Population health programs need to evolve: Best practices to scaling with automation

The healthcare industry is changing. Organizations have come to realize that it’s no longer enough to engage patients only when they’re sick, and have adopted health management population programs that enable greater long-term care. In this new series, we’ll explore how leveraging automated outreach to proactively engage members makes population health programs more successful, and provides the type of communication consumers increasingly expect.
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The healthcare industry can benefit by leveraging automated, proactive engagement to reach patients across several stages of care.

We’re constantly connected. We expect a text if our checking account gets low, an email if the book we ordered has shipped and a push notification through our mobile app if our flight is changed.

And just as we expect automated outreach from banks, airlines and other companies, we now expect reminders and guidance from healthcare organizations that have an interest in our well-being.

At the same time, the healthcare industry is undergoing a massive paradigm shift. In years past, healthcare organizations were focused on single episodes of care. A patient reported a pain or illness, and they would receive treatment.

Today, it is no longer enough to engage members only when they’re sick. Today healthcare organizations must focus on keeping members well through population health management and programs that enable prevention, deliver help for the chronically ill, and support outpatient care over the long term.

It’s at the nexus of these two trends that we can take a significant leap forward, and provide automated member outreach to scale critical population health programs beyond those that care managers and health coaches can reach. We can enable these skilled, valuable resources to focus on the highest-risk cases – presenting significant potential value to the industry.

In our work with three of the four largest population health companies, we’ve found that the most effective population health programs leverage automated outreach to proactively engage with members during the following stages of care:

  1. Reach and Enroll – Initial outreach to engage and recruit members into appropriate health management programs.
  2. Assess Risk and Parameters – Determination of a member’s health risk and treatment knowledge, as well as of monitoring clinical parameters.
  3. Engage and Address Gaps – Proactive efforts to help members reduce future complications by changing behavior or better managing chronic conditions.
  4. Drive Education and Adherence – Inform and help members adhere to programs and avoid developing more serious conditions.

Over the coming weeks, I’ll be providing a few best practices for each of these stages.  Some are quite basic, such as tracking and connecting through your members’ preferred channels, while others are suggestions for how you can take your automated programs to the “next level,” like asymmetric calling cycles. In the meantime, Scaling Population Health Programs with Automation provides step-by-step guidance on this important topic.

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Vance Clipson

About Vance Clipson

Vance Clipson, senior principal, industry solutions focuses on the healthcare and insurance verticals for Nuance Communications. Clipson brings 25 years of experience translating industry needs and data into market strategy and programs. Prior to joining Nuance, Clipson held positions with Milliman, PacifiCare Health Systems, United Dental Care and the American Cancer Society.