Ever since the COVID-19 pandemic drove millions of people online, customer expectations have changed for almost every business.

Two years ago, you could use your mobile device to decide which new car you wanted to test drive. Today, you can use your smartphone to complete the entire car-buying experience. Two years ago, shoppers walked inside their favorite retail stores to pick up merchandise. Now, they use their mobile devices to order from their favorite brick-and-mortar store online and arrange for contactless pickup.

These rapidly evolving customer expectations are shaping healthcare, too. Patient consumers have been using mobile devices to access their medical records in patient portals for two decades. And since the pandemic began, they’ve grown exceptionally fond of telehealth, with sustained 38X patient use from the pre-pandemic baseline. But today’s patient consumers want more. They expect and demand a complete digital experience from their favorite healthcare brands.

Health systems—and the tech world—are scrambling to keep pace. According to the Iqvia Institute’s 2021 Digital Health Trends report, more than 90,000 new consumer-facing digital health apps went live in 2020. That’s an average of more than 250 apps per day! The biggest growth is happening in disease management apps, which made up 47% of new app development in 2020 vs. 28% five years ago. Of those new disease management aps, almost half focus on mental health, heart health, and diabetes.

And data show that patient consumers are using their favorite health apps more often than ever before. In 2020, about 4 in 10 individuals that used a patient portal accessed it using a mobile health app. Additional research from the Office of the National Coordinator of Health Information shows that more apps are integrating with certified EHRs, a trend driven by the widespread adoption of secure, standards-based application programming interfaces (APIs) that allow patients to access their health information more easily, from whatever device they choose.

All these trends bring great opportunities—and risk—for healthcare organizations. The rush to meet customers’ growing digital experience expectations needs means IT leaders are greenlighting apps at a record pace. But if patients need multiple apps to access your health system, they’ll face a disjointed experience that leaves them frustrated. That’s why many organizations today seek a unified digital front door that combines all of their best apps and features and puts them in the palm of their patient consumers’ hand.

Let’s review how patient expectations have evolved over, the new digital realities patient consumers want today, and how health systems can close the gap.

Patient Portals: The Original Digital Front Door

The digital window into an online-first future of healthcare began at the turn of the 21^st century, when California’s Sutter Health became the first health system in the nation to implement MyChart. Suddenly, patients had online access to their test results. They could message their providers, refill prescriptions, schedule appointments, and take charge of their health.

According to an article published in the International Archives of Public Health and Community Medicine, a systematic review of the effect of patient portals concluded that 10 out of 27 studies reported positive effects in terms of medication adherence, self-care practice, improved patient satisfaction, and functional status.

That same article, published in 2018, saw the ongoing upside of emerging digital health technologies. “An enthusiasm is brewing in view of its unprecedented potential in disease treatment, disease prevention, and promotion of health,” the authors wrote. “It has the ability to reach out to every person, at every stratum in need of healthcare and thus may prove to be a silver lining in the healthcare system.”

As patients reported positive experiences with portals, they also developed an affinity toward technology in the way it enables better care. In 2018, researchers in Norway compared patients’ perception of care between an older hospital and a newly opened, high-tech hospital. The results: Patients receiving care in the new hospital reported perceived improvements in care quality based solely on being in a tech-enabled environment.

Beyond portals, newer technologies began having big impacts on health and financial outcomes pre-pandemic. An article published in Health Affairs in March 2019 explored consumer engagement practices at four healthcare delivery organizations. Among the highlights:

• Ochsner Health System in Louisiana piloted a Hypertension Digital Medicine Program using MyChart. After six months, digital medicine patients had more blood pressure measurements recorded into the EHR and more frequent clinical touches compared with in-person patients. Digital medicine patients also achieved a 14% improvement in medication adherence and an 84% patient satisfaction level. Today Ochsner has grown its digital medicine program to include care for type 2 diabetes.
• Sutter Health in California, a MyChart pioneer, continued high patient portal usage, with 79% of their patients seeking ambulatory care using the portal in 2018. They also used MyChart to exchange 16 million secure messages between patients and physicians, and to answer more than 90% of patient-initiated messages within one business day.
• Stanford Health Care in California implemented automated patient check-ins upon clinic arrival, indoor wayfinding tools, the sharing of doctor’s notes from appointments, and pre-appointment surveys to screen patients for signs of depression. Those screenings precipitated more than 6,000 referrals for psychotherapy, case management, nutrition, and other related services.
• UC San Diego Health in California hard-wired inpatient rooms to bring technology directly to the bedside.

