Empowering Patient Care with Consumer Engagement

In the early 1970's, Burger King's successful "Have it your way" campaign was launched. Now more than 40 years later, we live in a society where the desire to have it your way is an unspoken assumption, not a revelation. Uber Eats and Amazon Prime enable consumer engagement utilizing fast, personalized service, and in the field of healthcare the trends are no different. With healthcare treatment options and specialized patient care teams, consumers have the means to make more informed and more personal choices for their own courses of treatment. But, with all of these choices comes the pressure to make the optimal decision. 

Let's say you suffer from severe lower back pain that aggravates you to the point where you can't sit for any period of time comfortably. You see your primary care provider about the problem and together you discuss your options. Now, you're a smart person and think that the best thing for you (before you do anything invasive) is to understand alternative treatment methods and imaging options. In fact, this is a good opportunity for you and your doctor to encourage patient autonomy and develop a deeper doctor/patient relationship based on trust and teamwork.

To help ensure a positive patient experience, healthcare providers need to more actively involve their patients in their healthcare choices and decision-making. Fortunately, the encouragement of consumer engagement has been an important focus of EviCore research and operations for many years. SmartChoice, EviCore's consumer-engagement program, is a support system that fosters more active and informed decision-making by patients. Without guidance, patients typically fall back on limited resources when their doctors present them with healthcare decisions. SmartChoice provides patients with valuable clinical and cost information, making them better healthcare consumers. SmartChoice is one way that EviCore strives to show patients how to make the most of their healthcare plan.

What is Consumer Engagement?

Let's look at the current state of healthcare from the patient's point of view. Fear of the unknown is a major factor when people seek a diagnosis, even when a condition is treatable. That fear—and the fact that patients aren't trained healthcare professionals—can act as a constraint on patient autonomy. Patients typically do not participate in decisions about the what and howabout their course of treatment. Instead, they're limited to determining where they'll go for a procedure.

SmartChoice has explored the two most common frustrations patients and doctors express:

The Cost of Treatment

• High deductibles in consumer-directed health plans can make it hard for patients and doctors to choose a preferred course of treatment.
• Limited price shopping: Patients often aren't aware that not everyone charges the same for the same procedure – and many busy doctors don't have time to steer patients toward their best options.

The Convenience Factor

• Scheduling & Receiving a procedure is a difficult process to navigate.
• Roadblocks: Making appointments, traveling to the hospital, and parking are all points of concern, which is why patients often opt for the facility closest to work or home. 

Because we understand these issues, SmartChoice works behind the scenes to improve the patient experience right from the initial point of intake. The program addresses many of the issues all healthcare stakeholders face by furnishing patients with cost information and a concierge service. Critically, it empowers patients to comparison-shop for treatments or diagnostic tools and to make the best decisions for their lifestyle and budget. For providers, the program eases scheduling burdens and eliminates the need for in-depth knowledge of patient options in different networks. The upshot: SmartChoice helps reduce cost share for patients and health plans alike.

What is the Take Away?

Even if you aren't familiar with EviCore guidelines or programs, you've probably experienced pain points in the U.S. healthcare system. We want to help alleviate that pain by getting patients back to health quickly and efficiently. Some of the insights we offer and services we provide include:

• Cost comparisons of freestanding imaging centers

• Quick notifications of options and changes for patient ease of care

• Concierge service that can save the patient's money and time by taking care of appointment/travel logistics.

We recognize that there's a lot of information to digest in this article. But to make SmartChoice better, we need to learn even more about parts of the healthcare system that could benefit from additional navigational guidance. So we encourage your questions or comments. We'd love to know how we can help improve the overall experience for everyone involved. Meanwhile, watch for additional articles in this series over the next few weeks and check out our website for more information on solution management.

Here's to you and better health!