industry trends

Combating Physician Burnout in the Digital Era

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Physicians are burning out at alarming rates, and we should all be paying close attention.

According to the Agency for Healthcare Research & Quality (AHRQ), provider burnout now exceeds 50%.

For physicians, the negative health effects have serious consequences. Physicians now have the highest suicide rate of any profession In real terms, one physician is lost in the U.S. every day to suicide. This is an epidemic affecting all service lines, women and men, across rural and urban settings. Stories of depression, lack of desire to perform at a high level, and chronic fatigue abound.

Obviously this is impacting patient care. This makes conceptual sense—a burnt out provider will be less effective, resulting in declining outcomes, reduced patient engagement, frustration in the ‘system’ and poorer population health. And while the human costs are highest and most important, there are also financial costs for health systems and practices. Discussed at a panel at this year’s Becker’s Hospital Review Health IT + Clinical Leadership 2018 Conference, Dr. Tim Lineberry of Aurora Health made an important statement about physician burnout: “Burnout is a business issue. If you lose one physician … that's an immediate issue from a revenue standpoint.” This makes a troubling human issue a troubling business issue for health systems and hospitals.

One industry-wide, measurable effect of physician burnout is a physician shortage. Recent research by the Association of American Medical Colleges (AAMC) predicts a physician shortage of 100,000 by 2030. This shortage will be partially caused by physician burnout while simultaneously driving physician burnout, as efficiency and productivity expectations continue to increase for physicians. The result is an accelerating and deepening crisis.

How can we address physician burnout?

Many experts have pointed to the EMR as a primary culprit for physician burnout. This is because physicians spend roughly 50% of their day interfacing with an EMR. One solution to the EMR issue is to increase the usage of scribes. Currently underutilized, scribes are proven to improve physician satisfaction and reduce burnout by cutting the time a physician spends on documentation in half.

Scribes are certainly not the only group that can help address physician burnout. To more directly address the current physician shortage, policy and regulatory changes should be made to place more investment in Nurse Practitioners. A growing base of skilled providers, Nurse Practitioners are crucial to filling care gaps and to meet patient needs that do not require a physician. Given limited time and resources, physicians need to focus on the most urgent and crucial medical needs of the population, and leave pap smears and other procedures to other providers who are trained and able to give quality care.

The Keys to Any Physician Burnout Improvement Strategy

Most importantly, addressing physician burnout requires a clear strategy that takes into account the following components. According to Karen Weiner, CEO of Oregon Medical Group, “Best practice is to identify the sources of stress for the physicians of that particular setting, identify relevant interventions, create metrics with baselines and goals, then watch closely for improvements over time, and tweak the interventions as needed.” Following this expertise, there is no silver bullet or one-size-fits all solution to address physician burnout. The daily sources of stress for an orthopaedic surgeon will differ from the sources of stress that an urgent care provider has.

Technology: Friend or Foe?

What role can technology play in addressing physician burnout? Is technology only a hindrance? If utilized for peak performance, technology can alleviate some daily stressors for physicians:

  1. Patient intake and workflow management - for physicians who view decreasing control over their schedules as a daily source of stress, there are solutions that address patient intake and workflow management. The goal of these solutions is to replicate nuances, like intake protocols and custom workflows, within the provider’s schedule. This ensures the right patient sees the right provider at the right time.

  2. Algorithm-driven patient navigation - allows the patient to be ‘steered’ to the optimal provider. This could be closest/soonest, a member of the care team, or a Nurse Practitioner or Physician Assistant, all designed to alleviate the schedule stresses of the physician and her or his practice management system.

  3. Telehealth - a key component of the physician shortage issue, and by extension physician burnout, is location. There are not enough providers in certain localities. Telehealth solutions exist that take location out of the equation, allowing greater access to care for otherwise underserved communities. For these localities, greater access to telehealth translates to decreased burden on local providers.

  4. Healthcare IT compliance automation - in a highly regulated environment, physicians need automation to remain in compliance with all regulations. Solutions that automate compliance lessen the burden on physicians and support staff when it comes to compliance.

In summary, there are a multitude of methods to address the physician burnout crisis including manpower and technology. Prior to implementing any solution, however, the first and most crucial step is to listen to providers, determine their top sources of stress, implement solutions and refine them on an ongoing basis. This strategic thinking and listening should guide any and all investments in alleviating physician burnout. The human issue of physician burnout will only be solved by listening to physicians and addressing their specific needs.

Protecting Network Integrity in an Evolving Digital Landscape

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Protecting Network Integrity In an Evolving Digital Landscape

What exactly is network integrity?

