Did you see the recent Wall Street Journal article, "
Rural Hospitals Feel Pinch --- Strapped Facilities
Squeezed Further by Medicare Changes, Dwindling Subsidies"? If
you didn't read it, the headline says it all.
What the article doesn't tell you is how to "pinch
back." In other words, "How can your hospital succeed in spite of
Medicare changes and decreased subsidies?" One solution is
Now hear me out … I know "telemedicine" has become a healthcare
buzzword these days. But there's more to it than video conferencing
with a specialist hundreds of miles away. I also know that a lot of
rural hospitals are turning "telemed" into "teleprofit." That's not
rhetoric. It's a fact.
I've worked closely with Donna Jennings, an expert in the field
of telemedicine consulting, and we've learned quite a bit from each
other. As vice president of Valis, Donna not only knows her stuff, she's
been elbow-deep in setting up successful telemedicine programs
across the country.
Based on our discussions, I can tell you unequivocally, that
rural hospitals can benefit both clinically and financially from an
effective telemedicine program. While I've seen evidence of this
with my own clients and business partners, Donna shed some light on
a few lesser-known facts that it's important for your hospital to
For example, according to Donna, "Many hospitals don't know
that they can bill - and get paid - for telemedicine services
if the program is set up appropriately and is very tightly
She also stressed that, "It's important for hospitals to
realize that return on investment goes beyond the telemedicine
consultation itself. It's also related to things like reduced
readmissions and mortality rates and value-based care metrics,
which hospitals now get paid on."
Telemedicine can provide a multitude of benefits to your
hospital and patients. To help get your arms around them, I've
broken the advantages into four distinct categories:
- Improved access to inpatient and outpatient
care: Telemedicine allows your hospital to offer your
patients high-quality and consistent specialty care that's close to
home. And that care can be provided without the large investment of
hiring full-time, on-site providers.
- Improved patient outcomes: Telemedicine gives
your patients immediate access to the specialists they need so they
receive the right care, right away. This has been shown to improve
outcomes for inpatients. You know what that means for your hospital
when you're paid on performance. Earlier specialist treatment can
also result in lower costs. And telemedicine allows similar
benefits to outpatients, improving care without the cost and
inconvenience of travel.
- Improved hospital performance: Telemedicine
can decrease lengths of stay, mortality rates and patient transfers
to tertiary facilities as well as encourage appropriate admissions
and discharge decisions. But that's not all. When patients
have local access to the specialists they need, readmission rates
and outmigration can be minimized, which can be a major coup for
- Improved patient satisfaction: Telemedicine
helps reduce travel time, wait time and related stress and
uncertainty for patients needing specialty care. Inpatients also
benefit from continued care by their own doctor who knows them
best, with assistance from a well-trained telemedicine
specialist. And a well-organized and clinically sound
telemedicine program can produce excellent patient and family
I also learned about different grants that are available to
hospitals. According to Donna, "Many grants are available
to hospitals, especially in the area of rural healthcare. These
grants can help hospitals invest in a telemedicine program and,
with appropriate monitoring and outcomes support, hospitals can
retain the grants so they can continue, and expand, their
This is just the tip of the telemed iceberg when it comes to
leveraging the benefits and opportunities available to your
You can find out more during our upcoming webinar, "Building and Marketing a Telemedicine
Program," on Tuesday, September 9 from 12 - 1 p.m. (CDT). Donna
will take a deep dive into the clinical and financial side of
telemedicine, and I'll share a marketing perspective both in the
webinar and in my upcoming blog.
Rural hospitals across the country are looking for ways to
increase surgery volume. But in their search for an elusive
cure-all, many overlook opportunities right in their own backyard.
Consider the following example:
Most rural hospitals serve an older demographic. With an aging
population come age-related healthcare needs, like knee
replacements. And the total number of
knee replacement surgeries has soared 161.5% among Medicare
participants over the past 20 years.
Let me put that into context for your CAH:
- Today, about 4 million people - or 1 in 20 consumers over the
age of 50 - have had knee replacement surgery.
