- The Centers for Medicare & Medicaid Services (CMS) received sufficient pushback to propose reducing meaningful use requirements for patient engagement over the next few years, from five percent of patients to one single patient.
A majority of industry groups contends that these requirements are not only burdensome but also unfair because eligible professionals and hospitals are held responsible for the actions of patients. However, the real problem could stem from how healthcare organizations and providers approach patient engagement, particularly the belief that patient portals are the only means of supporting patient access to health information.
According to the Senior Vice President and CIO of Miami Children's Hospital Ed Martinez, the most effective way of engaging patients is to understand their habits as consumers of information and their technology preferences and capabilities.
Martinez sees mobile devices and applications as more effective means of connecting with patients than a traditional desktop solution. In this one-on-one interview with EHRIntelligence.com, he explains why providers need to rethink their patient engagement strategies and look past the patient portal as the primary means of enabling patient access to health information.
EHRIntelligence.com: Why doesn't the use of patient portals necessarily lead to patient engagement?
Ed Martinez: We need to put up portals because there are mandates to do it. The reality is the portal is there as a requirement or prerequisite, but no one is using it. If they are using the portal, they are doing so on a mobile device. So why not develop software that is much more user-friendly, more integrated into the end-user? And rather than giving the end-user just access to a portal, why not make it so that it is procedure- or process-based? I want to schedule an appointment, press that. I want to get my lab results, press that. That is more intuitive for a patient than having to go into a portal and siphon through mounds of information or navigation whereas on a handheld I can just press what I want and immediately get that information. I do see that happening and happening pretty quickly.
EHRI.com: How could a mobile approach to patient engagement improve on earlier approaches?
EM: The proliferation of mobile devices is exponential greater than that of computers. For example, we are in an area where there is a 70-percent Medicaid population, and we're also in one of the richest areas in the country. We're in the middle of the two. Not everybody has a computer in the home. We know because we have done surveys. But everyone has a smartphone. There isn't a person in Miami or the South Florida area who doesn't have a smartphone. We know that the future in marketing and hitting the consumer is in the mobile space. That's what we're attacking. Institutions that are savvy enough to keep their portals afloat but spend their resources on making more of an investment in the mobile space are going to come out on top. And consumers are going to reward those facilities because they are going to want to be associated with them more than those who don't provide those types of services.
EHRI.com: Can patient portals be re-purposed for mobile use?
EM: There are ways to re-write the portal so that both the portal and mobile device automatically presents the information. Of course, there is an investment in the older portals that has to happen. That said, it does meet the needs of a patient who simply wants to see information about their discharge and other one-two's. But there is so much more you can do when you start doing more native development that specifically hits workflow issues that are very specific to the things that people do on a daily basis.
EHRI.com: How is Miami Children's Hospital set up for mobile development?
EM: There is native development and HTML development that allow you to develop the software so that it automatically adjusts based on the device. There is a lot of both going on. Native development may not go away overnight only because there is so much more you can do when you specifically write the software for the mobile device. That said, with the development of the latest version of HTML, you can do a lot of cool stuff and be able to handle the entire mobile suite. That's probably where people start, integrating little things that are more native to a device instead of having the entire suite perhaps natively. If as a physician I want to see what a patient's trend is in terms of lab results, being able to show a trend chart is something pretty simple. But if I can do it on a native app, what I can do is provide drill-down capabilities and other things that maybe I could or couldn't do as well non-natively.
It becomes an issue of how much you want to invest and how much sexier you want to make it. One thing is for sure: Consumers prefer their devices — whether it's Android or iOS — over sitting down at their computer at home. Most of it has to do with not having the time to do any of this stuff. The world is connected, but it's connected with mobile devices.
EHRI.com: What are the organization's plan for traditional and mobile patient engagement moving forward?
EM: Today, we are writing in HTML and do a little in native software. I don't know if we're going to go away from it. There is a good reason to develop with a base on HTML and maybe add some components in native. Maybe we start doing both at the same time. We're going to evaluating it as time goes on. Part of it has to do with speed to market. If you write it once, you can use it for multiple devices and get it out. If it is really useful and you see that the workflow is being used, maybe you go back and re-write it natively. You don't want to write everything natively because it costs more and takes more time and speed to market is important right now.