As healthcare becomes more consumer-driven, patients are involved with more decisions regarding their care. This includes not only which health insurance provider and hospital to choose but, increasingly more, which mobile apps provide the best information. Trust is becoming a key factor for consumers in this decision process, as revealed by a recent survey – the 2015 National Healthcare Trust Index.
Conducted by PARTNERS+simons, a Boston-based marketing group, and MassINC Polling Group, the survey asked 1,200 consumers about trust and how it factored into their decision-making process when it came to hospitals and health insurance. The results were stunning: 74% said trust was the most important factor when selecting a hospital, superseding location (ranking at 54%), and only 49% said they trust their health insurance plan. In addition, of those who trust their hospital, 90% said they would recommend it to a friend.
Partners+simon CEO Rich Levy told Healthcare Dive some of the drivers behind the importance of trust stemmed from the Affordable Care Act. “The ACA started to give some decision-making to consumers – especially people who now had health insurance and had options. The hospital marketplace has become extremely competitive and hospitals have really started to reach out in a very large way to the consumer marketplace about their areas of expertise and their centers of excellence.”
Many of the survey findings, said Levy, provide information on how to potentially increase business. For example, 68% of respondents said they trusted information from their physician versus online medical sources, like WebMD. However, he said, “We see technology as absolutely playing a huge part.” For example, mobile apps about a specific surgery enable patients to be educated about the surgery and post-treatment and allow the patient to communicate more efficiently with the hospital and doctor. He also said EHRs play an important role with the overall continuum of care for patients. But, what’s key for hospitals in order to build trust is “making sure their physicians are aware of the available tools and that they use them. That’s going to ensure better outcomes and will increase that trust score.”
When it came to health insurance, the survey showed consumers cared more the company has their best interests in mind. Of the three main trust categories (ability, integrity, and benevolence), benevolence ranked first.
“When you think of the payer marketplace, people want to know their claims are going to be approved in a quick manner and they’re not going to have all kinds of red tape,” explained Levy. “That’s really when we talk about benevolence.” One way insurers are increasing their trust factor is via community outreach efforts. “I think payers are getting very savvy. There’s competition to keep rates affordable and we’ve already seen whether we have five main players or 100, they are going to continue to offer different levels of insurance, so there will be affordability. I don’t think people will be nervous with the big payer mergers unless there’s a reason to be,” Levy told Healthcare Dive.
Hospitals don't trust insurance companies
Not only are consumers concerned with trusting their health insurance company, but hospitals are as well. Another survey, the "ReviveHealth Payor Trust Index" conducted by ReviveHealth in 2014, found the largest commercial payers got failing grades when it came to trust. ReviveHealth CEO Brandon Edwards said in a press release, “Trust is an essential ingredient in the success or failure of healthcare’s most ambitious reforms: value-based care, population health, ACOs, health insurance exchanges, narrow networks and patient safety.” He summarized the survey results: “What our Trust Index tells us, is that the two key players in the American health system have an extremely long way to go to be able to truly work together to improve quality, increase access, and drive down costs.”
ReviveHealth's 2015 Payor Survey Trust Index showed provider trust of payers remains low, with all the major players showing slight drops compared to 2014. As stated in a company press release, "results show perception gaps forming between some payers that are proven to have strong operations yet are inspiring low trust. These gaps imply an increased need for greater transparency and communication between the two industry segments."
Telemedicine slow to gain trust
Trust for telemedicine services, which has great potential in serving a wide range of people, remains a major challenge in its adoption. In fact, a nationwide survey conducted in June by TechnologyAdvice Research found 75% of patients reported they would not trust a diagnosis made by telemedicine or would trust it less than an in-doctor visit. Also, 65.5% said they would be somewhat or very unlikely to choose a virtual appointment while 35.4% said the opposite. Seventeen percent of 18- to 24-year-old respondents and 24% of 25- to 44-year-old respondents said they wouldn’t trust a virtual diagnosis.
The study author, Cameron Graham, managing editor at TechnologyAdvice, told HIT Consultant, “If patients don’t trust the diagnoses made during telemedicine calls, they may ignore the advice given, fail to take preventative steps, or seek additional in-person appointments, which defeats the point of telemedicine.” The survey included several recommendations to increase acceptance and use of telemedicine. Almost 70% of respondents said one of these factors would make them more likely to use telemedicine:
- More convenient scheduling options;
- Lower cost;
- Less time spent in the waiting room; and
- Ability to make virtual appointments at home.
Trust, according to Graham, “is perhaps the largest issue that telemedicine vendors and healthcare providers will need to overcome.” Yet, the younger demographic is less skeptical of telemedicine and perhaps physicians and vendors should target their marketing resources towards this group, the study suggested.
Trust driving new technology
Although there are thousands of health apps and tracking devices currently available, what has remained is the “need for a relationship between patient and providers that views the physical and mental wellness of the patient holistically and helps the patient modify behavior to lead a healthier life,” iDAvatar CEO Norrie Daroga said in a company blog post.
The company is bringing avatars to mobile health technology to address that need. Their “Ask Sophie” app, developed using IBM Watson technologies and Intel Real Sense cameras, can answer health questions, set up appointments and phone calls with physicians, and create detailed reports about a patient’s current health. It records user responses to healthcare questions while tracking their emotional reactions.
The company was recently awarded an $800,000 subcontract from the Veterans Health Administration’s Virtual Medical Center (VA-VMC) to redesign existing virtual medical assistants with avatars “that bring interaction, engagement and empathy during each touchpoint with an avatar,” Daroga said in a press release. The new avatars will be integrated into the VA-VMC which gives veterans 24/7 access to avatars that guide them through various clinics and allows them and providers to connect and share information. Daroga told the Wisconsin Health News, “Our mission statement is to improve the delivery of healthcare through the use of avatars, and the specialty of the avatar is that it’s viewed as an empathetic or compassionate character that’s easy to talk to.”
Avatars are also being used in some patient portals, like Colorado Springs Health Partners’ FollowMyHealth, where an avatar will help patients explore their health records, schedule appointments, ask questions and refill e-prescriptions. Lynne Jones, director of marketing at CSHP, told InformationWeek the avatar will help the practice meet Meaningful Use stage 2’s requirement of 5% of patients engaged with the portal. And, although real people could have been used as online guides, Kathy Wells, vice president of customer engagement at CodeBaby, which developed the avatar, also told InformationWeek that avatars are more effective and approachable.
As long as consumers continue to make healthcare decisions, the industry will need to provide tools to maintain trust in their products. As Rich Levy stated, “Consumers are much more likely to do business with companies that they trust.” While it may sound like common sense, the stakes in healthcare are higher than ever and new technologies to ensure trust will no doubt play a big role.