom through the Live Meeting platform and use their phone and written comments to interact with each other and the instructor. Classes are highly interactive. Participants engage via streaming video and can hear, speak to and interact with both the "live" expert instructor as well as other class participants, sharing information or asking questions.

The Metabolic Health in Small Bytes Program which was piloted with 600+ Aetna employees, was developed from Aetna’s research study with Duke Diet & Fitness, Duke Integrated Medicine and eMindful.

Member comment:
 "Like the little engine that could I know I can, I know I can, thanks to you (instructor name) and the great supportive group with all the tips and great ideas."

Insights from Aetna’s Metabolic Syndrome Initiatives

Alex, Virtual Health Assistant is very new to Aetna’s wellness portfolio. “We announced it in February 2013.  We continue to monitor its use and feedback from members.  We will plan for enhancements as we feel is needed once we gain more experience”, Coppola shares.

Lifestyle Social Community was first piloted with Aetna employees 2011through 2012. “We’ve typically seen more involvement from individuals who have higher risk (e.g., see more chronic weight personal challenges vs. more casual weight loss)”, explains Coppola. Aetna has learned that it is important for the success of the participants to feel supported and have the opportunity to share in a safe environment. “Being anonymous helps members to feel secure in their sharing and providing encouragement to others. We are working through our future technology enhancements to the social community. We want to meet the needs and goals of the participating members, while providing a platform that includes the latest technology and makes it easy for members to engage with the coaches. We do know that individuals learn and are motivated differently and want to ensure our platform and the technology supports those needs”, adds Coppola.

With the Virtual Classroom's “Metabolic Health in Small Bytes” Program, Aetna has defined ways for participants to stay engaged between sessions. “Participants are given short homework ‘at-home practice’ assignments at the end of each class. They are asked to complete these short assignments prior to the next class. This has helped reinforce the skills and techniques taught during the classes and has given participants the tools long after the class ends. Participants have enjoyed the program so much that we are continually asked if they can participate a second time”, Coppola concludes.

 

Sharp Healthcare Uses Interactive Patient Care Technology to “Meaningfully” Engage Patients

Sharp HealthCare, a Malcolm Baldrige National Quality Award winner, continues to provide a superior patient experience by investing in technologies to bring better care to patients and their families.

Last October, Sharp Memorial Hospital, a Sharp HealthCare hospital, began piloting GetWellNetwork's Interactive Patient WhiteBoard™ in their cardiology unit to communicate and collaborate with patients and their families about their care throughout their stay.

"Our goals for the pilot were to engage patients in their care, deliver information they need, help them understand their treatment plan, provide a way for them to interact with their care team and prepare for their discharge,"  explains Verna Sitzer, MN, RN, CNS, Manager, Nursing Innovation and Performance Excellence at Sharp Memorial Hospital.

Patients use the Whiteboard to learn about their care team, their day (i.e. goals, schedule, discharge activities) and participate in the personalized communication area to journal and share information. Patients use their Whiteboard to see tasks that need to be completed such as viewing educational videos that have been ordered and filling in a discharge planning questionnaire. A summary of the patient’s education activity and discharge information is accessible to the care team for review and follow up.

Sharp uses GetWellNetwork’s Interactive Patient Whiteboard to help care providers engage, educate and empower patients along the care continuum. This patient-centered platform, delivered across mobile devices, computers and televisions, enables Sharp to implement a new care delivery model called Interactive Patient Care (IPC). Based on the premise that a more engaged patient is a satisfied patient with better outcomes, GetWellNetwork’s IPC combines the tools, process and people to activate patients in their care, transform clinical practice and advance key performance measures.

Pilot Insights

During the Whiteboard pilot, the Sharp team learned about the importance of enabling better communication between the care providers and patients. "Our patients wanted to have critical information and to be able to write down questions for the care team for a more meaningful interaction. Knowing what to expect and when to expect it is important for patients so we made this a priority in the design of the display,” adds Sitzer

One of Sharp Healthcare's big accomplishments was to connect the Interactive Patient Care solution to their EMR to capture the patient's engagement and document progress towards their discharge education plan. “Having this connection was an essential condition for launching the technology throughout the healthcare system. Providers are able to integrate patient education into their daily workflow using the EMR for ordering education videos and obtaining results of the education”,  explains Sitzer

Sharp Healthcare is in the process of rolling out the Interactive Patient Care solution to their other hospitals. Sharp Grossmont hospital implemented it early this year (February) and Sharp Mary Birch Hospital for Women and Newborns will begin this summer (July).

Sharp & Patient Engagement Framework

Last Fall, National eHealth Collaborative (NeHC) launched their Patient Engagement Framework. The Patient Engagement Framework is designed to guide providers along the path for meaningful use. Sharp Memorial Hospital has adopted this framework to further enhance the Interactive Patient Care Solution. Sitzer shares examples below and describes ways they are enabling patients to participate in the care process.