- That number is expected to grow to an estimated
yearly demand of 3.48 million procedures
Your CAH can leverage this opportunity, or opportunities like
this, to immediately increase surgical volume by:
- Developing a targeted marketing campaign for consumers
- Implementing a strong PCP program to build relationships with
physicians to help your CAH build surgical volume for the long
- Managing the surgical process effectively, as described in this
- Developing relationships with neighboring hospitals to share
surgical teams and services. This recent article in The Rural Monitor highlights
how robotic technology is expanding surgical capabilities of CAHs
in Michigan, Minnesota and Washington.
What if your CAH doesn't have an orthopedic surgeon?
The principles are the same. There are many opportunities to
develop relationships with specialists, whether they're independent
or part of a system.
If you have questions about how your CAH can keep your surgery
suites busy, give me a call at 920-544-8102 or send me an email at
firstname.lastname@example.org. I have some ideas and case
studies I'd be happy to share with you.
In my last blog, I shared
why it's important for your CAH to build a women's health
program. The facts spoke for themselves. So let's move on to the
- Analyze before you strategize: Conduct a
demographic and needs analysis to identify gaps, overlaps,
challenges and opportunities.
- Drill down. Your CAH can stand out in women's
minds by personalizing services - and marketing messages. For
example, is your primary audience women age 55+ who enjoy gardening
and knitting or is it physically active, service-minded middle-aged
women? That leads me to my next point …
- Know what women want. Studies show that women
want to be treated like women - not just "consumers." This
female-centric focus encompasses everything from providing a
feminine décor and tranquil environment to communicating with women
on a personal level and making it convenient for them to engage
with your hospital and staff.
- Build a core area of excellence. Develop at
least one core service to build as a competitive advantage, (e.g.
breast health). As you establish your CAH as an expert in this
area, it can help build the perception that your hospital is a
leader in other areas of women's health.
- Mine your mix. "Women's health" goes beyond
OB-GYN. It's evolving into a multi-discipline mix of service lines.
Increase revenue by taking a cross-departmental approach to carve
out niches from orthopedics, cardiovascular and other high-margin
services your target audience needs.
- Don't underestimate provider relationships.
According to a 2011 Kaiser Women's Health Survey, most women (83%)
report that they have a provider they see on a regular basis. These
women maintain a consistent relationship with the healthcare
system, which fosters the use of preventive and other women's
- Think virtually. This goes beyond using
telehealth services. Many CAHs are building virtual women's health
programs with the help of their marketing department or an external
- Partner for progress and profit. Work with the
community and local organizations to provide women's services
beyond the scope of your hospital. This is an effective way to
build loyalty among healthcare's number one decision-makers who can
drive business to other areas of your organization.
I've worked with many CAH clients to help them build profitable
women's health programs. If you'd like to learn more about these
specific strategies and see case studies, don't forget to register
for my June 4 webinar, "How to Build a Women's Health Program in Rural
Healthcare." If you have questions prior to that, shoot me an
email or give me a call.
We all know that women make the majority of healthcare
decisions. But the reasons for building a strong women's
health program extend far beyond this well-known fact. For
starters, The Advisory Board Company (a global research and
consulting firm) found that:
- Women account for about 60% of hospital volumes.
- Women have significant unmet needs for health services.
- Nationally, women in the 45+ age group has grown 25% over the
past 10 years and is expected to grow another 14% over the next
And then there's the Affordable Care Act:
- Under the ACA, women's preventive healthcare, like mammograms,
screenings for cervical cancer, prenatal care and other services,
generally must be covered by health insurance plans - with no cost
- The law also recognizes the unique health needs of women
throughout their lifespan.
I hope these facts have caught your attention
Because they can point to profit for your CAH. The time is ripe
for your rural hospital to build a women's health program that
address the changing needs of women throughout their lives.
While OB-GYN will remain a core focus, it's time to think beyond
the "baby stage." An aging population - especially in rural
communities - translates into additional needs for breast and
heart health services, urogynecology, screenings for osteoporosis,
hormone therapy, management of chronic conditions and more.
