Consumer Engagement Reference Architecture

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Engage consumers using familiar Microsoft technology to proactively improve health habits allowing health payers to control medical costs and improve member health.

Personal life style choices are one of the primary drivers of chronic disease and rising healthcare costs. As consumers, we need to think less about "getting care" from the medical system and more about "taking care" into our own hands and staying as healthy as possible. The more we engage and become active participants in our own health, the less healthcare services we'll need and the more healthier lives we'll lead. Recognizing this win-win opportunity, health payer executives are seeking the right balance of incentives and online tools to engage consumers in proactively improving their health habits as a means to not only control medical costs but also improve the health of their members. Sounds simple. Persuade people to lead healthier lives and they'll require less healthcare - and even save money themselves.

There's nothing simple about making this concept a reality, as health payer executives can attest. To help members engage in their own health and improve their lifestyles, many health payers have created member portals where members can find an ever-expanding inventory of resources to help them lead more healthy lives.

How to adapt to member behaviors

Unfortunately, this "build it and they will come" approach isn't as successful as it needs to. Not only is exchanging deeply ingrained bad habits in favor of healthy behaviors an inherently tough sell, but before members can even get to the growing stockpile of tools that health payers offer, they need to learn a completely new and unnatural behavior - logging on to their health payer portal on a regular basis.

As a result, member portals are now brimming with interactive tools, personal health records, and guidance for consumers to engage in improving their health. Yet, all of these tools are rendered useless unless consumers log on regularly to their health payer portal and actually use them.

Fortunately, there is way for health payers to drive up the adoption and usage rates of the personal resources they now offer consumers. The answer lies in asking the unorthodox question, "How can we adapt our portal and resources to the consumer's digital lifestyle and online preferences?" rather than, "How can we make consumers adapt their digital lifestyles to our portal and resources?" By weaving some or all of these tools into the fabric of the consumer's digital lifestyle, health payers can make their portal tools follow the consumer's digital lifestyle into the home, workplace, and devices in between.

​An engaging new architecture from Microsoft

To this end, Microsoft has published an interoperable and optimized Consumer Engagement Reference Architecture (CERA) that allows health payers and other members of the healthcare industry to directly engage members in health-related decision-making, while enabling seamless information exchange among hundreds of different health services and devices.

With CERA, you can scale and extend health coaching and care management into the daily lives of your members. When actionable insights and trusted guidance become a normal component of members' digital experience, it is easier for them to make value-based decisions about their care, adopt healthy habits, and self-manage medical conditions.

CERA allows you to take advantage of innovative personal technologies to generate individualized "moments of participation," during which members interact with other people or software agents in ways meant to inspire healthier behaviors and make small changes they can live with in the direction of better health habits. These interactions take place across a broad array of consumer channels, including home and cell phones, email, text and instant messaging, web conferencing, television, and remote monitoring devices such as heart monitors, glucometers, and bathroom scales.

CERA makes it possible for you to:

  • Increase the influence of coaches, care managers, and providers by politely engaging members in conversations at the appropriate time.
  • Enable members to ask for help in their own words.
  • Ask members to give daily or weekly updates on various health benchmarks, while delivering tips to them on healthy living.
  • Provide instant feedback on self-monitoring to shape and reinforce health behaviors.
  • Issue reminders regarding scheduled medication, testing, and doctor's appointments.
  • Seamlessly escalate any issue, along with documentation logs, to a live coach, customer service agent, or personal physician.

Built on a familiar, collaborative platform

Engaging members as fully and effectively as CERA does requires real-time collaboration capabilities, including the ability to discuss the same information through multiple channels such as cell phones, text messaging, instant messaging, virtual chat agents, email, and web conferencing. With this in mind, CERA was architected on the Microsoft Office SharePoint Server platform making it possible for you to:

  • Unify information presented on member, coach, physician, and health worker portals.
  • Integrate information from various medical systems.
  • Facilitate end-to-end collaboration between members, coaches, physicians, and other healthcare providers by enabling aggregation, organization, and search capabilities.
  • Deliver data and information to members wherever they are through mobile channels.
  • Unify communication between members and coaches.
  • Surface line-of-business application data such as user information, member health information, and activity logs.

A software tool that empowers your members

So people can function freely and securely within the CERA environment, Microsoft includes HealthVault, a software platform that lets plan users collect different types of personal health information - prescription medication lists, health histories, hospital discharge summaries, lab test results, fitness data - and store it in one place. This greatly reduces confusion, paperwork, and delays. The platform includes two key features. HealthVault Search is a web search service that enables users to quickly get answers to their health questions. HealthVault Connection Center makes it possible for health-related data from numerous digital devices - such as blood-pressure cuffs, heart rate monitors, blood glucose monitors, and peak flow meters for measuring lung capacity - to be uploaded into an account owners' records.

Designed with robust security, privacy, and technological interoperability as fundamental principles, HealthVault guards account holders' records against unauthorized access. For example, all data communications are protected using Secure Sockets Layer (SSL) encryption. An intuitive user interface helps account owners view, modify, aggregate, and assign access privileges to their records. Together, CERA and HealthVault allow health payers and solution partners to leverage existing portal resources while developing new ways to engage members and steer them toward decisions that promote better health. They represent a real breakthrough in the battle against rising healthcare costs and the challenges of engaging and keeping consumers engaged in their health.