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.

In 2008, Cisco launched their LifeConnection’s onsite health center which uses a Patient- Centered Medical Home model. Today, it supports over 42,000 employees and their families at Cisco’s corporate campus in San Jose, CA.

Cisco’s LifeConnections' Center offers primary and pediatric care integrated with care services including disease/condition management, health coaching, mental health, pharmacy, physical therapy and chiropractic as well as acupuncture services.

Cisco now has two physical LifeConnections' Health Centers, one at their headquarters and a second location at the Cisco Bangalore, India campus.  In addition, they operate a telehealth location in the Raleigh-Durham area of North Carolina.

Employees access LifeConnections’ services online for health management. “Within our Cisco LifeConnections' portal, our employees and their families can schedule appointments in real-time, view their medical records, communicate securely with their physicians and even send their doctor an attached document such as a food or exercise log”, explains Katelyn Johnson, Manager, Integrated Health at Cisco Systems. 

Cisco’s approach supports the findings from a recent Accenture Connected Health Pulse Survey which found that most patients (90%) want to use technology to self-manage which includes accessing their medical information, booking their doctor’s appointments and refilling their medications. The survey also revealed that patients do not want to give up the interaction with their doctor. 

Technology Transforms the Patient Experience

Working closely with employees and families, Cisco designed the LifeConnections’ Health Center to bring convenience, better care and transparency to the consumer.

Through ongoing interviews with patients, Cisco has heard feedback from consumers who:

     “Do not want to be burdened by the administration of healthcare”

     “Want technology to take away what I don’t like to do (i.e. clip board,

          discharge payment)”

     “Want to spend more time with my physician”

Cisco has used this insight to determine ways to leverage technology within the LifeConnections’ Health Center to increase patient satisfaction including:

Kiosk: Patients come into the Health Center and use a tablet to have a “paperless, self-service, check in” including verifying demographic information, paying co-pays and signing consent forms, taking less than five minutes of their time. 

Flat Screen Monitors in Care Suite: Within the patient-centric care suites, the patient and physician sit side by side to view and discuss health information projected on the flat screen such as the medical record with the latest vitals and lab results, x-rays and educational content about the patient’s condition. Cisco emphasizes the importance of providing transparency to the patient by showing them their medical record, in real time, during the visit. 

HealthPresence in Care Suite: Cisco has recently partnered with Stanford Hospital and Clinics to enable patients to access specialty care (tele-dermatology) through the use of Cisco’s own telemedicine solution called HealthPresence. A nurse assists the patient in the LifeConnections’ Health Center while the Dermatologist connects from the Stanford Outpatient center.  Cisco has found that connecting specialists with patients using this solution offers greater access to specialty care, reduces appointment wait times, and improves patient satisfaction. 

Matching Technology to the Employee Profile

Cisco has put healthcare technology in place to meet the needs and profile of their employees and families.

 “We are a high technology company and our many of our employees are engineers who literally live on-line.  Their average age is 42 years. Our employees expect our healthcare experience to mirror the way they work – which is surrounded by technology.  Specifically, they want technology to help enable care, remove access barriers and overall enhance their experience as a patient.” shares Sharon M. Gibson, Director Healthcare Business Transformation at Cisco.  “Not only do they want to see more information about their health status but they want to see trending data for themselves to better understand how their health stats change over time and how their behavior impacts those results.”

“Our employees are busy and always on the move.  They want to take care of their health in an efficient way.  Soon, we will also offer patients the option of e-visits with their doctors through WebEx, for example”, explains Sharon. “Online or e-visits would help engage employees in their health, whether from home or even remote sites, and bring the convenience that they demand”. 

“My participation in online communities (within BHive) provides me with a platform to engage & converse with my peers and build camaraderie based on shared interests. Through ‘Tastebuds’, our online community for foodies within Brocade, I have engaged like-minded individuals to discuss recipes, exchange restaurant reviews and promote healthy eating, resulting in a sense of belonging centered around a common interest.”