The article’s authors made this conclusion: As patients enjoy more user-friendly technology in non-health areas of their lives, they expect the same type of consumer-friendly technology in healthcare.

Present Day: What Patients Want to See Behind Their New Digital Front Door

As consumers embrace digital health in greater numbers and healthcare organizations increase the number of solutions they offer their patient consumers, insurers are taking notice. Some health plans, having seen how wearables like continuous glucose monitors (GCM) help people with type 2 diabetes establish improved blood sugar control, now provide digital tools like GCMs at no additional costs to their members.

And the amount of wearables, apps, and other technologies will only continue to expand over the next few years, with experts predicting the digital health market to grow by nearly 26% through 2025.

As more third-party digital solutions spin up and payers start bridging the gap between technology and patient consumers, health systems are left with a pressing question for 2022 and beyond: What should their digital front door look like now? A few years ago, it was commonplace for health systems to use the patient portal within their EHR as their de facto digital front door. But today, patients want to do more than the portal allows.

Make no mistake, patient portals do a fantastic job of helping patients track their care-related needs before, during and after their visit—from checking symptoms, scheduling appointments and messaging doctors to hosting telehealth visits, filling prescriptions, accessing test results, and paying a bill.

Patient consumers appreciate all of those features. But they want more. And many of the tools they’re seeking are in third-party apps. Among the most popular digital health features and tools patients love and access include:

Wayfinding apps – Hospitals typically have lots of services, many floors, and plenty of hallways. Internal wayfinding apps help patients navigate a large facility with ease. External wayfinding apps help them find parking spots closest to the location of their in-person medical appointment or their loved one’s inpatient room.

Find a Doctor and Find a Location tools – These typically live within a health system’s existing website and help drive loyalty and repeat visits. The most sophisticated ones even have provider ratings built right into the solution.

Apps to promote whole-person care – To meet consumers’ need for meaningful mental health solutions during the pandemic, many health systems are launching apps with branded meditation tools. The best ones allow users to choose the duration, music, and features they want during each session.

Health and wellness education – Quizzes like health risk assessments create fun and engaging ways to reach patients in a time of potential need.

Improved customer service tools – COVID-19 testing and vaccines put intense pressure on health systems, boosted call center volumes exponentially, and made it difficult to deliver timely customer service. To manage call volumes more effectively and improve service, many health systems are exploring chatbots that can accommodate simple queries like provider availability and practice hours. Chatbots give patient consumers answers fast, providing the type of immediate response mobile customers expect in the modern world.

Blog content – While they’re not necessarily transactional in nature, blog posts and videos remain great sources of organic app traffic for health systems. Patient consumers also relied on blogs more often during the early days of the COVID-19 pandemic, when they sought out the latest public health news. Today’s most engaging and popular healthcare blogs include videos, recipes, and actionable health tips—the kind of content consumers crave.

From the advent of the first patient portal to the current realities of a mobile-first digital world, healthcare technology has advanced at breakneck speed. To keep pace, health systems must bring their digital tools together and create a single, unified, and cohesive digital front door that carries their brand forward, improves health outcomes, and makes life easier for their patient consumers.

Continue learning about how to meet patient’s needs. Explore a new type of digital front door that can bring all your best technologies together in one place.

Patient empowerment. It’s been top-of-mind since the first online patient portal gave consumers a way to access their personal health information digitally. But never before has it been more important to get patient empowerment right than in 2022.

What makes this the year of the empowered patient? For one, technology has matured to the point that it’s finally possible to give patients a true digital front door, putting your EHR and your patient portal front and center while also allowing one-tap access to health risk assessments, wellness content, find-a-provider tools, and other information patients want at their fingertips.

For another, the advent of application programming interfaces (APIs) give healthcare systems access to out-of-the-box integrations never thought possible. At the same time, the Office of the National Coordinator for Health Information Technology (ONC) is calling on the healthcare industry to adopt standardized APIs to help people securely and easily access structured EHR information using smartphone apps.

While technological advances help to position 2022 as the year of patient empowerment, so too do providers’ ever-changing mindset toward technology and patient care. After more than a decade of trial-and-error, health systems are finding innovative ways to empower both patients and providers through the use of technology. In short, patient empowerment doesn’t mean disempowered providers. Instead, it means leveraging a full array of technologies to enrich the overall care experience for the people who provide the care and for those who receive the care.

But what does patient empowerment mean, anyway?