According to The Advisory Board, “Network integrity is your system’s ability to keep patients within your defined network of providers who are employed, affiliated, or in some way aligned with your organization. This could include a hospital, employed medical group, an ACO, CI network, or an independent physician organization.

By this definition, network integrity is an enterprise-wide effort. Providers must be on board with a health system’s network integrity efforts to minimize patient leakage across the enterprise. One of the most important parts of network integrity is the patient experience. While patient experience involves a number of factors, including in-patient experience, communication with the provider and the care administered, an increasing component of patient experience is mobile engagement.

Mobile engagement and patient experience are both rapidly changing and increasingly important to health systems and practices. According to a July 2018 Black Box Market Research survey, consumer expectations for healthcare providers are increasing. 92% of healthcare consumers surveyed say that improving customer experience should be a top strategic priority for medical providers over the next twelve months.  

These changing expectations are changing consumer behavior at a rapid pace. To illustrate, 88% of consumers under 40 say they'll choose their next provider based on online presence. Simply put, if providers and health systems fail to meet consumer expectations, which include having provider profiles and schedules online—network integrity will diminish as patients switch to more modernized providers. The key takeaway is that provider switching and shopping is happening now—and is threatening network integrity for health systems and practices across the country.

How to Maintain Network Integrity in a Rapidly Changing Market

There are at least three things that providers can do now to invest in network integrity to achieve real benefits over the coming years:

1. Improve your digital front door and digital curb appeal

To welcome consumers and retain them, providers need a welcoming digital front door. Consumers should be able to access a practice and its providers through a variety of digital access points including search engines, maps, digital assistants and social media. Additionally, practices need to develop digital curb appeal online through a consistent brand experience that promotes the provider’s brand.

While digital front doors and curb appeal are often associated with customer acquisition, the rise of doctor shopping and switching have turned these components into core tenets of maintaining network integrity. Having poor digital curb appeal is a threat to any health system’s network integrity because loyalty is being replaced with rapid provider switching.

2. Syndicate provider profiles, location data and schedules across digital channels

While it’s clear that provider profiles need to be visible across digital access points, less literature exists on effective ways to achieve this. Fortunately, companies such as Yext syndicate provider data across digital access points. Solutions such as Yext allow for control over the brand experience, thereby promoting a health system’s brand and providers.

3. Referral management

It’s simple—broken referral processes cost the healthcare industry an estimated $150 billion each year. Therefore, referral management is a high impact piece of any network integrity initiative. While there are several ways to address referral management, including reducing lead times and sharing data across constituents, a comprehensive referral management solution should be in place to protect network integrity.

With referral management, patient-provider matching is an often overlooked component. By ensuring that patients are navigated to specialists with the right expertise, waste is reduced and the patient experience is enhanced.

Many factors including patient experience, referral management, digital front doors, patient-provider matching, patient access and patient engagement affect network integrity. At the end of the day, however, network integrity is about getting a few key things right: first, welcoming patients into your network at multiple access points; second, providing a positive experience; and third, making it convenient for consumers to return. In a rapidly evolving landscape, these core tenets can help protect a health system’s network integrity.

How to Improve the Curb Appeal of Your Practice

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You’ve likely heard of the term curb appeal. A widely used term in real estate, there’s even a television show on HGTV named after the phrase. Curb appeal is the general attractiveness of a house or other piece of property from the sidewalk to a prospective buyer. In other words, curb appeal is the impression a prospective buyer gets when viewing a property from a short distance.

Houses have curb appeal—why can’t healthcare practices?

Some might point out that not every healthcare practice or health system has a physical street curb or sidewalk parched directly in front. The reality is that prospective patients are  viewing practices constantly—though they are viewing with mobile devices, tablets and laptops. 

Real estate for healthcare practices: the digital front door

Healthcare practices have digital front doors. The digital front door is an online place where users can view, and enter, a health system or practice. Multiple sources already cite the importance of the digital front door. According to Modern Healthcare, “That digital front door is key to acquiring new patients and building the kind of brand awareness and loyalty that keeps them coming back.”

The term digital front door is slightly misleading because it implies one main opening or entrance to a practice. In reality, users are searching for care in a variety of places online. These places include search engines, maps, digital assistants and social media. Yext, a leading location data management company, has notably stated that a company’s website is not their digital front door. Health systems and practices therefore need to have multiple access points across digital channels to welcome prospective patients.

