Every business runs on the most important concept of finance that is abbreviated as ROI. When the business entity is investing its assets like cash into an avenue ,business /stakeholders expect some revenue out of that investment.This is obvious for any industry, but is it the same for healthcare industry?
In the present healthcare market driven by rules, regulations and reforms and running on fee- for – value concept, it is not just the government or payers that are interested in improved quality but also patients that are paying more detailed attention to the quality of care they are receiving. We need to keep assuring patients that they are in safe hands by continuously exchanging information.
How is mobile aiding in patient engagement? How do we measure the impacts in numbers- how do we monetize it? When a health system offers mobile patient engagement tools to its patient community, how to measure the return on the investment of launching and maintaining the app?
Role of Mobile in engaging the patients:
Mobile technology is fast penetrating the healthcare industry. Mobile has become ubiquitous. When a mobile application aims at either informing, attracting, retaining a patient then the application is engaging with the patients.
Use of mobile application in empowering the patient and thus helping in reducing the readmissions
Of the many uncontrollable & controllable reasons for patient readmission one of the controllable reasons is lack of patient info /knowledge.
(National statistics suggest that at discharge only 42% of patients are able to state their diagnosis and only 37% are able to state the purpose of their medications.)
Lack of the knowledge of the conditions they are admitted for in a facility would lead to improper and inefficient self-management of the condition . They need to have knowledge of the conditions as to what it means, what are the changes from the actual that is happening to them leading to their admission, what is the impact of it on their daily life and what should be done to get better fast?
Mobile application that reminds a patient to take medication, that informs patient of the Do’s and Don’ts of managing the conditions , that can enable the patients to know what their condition in terms of the etiology , pathophysiology of it , if not in the complicated medical terminology at least in a common man terminology, helps patients understand the condition better and can prevent the recurrence and hence decrease readmissions.This empowerment of the patients would enable active and collaborative participation of the patient is managing the conditions and help busy providers to efficiently support them in overcoming the anxieties and apprehensions.
Monetizing the impact
Building a Case :
The Facts :
The CMS Readmissions Reduction Program penalizes the providers/facilities for readmission depending on the rate of readmission and time periods between the readmissions.
Consider a small to medium sized facility with around 500 beds with current readmission rate of 25%.
Let us consider that there are around 2000 patients that come under Medicare of which 25% i.e 500 patients use smart phones.
So at current rate, the number of readmissions= (25% of 2000) is 500.
Consider that with interventions using mobile application we could bring the rate of readmissions to 20 % from 25%. But not all the 2000 use the smartphone.
Penalty per readmission : US$ 10000
Penalty multiplier : 5
Where do we stand by bringing readmission rate from 25% to 20 %
|Number of patients under consideration||2000|
|% using smartphone (25%)||500|
|Readmissions withouts smartphone interventions||500 (25% of 2000)|
|Readmission rate with smartphone intervention||number of smartphone users *20% + non smartphone users*25% = 500* 20% + 1500 *25% = 475|
|Number of readmissions decreased because of intervention||25|
|Amount saved||25* 10,000 *5 = US$ 1,250,000|
Revenue = US$ 1,250,000
Role of mobile applications in improving Patient experience and attaining patient loyalty :
Even before the patient is admitted into the facility mobile can engage them through mobile by enabling the patient to differentially arrive at a condition that they might the suffering from ( informing them of the condition ) and empower them with information about the condition and help them manage it from home preventing further deterioration of the situation.
Mobile can help find the facility and provider that best suits their possible condition and book an appointment with them, track their progress !
Pre, during and post treatment communication with the provider is a major factor for patient experience and mobile can offer patients with reducing the time and effort needed to arrive at a facility and lead to loyal patients. A patient who is attended to at the right time by the right person and who is aware that he is under the umbrella of the provider is a satisfied patient.
Further more there are mobile application that helps the patient track their progress and that enable them to communicate with the providers at regular intervals . These help in retaining the patients and all these contribute to improved patient satisfaction and hence increased ratings during the patient surveys and result in loyal customer or in this case loyal patients.
Monetizing the impact
CMS began collecting quality and patient experience data from acute care hospitals on a voluntary basis under the Hospital Inpatient Quality Reporting (IQR) Program. Hospitals that participated in the IQR program were eligible for a full annual percentage increase in medicare reimbursements.
CMS will establish one overall VBP score for each hospital based on data collected through the IQR program. 12 Process of Care measures account for 70% of the score and 8 Patient Experience measures account for 30% of the score.”Hospital Consumer Assessment of Healthcare Providers and Systems” and it is a nationally-standardized survey that is sent to patients following a healthcare encounter which would depend on the patient experience , corresponding patient loyalty and the directly /indirectly contributes to attracting the patients.
Case One: Retaining the patients through mobile
A medium sized facility with the following :
Number of patients undergoing procedure : 40,000
Revenue from them : US$ 10,000,000
Net profit margin is say 3% : US $ 300,000
Contribution per procedure US$ 5000
If the facilities attrition in existing patients is 15% , the facility is losing a revenue of 5000 * 15% of 40,000= 5000*6000 = US$ 30,000,000.
Now if the facility can intervene (through mobile) in 10% of these 6000 patients, the revenue generated would be US$ 300,000 ( 5000*600) which is equal to the net profit margin of the facility.
Revenue in this case = US$ 300,000
Case 2 : Attracting the patients using mobile application
Consider a facility in a population area of 1 million of which the target population for a facility is 30% i.e 300,000
Let us consider that 1 in 10 people of this population use smartphones
(meaning of the target population smartphones have a potential to impact say 30,000 )
Using smartphones facility could attract 50 % of the smartphone users : 1500
and with these 1,500 patients, the facility was successful in generating a revenue of US$ 2000 per person without incurring additional costs.
Therefore, total revenue for 1,500 would be 3,000,000 (1500 *2000)
Revenue : US$ 3,000,000
Calculating the ROI
Costs: Cost of developing, maintaining and deploying a mobile patient engagement application may range from US$ 200,000 to US$ 600,000
ROI = (Gain from investment – Cost of investment) / Cost of Investment.
Calculating gain from investments : 1250000 + 300000 + 3,000,000 = 4550000
Cost of investment : 600000
ROI= (4550000 – 600000/600000 ) * 100 = 658%
Bottom Line :
In any industry, a business entity would finally look at numbers in terms of ROI. The healthcare industry is no different. An investment avenue such as mobile applications that reach out to patients seems to be an area that has a great potential for huge returns. But, as with other investment avenue mobile technology also carries its risks in terms of privacy and security of information and the penalties associated with breaching the associated rules and regulations. So any investment in healthcare industry should balance ROI with patient-centric quality care delivery.