A Strategy Framework for eHealth

There’s a conceptual diagram out there that Gartner and others have assembled that tries to outline the progression of eHealth. It looks something like this:

Source: http://www.envision-ebusiness.com/piicm_printerfriendly.asp?recordid=2

I’ve always disliked this diagram because it focuses on entirely the wrong stuff. It’s essentially a semi-random wish list of items ordered by how hard they are to implement. It’s fair to say that the harder things are to do, the longer before they come to fruition, and this chart is clearly showing just that. But that’s hardly an indicator of the relative importance of any of these initiatives.

Admittedly, this chart is woefully out-of-date (it’s practically a decade old), and sadly many of the items on this list remain on the wish list for hospitals and vendors alike.

Too often, hospital eHealth strategies are defined by exactly such a wish list of items rather than what really matters to organizational success. The goal becomes “check the box” on a list rather than focus on the business objective you’re actually trying to achieve. The strategy should drive your tactics, but so often vendor products are decided upon and then shoe-horned back into a strategy. The Most Wired surveys are similar in some ways. Though we’re clearly believers in technology being a critical part of healthcare transformation, checking boxes on a list doesn’t itself make anyone healthier or healthcare more profitable. These tools are a means to an end, and we want to focus on the end goals first.

A New Course

It’s time to rethink how the transformation to eHealth will continue and chart a new course for the next decade.

Geonetric’s eHealth strategy team has been working for the past few months to develop just such a framework for this transformation, and rather than list the capabilities to check off, we designed a concept we’re calling The eHealth Maturity Model. The model provides a structure that showcases the success (or failure) of your eHealth strategy.

Over the next few weeks, we’ll be posting details of the stages in this model (and some thoughts on how to implement them) on this blog. Here’s the summary:

Today we’re going to start with Level 1 of the eHealth Maturity Model – the one that most hospitals are barely able to do right now. It’s also where most hospitals stop. But we’ll begin here because, without it, you can’t progress to the more critically relevant stages.

Level 1: Critical Mass in Adoption

It’s sad to think that many hospitals invest hundreds of thousands, or perhaps millions, of dollars in systems that fail to be adopted by patients, consumers and providers. Yet they do. No matter how much you invest, if no one uses the software, your project will fail.

So the first step in the eHealth Maturity Model is to recognize that your constituents must actually use the software for it to be relevant. Perhaps that sounds simplistic, but it is shocking how many organizations have no idea how to measure, nor any strategy to influence, the adoption of eHealth software. If no one uses it, it doesn’t matter.

Success depends on four key factors: utilization, usability, adoption rate, and communicating value.

Utilization. Utilization is a measurement of whether your users are actually using your eHealth systems. It is the simplest adoption to measure. You must be able to measure key activities regularly in order to see utilization. In this case, “activities” refers to transactional activities that are meaningful. Page views and unique visitors are the simplest metrics but are the least useful. Instead, you need to be able to quickly see how many patients have registered for a class, paid a bill or set up an appointment. If you can’t measure this basic information, you’ll have difficulty showing changes in adoption over time.

Usability. Usability is definitely measurable, and a successful eHealth strategy must consistently show that your users can accomplish the tasks they want to accomplish.  (Consider the adoption of the iPhone as an out-of-industry example of how ease of use can greatly influence success.) To measure your site’s usability, you might use software that assesses the completion rates for key tasks, such as pre-registration. If you know that “91 percent of patients who started the pre-registration form completed it successfully” you are able to determine usability.

Adoption Rate. The rate at which users adopt your eHealth System is critical to its success. Of course, you’d like to see adoption increase over time. For example, “1,102 patients scheduled appointments online in March, a 6 percent increase over last month”.

Communication. The reason marketing is so important to eHealth is that everything revolves around communication. Your patients and consumers must understand the benefits of your software, such as what your patient portal does and how it can help them. For example, you might have an eNewsletter and print campaigns extolling the fact that “same-day appointments can be made instantly, online, at ourhospital.org.” You need a solid communication plan in place to ensure that everyone knows what you need them to know.

Questions to Assess Your Level 1 Success

In order to Reach Critical Mass in Adoption, Level 1, in the eHealth Maturity Model, you should be able to answer “yes” to the following four questions.

  • 1. Do I have tools that measure utilization of my eHealth software in real-time?

___ Yes, I can see activity online, 24/7 and generate aggregate reports.

___ No, I have to ask for a report to be generated.

___ No, I have no idea where I would find this information.

  • 2. Can I prove that users complete tasks 90 percent of the time successfully?

___ Yes, I have recorded real-time views of users completing tasks successfully

___ No, I can’t prove success rates

  • 3. Can I show that users adopt my software quickly and at an increasing rate?

___ Yes, I measure adoption rates and can show an acceleration in adoption

___ No, I measure adoption but it isn’t growing

___ No, I don’t know how to measure adoption

  • 4. Can I show that I am communicating the benefits of using my eHealth software to end users on a regular basis?

___ Yes, I have a defined communication plan to regularly tell my users about the value my software provides to them

___ No, I expect my users to figure out how my software benefits them

How to Reach Level 1 Success

If you’re coming up short on the assessment, your next question is likely about what your hospital can do to make sure the dollars you’re investing in your online initiatives are being used most effectively. Geonetric’s eHealth Strategy team is here to help. Give us a call at 1-800-589-1171, and we’ll work with you and your team to get you on the track to true eHealth success.


We’ll follow up in the coming weeks on the remaining levels of eHealth Maturity. Until then, I’m open to your feedback on Geonetric’s approach to achieving online success – let me know what you think.

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Eric Engelmann

About Eric Engelmann

Eric gets people excited. About healthcare. About technology. About Geonetric. It only takes a few moments of being in his presence to feel his passion and see his vision. A healthcare reform junkie, Eric can usually be found uncovering new ways to show healthcare executives how to leverage technology investments and develop patient portals that will improve care delivery. After earning his bachelor’s degree in business administration from the University of Iowa, he began his career in technology, founding Geonetric and never looking back. Through his leadership, Geonetric continuously receives honors and recognitions, including being named a Best Place to Work by Modern Healthcare, Software Company of the Year by the Technology Association of Iowa, and an Inc. 5000 Fastest Growing Company for five years running. When he’s not sharing his vision for the future of healthcare or accepting awards on behalf of his company, he can be found having lunch with his daughter at a local elementary school or donning lederhosen and entertaining his team at the Annual Engelmann Oktoberfest.

3 thoughts on “A Strategy Framework for eHealth

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