At its heart, patient empowerment is a process that helps people take responsibility for their own health and well-being. A patient empowerment framework, most often driven by technology, allows people to actively participate in their care plans and act in ways that mean the most to them. In the perfect scenario, patient empowerment can help improve quality outcomes and lower costs.

But while these tenets provide a general overview of patient empowerment, the fact is, the exact definition of the term has been widely debated across the healthcare landscape and among the medical community for nearly two decades. One of our favorite definitions comes from the Financing Sustainable Healthcare in Europe report, which says empowerment typically has two aspects: (1) the having and sharing of power, and (2) sources of power and ways to increase power.

We like this definition because of the shared aspect. It clarifies the fact that technology isn’t giving power to providers and taking it away from patients. Instead, it’s sharing the power among both groups to create transformative care.

What does patient empowerment mean for patients?

For patients, patient empowerment means convenience, ease of use, and reduced stress levels. Patient portals are the first step in delivering that convenience, and they’re being used today more often than ever before.

According to the College of Healthcare Information Management Executive’s (CHIME) 2021 Digital Health Most Wired report, 83% of acute care organizations report widespread patient portal utilization, up 9 percentage points from 2020. Consumers rely on patient portals for prescription refills (88%), language-specific patient education (83%), appointment scheduling (83%), and health care screenings (82%), among other functions.

Yet patient empowerment goes beyond the portal. Patient utilization with mobile apps also increased by 9 percentage points in 2021, including blogs that have helped patients receive vital health and safety-related information during the COVID-19 pandemic.

Together, patient portals and other patient empowerment technologies can help create more informed patients. Take the example of Elise Sweeney Anthony, Executive Director of Policy for ONC, who recently shared her own breast cancer journey and discussed how technology helped her become an empowered patient.

“The biopsy results that confirmed my cancer were available to me in my patient portal before I saw or spoke with my doctor,” she wrote. “This gave me the time to take it all in and do some research on the type of cancer I appeared to have.” Anthony then used that information, and a subsequent talk with a friend and breast cancer survivor, to create a more informed dialogue with her provider at her first appointment.

“These important steps helped me process my diagnosis and empower me to prepare for what was next. The fact that my care team supported my choice to receive my lab results in that way was invaluable,” she wrote.

What does patient empowerment mean for providers?

For providers, patient empowerment up-levels the quality of conversation they can have with their patients. While some people believe the plethora of available health information online means patients will rely less on providers now and in the future, in reality, the opposite of true. Because so much information is out there—and much of it is conflicting or not 100% relevant to a particular patient—empowered patients rely on their providers to cut through the noise and give them definitive direction, something “Doctor Google” can’t do for them.

Patient empowerment solutions bring tangible benefits to providers, too. Take the case of appointment no-shows, a problem that vexes clinicians, erodes patient loyalty, and impacts care and costs. According to a 2019 athenahealth study, just one no-show increases attrition almost 70%, and 32% of patients with one or more no-shows don’t return to the same practice within 18 months.

In this case, one simple empowerment solution—text messaging reminders—can help save the day. A 2016 pilot study evaluated the effect of text messaging reminders by tracking 557 appointments over a three-week period. Researchers found that sending text message reminders decreased the overall percentage of no-shows by 2%. A further cost-benefit analysis yielded a potential 1:6 return. These findings provide powerful evidence that text messaging is effective in reducing no-show appointments and is cost beneficial.

Connection is the key to empowering both patients and providers

The best news about patient empowerment in 2022: online platforms are now available to help health systems fully integrate all their potential empowerment technologies into one digital front door, giving patients a single point of contact for all their health care needs.

Being able to connect solutions that were previously disconnected achieves two goals outlined by Aisha Umar Akeel and Darren Mundy in a 2018 Health Informatics Journal article, “Re-thinking technology and its growing role in enabling patient empowerment.” In the article, they discuss the importance of two systems theory concepts—holism, or broadening the scope of the patient empowerment process to include as many stakeholders and technological roles as possible, and iteration, defined as being able to produce results for patients that can be repeated over time and used as a starting point for the next iteration.

To achieve these concepts, the authors introduce a patient engagement framework they call Unified Technology-Driven (UTD). Their vision is for all the elements in the UTD framework to interact with each other systematically. These elements include:

• Personalized technologies, such as symptom checkers, chronic disease management and other self-care tools, that help the self-directed patient
• Assistive technologies, such as wearable devices or medication aids, that help create more confident patients
• Participative technologies, such as online health forums and social media groups, that help create engaged patients
• Knowledge-based technologies, such as health libraries and information systems, that help create informed patients
• Access technologies, such as EHRs, that allow patients to stay connected with their providers and health systems of choice

This UTD framework, according to the authors, “minimizes the trivialization of any health stakeholder’s role in making the role of doctor and patient equally important. Most importantly, through connected, informed, engaged, confident and self-directed patients, the distribution of health information and apps can be open to diverse groups of patients in relation to their needs.”

