by Scott Zimmerman
Steps health systems can to take to maximize their existing appointment reminder systems to plan preventive care outreach campaigns that drive increased revenue
In the brave new world of value-based healthcare delivery, hospitals and health systems are focused on three primary goals for improving health outcomes: keep healthy patients healthy; prevent at-risk patients from developing chronic conditions; and closely manage patients with chronic diseases so that they don’t lapse into acute conditions.
The problem: patients are flawed, fickle people who often don’t follow doctors’ orders. According to the TeleVox Healthy World Report, “A Fragile Nation in Poor Health,” 83 percent of people say they don’t do what their doctors tell them. Doctors know this to be true. In fact, when we surveyed them, a mere five percent said they would give their patients an A grade for following treatment plans. It’s clear that everybody knows patients aren’t doing what’s needed to preserve their health. However, patients want to do better. According to The Healthy World report, almost 40 percent of patients say they would follow doctors’ orders if they got some kind of reminder or nudge from those doctors between their visits. Basically, patients are saying, “I am having a really hard time doing this. But, I would do a better job sticking to it if my doctor helped by reminding me and encouraging me along the way.”
The solution: stop being reactive. Reacting to a patient’s current illness and treating it no longer works. Health systems need to think about how to proactively engage patients in a way that will activate them to become more accountable for their own personal health. And, they need a systematic approach to do so – one that helps them asses a patient’s risk level and automate personalized communications so they can engage more, if not all, of their patients on a regular basis. Engagement communications can take the form of automated phone calls, text messages or emails between visits to keep patients on track with their treatment plans, prompt them to refill and pick up prescriptions, or remind them to schedule preventive screenings and keep already-scheduled appointments.
Activating patients to follow treatment plans is easier than it sounds. Ochsner Health System is using its appointment reminder system to engage and activate its patients to get the colorectal cancer screenings their doctors have ordered. The strategy is simple – send an automated phone notification letting patients know they are eligible and remind them to schedule the test. The results are impressive. In just two months, Ochsner scheduled 578 colorectal test screenings, generating $684,930 in revenue based on the national average of $1,185 per procedure. More importantly, since there is an expected 25 percent pre-cancerous polyp detection rate, an estimated 145 patients benefited from early detection as a result of these examinations. Patients also expressed appreciation, saying if they were not nudged or reminded, they would not have completed this important preventive test.
Like Ochsner, hundreds of thousands of healthcare providers already have appointment reminder systems in place. That means it’s relatively simple for them to begin promoting preventive care and activating patients to follow treatment plans. By taking the following steps, health system executives can transform appointment reminder systems into engagement communications platforms that drive increase revenue.
1. Assess your patient population. Leverage the patient data sitting in your electronic medical records system to analyze your patient population. Examine groups of patients that have something in common, like diabetes or congestive heart failure or COPD. Start where you are and use what you have to determine the patient populations that require the most focus. But also take the opportunity to determine where the gaps are and identify additional patient data that needs captured across your entire network of hospitals, physicians and clinics. Then, spend some time designing processes and workflows to capture that information electronically.
2. Stratify patient populations into low-risk, rising-risk and high-risk groups. To succeed in the new world of value-based healthcare, health systems must keep the healthy as well as possible through preventive care, and prevent the chronically ill from getting sicker. So, take the time to separate the patient populations you’re targeting into risk groups:
- Low-risk patients: These are the patients who are well. To stay well, these patients require care plans focused on wellness and prevention.
- Rising-risk patients: These are the patients who are at risk for health problems. To avoid developing the conditions they are at risk for, care plans require preventive screenings and lifestyle changes.
- High-risk patients: These are the patients who have chronic conditions and need to prevent further complications. To improve outcomes, these patients need to be managed carefully and proactively, and treatment plans must be designed with interventions in mind.
3. Create prevention-focused outreach campaigns. Once you’ve separated patients by disease state and risk-group, it’s time to develop prevention-focused campaigns that integrate multiple modes of communications such as voice messaging, SMS and email, and can be executed on a massive, yet highly personalized scale. Prompting patients to schedule preventive screenings should be a key focus for all of your outreach campaigns, across risk groups. If you’ve stratified your patients by gender and age, you can take a page out of the Ochsner book and leverage automated voice messages to successfully prompt patients to get screened for certain cancers that are recommended for their age and gender.
For your healthy, low-risk patients, wellness campaigns are also important and may include automated email or text messages with information encouraging them to exercise three to five days a week and make a good diet part of their day-to-day life. These engagement communications might include links to videos or articles that share tips for healthy living. Patients in the rising-risk group require support from their doctors as they work toward making lifestyle changes. For example, obese patients might require help setting and focusing on one simple goal at a time – like starting a daily walking regimen or getting their diet in check with a food journal. Regular, automated text messages or voicemails encouraging them to stay the course can make a big difference. Your high-risk patients require ongoing engagement and support to manage their chronic conditions. These engagement communications might include regular emails, voicemails or text messages telling patients to do something specific, like take medication or check blood sugar levels.
With proper planning, scaling campaigns for your population of patients is fairly simple. Start by developing a series of email, voicemail and text messages for each preventive screening you plan to promote. Next, create messages that map to common treatment plans for the disease states you are focusing on – these messages should prompt patients to take specific actions such as taking medication, checking blood sugars or taking their daily walk. Many healthcare providers also incorporate motivational messages focused on supporting patients as they work to achieve common lifestyle improvement goals.
4.Personalize and automate according to patient preferences. Once your campaigns are developed, you need to tap your electronic health records system to personalize messages with patient-specific data. You also must capture your patients’ preferred method of communication so you can engage with them on their terms. Find out whether they prefer receiving automated text messages, emails, or automated voicemails. Then, put your appointment reminder system to work automating the outreach campaigns you’ve designed.
The majority of health systems already have appointment reminder systems in place. Taking your program to the next level is a simple matter of maximizing that technology to engage and empower patients to take a more proactive role in their own healthcare. Don’t wait. Start where you are, use what you have and do what you can. When you take that approach, everyone wins.
Originally published on Becker’s Hospital Review, May 26, 2015