09 Sep, 2019
Tales from the Front Desk
Health Systems: Fixing the Gaps in Patient Access to Achieve Value-Based Care
"Patient Access" is the department that Sandra manages for a large health care system. Yet sometimes she thinks the name is an oxymoron. Getting patients into the multi-facility health care system quickly and easily seems to get harder every day. Despite the investment of a texting reminder service, far too many appointments are not kept. There just isn't the adequate staffing time to check health records and ensure that people with chronic illnesses make and keep their re-occurring appointments. When it's time to remind people of preventive measures, it takes even more time to identify patients who should be notified and to communicate with them. Although they've tried mailers, e-mails and simple texting, none of these approaches have yielded responses up to 10 percent. The most challenging situations are the patients who don't arrive for medical procedures for which space and personnel have been reserved, like colonoscopies. Or, the patients don't follow directions for preparing for a procedure, and the procedure has to be re-scheduled. The space and equipment go unused, the doctor's and the staff's time is wasted. Relying on the medical assistant and doctor telling patients what they need to do and when they need to come back, doesn't make it happen. Patients have good intentions, then they leave and reality hits. They're busy, they forget, or they don't have time to call back at a time when the desk is open.
Why Patient Access Disconnects Are Important
From the staff meeting Sandra attends, she knows that there is more at stake here than convenience and efficiency. Engaging patients in their care is mandatory for the health system to demonstrate its ability to produce good patient outcomes to the payers with which it contracts, to referral sources, and to patients' physicians who have choices in the hospitals they select. Patient satisfaction is also critically important. When patients are frustrated by playing telephone tag or long wait times - which ironically may happen when well-intentioned schedulers miscalculate for anticipated no-shows - the ratings go down.
Finding the Solution
Sandra has spoken with Steve, the IT director for the system, several times to try to find an automated solution. Steve is sympathetic. But after shepherding a successful, though intense, EHR implementation, he's reluctant to undertake a new project that might cause further disruption among the medical and office staff. Yet he, like all managers, knows the importance of demonstrating good outcomes and stellar customer service. Then Steve read an article in one of his technical magazines about the evolution of this new intelligent chatbot and its impact on health care. One application addresses the patient access problem, automating patient management and communication from appointments, to clinical follow-up, to the multilingual needs of a diverse patient population. With intelligent automated communication through the patient's smart phone, actual transactions like re-scheduling appointments and ensuring that patients were following directions for procedures could occur with no human intervention. The benefits to the patient access area were exactly what Steve and Sandra were looking for - keeping appointments, getting patients in for re-checks, notifying people for preventive screenings, getting them to follow complex prep for procedures before they arrived, and even asking questions about billing. Best of all, this system - called Asparia - was deeply integrated in the EHR system that the hospitals already used. There would be a near-zero deployment process and no new staff training. Just turn it on and under the surface of daily operations, all patient communications were automated with two way conversational texting and automated calls for those patients that do not consent to text. Steve couldn't wait to tell Sandra.
After some meetings and evaluation of how effective this system would be, the patient access department started using Asparia. Right away the staff noticed that they had more time available and that patients seemed more satisfied. In fact, patients went out of their way to report how much they liked the new system and how easy it was for them. The volume of no-shows dropped dramatically. Adherence with follow-up appointments increased, as did compliance with multi-step pre-operative procedures. Patients who needed screenings or vaccinations were automatically notified and could schedule their appointments on their smart phones, at their convenience. Response rates for these preventive notices increased as much as ten times previous rates. Sandra and Steve realized that they had accomplished much more than improving efficiency - they had closed a serious gap in the system's ability to manage patient care and to deliver superior outcomes. To read the results, click here.