BHive is a private online employee social community. BHive is leveraged to help promote many wellness initiatives which helped make Brocade one of the top 100 companies to work for, making Fortune’s 2011 & 2010 list.

Within BHive, employees friend and follow each other as well as earn points for posting and answering questions and contributing to discussions. The most popular topics that Brocadians are discussing online are WellFit (includes ViveCoach challenges, Sports Groups), WIN (Women in Networking), BInvolved (volunteerism & community involvement) and San Jose Campus (employees posting photos from various work events like the annual Chili Cookoff). Brocade uses BHive to gather information from employees through polls and discussions and generate engagement in offline company and community events. During May, employees worldwide participated in “Bike to Work” and posted their photos online. 

With the ViveCoach platform, Brocade engages employees through their mobile phones. During social challenges, employees receive mobile messages about additional challenge points needed by their team, team work-out reminders, healthy nutrition or fitness tips, reminders (“drink lots of water” or “take the stairs”), team banter and leader board status.  Brocade had a team of remote employees join a recent challenge and they are planning a competition that includes spouses and family members. “We believe that it is important to include employee’s family members so these lifestyle changes become more sustainable”, explains Lisa McGill, VP, Worldwide Human Resources at Brocade.

What is the secret for being on the leading edge of employee engagement?  In June 2010, Brocade launched their WellFit Council with 15 representatives from all departments and geographies. These employee advisory Council members are divided into four work teams (Health & Wellness, Fitness, Education & Communities) and meet once per month to provide input and guidance on wellness related events, education, communication channels/content and metrics to motivate and measure engagement at Brocade. Each employee member leverages their own employee network to bring additional ideas and feedback to the Council meetings and into the dedicated online WellFit Council discussion area within BHive. “Being part of the Council has been a great experience and for me it has really affected how I manage my health, wellbeing and work-life balance.  Some of the ideas are even rubbing off on my husband”, shares one WellFit Council member.

Learn more about Brocade’s successful initiatives to drive employee engagement at the Healthcare Unbound conference panel, "New Directions in Employee Engagement: Competition, Coaching, Community and Compensation".

Shape Up The Nation Comparative Data

According to Hewitt Associates’ survey with employers, A Road Ahead- Emerging Health Trends 2010, “changing employee behaviors related to health (e.g. encouraging employees to live healthier lifestyles and manage chronic conditions) will continue to be top of mind for employers over the next several years”.

Medium and large employers are evaluating different cost effective approaches that leverage technology to engage employees in their health. One approach that has generated results at the work place is social competition. Employees that participate in social competitions between co-workers and other companies gain the support and encouragement from their teammates to realize personal benefits such as getting more exercise, eating healthier and losing weight.

GTECH, a global technology company with over 3,000 employees in the U.S., piloted Shape Up The Nation’s platform back in 2007 in their headquarters office in Rhode Island.  They noticed their employees were actively participating in the program and decided to roll it out to all U.S. employees located in 24 states the following year.

“Our employees tell us that they like to have a structured program with the option of participating in any of the three options (e.g. weight, exercise and nutrition) with the team aspect”, explains Leo Perrone, Director, Employee Benefits at GTECH Corporation.

Through the technology, employees can track and monitor their progress. “What they really like is the comparative information because it motivates them to strive harder, serves as positive peer pressure and it helps the team captains to send out motivational messages”, emphasizes Perrone.

In fact the team captains are an essential piece of the social competition. GTECH recently had a meeting with their team captains to share best practices and make sure they have the tools that they need.  

Team captains regularly send out messages to encourage their teammates to try harder together and to congratulate them on their past efforts. Employees also send virtual ‘high fives’ and messages of support to their teammates.

Perrone discussed the employees’ response to the nutrition information that was tested in the platform this summer. “Our employee loved it. They entered in their meals and saw the calories, fat, protein, carbohydrates and sugar breakdown for the foods they are choosing. Our employees became more aware of what they are really eating on a daily basis”.   One of GTECH’s benefits for employees is the option to participate in six nutritional sessions each year. We agreed that the nutrition information from Shape Up  The Nation’s platform would be valuable to share with their nutrition educator for further insight.

