Top 5 Considerations for Selecting and Implementing Digital Care Journeys to Improve the Healthcare Consumer Experience

As digital patient apps skyrocket in popularity with the rise of remote care solutions due to COVID-19, hospitals and health systems are racing to implement these digital solutions to deliver high quality care more conveniently. Healthcare providers are now more inclined to embrace this technology to increase access to care, reduce surgical backlogs, and improve patient outcomes.

By implementing digital care journeys via digital apps, patients can access digital care plans on their smartphone, tablet or computer from home and are guided through journeys such as surgery, cancer care, mental health and COVID-19 monitoring. Patients receive personalized education, appointment and task reminders, progress-tracking, and post-op symptom monitoring using their own device. Digital care journeys help to optimize the patient by enabling providers to engage and monitor patients across care journeys to elevate the patient experience, improve outcomes and lower costs. To see the benefits of such technology, there are several key factors to consider prior to selecting and implementing a digital care journey platform. Let’s break down the top five considerations that health systems should examine when selecting and implementing digital care journeys.
‍

1. How Digital Patient Apps Enhance Workflows

By implementing digital care journeys, healthcare organizations have been able to reduce unnecessary contact with patients - especially important during the COVID-19 pandemic where decreasing the transmission risk was a high priority. In a post-pandemic world, it is unlikely that healthcare will resume previous, often inconvenient operations that required patients and providers to receive and deliver information that could be easily relayed via digital means.

There will be a learning curve for staff when implementing a digital patient app and the level of staff involvement varies depending on staff resources and goals.

Here are the 3 main levels of staff engagement taken from this white paper called “How to Implement Surgical Remote Monitoring.”

Workflow #1: Hands off (low touch):

Patient explanation: 30-60 seconds / patient (brochures only)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: None

• Patients are enrolled into the program at the beginning of their journey (e.g. at consent for surgery) or at discharge (for emergency surgery cases).
• Patients learn about the Surgical Remote Monitoring platform through instructional brochures and are educated only at the time of enrollment.
• Through the platform, patients have access to 24/7 self-care resources, giving them support through their care transitions (e.g. prehab, pre-op, and post-op recovery).
• If the patient shows a sign of risk, the platform can instruct the patient to take appropriate action (e.g. manage care at home, call the nurse, go to ER, etc.).
• This experience is entirely based on patient self-monitoring, and providers are not doing any real-time remote monitoring.
• While the hands off approach can have good results for improving patient satisfaction, reducing LOS and reducing phone calls, it has less of an impact on preventing readmissions.

Workflow #2: Hands on (high touch)

Patient explanation: 2-3 minutes / patient (brochures, verbal)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: 1-2 hours / week (1-2 nurses managing all alerts)

• This approach builds on the “hands off” framework, by adding:

• More staff verbal education to increase patient engagement. Patient usage of the program is reinforced by team members at all phases of care (pre-op, in-hospital and at discharge).
• Staff using clinical alerts and remote monitoring dashboards to intervene sooner for patients at-risk. This also allows the care team to view real-time patient-reported outcomes (e.g. symptoms, incision photos) to help make informed decisions such as whether an immediate follow-up visit is necessary.

• This high touch approach generally leads to more patient engagement and further reductions in ER visits and readmissions, as providers are able to be more proactive in catching complications earlier.

Workflow #3: Supercharged (very high touch):

Patient explanation: 5-7 minutes / patient (brochures, verbal, App demonstration)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: 15-45 mins / week / care team member (monitoring work is more distributed)

• This approach builds on the “hands on” framework, by adding:

• More staff promotion and education of the program, such as including a hands-on App demonstration for the patient before enrollment
• Using more customized alerts and dashboards for specific care team members - thereby involving the more appropriate team member for different issues flagged by the platform. For example, wound care nurses are alerted for wound issues).

• Patient adoption, engagement and ultimately clinical outcomes are highest with this approach.

By implementing digital solutions, providers are able to work smarter. Apps like SeamlessMD give patients the tools to effectively self-manage from home. They have access to an expert-approved education library and a wide variety of resources that empower patients to truly take care into their own hands. As such, digital patient apps can facilitate more efficient pre- and post-op guidance, allowing health care providers to redistribute their time and expertise more effectively. Furthermore with the implementation of SeamlessMD, leading healthcare organizations have been able to prevent post-surgical complications, increase same-day discharge, while decreasing length of stay, readmissions & ER visits. Digital patient apps also help to facilitate staff augmentation; that is, staff can spend less time on manually educating patients with physical instructional documents that patients often misplace, and on the phone.

Additionally, digital patient apps can help optimize Enhanced Recovery After Surgery (ERAS) programs by delivering standardized ERAS protocols and to collect ERAS-related Patient-Reported Outcomes (PROs) such as pain, opioid consumption, and patient compliance.

2. Accessibility

While apps are often lauded for their ability to make the delivery of care more “accessible,” accessibility must be assessed across several dimensions, including modality, UI/UX and language. Only then, can these apps be truly accessible for a wide demographic, including being accessible for populations across differing ethnic, racial, sexual, and gender minorities, patients experiencing physical, sensory, and cognitive disabilities, and patients in rural populations or with varying socioeconomic statuses.

