As I have discussed in previous blogs, today’s health care trends challenge hospitals and physicians to think differently about how they engage the community and consumers. With new dynamics due to health care and market reforms and the retailization of health care, providers need to strategically and systematically think about how to engage the individual in managing their health and their care.
A comprehensive consumer and patient engagement model should help providers attract and engage individuals in the key areas they value:
- Help in understanding and navigating the health care system
- Personalize information and care based on an individual’s needs
- Easy access and communication with provider and care team
- Support in managing an acute episode or a chronic illness
- Secure access to personal health records
To meet these needs it requires a provider organization to think about an individual as a consumer not just as a patient. Depending on the role an individual is assuming at a point in time they will have different needs and desires. In the consumer role, the individual is entering and navigating the system to select health insurance, find products and services to stay healthy, evaluate where to receive health care services and how much the service will cost. In the patient role, the individual is engaging with the health care system to receive care for a health need – prevention, acute and chronic condition.
The development of a customer relationship management (CRM) strategy that activates an individual in making the appropriate health care choices based on quality and cost and a patient relationship management (PRM) strategy that focuses on engaging the individual in receiving care and managing conditions will help providers meet the needs of the market There are several elements that support CRM including:
- Consumer Health Navigation – Support consumers in finding and receiving care from the right doctor, the right service, the potential costs and the right location.
- Health Management and Education – Using a variety of communication channels support consumer’s healthy behaviors through prevention and wellness strategies.
- Access to Clinical and Financial Information – Provide access to secure personal health information and plan/benefit information.
The elements of that support PRM include:
- Care Delivery Support – Offer patients 24/7 support, triage and access to care through virtual care models.
- Care Management – Support and engage patients in actively managing their condition through self-management and high-touch outreach.
- Clinical Coordination – As individual enter the health care system to receive care, help with the coordination of care across care settings.
When addressing the needs of an individual from both the consumer and patient perspective providers can improve their brand, keep consumers in their system and increase market share.
–Cynthia Kilroy, Sr. Vice President, Provider Strategic Initiatives, Optum