Building a comprehensive women's health program can increase
revenue for your CAH while building a loyal following of female
patients, engaging them throughout every stage of their lives. And
don't forget: these women have a big influence on the healthcare
decisions made by other family members.
Now that we've established "why" your CAH needs to build a
strong women's health program, my next post will focus on "how" to
do it - regardless of the size of your hospital and its
staff. In the meantime, I'd be happy to field any questions
you have about this timely topic.
You can also register to attend our upcoming webinar, "Building
a Women's Health Program," to learn the best strategies for program
Wednesday, June 4
12 - 1 p.m. CDT
Presented by the National Rural Health Association Partnership
1The Advisory Board, Future of Women's Services:
State of Women's Services, September 2008.
In the worlds of rural and critical access hospitals, size is
typically an obstacle. But in our eyes, it's never about how big
you are; it's about how you position and market yourself. With this
idea in mind, along with commitments to quality and strategic
marketing plans, our clients have received national recognition for
patient and employee satisfaction and quality of care - despite the
fact that they are "small."
Recently, we've seen personal evidence of the truth of our motto
by receiving eight national awards through the 31st
Annual Healthcare Advertising Awards and the 2014 Aster Awards.
The Healthcare Advertising Awards are sponsored by
Healthcare Marketing Report and honor healthcare marketing
professionals for exceptional quality, creativity and message
effectiveness in advertising. This year's competition was one of
the largest with over 3,700 entries submitted by some of the
nation's largest healthcare systems and marketing/advertising
agencies. From this impressive pool, we were incredibly proud to
- A Silver award for the Telespecialists, LLC logo design
- A Bronze award for the Black River Memorial Hospital "Up Again"
- A Merit award for the Bone & Joint pain management primary
care provider piece
- Two Merit awards for the Holy Family Memorial "life.Empowered"
- Cardiology - "I beat the widowmaker"
- Orthopedics - "I made it out of the rough"
Awards are also an annual competition hosted by Creative
Images, Inc. It recognizes the nation's healthcare marketing
professionals who've demonstrated excellence in advertising. This
year we won:
- A Gold award for the Bone & Joint Walk-In Care
- A Gold award for the new Legato website
- A Silver award for the Black River Memorial Hospital "Hoopla"
It just goes to show that being smaller doesn't mean you can't
Visit our portfolio to check out the winning
Addressing Health Literacy: An Always
Nearly half of all American adults - 90 million people - have
difficulty understanding and using health information, according to
the Institute of Medicine. 1
Low health literacy affects people from all walks of life. Even
many college graduates don't have the health literacy skills needed
to navigate the health system and actively participate in their
care. Holding an MBA does not necessarily mean a person understands
the medical jargon physicians - or nurses - often use. In fact,
well-educated people may be at an even greater disadvantage because
embarrassment about not understanding instructions they think they
should understand may prevent them from asking
The impact of low health literacy on rural hospitals and
Low health literacy can contribute to outmigration as confused
and helpless patients feel their needs aren't being respected or
met. They'll drive a little further, when possible, if the nearest
urban teaching hospital's communication style resonates with them.
Not addressing low health literacy can also lower your HCAHPS
scores and thus, reimbursements. And here's the kicker:
higher rates of hospitalization and avoidable use of emergency
services associated with low health literacy wastes billions of
Does your hospital have room for
Do your patients routinely answer these HCAHPS questions with
- During this hospital stay, how often did doctors treat you with
courtesy and respect?
- During this hospital stay, how often did doctors listen
carefully to you?
- During this hospital stay, how often did doctors explain things
in a way you could understand?
Make effective communication an "Always"
- Teach providers to lose the medical jargon -
Communicating in plain language won't undermine their authority; in
fact, clear communication enhances the perception of value of the
encounter and helps create trust.
- Create an environment free of shame and blame
- It works both ways: caregivers and patients should feel
there are no dumb questions.
