Host Jay Anders, MD welcomes Robin Wiener, co-founder of Get Real Health, and a nationally recognized leader and change agent in healthcare IT and patient engagement. She is now an executive with CPSI, a provider of healthcare solutions and services for community hospitals, their clinics and post-acute care facilities. The two get right down to it with an in-depth discussion of the state––and future––of patient engagement.
Dr. Anders begins with some thoughts on the concept and how it has evolved, noting that for the first 15 year of his career as a practicing physician, “patient engagement” was a pager call from an answering service with a patient on the phone.
He introduces Wiener, who led Get Real Health from a fledgling company to a 10-million-dollar-plus global entity, and most recently spearheaded the company’s multi-million-dollar acquisition by CPSI. Wiener recently launched her own podcast series, “Get Real About Healthcare.”
Dr. Anders is curious about Wiener’s pathway in the healthcare IT industry, and she explains that she began as a student of fashion merchandising and design at UCONN. From there, she moved into retail before segueing into HR and recruiting, which led to technology company recruitment.
After working with a variety of technology firms, Wiener and some partners started their own tech company. The founding of the new venture was not ideal, as it was closely followed by 9/11, but the team persevered and grew the firm both domestically and internationally.
Wiener recalls that the company homed in on patient engagement as early as 2010, and that has been its focus ever since. It began with custom development of systems, which led to a healthcare client, and eventually involved Microsoft HealthVault.
In the wake of hurricane Katrina, there was a plethora of patients suddenly without access to health records. Homes, doctor’s offices, and hospitals were all flooded. People were at a loss, and the company realized that securing this type of information in the cloud made sense.
Shortly afterward, they built their first patient platform for the American Heart Association. The American Cancer Society soon followed. The concept was simple: Build a highly flexible system that can accommodate multiple languages and could provide the information patients needed––focusing on the patient first.
“Not being in the medical world, we just assumed that’s how we should look at it,” recalls Wiener.
Dr. Anders notes that this has been a recurring theme in healthcare IT––not enough patient focus.
Today, Get Real Health provides patient/member engagement solutions for both provider practices and payers. Its largest installation is an engagement platform used by two million people in the Canadian provinces of Alberta and Saskatchewan through the Department of Health.
Wiener tells how Canada’s socialized medicine model necessitates a different approach, with a centralized database, or HIE, providing visibility into all information from a practice, hospital, or pharmacy. Another international deployment was recently launched in Abu Dhabi.
Domestically, Steward Health, which operates 650 clinics and 40 hospitals, is another client. Get Real Health serves as the digital front door for the system––providing a singular patient portal for bill payment, scheduling, secure messaging, and telehealth across all facilities. Wiener notes that this approach puts patients squarely in the middle of their care––not only allowing them to manage the financial aspects but helping the health system educate them and keep them healthy.
Dr. Anders points out that nearly all EMRs have patient portals, which are not universal but are unique to a specific incidence of that EMR. This makes it hard for patients to manage. He asks Wiener about bridging the gap between patients and care facilities.
Wiener points out that while COVID has been terrible, it has forced technology to move faster and farther. Telehealth, for example, was resisted by many physicians, but now that reimbursement has been solved, the challenge is making those encounters as efficient and information-rich as possible.
Going forward, connecting multiple devices such as remote monitoring systems, smart watches, and digital scales, along with information gleaned from patient surveys and questionnaires, will help clinicians have more meaningful interactions with patients.
The ability to pinpoint regional trends using AI-powered technology will help with the development of programs that will advance population health.
“There is so much power here that we haven’t even tapped,” says Wiener. “But we’re starting to very slowly tap in around the world.”
Dr. Anders asks about the combination of Get Real Health and CPSI enhancing healthcare delivery for rural critical access hospitals. Wiener points out that the connectivity is there, and that in the future, there will be a national database that will help, for example, to extend the reach of clinical trials to consenting patients regardless of location. She notes that Get Real Health also expands the CPSI footprint internationally.
It’s all about the data
Dr. Anders mentions the recent Oct. 6th data exchange and blocking deadline and asks how Wiener’s company could help delivery systems with compliance. Wiener says they have no choice, and with FHIR interfaces they have been able to make sure information is not blocked for a while.
Dr. Anders asks about the importance of good, granular, structured clinical data in the exchange. Wiener echoes his assertion that structured data is essential and that data must be parsed out in ways that are readable for the patient.
“It’s got to be something that’s put together, it has an algorithm behind it telling you if you’re in trouble, if you’re doing fine, even reminders to take your medication, those kinds of things,” says Wiener. “But we need to be able to get that information out of the hospital system to be able to do it.”
Looking into the crystal ball
Dr. Anders asks about what the future of patient engagement holds for Get Real Health and CPSI. Wiener believes it will involve more care management with action plans, but also the continued evolution of the digital front door to empower patients.
Dr. Anders asks if she envisions a time when he’s ill or injured while traveling, say, in Australia and if local providers will be able to access his health records. Wiener shares that there is an emergency access element, including a QR code that a patient carries in a phone or wallet. The patient decides what information is accessible on the web using that code (medications, chronic conditions, etc.), and it represents a “break-the-glass” emergency resource that travels with you.
If there were one thing you could change…
Dr. Anders closes the podcast with his signature question, “If there were one thing in healthcare or healthcare IT you could change, what would it be?”
“Silos. I would knock down the darn silos. Information should flow. You should not have to deal with trying to go to 14 different places to get your records, they should be at your fingertips. And it’s so frustrating. I dealt with my parents, too, and having to fight hospitals to get their records is ridiculous. So, I would knock down all these darn silos of data and have it in one place for all of us to get to, to get better health. Because I think if we all knew what the heck was going on with ourselves and our bodies and what’s happening, we would make better decisions. That’s my big thing. Knock down the silos, man. That would be awesome.”