Make patient empowerment part of your 2022 plans today

With the right platform, health systems today can bring together multiple disparate apps and other point solutions to create a single, connected destination for all of their health information. Doing so will help you achieve patient empowerment in 2022 and use technology to help both patients and providers maximize care now and well into the future.

Continue learning about patient empowerment. Discover how to connect the disconnected.

Meaningful data points in this article:

• “Half (50%) of healthcare consumers surveyed agree that a bad digital experience with a healthcare provider ruins the entire experience with that provider and 39% believe a good digital interaction has a major influence on the patient experience” (Accenture, 2020 Consumer Health Survey).
• Greater than 71% of all website traffic to healthcare websites is now through mobile devices (Statistic, 11/3/2020) and in 2020 Duet Health clients have 40% of all EHR utilization coming from mobile apps – with some mobile app utilization at almost 60%. 
• “While a majority of healthcare consumers are open to receiving virtual healthcare services from their traditional providers (54%), they are also willing to receive virtual care from technology or social media companies such as Google and Microsoft (27%); retail brands such as Best Buy, Walmart and Amazon (25%); and medical startups (21%). (Accenture, 2020 Consumer Health Survey).

Patient Engagement & Digital

Today’s most successful Providers are the ones delivering their patient consumer digital tools and technologies enabling deeper engagement opportunities that help them activate and participate in their healthcare experience.  As we all now know, COVID proved to be a fast forward to digital health expansion and like a ball rolling downhill, patients and providers are increasingly expecting more and more connectivity every day as digital engagement with their healthcare organizations like never before. Virtually all other domains are built upon the concept of maximizing consumer engagement with goals of customer acquisition and retention, but in health, many healthcare organizations have only recently begun to align themselves toward a consumer-focused mindset and are thus typically late to respond to current consumer expectations. 

For years now the data has supported the idea that patient (consumer) satisfaction leads to higher profitability, but the 2016 Accenture study and its findings may provide context to this notion: 

“US hospitals that deliver “superior” customer experiences achieve net margins that are 50% higher, on average than those hospitals providing “average” customer experience”, (Accenture, 2016). 

The key here is the emphasis on superior by superior, we mean comparing organizations and providers that are dedicated to delivering superior results as opposed to those providers that are simply “checking a box”.  Those that don’t simply check boxes are driven by a need to provide real value to patients as a part of the solutions they are presented.

Often times, healthcare revenue opportunities and the hard dollars associated with them are lost every day in the US, as health systems undervalue and underdeliver in digital technologies and the vital role they are providing the patient. In 2021 and beyond, this focus on the customer experience has to include a focus on digital technologies, again highlighted by Accenture in their 2020 Consumer Health Survey (Accenture, 2020).  It provides compelling data points supporting the notion that patients want as much digital care as possible. 

In fact, Accenture found:

• 62% of consumers would choose virtual for health and wellness advisories. 
• 57%_. of consumers are open to remote monitoring of ongoing health issues through at-home devices. 
• 52% of consumers want routine appointments through telehealth”. 

Keep in mind, these are just the top three.  Patients want more and more digital care and digital tools made available to them and the data supports that they are using in much larger quantities than ever before. 

Furthermore, greater than 71% of all website traffic to healthcare websites is now through mobile devices (Statistic, 11/3/2020) and in 2020, Duet Health clients have 40% of all EHR utilization coming from mobile apps – with some mobile app utilization at almost 60%.  Patients are not just using digital tools on the desktop, they are using the modern devices that have now far surpassed the tipping point and are saturated throughout consumers of all ages, races, and in all locals – urban, suburban, and rural.  Immediate access to high-speed Internet services has never been greater nor has it ever been easier and more ubiquitous – these consumers are utilizing digital technologies for so much of their daily lives that the migration to healthcare feels long overdue.

And providers and healthcare organizations with well executed digital tools are nurturing and grooming them to become profit centers.  These apps and websites can be provided within budgets that enable continual growth, while their success is measured through their ROI—making them attainable. 

