Atheneum Learning’s launch of its Flexible CBT eLearning program through Cigna’s Network Rewards Program shows how understanding business changes opens up opportunities.
Traditionally, continuing education programs are marketed directly to the clinicians, therapists and social workers who require CE credits to maintain their licenses. The easiest and cheapest method for acquiring the CE credits is often the one chosen by providers.
When I looked at healthcare beyond the clinicians however, it became clear to me that insurance companies, employers, Medicare/CMS have reasons to encourage improved skills in their provider networks. It’s no longer about cutting provider reimbursement rates, it’s about getting better health outcomes (in this case behavioral health) to avoid hospital stays, enhance functioning in the workplace, and improve quality of life. (Note: 60% of absenteeism is caused by behavioral health problems.)
Improving quality necessarily lowers costs.
Our experience fixing defects and cutting rework in manufacturing showed that, and hospitals are starting to use lean techniques to improve safety and quality of care for patients.
This insight helped focus our efforts on channels that have a vested interest in improving outcomes. Now, we don’t just provide eLearning, we have programs that drive skills acquisition, meaningful use and outcomes, meeting today’s concerns of insurers and employers. And the patients are happier too.
Go to www.atheneumlearning.com
American Well Wins Gold at the Edison Awards
As a committee member for the Edison Awards and a judge for the last three years, I am convinced that most innovation comes from early stage companies. So I am always on the lookout for companies that have unearthed critical problems that need fixing, and they go about building the “fix”.
Last year I approached several companies, encouraging them to apply for an Edison Award. American Well is one of those and I am pleased that they just won the Gold Award for INNOVATIVE SERVICES - Health, Wellness and Safety in the 2011 Edison Awards competition Go to www.americanwell.com and read about how they are transforming healthcare. If you are in Minnesota, you know about their services. And if you frequent Rite Aid, you know about their services.
American Well placed with a field populated by Ford, Coca Cola, GE and many other well known brands. For a new company, this is great exposure and terrific feedback that what they are doing is important and appreciated.
Go to www.edisonawards.com to find out who else won awards.
January 2011: ARE ELECTRONIC HEALTH RECORDS AND MOBILE APPS THE BIGGEST CHANGES OCCURRING IN HEALTHCARE, OR ARE THERE MORE?
Reading news reports, you’d think that technology is the big story. But if you look further you will unearth opportunities well beyond a new technology or a mobile download.
Over the last year I’ve worked extensively in healthcare, investigating industry issues and creating entry strategies for several clients. Here’s what I’ve learned:
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Hospitals have taken control. They have responded to government reporting requirements and threats to their reimbursement levels by dramatically improving safety and quality of care, demonstrating once again that “you are what you measure” and you improve what you get paid for. Insurance companies and employers are taking control. Responding to runaway costs, they are collaborating to improve patient health, engaging patients and medical providers for better outcomes. They intend to break the adversarial cycle created by the exclusive focus on reimbursement.
I invariably find that a good grasp of a market spurs ideas for successfully launching my client’s product or service. My insistence on understanding the critical business pressures and goals may be frustrating at times for small companies that feel the pressure to “just make sales”. But when the client has been trying to make meaningful sales happen for months with little success, bumbling around trying to sell their product, the smart ones realize they need another approach.
THOSE “AHA” MOMENTS. THAT IDEA FOR HOW TO ADDRESS A SERIOUS PROBLEM AND IT’S ONE NO ONE ELSE HAS FIXED. THAT’S WHAT I LOOK FOR.
Two examples: The industry changes, above, yielded very different strategies for a couple of clients, opening opportunities that eluded them before.
One of my clients has content that frankly has no competitors if we package it in programs that solve those “improved medical outcomes” goals that insurers and employers want. But we are doing much more by helping the insurers track the results of our program to reduced costs, and to better performance of the employee when he is at work.
Prior to this program, insurers and employers were unable to identify the measurable results of their health investments in this medical segment. By solving larger problems in a program wrapped around my client’s service, we are negotiating significant contracts and building receptivity for future products.
Another client also has a “gold standard” service with a lot of opportunity but their cost of sale almost matches the average sale made over the last year. Since this is an unsustainable model, they asked me to assess a couple of markets for them and identify entry strategies. My findings about the hospital market show there are different, and much larger opportunities than they envisioned. Here’s the story:
Most small companies, like my client, grab any sales opportunity without understanding the unique principles that they should be using to look for profitable revenue. Not that you should turn away good business but most of the effort should be on opportunities
that meet criteria like those I laid out for this client.
THIS IS WHAT I SET AS MY OBJECTIVE.
Identify one application within the hospital market that:
· shows an urgent need for the service
· resonates high enough in the organization to capture attention
· has a big enough internal user community to justify a large investment
· can support a different financial model since their current pricing model will not build a big company
· has a broad enough need that many hospitals can use the product
Being very clear about the criteria I used, and through in depth interviews to identify significant changes in the hospital market, I created an approach totally different than the unsuccessful one that was in place.