SeamlessMD has several accessibility features that take into consideration the diversity of patient populations and their potential needs to be able to effectively utilize the platform. For example, some of the design features include:

• Omni-channel access, including smartphones, tablets and desktop computers
• Health literacy universal precautions
• Grade 6 level plain language throughout
• Simple step-by-step illustrations
• Large font
• Positive role-modeling videos
• WCAG 2.0 Level AA guidelines met
• Bite-sized, real-time messaging
• Multiplatform Access
• Color-blind tested
• Screen reader-friendly
• F-shaped inverted pyramid content to fit online reading patterns
• Caregiver engagement

‍

Learn more about how SeamlessMD prioritizes patient accessibility to support a user-friendly experience for all patients here.

3. EHR Integration Capabilities

When implementing a digital patient app, it’s important to consider how to integrate the app into existing Electronic Health Records (EHRs) for a connected healthcare platform - leading to a streamlined workflow for both patients and providers. There are a number of factors involved to assess whether or not a digital patient app can effectively integrate into an EHR system in its current state such as costs and different Application Programming Interface (API) configurations.2

Even if you choose not to integrate the digital patient app with your EHR until later, it is still important to ensure that the app can fit your EHR integration needs in the future. As such, consider looking at digital patient apps that are already listed as validated integration partners for large EHRs such as the platforms listed on Epic’s App Orchard and Cerner’s CODE program.

SeamlessMD can be embedded into the EHR provider workflow and it is the first patient engagement platform to have validated, turnkey FHIR integrations with both Epic & Cerner via their marketplaces (Epic App Orchard and Cerner CODE). SeamlessMD can also integrate with Meditech and AllScripts through similar turn-key integrations. The EHR integration accelerates patient enrollment as patients can quickly and easily access the app within their chart, and it makes it easier for staff to receive alerts, and review dashboards without leaving the EHR or signing into a different system. Read more on SeamlessMD’s EHR integration capabilities here.

4. Tracking And Analyzing Data to Improve Outcomes

Using digital care journeys powered by SeamlessMD helps to enhance patient-provider communication.The technology guides patients via personalized education, progress-tracking, and post-op symptom monitoring using their own device (e.g. smartphone, tablet, computer). Patients can access education and self-report data such as pain scores, symptoms, range-of-motion, and share photos of their wounds through the platform remotely. At the same time, the healthcare providers can monitor patients on dashboards in real-time allowing for personalized care recommendations and quicker intervention from the surgical care team if necessary.

Furthermore, with SeamlessMD, providers can automate Patient-Reported Outcomes data collection.. Organizations can customize and automatically collect PROs across the episode of care, including validated survey instruments (e.g. PROMIS, VR-12, HOOS, KOOS, etc.). Furthermore, clinicians can generate real-time, custom reports and dashboards to measure response rates, graph trends, and benchmark performance. PRO data can also be transferred back and forth between the SeamlessMD platform and existing databases.

‍Read the full case study here.

5. Privacy and Security

Privacy protection is a high priority item for healthcare organizations opting to use digital patient apps and should be a top priority before and after implementation. According to the American Medical Association, there are a few considerations to ensure the security and protection of information. Of utmost importance is compliance. Any digital patient app storing patient information should be compliant with local healthcare data privacy law, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States, the Personal Information Protection and Electronic Documents Act (PIPEDA)  and the Personal Health Information Protection Act (PHIPA) in Canada, to name a few. This protects the way personal medical information is stored and shared through technology, encrypts data, tests security measures, and ensures a safe app environment.1

SeamlessMD complies with HIPAA, PHIPA, PIPEDA, PHIA and other privacy legislation. SeamlessMD maintains SOC 2 Type II compliance through annual audits by a certified auditor (CPA). SeamlessMD’s information security program includes policies for SOC 2 and HIPAA/PIPEDA compliance, including annual security and privacy training for staff, audit loggings system, internal assessments (risk assessments on NIST-800-88 standard), external assessments (3rd party penetration testing by a certified CISSP and SOC 2) and more. All data collected is encrypted and stored on secure privacy-compliant servers with our hosting provider, who are ISO 27001 compliant and HITRUST certified. The data center for data storage and backup is physically located in Canada for Canadian clients and the United States for US-based clients.

SeamlessMD is part of government validation programs such as Ontario Health’s Verified Virtual Visit solutions, Ontario Telemedicine Network’s vendor of records, and Canada Health Infoway’s pre-qualified remote patient monitoring vendors. This provides further confidence in selecting solutions that have been vetted from a security and privacy perspective.

Download our whitepaper How to Implement Surgical Remote Patient Monitoring to learn more about implementing digital care journeys to reduce length of stay, readmissions and ED visits.  

References

1. https://www.ama-assn.org/practice-management/digital/how-keep-patient-information-secure-mhealth-apps
2. https://academic.oup.com/jamia/article/28/11/2379/6364773

‍