Innovate patient engagement solutions

The nearly overnight shift to telemedicine due to COVID-19 is a good time for physicians to innovate their approach to patient engagement, says Robbie Hughes, CEO of Lumeon, a care orchestration platform for health systems based in Boston, Massachusetts.

Hughes describes the virus-induced shift to telemedicine as a “lurch” that for many practices happened in a rush, and says that it provides an opportunity to think about the difference between virtual care and telemedicine.

“Virtual care is not just doctors taking consultations online,” he says. He envisions it more as using virtual technology to determine the best way to provide a patient’s care.

“Virtual care is the hybrid model where you are trying to determine what’s appropriate for a patient and what’s not and how to deliver that in a virtual care in a way that can drive a huge amount of precision.”

He gives an example of a solution that allow a care team to triage patients at the point of referral for surgery to determine whether they need to come in for surgery. This involves triage forms, text messages or phone calls, but not necessarily consultation. “That’s not telemedicine, that’s virtual care,” he says.

Moreover, virtual care, he says, is not the result of a rushed response to a pandemic, but “a thoughtful and deliberate care design,” he says, one that can determine that a certain number of patients on a panel may be able to be managed without ever coming into the clinic. “It’s a different way of thinking of care.”

One of the ways he recommends approaching this shift is to consider how much patient engagement needs to be conducted by a physician and whether some of it can be hired out to other professionals in a practice, be they administrative staff or nurses.Not only does this allow physicians to do the work that they are best trained to do, but it can reduce burnout and improve patient care, he says.

He points to accountable care organizations (ACOs) as an existing model that already does this.

Additionally, he urges physicians not to leap too quickly into patient engagement technology solutions without first considering the context and purpose of that engagement. He references chat interfaces for websites. “It might be reasonable to argue that a chatbot is meant to act as a filter. But the reality is that the filter is only as effective as the risk the health system is prepared to take around it.”

For example, if a patient reports a headache and seeing bright lights early in the morning, he posits, most algorithms will recommend the patient either go to the emergency room or speak to a nurse immediately. “The challenge is, the more you create open access, the more you create the possibility of the patient engaging with the health system, the more you have to staff that on the other side.”

“[Patient engagement solutions] are therefore only good as they result in appropriate information being shared with the appropriate person at the appropriate time and reason,” he says.

Otherwise, such solutions will just create new ways of patients accessing physicians that will increase physician workload but not necessarily improve patient outcomes.