June 27, 2012
It’s a funny term, the concept of “automated hovering.” But it was that term that made me read the recent article in The New England Journal of Medicine, Automated Hovering in Health Care — Watching Over the 5000 Hours.
The premise is simple. For any of us with a chronic health care condition, we rarely “visit” our health care professionals — 37 physician office visits a year is the “average” for someone with multiple chronic conditions. This leaves us with 4,963 waking hours a year to skip going to the gym in order to watch “American Idol”, forget our medication, smoke cigarettes, drink martinis, and eat food rich in sugar, salt, and fat.
The question posed is, how can we “hover” over these consumers during their 5,000 waking hours per year (I would call this patient engagement) and improve their life choices in a way that improves their health and reduces their health care costs, and in a way we can afford? Conventional approaches to improve consumer engagement are personnel-intensive — using home visits by staff or via telehealth. The challenge is the cost. Would these interventions produce a positive ROI for the time and money invested?
There are two approaches to addressing this question – hot spotting and automated hovering. The “hot spotting” approach relies on analytics. Hot spotting is identifying and implementing preventative care for health care’s “high utilizers.” And, in this case, using data to identify the consumers with projected high health care costs where these personnel-intensive interventions would pay off in terms of reduced service utilization. While this may seem like only a concern of payers, this is a necessary analytical skill for any provider organization that is involved in a system where they are assuming more performance risk (in ACOs, health homes, case rates, etc.).
The second approach is the concept of “automated hovering” – using technology in lieu of staff for this time-intensive patient engagement. With the drop in the cost for all types of consumer-centric health technologies, there are many new opportunities to automate much of this consumer engagement process, and in ways that consumers really like. The NEJM article gave the example of tying medication adherence through an automated pill dispenser to a chance to win a cash prize. But, there are many examples of “automated hovering” that we have reported on in earlier editions:
For any service delivery organization working with consumers with conditions that are influenced by the consumer’s own behavior, these twin concepts are key to competitive advantage in the market. Does your management team know how to use commonly available technologies (such as EHRs and remote monitoring apps) to identify the consumers that would benefit the most from new enhanced engagement strategies – the most effective and consumer-centric approaches to delivering those strategies? Stay tuned.
Monica E. Oss
Chief Executive Officer, OPEN MINDS
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