Engaging Millennial Parents to Increase Well-Child Visits

Scheduling well-child visits can be problematic for young parents. Many don’t know how often to bring in their children or understand the importance of regularly scheduled visits. Regular visits are particularly critical during the first three years of a child’s life to track growth and development, help prevent illness, and allow early intervention when necessary for optimal outcomes.

Text message reminders have become an expected touchpoint for dental appointments, vet visits, car maintenance, and various other services for today’s consumer. But some providers have been slow to engage parents via text to help keep their children on track with recommended care plans.

Millennials, who are accustomed to checking their text messages regularly throughout the day, respond positively to businesses that reach out to them via text. Young parents want the efficiency and convenience of smartphone messaging in most aspects of their lives, including appointment reminders.

See how Park Nicollet utilized PerfectServe’s Patient & Family Communication functionality to launch a text message appointment reminder program helping new parents more closely adhere to the recommended well-child visit schedule.

Constructing the Program

In 2016, Park Nicollet, part of HealthPartners, a nonprofit healthcare system based in Minnesota, launched a text-message-based reminder program to proactively support young parents in scheduling well-child visits from infancy to late childhood. The American Academy of Pediatrics (AAP) recommends six visits in the first 15 months (Health Plan Employers Data and Information Set [HEDIS] measure), which fits into the broad scope of 12 recommended well-child visits by age three.

To promote parents’ adherence to the advised schedule, our team set five goals aligned with best practices from AAP’s Bright Futures initiative:

  1. Keep children on time for well-child visits.
  2. Prevent missed visits and gaps in care.
  3. Improve the patient and parent experience.
  4. Support Bright Futures—recall and reminder system.
  5. Improve the HEDIS measure.

A program was launched using an algorithm based on birth dates to send text messages at appropriate intervals to parents of children aged two months to 36 months. Instead of waiting to reach out until after appointments were overdue, preemptive texts encouraged parents to schedule before the next well visit, offering a direct link for parents to easily schedule an appointment. The seamless and automatic process allowed Park Nicollet to reclaim precious staff time that was previously used to manage reminders.

Program Structure

Birth to Three Years

A SMS text message is sent to the child’s family or primary caregiver 30 days prior to the next well-child visit,
based on the child’s date of birth. Then, text reminders are only sent if an appointment is not scheduled in the appropriate timeframe.

Three to 10 Years

A text message is sent to the child’s family or primary caregiver two weeks prior to the next well-child visit, based on the date of the child’s last well-child visit. Then, a text reminder is only sent if an appointment is not scheduled in the appropriate timeframe.

Launching the Program

Launching the program with a small patient population (birth to three years) enabled Park Nicollet to see results quickly; early results showed that the text outreach was positive. Patient satisfaction increased among parents, who loved the ease and convenience of the program. Prior to the texting program, patients were seen an average of one month after their recommended well visit. Only three to six months after initiating the text reminder program, the one-month average gap was cut in half, meaning patients were seen closer to AAP recommendations.

Implementing the program on a smaller scale provided an opportunity to identify and address problems before expanding to the larger population. The biggest challenge involved parental consent and whether to design an opt-in or opt-out program. Park Nicollet defaulted to an opt-in program, requiring parents to provide consent to start receiving text reminders. Eventually, this obstacle overcome by training frontline staff to have parents sign consent forms, but the face-to-face process limited enrollment to the parents who were already making and keeping appointments.

Efficient enrollment and expansion required automation and updating of the electronic health record (EHR). Following the EHR integration, enrollment consent was captured in the EHR and parents didn’t need to be present in the office if they had consented to text messaging as their preferred appointment reminder.

With enterprise-wide expansion of PerfectServe’s Patient & Family Communication to all HealthPartners facilities in 2017, the automated process increased enrollment by over 35,000 and increased well-child visits by 10%. Based on the last reported 12-month period, enterprise-wide enrollment has over 79,000 active patients, which includes HealthPartners and Park Nicollet, and over 43,000 enrolled patients for Park Nicollet alone (see Table 1).

Table 1

Development and Expansion

With expansion of the program to Park Nicollet’s entire clinic care group in 2019, they began using text reminders for well visits for children up to age 10. Future initiatives with the program for Park Nicollet included incorporating additional languages (a sizable subset of HealthPartners patients is non-native-English speaking). In addition, increased enrollment of the millennial population presented opportunities to address various patient population needs—such as:

  • Reminders for flu vaccines and other immunizations.
  • Health metrics monitoring.
  • Checks for postpartum depression.