Digital engagement should be straightforward and focused on features that enable patients to immediately transact in revenue driving actions; with everything from delivering their fully billable telehealth appointment to offering real time scheduling, registering for classes and events, easy bill pay, as well as remote patient monitoring and recording patient recorded data and outcomes that can further increase reimbursement but there are so many more to offer.  The world of digital patient engagement opportunities has only just started to open up and will continue to increase for years, offering those providers with the best digital tools the best opportunity for growth and advancement and their patients the best outcomes.

Digital Engagement – Attracting and Retaining Patients

“Half (50%) of healthcare consumers surveyed agree that a bad digital experience with a healthcare provider ruins the entire experience with that provider – and 39% believe a good digital interaction has a major influence on the patient experience.  More than a quarter (26%) are even willing to switch to a new provider for high-quality digital services. 52% of consumers who have a primary care physician agreed that a bad digital experience with a provider ruins the entire experience with the provider, compared to 42% of those without a PCP.”  (Accenture, 2020 Consumer Health Survey).

There is a lot to unpack within the data above as these insights run to the heart of both the attraction as well as the retention of patients, but let’s work through it.  In planning to attract new patients, it is quite clear patients are already seeking high quality digital experiences and providers that have are able to highlight their availability by telling the stories of their digital impact, a new way to distinguish their offerings from the competition.  In a world where healthcare organizations are often thought of in a commoditized fashion by patients, these technologies are something specific that can be demonstrated in a meaningful way.

It is also quite clear that digital technologies falling short actually provide a negative experience from one that may have initially been viewed as a positive and should be directly associated with patient retention strategies.  This is the compelling reason for providers to avoid “checking the box” when offering digital technologies and to ensure that what is presented to patients offers advantages and provides a quality experience that can be seen and felt.  For example, oftentimes providers fail to realize all that they are asking their patients to do or all that patients would like to utilize in order to be successful in following up after an appointment.  Digital tools should be a conduit to furthering a positive experience and helping to ensure the patient is successful in their relationship with the provider moving forward. 

The digital competition for patients is intensifying

Providers of all types need to recognize the very real threat of competition coming from digital technologies that are already eroding their marketing share. “While a majority of healthcare consumers are open to receiving virtual healthcare services from their traditional providers (54%), they are also willing to receive virtual care from technology or social media companies such as Google and Microsoft (27%); retail brands such as Best Buy, Walmart and Amazon (25%); and medical startups (21%).”

Competition from all sides is not coming soon, it is here today.  What is coming soon are more and more competitors to the table as the opportunity to grow digital services can happen faster and is often much easier than brick and mortar options and often provides the opportunity for even greater profit margins in the process.  Where competition has traditionally been found on a geographic basis in healthcare this boundary is disappearing by the day and competition can come from large distances and in ways traditional providers are least expecting it.

Providers are in a prime leadership position if they just start competing

The best news for providers from Accenture and other relevant data is that “55% of consumers say “trusted healthcare professionals” would motivate them to take a more active role in managing their health.  Concurrently, only 11% of consumers said that their regular healthcare provider recommended digital tools to manage health.”  (Accenture, 2020 Consumer Health Survey). 

The health provider has long been the most trusted relationship a patient consumer has, and that relationship has not eroded and should instead be utilized to take advantage of the opportunity that is available right now. What providers need to do is harness their trusted relationship and use it as a channel to introduce patients to their tools, their opportunities, and embrace the role they play in this experience.  Digital tools and technologies can be developed rapidly and companies like Duet have existing platforms and tools that are cost effective and leveraged in short periods of time – developed with ROI centered models in mind in order to deliver immediate value, thereby  allowing providers to move rapidly and sustain what 2020 and beyond should have transformed in order be their competitive advantage.

Forgive us—we know there are a lot of numbers in the title of this post, but it’s hard not to be impressed by them when Advocate Aurora Health’s chief brand and consumer experience officer Kelly Jo Golson mentioned them in a recent article with HealthLeaders talking about their LiveWell patient app.

Highlights from the article include:

• How AAH’s emphasis on consumer empowerment reinforced their broader strategy of enhancing patient health outcomes and engagement.
• Key user information driving the remarkable growth of the LiveWell app that led to 1.2 million users in just 18 months.
• How self-service features such as telehealth capabilities, appointment reminders, and text messaging further strengthen AAH’s consumer-first focus for LiveWell.
• The growth of health and wellness-focused digital content use and engagement resource notably used by their users.

We highly recommend giving the whole article a read here, and if you want to learn more about how you can offer your patients with a comprehensive and user-friendly mobile app that can increase patient engagement and help drive new revenue, contact us to see how our award-winning Gemini patient experience software can do that for you!