HOSPITALS HAVE TAKEN CONTROL; INSURERS AND EMPLOYERS ARE TAKING CONTROL: GOOD CLUES FOR GETTING TRACTION IN HEALTHCARE
As you know, I work with technology and information companies that solve major business problems.
I especially like companies that provide solutions for financial services and healthcare because complexity and structural changes yield huge opportunities.
My advice: spend the time to understand what is driving the changes because with that and an “aha” moment, you can drive significant business.
February 2010: HAVE WE REACHED THE TIPPING POINT FOR INNOVATION IN HEALTHCARE AND LIFE SCIENCES?
Thoughts from Babson’s 7th Annual Healthcare and Life Sciences Forum
Did you know that peer review of clinical data is no longer considered the best? Or that for every $100 of cost associated with a hospital stay, it would cost $60 in a long term care facility or $40 at home?With a gathering of some of the most innovative thought leaders in the northeast at Babson’s 7th Annual Healthcare and Life Sciences Forum last week, participants received a candid and in-depth briefing about what is spurring the rapid change we are seeing today. The expert consensus was that we’ve made huge strides in accepting electronic health records, creating remote patient care that works, and facilitating mobile access to records and advice. With 17% of US GDP currently spent on healthcare however, there’s increasing urgency to drive down costs and improve outcomes. Here are my observations.
WHERE IS THE TIPPING POINT?
Are we near it, or is it behind us? The opinions of the healthcare forum panelists differed but most agreed that today’s standard for a tipping point is “meaningful use” rather than “meaningful implementation”. If doctors and patients don’t use the new technologies to a significant extent, then no tipping point has been reached.
By the way, from Gladwell.com I discovered that the origin of “the term tipping point refers to that moment in an epidemic when a virus reaches critical mass. It's the boiling point. It's the moment on the graph when the line starts to shoot straight upwards.”
Massive financial incentives: One reason the tipping point will be reached soon, said John Halamka, CIO of Harvard Medical School and Beth Israel Deaconess Hospital in Boston, is that under the new stimulus bill clinicians will receive up to $44,000 to implement electronic health records for their patients. The resistance from doctors who hadn’t the dollars to spend, especially on technology they had yet to master, is expected to melt away as financial incentives and faster reimbursement foster alignment between doctors, hospitals and payers. Doctors working within the Boston-based hospital complex have already benefited from many of these changes. By understanding and aligning interests of patients, providers and payers to launch services that deliver real value, as I have in other industries, we will make that “meaningful use” line shoot straight up.
More about the tipping point: Rob Havasy from the Partners Center for Connected Health agrees that the tipping point is near, particularly in mobile health. Mobile access to records, health advice, appointments and patient communities like PatientsLikeMe has been fostered by the alignment of money and by consumer acceptance of technology.
Chris Steel, representing PA Consulting’s expertise from the UK, says they’ve found that 40% of the hospital beds in the UK are filled by those 5% of patients who would be better served remotely. They are working intensively to improve remote utilization and improve patient care in the process. His research in the US shows that one in four Americans would upgrade their wireless plans if they had better access to healthcare information. This figure alone shows that consumers are ready. Alignment of interests will make it happen.
REMOTE SERVICES WILL BE THE NEW NORM
A couple of weeks ago I had a far-reaching discussion with the CEO of one of the Blue Cross/Blue Shield companies - - someone who has managed a significant performance turnaround for this payer in two very short years. In addition to much-needed changes in management, accountability and customer programs (he established advisory boards with his 25 largest customers that offer Blue Cross plans to their employees) he is also implementing a remote doctor/patient service for diagnosis and treatment of non-threatening conditions. The service, which is accessible by phone or webcam, allows patients to be connected to a doctor remotely as needed; the doctors sign on in their spare time to provide care to patients calling in from all over the country and then send the patient record along and collect their fee for the consult. Doctors are experiencing better utilization of their time in the office and higher fee income; patients receive instant response to their medical issues. It makes sense for the payer to sponsor this because it is one way to reduce the cost of care while improving outcomes through fast response and quick intervention.
WHERE ARE THE NEXT BIG OPPORTUNITIES?
Some of the most compelling insights came from panelists who described their ideas for future opportunities for innovation. Each idea will benefit from developments and innovations previously made in other industries. My work over the years in financial services, data modeling and intelligence, and real time on-demand services is particularly appropriate when you read this list. In addition, my past experience with companies like Pfizer and CIGNA confirms that the healthcare field is ripe for efficient, customer-enhancing solutions to real problems. The opportunities proposed, and I agree, are as follows:
· Mobile phone applications enabling universal accessibility; remote service of patients to save time
· Applications for the 65+ crowd; the fastest growing smart phone segment has distinct healthcare needs
· Communities to promote interactive communication between friends (the “biggest loser” game)
· Getting employers to engage employees in their own health issues
· Data mining and better analytical tools; analytics and decision systems that allow informed action on the spot
· Ability for a doctor to find structured and unstructured data (aka “Google search” ) across all his patients’ records
· Change management to overcome resistance from some doctors, patients and others
· Interoperability between multiple systems; common standards
