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At the Health IT Summit in Denver, a Look at What Can Be Accomplished Under the Banner of Patient Engagement

July 12, 2018
by Mark Hagland
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Debe Gash of Saint Luke’s Health System shared her organization’s story of patient engagement progress

Even as the term “patient engagement” has become hotter than ever, the reality is that the leaders of most U.S. patient care organizations haven’t yet figured out how to execute on the concept. But Debe Gash, senior vice president and chief digital officer at the Kansas City, Mo.-based Saint Luke’s Health System, offered attendees a lot to consider, as she shared the innovations taking place in her organization, on Thursday morning, at the Health IT Summit in Denver, sponsored by Healthcare Informatics.

Speaking on the topic “Using Mobile Apps to Increase Patient Engagement,” Gash told the audience gathered at the Grand Hyatt in downtown Denver that patient engagement has to be a strategy, not just a wish. That’s especially true at any large integrated health system such as St. Luke’s she noted. St. Luke’s encompasses 10 hospitals with a total of 1,100 beds, with 1,500 providers, 750 of them employed, and 1.5 million clinic visits. It also encompasses 17 retail clinics, and four micro hospitals, with eight beds each.

Indeed, Gash told her audience, St. Luke’s Health Systems’ overall strategy encompasses mobile apps, patient engagement, and various strategies around patient/consumer convenience and service, all of them interrelated.


Debe Gash speaks at the HIT Summit-Denver

“Our growth has primarily been in the ambulatory space; we heard from our customers that they wanted more access to care in their neighborhood.,” Gash said. “So we’ve been deploying our clinics, our big boxes, and have embarked on this initiative to build micro-hospitals in our area. A micro-hospital,” she explained, is a small facility of eight beds, anchored by an ED. And if we need to perform a procedure or they need more complicated care, we transfer them to larger facilities. We’ve opened four of seven so far. In fact, our fourth micro-hospital opened just this week. These are exciting times for us.” Further, she reported, “We’ve gotten into the retail space. So far, we’ve created 17 clinics, and they’ve served us well.”

Among the guiding principles in this journey has been the articulation on the part of patients of what they want in terms of service, convenience, and interactions with providers.

Gash cited a recent survey that found that millennials’ demands for digitally facilitated healthcare are accelerating. Among other survey results: 71 percent of millennials want to book appointments with mobile apps; 74 percent would prefer to see a doctor virtually; and 75 percent look at online reviews before selecting a physician. What’s more, one-third downloaded a health app in the last 30 days; and 42 percent have used synchronous video telemedicine.

But the idea that interest in the digital facilitation of healthcare delivery and service is limited to younger people is deeply mistaken, Gash told her audience. “It’s a myth that older people don’t use technology,” she said. “My mother is 76, and she had problems using a flip phone; but I got her a smart phone, and she uses her smart phone more than I do. I see that with the elderly community; it’s an interesting dynamic. But even more interestingly, the millennial generation really want to use digital features in their use of healthcare.”

A new world—of consumer demands

The reality, Gash told her audience, is that the old, provider-centric world is falling away quickly now, and is rapidly being replaced by a world in which provider organizations will have to compete strongly with one another for patient loyalty and engagement. Indeed, she said, “For a growing number of people we serve as providers, companies that fail to offer a friction-free digital connection are just not going to be acceptable anymore. And when consumers have a choice, and more do now, it’s going to be critical that we provide friction-free digital services. Kaufman Hall found in a recent report,” she said, “that only 14 percent of hospitals offer digital tools for consumer engagement, and only 23 percent offer some form of telemedicine—and that is primarily inpatient consults, but not direct-to-consumer-type solutions. Only 20 percent of healthcare consumers have digital access to pricing. It’s not something that you can go out and search on your own. And only 43 percent provide messaging between patients and providers. And I personally believe that that figure is that high only because of the meaningful use program.”

And those deficiencies are a problem. “The lack of contemporary digital experience, I believe, is a major vulnerability for hospitals and health systems today,” Gash told her audience. “And that’s because we’re seeing [disruptive new] entrants into the healthcare industry that can pose a threat to our not-for-profit systems. Look at the merger of United Healthcare and Optum, and of CVS and Aetna,” she said. “What are they doing? They’re employing physicians and practices, acquiring practices, employing health management programs; and their goal is to basically do that primary care service. So they’re pulling assets out of the healthcare system, and they’re highly capitalized companies. So that’s the threat. And what are Apple and Amazon doing? Apple says, we can go directly to the consumer; they’re good at that. And what could Amazon do? They’re investigating healthcare, and they, too, are highly capitalized companies.”

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