Extending the digital front door analogy

In the analogy of the digital front door, patients are already looking at the practice’s entrance and potentially choosing to enter. Digital curb appeal, then, is the overall attractiveness of the practice from a glance. These glances are online and can come from channels such as search engines, third party sites, display banners, maps and social media. Additionally, user experience and brand experience greatly affect the overall appeal of the practice in the eyes of prospective patients. This is the essence of digital curb appeal.

Why is digital curb appeal important?

Digital curb appeal is a fundamental part of any patient acquisition strategy. It encompasses visibility, access, user experience and more. Beyond a digital front door, which focuses on patient acquisition, curb appeal is developed using a mixture of user experience and branding. The results of strong digital curb appeal are increased brand awareness and a consistent flow of patients to your practice.

How to develop digital curb appeal

1. Drive traffic to your digital front door

Since the proliferation of digital media, there are a multitude of ways to efficiently drive traffic to your digital front door. These methods include search engine optimization, social media posting, paid search ads, display banners, video and native advertising. You should ideally employ search engine optimization, organic social media and at least one paid channel to deliver quality traffic to your digital front door.

2. Provide a consistent brand experience

Your users will most easily remember your practice if they have a consistent, memorable, positive brand experience. This can be achieved by ensuring that all brand visuals and messaging are consistent across digital touchpoints.

3. Differentiate with an innovative user experience

One way that your practice can stand out and “cut through the clutter” is with a differentiated user experience. There are two major ways to differentiate user experience: first, providing a seamless experience; and second, by providing a truly innovative experience. By enhancing your user experience with technologies including chatbots and digital assistants, you can transform user experience into a strategic differentiator.

Putting it all together: Digital Front Door + Branding + Differentiated User Experience = Curb Appeal

Building digital curb appeal is a broad initiative that involves an investment in branding and user experience as well as the development of a digital front door. With a great looking front door, a welcome mat, consistent style and curb appeal—prospective buyers will come knocking at your door.

Guest Blog: How to Prepare for Consumerism in Healthcare

Carrie Liken is the Head of Industry/GM - Healthcare at Yext, where she has visited with 230 health systems over the last year and a half. As a former Google employee and graduate of Harvard Kennedy School, Carrie provides deep knowledge of the health space and how technology impacts patient discovery and acquisition.

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Consumerism. This term is not new in healthcare. However, in visiting with over 228 health systems in the last year and a half, I can say that health systems are grappling with this concept and not really succeeding. To start, I’m more frequently hearing health systems refer to patients as consumers. And, they should be, because the patient is — in fact — a consumer, and there are specific things health systems can do to prepare for this shift. A consumer is defined as someone who purchases a good or service for personal use. Given that patients are starting to own more of their healthcare decisions and are becoming more financially responsible for their healthcare, it is only natural to begin to think of the patient more as a consumer and less as a ‘patient.’

In January of 2018, we conducted a study charting the evolving patient journey and found that patients exhibit similar behaviors when searching for healthcare as they do when they search for products. Our study showed that over 76% of people search for providers (rather than physical locations) and one of the key decision-points in the provider selection journey has to do with where the provider is located. (Yext Study 2016 and 2018) A Think with Google study in retail showed that 66% of people look for the location of the closest store when identifying where to find a product.

In this case, the provider is the health system’s “product”. Consider how patients are consumers in other parts of their lives: When a consumer wants to purchase a kitchen towel, all she needs to do is consult Amazon, perform a search for a kitchen towel, click on the kitchen towel product and the Buy Now button, and voila! she has a kitchen towel within 2 hours to 2 days (assuming she has a Prime Now or an Amazon Prime account). This flawless execution of search to purchase to receipt is the norm for a consumer, and one that the consumer — when becoming a patient — is jarringly something she is not experiencing for her healthcare. Search to purchase to receipt is easy in every vertical (think restaurants, hotels, flights, products, etc.) except in healthcare.

It is not easy for a patient as a consumer to find the right provider for the right treatment at a convenient time that both matches the patient’s and the provider’s schedules. But, the patient as a consumer is trained to expect that this should be easy, because it is easy in every other vertical that touches a patient’s life.

So how can health systems prepare for Consumerism in healthcare and meet the patient’s expectations for her healthcare as a consumer? You can take three critical steps:

  1. Organize Your Provider Data. Google, Facebook, Amazon, etc., are building public knowledge graphs that can answer any question a person asks of them. Health systems need to be responsible for ensuring that their internal knowledge graphs are able to feed the public knowledge graphs with accurate, consistent information to ensure the right answers are provided when a patient asks. The only way to do this is to ensure that your provider data is cleaned up and structured in a way that these public knowledge graphs can consume. How do you do this? Determine where your data currently lives (and in how many places) and start to consider how to pull it all together into one single source of truth. Without a base layer of knowledge about your providers, it will become increasingly more difficult to succeed in marketing in the intelligent future.