A Roadmap for Getting Started

Leveraging technology with a trusted and experienced partner enabled the team at Park Nicollet to create a program that worked for patients’ families. Following a digital roadmap, PerfectServe and Park Nicollet worked together to build reports derived from actionable, engaging, timely, and relevant data. Based on these insights, here are five recommendations for implementing a successful texting program:

  1. Partner with a solution that has proven expertise with EMR systems and experience providing reliable, secure communication to patients and their family.
  2. Engage a project champion to guide project design, implementation, effectiveness, expansion, and quality assurance.
  3. Assemble a multidisciplinary team—mobile communication technology partner, EMR vendor, physicians, quality improvement specialists, health information management (HIM), compliance and legal experts, growth strategists, and frontline managers—and solicit input from all stakeholders.
  4. Launch a scaled down program with a small population to identify and address problems before expanding to a larger patient population.
  5. Initiate the process with a mindset of patience. Avoid trying to implement the program hastily and without forethought. This endeavor demands careful preparation to ensure success.

PerfectServe’s Patient & Family Communication solution gives providers a simple and elegant way to engage directly with patients. From sharing directions to your office before an appointment to checking in with patients post-discharge, text messaging is a quick, effective, and easily automated way to stay connected with any patient population—most of all millennials.

Learn more about how PerfectServe supports patient-provider communication by contacting one of our Clinical Communication Specialists below.

4 Simple Steps for Reducing Third-Party Vendor Costs

In the era of nonstop mergers and acquisitions, healthcare organizations are taking on immeasurable costs in the form of third-party services. When a health system acquires a private or independent group practice, the health system inherits all the practice’s employed third-party services and systems, including:

  • Electronic Health Record (EHR)
  • Practice Management
  • Revenue Cycle Management
  • Medical Answering Service
  • Security, Maintenance, and More

When healthcare organizations merge, issues with purchased services compound as the health system takes on all existing service contracts from the practices affiliated with the previous organizations. Purchased services represent as much as 20% to 25% of an organization’s annual spend,1 so consolidating services is a valuable opportunity to save on spending.

Standardizing third-party processes and technology can be an untapped source of savings across the healthcare supply chain. To help you identify areas in need of improvement, here are four steps that can help successfully lower your organization’s purchased services costs:

Step One: Mine the data.

For many healthcare organizations, simply gaining visibility into third-party contracts and expenses can be challenging. Contracts are often managed by various people throughout healthcare organizations, or even services outside organizations, such as group purchasing organizations (GPOs).

Start gathering the actualities by creating an inventory of all third-party vendors used throughout your organization, as well as the associated stakeholders and contracts. It’s important to speak with each stakeholder and review each contract thoroughly.

Next, collect all financial data for your vendors. Check with your accounts payable department and take a look at current and past purchase orders. While purchase orders won’t tell the whole story, they are a good place to start to get an idea of total cost. Many third-party vendors have variable costs that make it difficult to get an accurate account of how much they’re really costing. Reviewing your general ledger will help you uncover variable costs.

There are a few key questions to consider when reviewing your service contracts:

  • What rate is this vendor currently charging me and how often?
  • Is there an auto-renewal in place? If so, when?
  • What are the scaling terms and are there fees associated with scaling?
  • Are there termination clauses? If so, what are they?

Place vendors into categories to get a more accurate picture of how much your organization is spending in specific areas. You may find that the individual costs of many of your third-party vendors are relatively small, but when aggregated by category, the numbers compound quickly.

Step Two: Gain Executive Buy-In

Equipped with your data, it’s time to engage your decision makers. Engaging organizational leadership early in the process is a great way to build a case to move forward. Speaking with executives can help you understand the different viewpoints and situational nuances in your organization, which helps you navigate roadblocks and build the business case to make changes.

Step Three: Evaluate Performance

Analyze vendor and service performance in three key areas:

  1. Comparing Spend
  2. Assessing Utilization
  3. Evaluating the Quality and Effectiveness

Some vendors charge hidden or variable fees, so looking at one month’s service charges can be misleading. Look at each vendor’s historical cost, trends, and variability. Then, consider local benchmarks: What prices are other vendors in your area offering for a similar service?

Another important aspect to consider is utilization. Here are a few simple questions that can help you assess your organization’s use of a particular service or vendor:

  • Who is actively using the service/vendor?
  • How is the service/vendor being used?
  • Could the service/vendor be used more efficiently?

