Assessing the Covered California Online User Experience

The rollout of Covered  California presented many challenges, and turned out to be an expensive learning exercise. Many of the issues were clearly identified late in the game and are illuminated in this excellent report and videos sponsored by a grant from the the California Health Care Foundation

California enrolled 1.4 million people in new private health insurance plans during the first open enrollment period under the Affordable Care Act. In February, as state officials were administering the sign-up campaign, research supported by the California HealthCare Foundation (CHCF) was conducted to study the experiences of consumers attempting to enroll online at www.CoveredCA.com.

CHCF commissioned gotomedia, a San Francisco-based user interface research and design firm, to observe and interview a diverse group of Californians applying from computers in their own homes. Researchers observed consumers as they explored the site, created accounts, entered household and income data, and compared health plan options.

Online ACA Marketplaces: the Value of Consumer Experience Assessments

The result is reported and may be downloaded here in this white-paper.

Several videos are available which demonstrate several users attempting to use the Covered California Website.

 A video clip of a consumer trying to use the CoveredCA.com website shows this problem and illuminates how direct observation can be a revealing way to more fully understand the consumer experience.

Confusing Eligibility Results and Next Steps: Many users were not sure what they qualified for. Those eligible for Medi-Cal were disappointed at not being able to complete the enrollment process online. Watch Video

Understanding Questions: Some participants resorted to guessing and online searching when they didn't understand questions and when definitions and help were not available or inadequate. Watch Video

Steps and Sequences: Some participants were uncertain where to start on the site and about next steps as they progressed through the process. Watch Video

Entering Simple Data: Some users struggled to enter simple data, such as phone numbers, in the format required by the online system. Watch Video

State leaders and consumer advocates have identified several report recommendations as high priorities when planned enhancements are made to CoveredCA.com. The full reports on CoveredCA.com and HealthCare.gov are available on CHCF’s website.



Read more: http://www.chcf.org/publications/2014/05/covered-california-online-user-experience#ixzz35iOhi5O2

HIPAA Fines having Major Impacr

Groups hit with record $4.8M HIPAA fine

HHS' Data Breach Report: 7 Key Findings

Stolen laptops lead to important HIPAA settlements

And finally, not all data breaches are electronic:

This breach involved records from a hospital emergency department that should have been shredded ending up in a dumpster in front of the hospital. "It was a windy day. Security forgot to put a lid on the dumpster. The records are down the street," Hinkley recounted. Ultimately, school children nearby ended up collecting the records and returned them to the hospital. "The security guard said, 'not my job,'" said Hinkley. "How could someone seeing papers (flying about) not think, 'Gee, is that something I should think about?'"

The incident could well serve as the poster child for inadequate employee training, added Hinkley. The key is to "have it be owned by everybody from the first person the patient sees to the last one they see and everybody that touches their data in between."

EHRs and other digital storage or HIT network has been delayed, despite HIPAA regulations. Implementation may be delayed due to a multitiude of mandated changes in health reform. Institutions are hard pressed to comply due to financial limitation meeting all their responsibilities. 

Referral Network in the Digital Age, and the Affordable Care Act

How do you build your referral network ?

How can your practice stand out.  What is your HUMP DAY ?

Most of us when beginning a medical practice would contact established physicians, and meet them personally, handing out a curriculum vita and business cards, then sit, hope and wait for referrals.

Today young physicians immediately sign up for any health insurer or health plan to join  their network  of providers. They will accept plans that have good reputations and avoid the ones with less quality. Young providers may even seek out word of mouth from fellow practitioners to select those that pay promptly and fairly.

What Triggers Word of Mouth?

How important is this tested by time methodology for building a medical practice following? Your medical services are a  product, and can be marketed in many ways the same as merchandise. This of course is anathema to some professionals.  However given the current state of transition in the marketplace of health care, such as accountable care organizations, and the affordable care act it is still foolish to depend upon a laundry list of providers and their networks.

The Power of Word of Mouth

Word of mouth drives all sorts of products and ideas to catch on. It’s 10 times more effective than traditional advertising and shapes everything from the products people buy to the services they use. But why do people talk about some things rather than others?

