With providers now sharing responsibilities for the well-being of patients with concerted efforts toward delivering coordinated care, emphasizing proactive health practices and managing populations effectively, the role of the contact center is ever-more important to help bridge communication gaps along the care continuum. By providing adequate follow-through on patient communication strategies, integrated healthcare networks and accountable care organizations will satisfy these gaps, keeping patients engaged, improving retention and cost savings.
Outlined below are different communication pain-points for large networks and ACOs, along with contact center solutions to maximize your patient communication and engagement efforts.
Gaps in finding care
The patient education gap. Patients need to play a more active role in their care plan, but providers must educate patients in order to define new accountability expectations. With a shift in healthcare to re-educate our national population to aim for wellness rather than seeking care for sporadic episodes, providers must help shape this new way of thinking. Especially with new patients entering the system, it's crucial to play a role in this education segue period given how many patients will enter the system with a pre-existing condition.
Without a consistent patient acquisition and membership engagement plan, patients may remain inactivated, resorting to reactive care and continuing on the path of high healthcare cost and a loss of reimbursement funding for your network. Utilizing the contact center for strategies such as targeted marketing campaigns, service line marketing support, class and event registration and patient outreach will serve to educate patients, promote wellness and encourage patients to shift from reactive to proactive healthcare.
The newly insured gap. With the influx of newly insured patients entering the system, ensuring patients have a primary care physician is critical in scaling patient access. Those patients without primary care may rely on the emergency department to treat episodic care, yielding a counterproductive result for population health management and patient education efforts.
In knowing that 56 percent of current emergency department visits are avoidable1, the time is now to expand communication outlets around physician referral and encourage patients to utilize the proper care outlet. Elevate your contact center efforts to not only provide traditional telephony physician referral services, but appeal to patients using varying mediums to gather information. Due to technology, patients now demand access to information online, which prompts providers to consider optimizing online physician profiles, offering online and mobile physician finders and providing a chat feature to capture potential new patients via the website.
Gaps in accessing care
The unscheduled gap. In our current environment, upward of 60 percent of primary and specialty physician referrals go unscheduled.2 This leads to patients never receiving care, exacerbating conditions and cost.
Utilizing the contact center to transfer patients to the appropriate office/department or book appointments/services at the time of referral can significantly lower the percentage of patients who seek out competitors or delay care. This not only helps capture new revenue, but prevents the escalation of a patient's illness and can aid in chronic disease management.
The reminder gap. Multiple studies show that when patients are not reminded of appointments, up to 23.1 percent on average miss their scheduled visit.3 Patients' health issues then go untreated, and the bottom line is impacted due to no-show rates.
In regard to appointment reminders, the contact center is paramount in alleviating staff bandwidth by fulfilling reminder calls and automating SMS texts and emails, all which improve fill-rates, yielding a significant return on the dollar. To maximize these efforts, reminders can also be implemented for classes and events like wellness screenings to improve attendance and new patient acquisition.
Care compliance and population health management gaps
The follow-up and continuation of care gap. Thirty-six percent of patients do not get the lab results, specialist referral or follow-up they need post-discharge or release.4 Given this, care compliance fails and continuation of care ceases, leading to adverse events and costly readmissions. In a study conducted in 2012, 19 percent of 400 discharged patients reported adverse events during follow-up.4 Partner this information with the knowledge that over 11 percent of readmissions are avoidable, it's evident that patient follow-up promotes compliance and reduces costly reimbursement penalties.
Having the contact center act as an extension of the organization for clinical and non-clinical follow-up calls ensures these discrepancies are captured and escalated to the appropriate department, preventing 30-day readmissions. To maximize these calls, capturing information related to patient satisfaction can provide valuable data on how to improve the patient experience and additional patient communication gaps, as well as serve as a referral point to continue to promote care. Also, using the contact center to administer lab and imaging results ensures a seamless patient follow-up for physician offices and ancillary providers.
The engagement gap. Connecting the ends of the patient care journey and continuing to foster patient relationships serves to reinforce all previously covered strategies, promote patient retention and encourage the continuation of wellness and chronic disease management.
Using the contact center as a patient outreach resource for initiatives such as screening promotions, shot clinics, member management outreach or to help conduct surveys keeps patients engaged and serves to keep your organization's brand involved with the community.
Standing in the way of patient communication success for large integrated networks and ACOs are these large gaps in connectivity, coordination and communication. The benefits afforded by proactive care and a new healthcare setting cannot be reaped if providers are unable to bridge these gaps. Maximizing the contact center beyond traditional hospital marketing and operational support will build network success for countless reform efforts. The role of the contact center in the new healthcare setting goes beyond basic patient communication efforts of the past, and is an ever-changing resource to be challenged creatively as the healthcare landscape alters.
Matthew Holz leads the strategy and product development efforts for BerylHealth's marketing services product. Mr. Holz comes to his position having over 10 years of market and product development experience. Prior to his work at BerylHealth, Mr. Holz was the healthcare product manager for a regional data management and analytics company in Cleveland.
1 NEHI. Reducing Emergency Department Overuse: A $38 Billion Opportunity, 2010. http://www.nehi.net/bendthecurve/sup/documents/ED_Overuse_Brief.pdf
2 ReferralMD, Infographic: Our Healthcare Referral System is Broken, 2012.
http://www.hitconsultant.net/2012/12/26/the-20-most-insightful-healthcare-technology-infographics-of-2012/
3 Pittsburgh Post Gazette, No Shows Cost Health Care System Billions, 2013. http://www.post-gazette.com/stories/business/news/no-shows-cost-health-care-system-billions-676653/
4 BerylHealth, Infographic: Making the Patient Experience a Priority, 2012. http://pinterest.com/pin/1829656070497749/