What 5 Things Define Digital Health?

Some argue that skewed logic is better than none at all. I’m not some people. It’s drawing an errant conclusion from a set of misaligned facts; like 2 + 2 = fish.

If A is true and B is true, then C must be true. But truth is like poetry, and people hate poetry. Consider and example from the movie, Monty Python and the Holy Grail. This comes from a scene in which the villagers try to deduce whether a woman is a witch.
Leader: Why do witches burn?

Leader: Why do witches burn?

Villager: Because they’re made of wood?
Leader: Good! So, how do we tell whether she is made of wood?
Villager: Build a bridge out of her!
Leader: Ahh, but can you not also make bridges out of stone?
Villager: Oh, yeah.
Leader: Does wood sink in water?
Villager: No! No, no, it floats! Throw her into the pond!
Leader: What also floats in water?
King Arthur: A Duck!
Leader: Exactly! So, logically…
Villager: If…she…weighs the same as a duck…she’s made of wood.
Leader: and therefore…
Villager: A Witch!

What is the skewed logic that has healthcare running in circles? The lodestar is the illusion that states that CMS ratings matter, and that providers should employ digital health agencies to reinforce the illusion. Ratings force providers to take a journey without a map or an exit ramp in site.

Providers have been trained by CMS to follow a Groundhog Day strategy: CMS wants us to do ‘A’, we do ‘A’, and CMS wants us to do ‘A’ again. And that strategy is played liked the game of musical chairs. When the music stops, there are fewer and fewer providers.

Does anyone outside of CMS and those responsible for raising your scores really know how your health system scored? What benefits has the pursuit of higher ratings yielded?

I spent ten minutes trying to find the newest CMS provider ratings report. (See how long it takes you to find out how your provider scored.) And I did not even know that there was a new report until someone told me about it. The vast majority of the collective population of patients has no idea those theses ratings even exist. If you surveyed 100 of your employees, less than ten of them could tell you your firm’s rank, what your number was, and which provider ranked above yours.

There are over six million links to CMS provider ratings. My guess is that all of those links were posted and viewed by a group of people so small that they would fit comfortably in a Hyundai. To quote the Bard, it is much ado about nothing, at least to everyone not involved in their measurement and reporting.

This is a true story. The wife of the chief innovation officer of a large health system needed surgery. He ensured that she received “white glove treatment.” The result? She raved about her experience. Out of curiosity, he read her HCAHP survey, and he learned that she scored the hospital very poorly. When he asked her to explain the conflicting results she told him that it had to do with her expectations. Nobody had asked her what was important to her.

She scored her survey low, but the items in the survey did not reflect what was important to her. Much ado about nothing.

As an industry, we are spending millions of dollars trying to improve experience ratings around issues that are relatively unimportant to the people who matter. If A is true—we need to improve our ratings, and B is true—we spent money and resources to be better, then C must be true—we will get more patients and care will improve.

But nobody has been able to prove that ‘C’ ever happened, and if ‘C’ happened, nobody has been able to prove that it resulted directly from ‘A’ and ‘B’. There is a big disconnection between what CMS and providers believe is important to patients and what patients believe.

Everyone who has ever been a patient will tell you that one of the biggest problems they have regarding how they experience healthcare is how difficult it is to access and interact with every facet of healthcare. Even patients who gave their health system perfect scores on their surveys will tell you how difficult it is to get their provider on the phone and how outdated the methods of access are.

Only a small percentage of what people perceive as healthcare happens inside the hospital. For most people being in the hospital happens only once every few years. The majority of bad experiences have to do with the amount of effort required by the patient before they enter the hospital and after they leave the hospital.

A collection of articles of the top ten technological advancements of the last decade list five advancements that are found on every list; GPS, iOS, Android, social media, and YouTube.

The one industry that stands out in the minds of its customers for having made almost no use of any of the five advancements, let alone using all five of those advancements is healthcare. The combination of those technologies gives every customer in every industry 24 x 7 access and engagement to every firm with whom they do business. Retail—check. Banking—check. Travel—check.

Healthcare—no check.

If you really want to improve patient and customer access, experience, engagement, and satisfaction throughout your organization set high goals for enabling your patients to use those five technologies. Without these five things, digital health does not exist.

You can keep paying millions to a digital health agency. But a digital health agency will not help you make any of those tools effective. Paying a firm to brand your system as a leader in digital health is very different from being a leader in digital health.

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