Patient Engagement, Stimulus Funding and Social Media

The $19B health care stimulus bill provides incentives for providers to install electronic health records (EHR) and for meaningful use of the data to improve health care.  The Department of Health and Human Services (HHS) has been charged with administering the HIT stimulus dollars. HHS commissioned a Health IT Policy Committee which in turn formed a Meaningful Use Work Group to define what constitutes meaningful use. Providers and vendors have largely been waiting for the definition of meaningful use before making any tactical and strategic decisions for the implementation of health care IT improvements.

Yesterday, (16 JUN09) the Meaningful Use Work Group published their proposed definition of meaningful use which could have significant impact on the use of social media to improve health care.. (See http://healthit.hhs.gov/portal/server.pt?open=512&objID=1269&parentname=CommunityPage&parentid=2&mode=2&in_hi_userid=10741&cached=true#MeaningfulUse). In the proposed definition, engaging patients and their families is one of the policy priorities. The objectives tied this priority are to provide access to patient specific educational resources by 2011, upload data from home monitoring devices by 2013, and patients have access to self management tools by 2015.

There are many companies that have developed social media applications that would help achieve some of these objectives. Companies like Voxiva (www.voxiva.com), and Cielo (www.cielomedsolutions.com) have applications for patient outreach from the providers office that are connected to EHRs.  Companies like Mycareteam (www.mycareteam.com) and Diabetesease (www.diabetease.com) have standalone on-line care modules for diabetes that are consumer driven — not connected to the EMR. And disease management companies such as Healthways (www.healthways.com) and Healthdialog (www.healthdialog.com) have payor and employer provided sites that provide online education and self management resources.

So which social media applications are positioned the best to grow as the stimulus dollars flow? I see five main elements of the definition that define the strategic opportunity:

1. The solution provides tools that engage patients and their families. This is really what social media is all about — engaging people through online tools. Successful applications will use all the available social media tools (blogs, chat, RSS, SMS, email, widgets, social networking, podcasts, media sharing, wikis, etc.). While some of the online applications I mentioned before use some social media tools none that I have seen integrate all of them into a total experience that engages through multiple modes.

2. The solution is personalized — read data driven. The best applications will be driven by clinical decision support systems or by the EMR. Remember, this is about meaningful use of technology so there must be some connection to the EMR for the application to help meet that objective. This will make it difficult for standalone consumer driven applications that help manage a condition to measure up.

3. Connected! The 2015 objective specifies the ability to upload from home monitoring devices. Connectivity needs to happen at both ends — at the EMR when the solution is prescribed and at home, work or wherever the consumer is through the phone.

4. Critical mass. Applications that are designed to educate or self manage only one condition will have a hard time surviving. If providers are going to integrate a social media application into their systems they will need to integrate it into their practice. A solution that provides patient engagement, education and connectivity for multiple conditions will have more value for the provider and will be significantly easier to implement and maintain.

5. Leverages the patient-consumer relationship. If consumption is the goal, the solution needs to be prescribed by the provider the way any other therapy is prescribed.  See posting on information therapy (http://socialnetworkingforhealth.wordpress.com/2009/06/17/enabling-change-through-information-therapy/)  or visit The Center for Information Therapy (http://www.ixcenter.org/).

While the definition is only proposed at this point I think it begins to frame the strategic opportunity for health social media applications. Should the definition be approved and implemented, EMRs and providers will become critical leverage points that could redefine both the distribution model and the product development needs for social media health applications.