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The Pursuit of Health Information – and Trust

Trusting a Partnership for Health InformationWhen making workplace health-plan decisions, what type of healthcare information is desired by Iowa employers? Do employers know about web-based resources on Iowa hospitals? Who do employers trust to be their primary source for health-related data?

We asked a series of important questions in our 2013 Study. And, you might be surprised by the results.

As you might imagine, the needs and desires can vary greatly based on employer size. Using a 6-point scale, with 6 being ‘most important,’ Iowa employers responded that ‘Cost’ information was most important to have (4.9 score), with the largest of employers (1000+ employees) scoring this a 5.7. ‘Comparing Physicians’ followed next with an overall score of 4.5, while ‘Health Status/Wellness’ and ‘Comparing Hospitals’ both scored 4.4. Healthcare ‘Use’ finished with an overall score of 4.3.

Importance of Health Information to Iowa Employers

As found in the chart below, Iowa employers are unfamiliar with existing web-based resources on Iowa hospitals. Larger employers appear to be more aware of these web resources, but only a very small number of employers reported being ‘Very Aware’ of this on-line information. In case you are curious, some of this information might be found on the Iowa Hospital Association and Iowa Healthcare Collaborative websites. As mentioned earlier, ‘cost’ information appears to be most desired, followed by comparing physicians and hospitals, presumably on quality-related metrics.

Knowledge of Web-based Data on Iowa Hospitals

When employers responded to how optimistic they are on the effectiveness of ‘Medical Homes’ and ‘Chronic Disease Management Programs,’ employers with over 1000 employees were at least twice as likely to be optimistic (43 percent) than smaller employers with under 250 employees. Overall, only 21 percent felt optimistic about these initiatives being effective to improve workforce health. Another 30 percent were not that optimistic and responded that such initiatives will make ‘No Difference.’ Half of all employers indicated that they would need to have more information on both programs before making judgments as to the effectiveness of health improvement.

Primary Care Initiatives in Iowa

So, if organizations desire critical information to make future decisions on workforce health, it begs the question who they desire to be the primary source of this information. This question elicits some very interesting results.

Overall, 27 percent of Iowa employers desire insurance companies to be the primary source of health information. Yet interestingly, the largest employers with 1000+ employees were less likely to desire insurance carriers to be the primary source – only 18 percent voiced their interest. Only three percent of organizations desired the government to be the primary source of health information, which speaks volumes about their lack of appetite for a single-payer system.

Primary Source of Health Data

The preponderance of organizations (two-thirds) voiced their desire for ‘Health Providers’ (hospitals and physicians) to be the primary source of health information to help manage their costs. More questions will need to be asked of organizations in the future as to ‘why’ they desire health providers to be the primary source, but my initial take is simply they appear to trust this source more than other sources.

The healthcare provider community may take some comfort in knowing that a majority of employers view them as a trusted resource. With this trust, however, comes the responsibility to validate and enhance it by providing a greater array of transparent information on costs and delivering higher-quality outcomes. From our 2014 Study, we know that employers expect to receive reasonable costs, consistent quality of care and safe care that is appropriately delivered to patients.

This type of feedback for insurance companies is most assuredly humbling. Yet, it should also re-awaken the pursuit of new initiatives to make inroads on gaining a trust-related partnership with their clients. The silver lining for both health providers and insurance companies reveals lots of room for improvement – and immense opportunities. But opportunities can only happen if relentlessly – and thoughtfully – pursued.

Trust is the currency of commerce. In our healthcare world, we can always use more of it.

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And the ‘Winners’ Are…(Part III)

Winners in Health CareMy blog, Seeking Truth in Health Care (Part I) briefly discussed my observations in the employer community regarding health insurance, while last week’s blog, ‘Disruption’ Will Be Painful (Part II) touched on potential implications for the health care providers here in Iowa. This blog attempts to tie together both blogs – in other words, help identify what providers will need to do in order to ‘win’ in the future.

I must mention again that there are no easy solutions – disruption is painful. However, there does appear to be a consensus on the ‘winning’ strategy for those organizations who are willing to face the inevitable disruption in health care.

So here goes.  The ‘Winners’ are those organizations that:

  1. Completely embrace a ‘Culture of Full Transparency’ – both in cost of services and successful health outcomes delivered
  2. Develop and consistently demonstrate a ‘Culture of Safety’
  3. Master a ‘Coordination of Care Culture’
  4. Tie Value to Costs

Perhaps you may have noticed a common word in three of the four elements – CULTURE. It will be difficult, actually impossible, for any organization to ‘win’ without first instilling full Transparency, Safety and Coordination of Care within the fabric of the organization. Simply put, the culture is the DNA of the organization. Being patient centric should be the destination for all providers in the future – no exceptions allowed.

Merely broadcasting to the public through various media channels that these four elements are present within the organization will no longer cut it. The public is not that gullible. People talk…and people listen. If these essential changes are not incorporated into the organization’s DNA, the health care provider is nothing more than a marketing organization – and having a winning strategy will be unattainable.

Tying value to costs will help employers and their employees better assess which provider to use under varying circumstances of care. The health providers that can apply all four elements will earn the TRUST from their communities.

In health care, TRU$T is the ‘currency of commerce.”*

This new transformation will not take place overnight. After all, it has taken many decades to get us in the situation we are today, and it will take time to transform into a new and improved “system” of care. The new transformation has begun for some organizations, while for others, not so much. Every journey begins by taking a first step.

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*Dr. David A. Shore, Harvard School of Public Health

The Currency of Commerce (Part 1)

Trusting Healthcare Providers in Iowa(Part 1 of a 3 Part Series)

Almost two years ago I attended a 5 day executive program at the Harvard School of Public Health in Boston.  This forward-thinking program, “Forces of Change: New Strategies for the Evolving Health Care Marketplace,” provided a very robust discussion on many salient health care topics that continue to evolve to this day. One topic in particular immediately grabbed my attention, and frankly, was THE main reason I attended this program.

The topic?  The trust crisis in healthcare.

I know, trust can be an overused word, but there is no denying the importance it has both in our personal relationships and in our commerce. I can think of nothing more sacred than the trust we place in those who provide physical and mental services to us when we become injured, sick or frail. What happens if we don’t have appropriate trust in our doctors, hospitals and other medical-related service providers?

A lot.

According to David A. Shore, the Harvard professor who organized “Forces of Change” and is the founding Director of the Trust Initiative of Harvard School of Public Health, “trust improves medical outcomes.” In fact, trust “is the #1 predictor of loyalty to a physician’s practice. Patients who trust their doctors are more likely to follow treatment protocols and are more likely to succeed in their efforts to change behavior.”

Here’s another interesting fact that comes from his books about trust, “Patients sue doctors and hospitals not so much for making a mistake – but for not being straight with them, for covering up, for refusing to acknowledge the error and apologize for it.  It is the breach of conscience that they are furious about, and that leads them to seek redress in court.”

Defining PATIENT TRUST in healthcare can sound something like this: Having trust in the clinical skills and knowledge of the physicians, the other professionals, and the service organizations with whom the patient comes into contact. It is confidence in the integrity of all these clinicians and organizations. And it is the confidence that, whatever else they may do, they will fulfill their role as the patients’ agent.

As Shore puts it, “Trust is the currency of all commerce.”

We continue in next week’s blog about the implications of having trust in healthcare.