Automation brings digital patient experiences to life in the value-based care environment

Automating routine interactions, such as appointment reminders, can improve patient experiences and help providers excel in value-based care.

By admin

Aug 31, 2022, 8:00 AM

As the healthcare industry continues its march toward becoming a more modernized, digitized, and value-based future, patient experiences have become top of mind for organizational leaders. With consumers becoming increasingly choosy about their care options, healthcare providers are becoming more motivated to build welcoming, intuitive digital front doors.

Patient engagement technologies, from online portals to text message reminders to wayfinding apps, are crucial for relieving burdens on overworked staff, improving communication with the community, and fostering better clinical outcomes for patients with rates of spending.

Like most organizations, Community Health Network (CHN) in Indiana has been investing heavily in innovative ways to digitize the patient experience. The health system, which services several hundred thousand patients across the central region of the state, uses a variety of methods to streamline and automate everything from scheduling to appointment reminders to identifying gaps in care.

But unlike some of its peers, CHN is conducting its digital transformation efforts against a background of significant financial risk. The health system is at the forefront of the transition value-based care, participating in multiple downside risk contracts that cover approximately three-quarters of its primary care population.

“We’ve always been aggressive about participating in downside risk arrangements – we’ve been in a NextGen ACO and are now in the Enhanced track of Pathways to Success,” said Patrick McGill, MD, Chief Transformation Officer at Community Health Network. “We also have five Medicare Advantage contracts, four of which include downside risk. We feel that’s a better way to deliver care that offers better experiences for our patients.”

“It’s important to have digital tools and analytics capabilities during this process: we need to understand the patient journey and how to strategically engage with individuals in a way that brings positive behavior changes and better results for them and for us.”

Simplifying the primary care process with digital experiences

Proactive and comprehensive primary care is particularly central to success with value-based care, said McGill, a practicing primary care physician himself. Patient-friendly digital experiences are crucial for ensuring that attributed individuals stay on top of their preventive healthcare needs and engage with the healthcare system in a positive manner.

“We can’t afford to hold onto these completely manual processes,” he stressed. “The volume is too high and the frequency with which we need to outreach to patients is too great. We used to have people calling patients, sometimes multiple times, and spending hours upon hours on the phones. The staff didn’t love doing it, patients didn’t respond to it, and leaders were concerned about the costs.”

“Now, we can send automated messages, either through the phone or through text messages, which takes a tremendous amount of work off the plates of our team members. We still have real people outreach to patients who haven’t responded to other attempts, but now we’re doing outreach by exception rather than giving our staff a list of 70,000 patients who need to be contacted. That’s a huge savings in terms of peoplepower and stress for everyone.”

Overcoming technology challenges to improve engagement rates

However, automation isn’t always easy. When implementing new patient engagement tools, health systems routinely deal with technical issues, including interoperability and integration concerns, user experience woes, or uneven uptake among staff and consumers.

In CHN’s case, the health system was sending tens of thousands of text message reminders to its primary care patients every month, yet their communications weren’t getting through to the recipients.

“We were sending messages that were getting blocked or blacklisted by the phone service carriers,” McGill explained. “Patients weren’t receiving their appointment reminders and care gap reminders, and we had no idea that was happening because everything looked fine on our end. About 25,000 messages weren’t getting where they were supposed to. When you’re in a value-based care arrangement with downside risk, you can’t afford to have those engagement pathways blocked.”

“When we switched patient engagement vendors, we were able to make some changes to stop that from happening, such as creating custom short codes to identify the messages and staggering our message send rates so that we weren’t sending huge volumes of messages at once time, which the carriers don’t like.”

“Once we fixed those issues, we saw a tremendous improvement in no-show rates, were able to close many gaps in care, and started seeing the overall positive results that we are consistently striving to achieve.”

Aligning digital healthcare experiences with other areas of consumer life

Consumer expectations are high and are only getting higher, especially as regulators continue to publicize providers quality metrics and actively work to increase transparency around the costs of services. A smooth digital experience could be the difference between keeping a patient and losing them, said McGill.

“We’re really trying to strive for the enjoyable, easy-to-use experience that people have in other parts of their life,” he said. “You can get a text message to confirm a restaurant reservation that you made on your smartphone. Why can’t we do the same thing in healthcare? Obviously, the technologies exist. It’s just a question of translating those experiences to the healthcare environment.”

Healthcare does need to address some challenges that don’t exist in other industries, he acknowledged, including patient privacy and the complex relationships between providers, payers, and other stakeholders.

“We can’t automate everything, and it’s not necessarily our goal to strip out all human-to-human interactions. But certainly, there are opportunities to reduce the friction with some basic tasks that make the current healthcare environment so difficult to navigate.”

“If we can solve these easy problems with available technologies and integrate those aspects of care into the digital patient experience, we’ll be able to provide the type of care that consumers really want – and value-based healthcare systems need to provide – so everyone can achieve their shared goals.”

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry. Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.