Generating word of mouth or getting something to go viral sometimes seems like magic. Like catching lightning in a bottle. But it’s not. There’s a science behind it. Triggers are only one of the six key principles that drives all sorts of things to catch on. Understand that science, and you can make your own services and ideas more contagious.

Those who are new to a community will often ask social contacts, church members or get a referral from the local medical society. The truth is that most patients have no idea of who the preferred and/or best qualfied physicians are in the community.

The final decision may be the result of a combination of word of mouth, direct referral from a friend, accessibility and a prompt appointment. Demographics play a large role in obtaining health care. A geriatric medical clinic would use methods different from a pediatric clinic. Subspecialist practices can market to consumers directly, or if in a monitored network...social networking with referral sources directly may be more effective in building your network.

Generating Word of Mouth

The best thing about word of mouth is it is available to everyone. It doesn't require large amounts of capital, it just requires people to talk. The challenge is how to start people talking. It just requires people to start talking, and how to make your message(s) stand out from the noise.

Today, social networking includes social media using Facebook pages, Google + pages and Linkedin ( a network of professional colleagues), and their are medical interest groups to join that narrows your interest to your target population. There is a variety of lesser known social media platforms such as Digg, Pinterest, Delicious, or Newsana. A professional blog with RSS feeds and a subscription tab also can be a resource for your practice. Backlinks, which are links between different platforms also enhances your visibility. If you are using social media the understanding of hashtags and their use magnifies and focuses your audience.

There are a large number of tutorials and courses covering these subjects. Finding an expert in social media is not difficult.

What are the limitations of Social Media?

When asked, most will estimate that social media accounts for 50% (average) of chatter. However 50% is wrong ! The actual numbere is 7%. Research by the Keller Fay Group fins that only 7% of word of mouth occurs online. This figure may not represent certain demographics, such as an age group 11 to 30, where use of social media is greater than 7%. Now even that may be changing as older adults use social media much more in the past four years as social media platforms have expanded in quality and quantity. There is also significant churn ie, those entering and departing the social media niche.

These details are in much greater detail in a book by Jonah Turner, CONTAGIOUS, WHY THINGS CATCH ON

One in 10 U.S. Residents Affected by Large Health Data Breaches

Monday, June 16, 2014

TOPIC ALERT:

• Privacy and Security

Click on topic to receive periodic emails.

More than 1,000 medical record breaches involving 500 or more people have been reported to HHS since federal reporting requirements took effect nearly five years ago, according to HHS,Modern Healthcare's "Vital Signs" reports (Conn, "Vital Signs,"Modern Healthcare, 6/13).

HHS has been tracking data breaches since September 2009, when the HIPAA breach notification rule went into effect. The agency reports health information breaches affecting more than 500 individuals on its "wall of shame" website (iHealthBeat, 4/1).

Since 2009, HHS has received:

• 1,026 reports of breaches involving 500 or more individuals; and
• More than 116,000 breach reports involving records of fewer than 500 individuals through March 1, 2013.

In total, large health data breaches reported by health care providers and their business associates have affected the medical records of about one in 10 U.S. residents, or 31.7 million people. 

Meanwhile, more than 32,600 HIPAA complaint cases have been investigated, with more than 22,500 of them closing with corrective action, according to HHS Office for Civil Rights spokesperson Rachel Seeger ("Vital Signs," Modern Healthcare, 6/13)

Privacy Penalties on the Rise

In related news, HHS Chief Regional Civil Rights Counsel Jerome Meites at an American Bar Association Conference last week said he expects penalties under HIPAA to increase drastically in the next year, The Hill reports.

Since June 2013, HHS has received more than $10 million for HIPAA violations, according toLaw360. However, Meites said, "I suspect that that number will be low compared [with] what's coming up" (Viebeck, The Hill, 6/13).

Many EMR and EHR services are cloud based, and dependent upon internet connectivity.  Despite HIPAA we can expect breaches from otherwise secure sites. It is important to notify patients when breaches occur.