One-to-one transactions do not really constitute holistic engagement. Payers should take a fresh look at what it really means to engage consumers by providing solutions that empower their consumers to make decisions that lead to improved outcomes. 

The need to engage consumers in their healthcare is becoming a non-negotiable under value-based care models. As a result, providing consumers with technologies that help them track their steps, receive text messages or schedule appointments online has become commonplace. That’s “all well and good” but only one part of the full solution.

There’s nothing wrong with providing all these tools. But one-to-one transactions do not really constitute holistic engagement — consider the burden placed on consumers when they need to access a different scheduling app for each healthcare organization that they work with. Passwords, URLs, apps, appointment schedules — it all becomes a series of hurdles for a member who is trying to manage a chronic condition for themselves or a loved one.

Payers, therefore, should take a fresh look at what it really means to engage consumers by providing solutions that don’t just facilitate current processes but empower consumers to make decisions that lead to improved outcomes.

For example, Medecision developed Aerial InCircle™, a social-mobile platform that connects everyone in a member’s trusted health circle — physicians, caregivers and trusted family and friends — and enables them to actively participate in care, treatment and wellness plans. To accomplish this, the app allows all members of the health circle to access real-time information about a member’s health and then participate in meaningful, context-specific conversations.

One example of how InCircle is currently being used to support personalized engagement is among young mothers who are Medicaid beneficiaries. Our work with a client operating a pediatric medical home showed us that many of these moms care for children with multiple conditions, and they spend so much time taking care of their kids’ healthcare they can’t go to school and it can impact their ability to work. Instead of simply facilitating one-to-one transactions, the app makes it possible to streamline communications between the mom, the care manager, the school nurse, the babysitter, the dad, the grandmother — as well as the healthcare organization’s care providers. Basically, it makes it possible to include anyone who is responsible, in any way, for caring for the child — helping keep him or her out of the ED and soothing the mom’s fears through communication.

Here’s how it works: A real-time, longitudinal personal health record sits at the core of this “next-gen care engagement” model. The digital record is then shared by the mom with selected members of this care circle.

It allows her to share, at a permission level, with whomever she wants. If she wants to share some info with a grandmother and other info with the school nurse, she has the ability do that.

As a result, the mother can turn to this connected community for help. For example, if she has questions about potential reactions to a new medication her child is taking, she can use the secure messaging feature to bring the care manager, health system nurse and school nurse into the conversation. Because these clinicians have access to the personal health record, they can respond with patient-specific advice. For example, the health system nurse could tell her what type of side effects warrant further attention. The school nurse could then monitor for these side-effects when she comes into contact with the child at school. This type of engagement has the potential to empower the mom to better manage her child’s health. Without such engagement, and with her anxiety mounting, many moms head to the emergency room.

Establishing a care circle, permission granting and secure real-time communication are important elements of this app but none of this would be worth anything without the data that feeds the personal health record. The data makes it possible for everyone to collaborate without wondering what medication the mom is referring to, what it looks like, what the instructions are.

A different approach

To develop similarly engaging solutions, organizational leaders need to question — and reach beyond — current development practices. You can’t just get some cool technology and hand it off to your members. Doing this work and creating these apps without mapping customer journeys and looking at them holistically is really just a waste of money.

To start, it’s important to understand the type of engagement specifically needed with member populations and from this understanding develop priority use cases. With Medicaid beneficiaries, for example, engagement might focus on meeting access to care challenges. As such, social determinants of health (SDOH) — the conditions to which people are born, grow, live, work and age — become increasingly important.

The ability to get a ride, have access to the right kinds of foods, afford a medication, or to continue taking a medication even if you don’t like a side effect — all of these things that happen in between medical interventions are what really drive outcomes for these consumers.

Perhaps most important, healthcare leaders need to develop a consumer segmentation framework that places consumers in groups based on a set of shared characteristics.

Without a standard segmentation model for how consumers managing chronic conditions think and behave, many health plans miss the mark — they engage with consumers as if they all think and act the same, being driven mainly by their clinical condition. We know that’s not the case — people are driven by complex personal, cultural and familial perspectives. We are all people with pressures, preferences and interpersonal commitments — the more our healthcare stakeholders understand our motivators, the more successful they’ll be at engagement.

In the final analysis, by making adjustments to their approach, health plans will come to the realization that engagement is not just about providing digital tools or apps, it’s about empowering people with data and insights that help them achieve their own personal goals.

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