   Stage 1: Inform Me

'We use the Interactive Patient Care solution to send the patient messages about what we need them to do during their stay so they can play an active role in their recovery.  We have them watch a video on hospital safety when they are admitted and recommend other relevant educational information. We ask them if they would like to take a self-assessment of their risk for falling and provide them with a video about fall prevention”, describes Sitzer.

   Stage 2: Engage Me

Sharp Healthcare puts their patients in the driver’s seat and gives them the option of when they would like to be engaged.  Sharp has devised pathways to deliver and gather information from the patient. The 'discharge pathway' presents a set of questions when the patient is preparing for home to determine if there are obstacles that need to be addressed and confirm that all educational information has been viewed and understood.  "Our motto is 'when the learner is ready, the teacher will appear’," shares Sitzer. "We want to give our patients control over their recovery."

   Stage 3: Empower Me

By giving patients the information that they need, Sharp empowers them to participate in the care planning process, enabling them to ask questions of and provide answers to the care team. For example, patients are able to respond to assessment questions, message providers or services about their needs, or respond to focused surveys on their care or service experience. Their responses notify a provider to deliver patient and family- centered care.

   Stage 4: Partner with Me

Care pathways can be tailored to meet various health conditions such as heart failure management.  These modules rely on the patient partnering with providers to meet specific goals. For example within the heart failure module, patients must complete certain videos and comprehension questions to move to the next module or phase so that they get the necessary education and preparation for discharge.

   Stage 5: Support my e-Community

The Sharp Healthcare team is planning to use the Interactive Patient Care system to support patients after they leave the hospital. "We are working on ways we can use this system to provide the patient with personalized education information when home through online and mobile channels," explains Sitzer.

In the future, Sharp Healthcare would like to tie in health-related devices to gather and monitor information about the patient to provide support or to intervene when needed.

Social Engagement Strategies for Consumer eHealth Workshop

Pinnacle Health Social

mHealth + Telehealth World 2013- World Congress

July 24- 26, 2013 in Boston

Join our 2- hour Workshop to explore Social Engagement Strategies that activate consumers to participate in their health; sharing and tapping into peer lifestyle experiences and gaining expert guidance. You will see what healthcare leaders are investing in today, explore social eHealth opportunities for consumer engagement in the future and discuss how to launch a social strategy within your organization.

During the Workshop,

  • Learn about key Social Engagement trends including social segmentation, social connect (programs & experts) and social data
  • See examples of Social Engagement Approaches used by Healthcare Innovators; Payers & Providers
  • Hear a Case Study of a Provider solution that “meaningfully” engages consumers with a private social community integrated with personalized content and communications
  • Participate in a Social Engagement Planning Discussion; Considerations, Approaches and Mobile & Tele-health tie-in Opportunities
  • Participate in a Group Innovation Exercise: Collectively define a specific social engagement initiative to positively impact consumer health (Workshop participants shape exercise)

Workshop Leaders:

Sherri Dorfman, MBA, Chief Executive Officer & Consumer eHealth Engagement Specialist, Stepping Stone Partners

Lucy Reynales, Director, Wellness Layers

Shelley Marshall, Web Marketing Manager, PinnacleHealth

Accelerating Consumer eHealth Engagement Strategies

mHealth + Telehealth World 2013- World Congress

July 24- 26, 2013 in Boston

Innovative healthcare organizations are developing comprehensive engagement strategies to support consumers across the care continuum. They are aggressively testing and learning about how to effectively use mobile technology to guide, motivate and support consumers for better health outcomes. 

During this session, you will learn about: 

  • Evolving Consumer Engagement Landscape & Trends
  • Engagement in Action and Insights from Innovative Providers & Payers  
  • NeHC Patient Engagement Framework & Examples at Each Step
  • NeHC Consumer eHealth Readiness Tool powered by HealthCAWS- Assessment & Path Forward 

Speakers:

Sherri Dorfman, MBA, CEO & Consumer eHealth Engagement Specialist, Stepping Stone Partners

Rose Maljanian, MBA, Chairman & CEO, HealthCAWS 

Geisinger’s mHealth Journey Down the Patient Engagement Path

Geisinger Health System launched its patient portal (MyGeisinger®) mobile app called MyChart, back in 2011. MyChart enables patients to use their smart phone to view medical information (i.e. meds, allergies, immunizations, test results, current health issues), communicate with the care team, view appointments and receive health reminders.

Following the MyChart app, Geisinger accelerated its mobile initiatives with text messaging pilots and a cardiac mobile app pilot. The mHealth team at Geisinger continues to learn how patient engagement can be increased by leveraging electronic health information to improve access, collaboration and care guidance. 