- Use the teach-back method - Educate physicians
and staff in this tried-and-true method of testing whether they
have communicated in a way patients understand.
Getting started is easier than it sounds!
There are an overwhelming number of resources out there,
including solid information curated by the NIH. If you're brave
enough and have time to do some heavy reading, look here.
Or, for a quick start, check out these reliable, user-friendly
- The AHRQ Health Literacy Universal Precautions Toolkit has
everything you need to know to assess your current performance on
health literacy issues and begin to make significant changes. Download it for free.
- The "Always use Teach-Back!" training tool kit is a free
interactive online learning module for providers developed by the
University of Iowa, The Picker Institute, Des Moines University and
Health Literacy Iowa. Access it here.
If you are not already aggressively addressing low health
literacy in your community, getting started is not as difficult as
you may think. And it's the right thing to do for hospitals and
Wherever you stand on the Affordable Care Act (ACA), I think we
can all agree that preventive care is in the air. The ACA and
many of its programs, parts and parcels focus on care coordination,
prevention and wellness. That has both employers and health
insurance providers placing greater emphasis on wellness. And
consumers are following suit.
SymphonyIRI (a market research company) found that:
- ¾ of all consumers are trying to eat healthier today to save
money on health care later.
- 30% of all adults (on average) are concerned about weight
- 29% are worried about stress management.
- As people grow older, their health concerns become more focused
on problems associated with aging instead of weight and stress. The
top two health concerns of seniors, aged 68 and older, are:
- Heart-related issues.
OK, so I think we're clear on why your rural hospital
needs to take note of these facts and stats. But that leads to an
even more important question: How can your CAH leverage
these trends? I'll give you some examples:
- Develop a campaign around preventative care, such as mammograms
- Don't waste consumers' time by telling them what it takes to be
healthy and all the reasons it's important. They already know what
and why, and will just tune you out.
- Focus on making it easy and "nonthreatening" for them to take
action, like holding a "Mani and Mammogram" event.
- Offer a farmer's market on your hospital's grounds to increase
physical activity and promote healthy eating.
- Leverage the ACA by partnering with local businesses offering
employee wellness programs.
- Employers know that wellness programs help reduce absenteeism,
employee turnover and insurance premium costs.
- The ACA supports workplace wellness programs, such as those
that provide incentives for attending a weight loss, nutrition or
smoking cessation program.
- Building strong business partnerships can ultimately result in
stronger consumer/patient relationships for your CAH.
- Get involved in the community to promote preventive care. WEPAC Hoops for
Hope Weekend is a great example. Ashland Health Center and
Comanche County Hospital put on an annual event with 90% of the
proceeds going to pay for mammograms, pap smears and colonoscopies
for women in those five small towns.
These health and wellness initiatives can lead to more revenue,
increased volume and stronger patient relationships for your CAH.
That's a fact. I'd be happy to share some proof points with you.
Give me a call or shoot me an email if you'd like a professional
perspective on what your CAH is doing - or could do - to leverage
health and wellness trends in 2014.
Patients want to take a more active role in their healthcare,
sometimes they just don't know how. Improved engagement
not only benefits the patient, but also can lead to increased
satisfaction scores, greater quality and safety and a higher
likelihood of patient compliance. Here are a few ways you can
begin to improve patient engagement:
- Create an environment for shared decision
making. Involving patients in the decision making process,
or making sure their voices are heard will make them feel as though
they are an integral part of the hospital (which they are).
- Develop a powerful patient portal. The world
is going digital, and patients want access to their information
wherever they are, 24/7. A patient portal can give them this access
and improve their overall engagement in their health needs.
- Create a strong web presence. A website can
create the first impression your patients have of your facility and
staff. Having useful and relevant information will frame you as a
- Generate a strong patient feedback program.
Most hospitals have places for patients to give feedback. The key
is what you do with that information.
- Traditional advertising. Though some
traditional advertising, like newspaper or direct mail, may seem
outdated, they actually still have a strong effect on patient
engagement. People want to be affiliated with a respected
organization; traditional advertising can help show patients that
your organization is just that.