  2. Activate Your Provider Data through Syndication. There has been a 32% decline in visits to health system websites in the last year. (Yext study, 2018) Currently, 83% of people are visiting other microsites and micro experiences without ever reaching a health system website to make an appointment. (Yext study, 2018) It is all the more important that your correct provider data is fully activated and syndicated on third party sites to ensure brand consistency and patient acquisition. Don’t leave the patient experience up to third party sites without taking full control of that experience. You, as the health system, need to own the experience on and off your website, now more than ever.

  3. Schedule, Schedule, Schedule. Patients are consumers. They have high expectations in healthcare and are frequently disappointed by the digital experience. If you haven’t started to activate Online Appointment Scheduling within your health system, you’re missing a huge opportunity to provide a positive patient experience as well as address patient expectations for their healthcare. How many of those patients will opt to find another provider who does provide online appointment scheduling? By cleaning up your provider data and activating it through third party channels, it’s now up to you to close the deal in the final mile of the patient journey. For those health systems I’ve spoken to who have activated online appointment scheduling, I’ve heard that the patient who books via online appointment scheduling is more likely to no-show at a much lower rate. That is literally revenue contributing to the bottom line of a health system!

Your consumers expect more of your health system — and it’s only going to get more complicated. By taking these above-mentioned steps, you will undoubtedly be setting yourself up for the future of intelligent search in healthcare.

Trust: The Key Component to Finding a Doctor

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How can I trust a stranger, whom I have never met, with the most precious asset—my health?

In the past, when selecting a provider, trust was established primarily through word of mouth referrals in addition to baseline qualifications such as education, licenses, and experience. This information allowed people to make judgments on both a provider’s character as well as their competence.

While these mechanisms still apply, the increasingly digital, fast-paced and less personal 21st-century world has largely replaced word of mouth with modern technologies. These technologies include 5-star rating systems for doctors, and more recently, advertising platforms that require providers to pay money to show up on a provider search function. However, these technologies fail to match patients with the right provider - and thus do both patients and providers a disservice.

Doctors dislike 5-star rating systems because they are:

1. Skewed to negative ratings - one or two poor ratings based on a misunderstanding can ruin a provider’s patient flow.

2. Patients want “the best” - only providers with the highest ratings will take a majority of the patients when in reality there are many more competent doctors with better availability than those with highest ratings.

3. Higher star ratings do not reflect fit - care providers with five stars are often not the best fit for the patient’s specific needs. Star ratings inherently cause sub-optimal patient traffic to each doctor, creating a poor experience for both parties.

In a similar vein, sponsored provider search ads have appeared recently in an attempt to mimic the paid search engine experience available on leading search engines.

However, sponsored provider search ads create a pay-to-play system that:

1. Rewards providers who spend on advertising instead of the physicians that are the best fit for each patient

2. Profits off the patient’s lack of knowledge, and lack of trust, about who their best provider should be

3. Treats providers and patients as commodities and not as humans looking to provide and receive care

Additionally, these technologies do not align with a provider’s or health system’s objectives. In a world where health systems need to drive triple aim to be successful, and volume-based care has been replaced with value-based care, quality, accuracy, and humanity need to be prioritized over volume, inaccuracy, and commodification.

DocASAP: Using Technology to Restore Trust in the Physician-Patient Relationship

Fortunately, there are technologies today that guide patients to the correct provider while aligning to the needs of providers and health systems. The most notable of these technologies is intelligent online appointment scheduling. Intelligent online appointment scheduling has many facets, all of which are central to its ability to meet the needs of patients, providers, and health systems.

The components of intelligent online appointment scheduling include:

1. Matches patients with the right providers in the right setting at the right time

2. Increases patient access to care through omni-channel pathways

3. Replicates the health system’s workflows, rules and protocols

4. Gives the provider 100% control over their schedules
 

The best care can be provided by matching patients to the optimal provider based on the patient’s needs. More importantly, in this model, providers and patients are treated as humans instead of commodities. Accurate clinical protocols ensures that patient needs are awarded the consideration they deserve, while accurate operational protocols drive patients to the right provider. Lastly, because DocASAP focuses on retaining patients within a health system, increased retention leads to longer-lasting relationships between the providers and patients.

To summarize, the physician-patient relationship can still be built on trust, even in today’s digital world. To achieve this, however, healthcare technologies must meet the needs of all parties and treat them as humans, not commodities.