Health systems have invested heavily in building comprehensive care networks.
But patients often get lost as they try to navigate follow-up care on their own or with the help of fragmented communication tools. A result is poor health and financial outcomes.
At Becker's Hospital Review's 13th Annual Meeting, in an executive roundtable sponsored by Care Continuity, Steven Mason, CEO, Kyle Callahan, chief strategy officer and Michael Murphy, vice president of sales, all of Care Continuity, discussed how their patient navigation solution can help address these challenges and achieve improved outcomes at scale.
Care Continuity provides targeted patient navigation solutions that increase successful care transitions and outcomes for patients, providers and health plans.
Three key takeaways were:
1. Network integrity is crucial to the health systems that have invested so heavily in building these robust, comprehensive networks. A network is a an extremely valuable asset. But to maximize the value of this asset, health systems must intentionally help patients navigate the network on their personal care journey. That's because patient self-navigation simply doesn't work very well. "If you're not doing that proactively and in a cost-effective, efficient way, then not only do the patients suffer, but all of the assumptions around the health system you've constructed or the health plan network you've constructed start to break down," Mr. Mason said.
2. The current approach to ensuring network integrity is extremely inefficient and costly. This approach tends to rely on various digital tools that patients don't use and/or labor-intensive patient navigators. Engagement rates with disparate digital tools like chatbots and portals are not a panacea and generally don't have high engagement rates. And the current approach that most systems take to ensuring network integrity is labor-intensive, inefficient and expensive, Mr. Mason said.
For example, one system CEO he spoke with mentioned employing dozens of patient navigators, yet this CEO was unsure exactly what they were doing. Often, healthcare leaders "have bought into the concept, but don't have a systematic, rules-based, intelligent way to organize their labor force and give them the tools so that it's repeatable and scalable," he said.
3. A data-informed solution can reduce the costs of patient navigation, effectively use the network and improve patient outcomes. Building network integrity requires a combination of the right technology paired with a patient navigation service layer.
Care Continuity was designed to gather data to help inform its efficient and scalable platform. "We have a lot of feedback that's coming back into our platform — which patients are going to engage, which ones are going to need procedures, both diagnostic and interventional, in the nearest time frame," Mr. Callahan said. This data enables an opportunity analysis about targeted service lines. Care Continuity's platform can identify cases with the most opportunity and the greatest likelihood of success.
For example, a hospital with 75,000 annual emergency department discharges has 200 people discharged daily. Of those patients, 15 percent — 30 people — will represent at least 47 percent of downstream margin. In one case, a hospital previously targeted 16,208 patients, about 5,000 of whom engaged and developed 1,203 new specialist relationships. With Care Continuity, the targeted number dropped to 7,587, about 5,200 of whom engaged and formed 1,426 new specialist relationships — a 7:1 return on investment versus the previous 4:1.
Care Continuity identifies and prioritizes the at-risk and high-value cases that are most likely to need navigation, providing guided patient navigator workflows and care concierges that help stop leakage and quickly connecting patients to care. The results include increasing specialist relationships and service line growth while reducing costs and readmissions.