Mobile Patient Data Capture

One of Geisinger’s key mhealth projects entails the electronic capture of patient reported data. “We’re using a third party tool to gather information from our asthma patients about how effectively they are managing their condition. Patients answer the five to seven question asthma control survey on their computer or mobile phone. So far, 13% of our patients are using their smartphone to respond and we expect that percent to grow”, explains Chanin Wendling, Director eHealth at Geisinger. Patients with a poor asthma control test score, indicating that their asthma may not be under control, receive an intervention call from a nurse who will help them better manage their condition. “This used to be a paper based survey which made it impossible to provide needed clinical support. Now that it is electronic, the survey can be delivered outside of the clinic and alerts can be sent to the clinician to catch problems before the patient ends up in the ER”, describes Wendling. “With this technology, we are able to check in more often with the patient. We have implemented the national best practice to have persistent asthmatic patients complete the survey every 90 days.”

Geisinger is also using mobile electronic capture to identify patients with potential health problems. When checking in for their doctors’ appointment, patients are handed an iPad to enter their health information while in the waiting room. Patients are prompted to answer certain personalized questions based on their health profile. For example, patients 65 and over with a chronic condition receive depression screening questions. “We capture and integrate the patients’ responses into their EMR so that their care team can quickly address specific needs and concerns”, adds Wendling.

Three Mobile Texting Pilots

In six short months, Geisinger has planned and launched three text messaging pilot initiatives. Geisinger will be using the findings to expand and refine the project or move onto a new mobile texting opportunity.

Last September, Geisinger started with appointment reminders to 4,000 enrolled patients total across two services areas; Pediatrics and Women’s Health. “We are currently evaluating this pilot based on the reminder’s impact on the ‘no show rate’ and more importantly on patient satisfaction. Based on the results, we plan to ask patients if they would like to receive a reminder in the future”, Wendling explains.

In September, Gesinger also launched a medication reminder texting campaign in collaboration with Geisinger Health Plan. Less than 50 patients enrolled to receive the daily text. “We expected more patients to sign up and experienced a high opt- out rate from those patient who enrolled. We learned that the daily text with a simple message to take their medication was too frequent so we are reevaluating the program. We may use the text reminders for medications which are taken less often such as once a week or month”, shares Wendling. “We are also questioning if the text message alone is enough or can we deliver more value using a set of messages for the broader disease?”

In November, Geisinger began using text messaging to support an existing program, “Conservative Weight Loss”. During this12 -week program, 240 patients enrolled to receive three texts per week; a reminder to weigh in, an educational and a motivational message. To evaluate this text message program, Geisinger will be reviewing patient satisfaction rates and weight loss results.

Conservative Weight Loss Program: Text messages Week 1

>Monday (nutrition) 
“Take smaller bites and chew longer to savor food. Also eat slowly:it takes your brain   20 minutes to let your stomach know there is food in it. Text HELP 4help”
 
>Wednesday (self-monitoring)
“Think before you eat! Keeping food logs will help you with this. Keep honest, accurate food logs daily! Text HELP 4help”

>Friday (motivation)
“Reward yourself along the way with non-food rewards. Buy a smaller dress or a new pair of shoes, or take yourself out to see a movie. Text HELP 4help”

When texting for HELP, the patient receives a text response with the phone numbers for technical assistance and clinical assistance.  “We do not yet have the option for the patient to text a question to the provider and then have the provider text or call them back. The first attempt at that will likely be a medication program with our Pharmacy team. There are a lot of operational and support issues that we have to figure out first”, explains Wendling. 

Cardiac Mobile App Pilot 

During the last few weeks, Geisinger has started testing a mobile Cardiac Rehab app internally to monitor the clinical data to decide whether to pursue a12- week patient pilot. The Cardiac mHealth application is designed to guide and support the patient throughout recovery. Within the cardiac app, patients can access educational information, receive medication reminders, track activity through their smartphone and provide feedback to their care team about any concerns. “Our patients in Cardiac Rehab are onsite three days a week. This is too much for many patients. During the pilot, we want to see if we can use technology to support their participation in Cardiac Rehab Program without the extensive onsite requirement throughout the 12 weeks”, Wendling explains. 

Future Mobile Health 

Geisinger is exploring ways to bring mobile health to different parts of its provider and payer organizations to drive patient engagement. This innovative health system is most interested in mobile health initiatives that strengthen the patient – provider relationship through the capture and sharing of information and tools to support better care decisions.

In addition to expanding texting programs, Geisinger is developing a mobile app strategy and will likely target apps around chronic disease management, health and wellness and the patient experience.  In the area of chronic disease management, Geisinger is currently looking at an asthma app to connect in with care in their Pulmonary department. The app would help patients with reminders, tracking symptoms, alerts when at risk for an attack and general information about their condition.  Discussions are taking place with clinical leaders on other conditions where an app may help with patient care.  

“At Geisinger, we are always exploring new ways to better personalize care and empower patients.  mHealth can do both, but it is not an add on.  It is a complete reengineering of the health system and we are only beginning to scratch the surface of the potential for it to bring healthcare and wellness to the patient”, shares Dr Steven Steinhubl, Director of Cardiovascular Wellness at Geisinger. 
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