How Medical Teams Can Use Technology-Enabled Communications to Engage and Support Patients
Patient engagement is a strategy that will be critical to the financial stability of healthcare organizations in the future. In fact, not just in the future; engagement is important now. As the healthcare industry continues to move further away from fee-for-service payments and deeper into value-based payments, organizations are being rewarded for things like quality, efficiency, outcomes and satisfaction. At least 30 percent of Medicare payments are now tied to alternative payment models that reward the quality of care over quantity of services provided to beneficiaries, and CMS is working to get that number to 50 percent or more by the end of 2018. Healthcare providers can achieve better quality results through engagement initiatives – so it makes sense for medical teams to expand their patient engagement efforts. In order to do that, many healthcare organizations are using technology-enabled communications to fill gaps in care and make care more connected.
Value-based payment models are creating a new standard of healthcare. Providers are being held more accountable for the health of their patients, and that is driving medical teams to become increasingly involved in the lives of their patients outside of the exam room. West recently surveyed 383 healthcare professionals to learn more about how healthcare teams communicate with patients. Survey responses indicated that 95 percent of hospitals and health systems are using engagement communications to try to reduce hospital readmissions. Also, 80 percent of physicians use engagement communications as a way to improve routine care. Clearly, healthcare teams believe that they can support patients and drive improved clinical outcomes by using technology-enabled communications to engage patients.
Patients have also shown that they believe engagement efforts on the part of healthcare teams are beneficial. Patient feedback collected through Medicare's HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) shows that many patients who had been hospitalized felt they should have received more communication from their healthcare team after being discharged. An alarming one out of two patients surveyed admitted they were confused about some aspect of their discharge instructions. This red flag shows there is a need for better follow-up communication, especially considering that hospitals are under a lot of pressure to minimize readmissions.
Connecting Care, Solving Problems
There are countless opportunities to engage patients and solve problems across the care continuum. Medical teams can use automated surveys and monitoring devices to track the health of patients at home. Every day, providers are relying on automatically delivered messages to remind and encourage patients to take preventive actions that lead to better health. And some healthcare providers are also using technology to recognize and respond to issues sooner in chronic care patients. Efforts like these that make care more connected are solving some of the healthcare industry's most common and costly problems.
Reducing Hospital Readmissions
Whether patients are discharged to their home or to another facility, they need support during their transition out of the hospital. Medical teams can use technology to learn about the needs of patients and then take actions to address those needs.
Hospital staff can utilize technology to automatically send follow-up messages to patients a day or two after discharge. An automated survey is a simple way to assess how well a patient is fairing after discharge. This type of technology-enabled outreach helps healthcare teams identify signs that a patient is at risk of being readmitted. For example, a patient that complains of pain, or that has not picked up prescribed medications should be contacted. An early intervention – triggered by a patient's survey response – could be the key to preventing a readmission.
Technology-enabled communications also help ensure that follow-up appointments, which are critical to recovery and readmission prevention, are scheduled with a primary care physician or specialist. Leveraging outreach technology to coordinate follow-up care for patients not only relieves stress, but it also ensures that patients will receive the necessary follow-up care.
Readmissions are a costly, pressing problem for hospitals. Hospitals are now more accountable for patients after discharge, and they can receive penalties for avoidable hospital readmissions. The Hospital Readmissions Reduction Program penalizes hospitals for having too many readmissions within a 30-day time frame. During the period between October 2016 and September 2017, more than half a billion dollars in payments will be withheld by Medicare from hospitals that incurred penalties based on readmission rates. These are just a few of the reasons why hospitals are working to combat avoidable readmissions by boosting patient communication and engagement.
Managing Chronic Disease
Healthcare providers know that for patients with chronic conditions, much of the disease management happens outside of the hospital or clinic. Consequently, healthcare teams and patients are using devices – like blood pressure cuffs, glucometers, and pulse oximeters – with sensors that send data back to medical providers for evaluation. Chronic diseases can rarely be managed just during face-to-face office visits. Chronic disease management is an ongoing process that typically requires patients to make lifestyle adjustments and maintain healthy habits. Healthcare providers can help patients successfully manage (and often prevent) chronic illnesses by monitoring patients and staying in contact about the steps needed to achieve optimal health.
The goal is for medical professionals to be able to receive patient data and respond with information that instructs and motivates patients. By leveraging technology, medical teams can create an engagement loop that supports two-way communication and makes patient engagement possible. Here is an example:
After being discharged from the hospital, a patient with diabetes is assigned to a care management program. The patient's care manager uses technology to create a series of automated communications that support the individual's care plan. When it is time for the patient to schedule foot and eye exams, he will receive a notification. He will also receive a simple text message reminding him to make an appointment for an A1c draw. Daily automated calls are set up to collect blood sugar readings, and a seasonal email with information on flu prevention and flu shots will be delivered to the patient. All of these communications will be customized and timed appropriately. Since the messages are pre-scheduled, there is little manual effort required on the part of the care manager, but the patient will receive communications to keep him continuously engaged. At any point, if the patient shows signs that his diabetes is not being managed effectively, the care manager can adjust communications and schedule a live discussion or office visit. While this is just one example, it shows some of the advantages of using technology to manage chronic conditions.
Around 86 percent of healthcare costs in the U.S. are attributed to chronic disease, according to the Centers for Disease Control and Prevention. About half of all adults in the U.S. have one or more chronic health condition, and one in four adults has two or more chronic health conditions. Clearly, patient engagement that improves disease management and prevention is important in today's healthcare industry.
Driving Preventive Care Participation
A big challenge across routine care is getting patients to participate in preventive services. Patients often do not know which services they need and when. Or, they may not understand how important preventive care truly is to maintaining good health and avoiding trips to the emergency room. Data shows that Americans only use routine care at half the suggested rate. However, there is proof that providers can influence patients' actions through engagement efforts, meaning they have some power to steer patients toward recommended preventive screenings.
Louisiana-based Ochsner Health Systems is one example. Ochsner found that it could easily drive patients to participate in routine screenings by leveraging technology-enabled communications. The health system implemented an automated outreach program to encourage patients with recent colonoscopy or upper endoscopy orders to schedule a screening. Ochsner sent phone notifications to 3,137 patients, and in just one month, scheduled 578 screenings. Many of the patients that received the prevention-focused messages stated that they would not have sought out the preventive service on their own. Therefore, the engagement messages were responsible for getting patients to participate in the potentially life-saving service.
This example confirms that technology-enabled communications can increase participation in preventive care. It also makes it clear that there are opportunities to use similar engagement efforts to encourage participation in other kinds of preventive services – from cancer screenings to immunizations.
Payments that are tied to quality and performance are causing the old, reactive approach to patient care to dissolve. The need for engagement activities will continue to increase with the rise of value-based payment programs. Healthcare providers are learning to connect with patients outside of traditional care settings across the entire care continuum, and they are doing it with the help of technology-enabled communications.
About the Author
Allison Hart is a regularly-published advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting. She leads thought leadership efforts for West's TeleVox Solutions, promoting the idea that engaging with patients between healthcare appointments in meaningful ways will encourage and inspire them to follow and embrace treatment plans - and that activating these positive behaviors ultimately leads to better outcomes for both healthcare organizations and patients. Hart currently serves as Vice President of Marketing for TeleVox Solutions at West (www.west.com), where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.