If you can’t find it, make it,’ says California health system

Consumers were asked what they wanted in an affinity card

When Memorial Health Services began the quest for a health care "smart card" that would fit its vision of customer service, marketing, and registration, there was nothing available that filled the bill, says Annette Walker, MHA, vice president of Memorial Care, the Long Beach, CA-based system’s "brand" name for its hospital-physician network.

As a result, the organization created its own multipurpose card, the Memorial Care Medical Information & Access Card, and piloted its use in two offices at Saddleback Memorial Medical Center, one of the system’s five hospitals. Among other outcomes, Walker adds, the monthly credit card volume — in point-of-service collections — at those locations increased from $600 in January 1998 to $12,200 in March 1999. "The results are so far above what we expected," Walker says. "We would have been happy with 100% improvement."

Identification cards of various descriptions are making their way into the health care industry, and Walker says Memorial looked at many of those before designing its own card. The card it finally developed may be unique in the industry, she points out. "We tried to buy it, and it didn’t exist." (See article on "smart card" for pregnant women, p. 75.)

To create its version of the perfect health care card, Memorial looked at the existing patient care scenario and brainstormed on how to make it better. "Health systems are incredibly technical but can’t seem to get the patient’s [information] from one department to another," Walker notes. "We sat back and said, What’s wrong with this picture?’ We decided to try to fix it for our system, not only for the hospitals, but for the physicians."

That meant nearly two years of extensive research. Memorial representatives talked with airlines about their frequent flyer programs and with grocery chains about their loyalty cards, Walker says. They gleaned ideas from credit card companies and other entities "with experience in giving cards to the public."

The most expensive and exhaustive part of the process, Walker adds, was the consumer research — focus groups and telephone surveys involving more than 1,500 people — aimed at determining what the public wants in a health care card.

"We asked, If you had a card, what would you want it to do?’ They even named it. It’s a mouthful, but Medical Information & Access Card is the official name. We tried The Well Card,’ but [consumers] said that sounded like an HMO."

Memorial also grappled with whether its card should be a true "smart card," meaning it would contain a computer chip, Walker says. Management decided against that option, finding that the current health care environment doesn’t support such a card, she adds.

Research involving numerous physicians showed that office personnel didn’t have time to maintain a smart card, Walker points out, so there was no need to spend the extra money to create a system that would depend on their interaction to keep the database updated. The card is designed so it can be adapted to that technology in the future, she adds.

The Memorial card looks much like a credit card with a magnetic stripe, but it’s filled, front and back, with the holder’s health care information, Walker explains. "It’s the handiest thing you ever had. The last time I registered my son for kindergarten, I had everything I needed."

The card lists emergency telephone numbers, allergies, medications, Social Security number, physicians’ names, demographics, and insurance information. Children’s cards include their immunization records.

To ease the registration process, Walker says, the card can be swiped into a credit card machine, showing the registrar the patient’s demographic information. Plans are to include an interface allowing the information to fill in the registration data fields automatically, she adds.

Because the card allows the registrar to determine eligibility and co-payment responsibility more easily before the patient leaves the office, the potential is great to completely avoid the billing cycle, Walker notes. That’s a compelling reason for physicians to put in their offices the machines that read the cards, she says. Because the card "readers" are sold only to physicians that are part of Memorial Care, it’s also an incentive for them to make that affiliation, she adds.

The Memorial card is not used as a credit card, she explains, it simply helps the registrar give the patient so many options for paying that it’s hard to say no. Making a credit card option easier to use, however, showing the patient what he or she is responsible for, and simply asking for payment are the keys to the increase in Memorial’s credit card volume, she says. "VISA [officials] told us consumers use credit cards for 30% of their transactions, but for only 3% of their health care transactions. The opportunity is there."

By May of this year, 78 physicians and one hospital were using the Medical Information & Access Card, and the service was to be expanded to the remaining four hospitals by the end of June. "Potentially 700 physicians [could be included] if we got everybody we wanted."

Card aids customer service, marketing

The more cards that are issued, the smoother the registration process will become, Walker says. "[Staff] will have the ability to recognize and acknowledge patients in a professional manner. It’s a customer service initiative."

The idea is that use of the card will mushroom, creating an "affinity" with Memorial Care among physicians and patients, says Kevin Torres, MPA, director of information services at Long Beach (CA) Memorial Medical Center. "As more patients are continually signed up, present at the physician’s office, and have the information already there, they’ll think, Maybe I should be part of this whole thing.’

"Patients seem to like that card in their hands," he adds. "It’s not a membership, just an affinity, but will they be more likely to use Memorial? We think so."

The card will help the organization use its marketing dollars more appropriately, Walker says. "In surveys, patients say one of the things they do like about health systems is receiving appropriate health care information."

The card also allows the facility to target its marketing efforts more precisely. For example, having the patient’s demographic profile in its database will allow Memorial to send information to a 40-year-old woman with a 5-year-old son about when to have her first mammogram or what the health care concerns are for a young child, she says. Similarly, the woman won’t receive an unneeded brochure about preventing prostate cancer. "We spend so much money [sending information] that ends up in the trash can. If we can target better, consumers and patients appreciate that."

Patients can apply on-line

Another marketing tool, the Memorial Care Web site, offers Internet users the opportunity to apply on-line for the Medical Information & Access Card, Torres points out. Information about the card is one of five categories listed on the first page of the site. It also explains Memorial’s partnership with television station KABC, promoting weekly reports on health care issues, and with former U.S. Surgeon General C. Everett Koop, whose own Web site (drkoop.com) can be accessed from the Memorial site.

Clicking on the paragraph about the card takes users to the next page, where they see more details along with a short testimonial on the card from Dr. Koop. On subsequent pages of the Web site, users can fill out on-line forms, giving their demographic data and medical history, and apply for either an adult/senior card or a child’s card. The cards are mailed within a couple of days, Walker says.