GTECH plans to continue with this social competition approach. “This is a foundational program for us since it makes a difference in the personal health of our employees and it also helps with team building. Our employees get to know each other through these competitions and this helps our business” concludes Perrone.

More on employee engagement as the series continues...

Have you seen "Challenge Me" as an engagement driver?

MyRegence.com

During the 6^th Annual World Technology & Innovation Congress (WHIT), I led a panel to share Social Community insights from The Regence Group and Blue Cross Blue Shield of Rhode Island. With my extensive online community experience, I was impressed with the capabilities and design of this healthcare social community that Regence has built and grown to over 600,000 members across five Plans and four states. 

Torben Nielsen, Director of myRegence.com has been leading the community development from the beginning, incorporating features to engage the member such as rewards, ratings, decision support tools and an integrated experience tying together content into community.

Key Concerns for Social Communities

As health plans develop their social community strategy, they often confront three key concerns from internal stakeholders. The first is around addressing negative comments by members. “We tell them that your members will say what they want about your plan but you have an opportunity within the community to have a customer service contact them directly to resolve any issues or post a response to their comment”, explains Torben. A second concern is about the posting of personal health information which can be filtered by the community software.  The third issue is about consumers offering inaccurate information. “One of the roles of our moderators is to ensure that the member is directed the right answers when necessary”,  replies Torben.

Engagement Capabilities within the Community

The Regence group designed MyRegence.com with  a compelling set of features to engage and empower members. Here are four capabilities that I feel are the most compelling:  

1. Reviews. This social community requires that you have a claim before you can review your provider experience. Your provider can post a response to your comments following your review. Other community members can send you a message to learn more about your experience as they consider using the provider.

2. Rewards.  Members earn rewards points for using the Community to review new health information, become part of a wellness group and for entering their wellness activities such as exercise, diet and preventative care.

3. Decision Support.  As a member considers a particular treatment option, he can review the percentage of members who have had the treatment done or prescribed and see the estimated treatment cost range and an estimated personal cost.

4. Integrated Experience.  When a member reads information about eating healthy, she can click a link to watch videos from Chef Tse, discuss ideas for cooking light meals with the community and request to receive eNewsletters filled with food related articles and links into additional content and community discussions of interest.

My Blue Community

The Regence Group has defined a part of my Regence.com as the My Blue Community to serve as a national online community platform that supports members from other participating Blues plans including early adopters  Blue Cross Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts and Blue Cross Blue Shield of Louisiana. Kimberly A. Holway, Market Segment Manager, Strategic Marketing & Product Innovation from Blue Cross & Blue Shield of Rhode Island discussed their experiences planning and rolling out My Blue Community to their members this past summer.

Value Proposition to Members

“When we marketed My Blue Community to our members, we positioned it as a ‘safe and secure place to share experiences and get support’ from others”, explains Kimberly.  “We view this as a way to expand the network so that members can more readily find people with their same health issues and interests”.  BCBS of Rhode Island members are expressing the value that they see with the community. One member confirmed that it was a ‘safe environment to seek advice’ with peers that are ‘trustworthy’.

As Torben pointed out, you need to be a member of the health plan to log in which ensures that they are an adult participating in the community.

Another BCBS Rhode Island member expressed the value that she gains ‘by reading what other people have posted’ and ‘seeing stories which are relatable’.

Member Engagement Validation

There is so much to learn about how consumers engage in private vs public (e.g. Facebook, destination health sites) social communities. Healthcare organizations are experimenting with both formats to understand the differences in the content shared and the frequency that consumers engage just to name a few. When evaluating engagement, it is also important to understand how much consumers gain when contributing vs consuming content from these communities.

How can health plans bring new sources of value to educate, support and enable members to collaborate with others about their health within these social communities? Stay tuned.