Want to learn more? Join the Rural Healthcare Marketer on
April 2 to delve deeper into this topic and see how rural hospitals
across the country are leveraging their marketing efforts to engage
patients and help them be an active partner in their
Wednesday, April 2
12 - 1 p.m. (central time)
Presented by the National Rural Health Association Partnership
According to a Pew Internet Project (2012 survey) related to
health and healthcare, 72% of U.S. Internet users searched online
for health information during the past year. Think of what this
could mean to your hospital if even a fraction of these consumers
looked to your physicians as thought leaders in their fields!
Problem is, one five-letter acronym may keep your docs from
taking advantage of social media. You guessed it: HIPAA.
While that could be the end of the story-it shouldn't
be. Your CAH and its providers can use social media without
breaching patient confidentiality and other HIPAA rules. One way to
do this is to connect with patients collectively-rather than
individually. Here are some tips to keep in mind:
- Keep it general. For example, discuss "healthcare topics in the
news." Providers can share their perspectives, addressing potential
benefits as well as concerns about specific procedures, medical
"break-throughs," medications, etc.
- If a consumer responds with a specific health-related question,
do not answer it using social media. Direct the person
offline, using a standard response to call your office and make an
appointment, or if it's an emergency, call 911 or go to the
- Include a disclaimer that directs consumers to consult with
their physician and that your recommendations are not substitutes
for actual medical assistance.
You might want to check out this video, "The Doctor is Online: Physician Use,
Responsibility and Opportunity in the Time of Social Media." It
includes insights from a pediatric gastroenterologist at Texas
Children's Hospital who blogs at 33Charts, along with several
experienced physicians who are also active in social media. While
it was originally developed for medical students just beginning
their residency program, your CAH and docs can benefit from these
quick tips and guidelines.
Be sure to Like us on Facebook and Follow us on Twitter to learn more about using social
media in healthcare.
"Hospital Consumer Assessment of Health Providers and Systems"
survey (HCAHPS), even the acronym is a mouthful! No wonder
hospitals are in a quandary about how to use HCAHPS survey results
to improve patient satisfaction scores. But quandary or not,
there's little time for debate.
Today, low scores not only threaten your hospital's ability to
gain - or even maintain market share - they can result in a lack of
reimbursement. Under the current value-based purchasing program, a
hospital may even face financial penalties if its scores are too
As your hospital takes steps to attain sustainable
patient-centered excellence, here are some considerations to keep
Know it all: Before you can effectively improve
your HCAPHS scores, you need to "know what you need to know." For
- What are your hospital's strengths and gaps, based on patients'
perception of the care they receive?
- What units are performing at a high, low or mid-range
- What specific, measurable goals (and stretch goals) do you want
to achieve and by what dates?
Communication could be your differentiator: The
better you are at clearly communicating - and listening - to your
patients, the better your chances of receiving a higher score.
- The HCAPHS survey includes several questions related to how
well doctors, nurses and other staff explained things to a patient
and how well they listened to the individual.
- Today, consumers expect to receive safe, quality care from
whatever hospital they choose. No difference there. But … effective
communication could help your CAH stand out from your
Don't overlook key influencers: From the nurses
who provide care to patients every day of their stay to the
environmental service workers who clean patients' rooms - frontline
employees are integral to the patient experience. Be sure to:
- Share survey results with frontline staff. This will help them
understand the importance of their role and align their behavior
with your hospital's patient-centered focus.
- Give credit where credit is due. Positive reinforcement can go
a long way in keeping employees motivated to continue the journey
Above all, don't let the nebulous challenge of "improving
patient satisfaction" overwhelm you. You can start by zoning in on
specific areas and "quick wins." Here's one to get you started:
Some hospitals have found that when doctors sit down to talk
with patients vs. standing, it positively affects a patient's
satisfaction score. This simple nuance gives the impression that
the doctor is less rushed and more focused on the individual