One of the challenges for the healthcare industry is getting patients to adhere to their medication regiment. among the most common examples is that of antibiotics. Something that we learn in nursing school is that patients often will stop taking their antibiotic when they are feeling better, rather than taking the full course of the medication. Another example is getting patients to do prescribed exercises the improve body and system function, such as weight-bearing for bone and muscle strength or aerobic exercises for respiratory function.
The challenge, of course, is hat once the client has left the healthcare facility, it is up to them to comply on an ongoing basis by incorporating the new regiment into their old routine. I think we can all find examples in our lives where doing so, despite knowing the benefits, is challenging and results in failure.
What if healthcare organizations had a department for follow-up with clients on an ongoing basis to remind and ensure compliance?
Think about a position for case workers, nurses, and therapists (PT, OT, RT, SLP, etc.) They can follow-up with the client via phone or video to ensure compliance.
One challenge: who pays for it? Let's establish the chain of commerce: the client has health insurance and seeks care from the provider. The provider cares for the client and bills the insurance company. The insurance company takes premiums from the client pool and pays the provider. The provider gets a combination of payment from the client and the insurance company.
Let's think about this. The client is NOT going to want to pay every time that they get a phone call from the provider. That would almost certainly cause reduced compliance due to avoidance. It would be like a bill collector.
Who in the chain has the most to gain, financially? The insurance company. Improved adherence should lead to a better health outcome fore the patient, which should result in lower ongoing costs, and then to reduced need for reimbursement from the insurance company.
The insurance company has an incentive to give financial incentives to the healthcare organization for following up with the client to ensure adherence. If the client takes their pills everyday, exercises, etc. then there should be some specific, measurable long term goals that would be met.
By achieving those metrics, the healthcare organization can finance the employees whose job is to follow up with clients and see how they're doing, including what friction or barriers they have to sticking with the program.
This provides a remote work position for teams or for people who are unable to work in person. This is an established position: I have a friend who works in oncology. She works 3 days per week, one of which is remote and responds to incoming messages through the client portal. Either in addition to that or as a separate position, people can use that position proactively to reach out to clients to see how they're doing by text, phone, or video. Examples of employees who may like this position include the rotation that my friend participates in, and someone who is on disability leave but could still do work, just not in person.
Finally, the healthcare organization could give the client financial incentives by showing adherence to the regiment. That could come in the form of direct payment (cash or gift card) or reduced billing.
There may be some who feel that the hands-off, self-determination approach is best: if you want to get better, it's up to you.
Others may think that the financial incentives lacks the altruism of helping people: people should be helped without needing financial incentives.
However, the pragmatist knows that neither of those approaches is realistic. Companies expect to make money, workers expect to be paid, and clients expect service. By catering to improved outcomes from both the individual health as well as the financial perspectives, the interests of all parties are served.