Finally, do some digging to find out your staff’s level of satisfaction with the third-party service/vendor:

  • What level of results is the service or provider currently delivering?
  • Are your stakeholders satisfied with the performance?
  • What kinds of performance metrics can the service or vendor provide?
  • Does the service or vendor meet your organization’s performance metric needs?
  • Does the service or vendor make your staff’s job easier?

Step Four: Consider Standardization Options

Completing steps one through three will give you a firm grasp on the types of vendors you have and the services you’re paying for, how they’re being used throughout your organization, and your staff’s readiness to try new solutions.

If you consider replacing multiple similar vendors with a single standardized solution, make sure the solution you select does the following:

  • Addresses all stakeholder needs and goals.
  • Decreases (and if possible, helps to standardize) your organization’s overall spend.
  • Contributes to your organization’s strategic objectives.

When your organization undergoes a merger or acquisition, it’s more important than ever to conduct a high-level review of the spending and operating efficiency of the larger organization. At the end of your evaluation, you should be better prepared to make specific service and vendor selections based on your analysis and your organization’s strategic priorities.

1Vizient, 2020

How much is your answering service costing you?

medical answering service warning

Sometimes, traditional medical answering services come with hidden costs that could be undercutting the success of your practice. Costs associated with human error—such as lost and delayed messages, negative patient interactions, inaccurate symptom descriptions, and more—carry significant risk for your patients and your practice.

Mistakes that were once par for the course with answering services have become largely avoidable in a modern healthcare environment. Since quality communication between patients and providers (before, during, and after business hours) is a fundamental pillar of patient care, it would be wise for any organization using a live medical answering service to ask yourself the following questions:

Are your patients being served a positive experience with your practice?

Any negative encounters with your practice (including over the phone) can begin to erode the trust and positive relationships you have built with your patients. Many patients perceive the answering service as an extension of your practice—not a separate, third-party service. That makes live call agents a contributing factor to your overall patient experience, a factor you have limited control over.

If a patient feels at any time as though their medical needs are not met with the level of urgency they feel is necessary, their trust in your practice quickly dissolves into frustration, fear, and motivation to seek care elsewhere. Whether or not a patient leaving costs you any recurring revenue, word of mouth can impact your organization’s reputation for care quality and, therefore, your ability to bring in new patients.

Is your staff empowered to use their time as efficiently as possible?
It’s tough to assign a dollar amount to the frustration of having to resolve a breakdown in patient care caused by miscommunication. It’s impossible to quantify the impact of anxiety your staff can develop when they feel unable to deliver the best patient care due to issues with the clinical communication process. But if your communication process isn’t optimized to help providers focus on delivering proper patient care, you may wind up calculating costs in terms of turnover and other negative effects of low provider satisfaction and burnout.

Are you legally or financially at risk?

Some unlucky practices have discovered a best-kept secret of certain deceptive answering services: subcontracting. In some cases, live “medical” answering services turn out to be subcontracting their work out to other answering services that don’t always have a medical focus or adhere to HIPAA compliance standards.

Few medical practice leaders would knowingly risk placing subpar answering services between their patients and their providers or practice. In fact, a practice in this situation is at risk for fines and penalties associated with breaches involving PHI and unsecure communications.

Another scenario in which a practice using a live answering service may be at risk includes one where the answering service is referencing an outdated provider shift schedule.

Consider this worst-case scenario A patient, unknowingly suffering from a stroke, calls your practice after hours to report blurred vision and confusion. The medical answering service, operating off of an inaccurate on-call schedule, fails to deliver the patient’s message to the correct on-call provider for another hour. Due to the time-sensitivity of this ailment, your practice could be at risk for a malpractice suit.

An unforeseeable and adverse incident like the one above could become a substantial loss for your practice.

Are you safeguarding your reputation?

Imagine another unfortunate scenarioA critical care surgeon with his own practice routinely performed emergent consults for a local hospital. But then, the hospital stopped calling. They felt the surgeon’s medical answering service was unable to deliver messages in a timely, efficient manner. The hospital now works with other providers instead.

Don’t let the above scenario happen to you. Your credibility and reputation in the healthcare community can be negatively affected if outside consultants and hospitals cannot reach you quickly in times of emergency. The impact of an unreliable reputation can be detrimental to your providers and your practice. It may seem easier to stick to the status quo with a live answering service, but is it worth letting avoidable lapses in communication tarnish your reputation?

Have you uncovered all hidden fees?

Most medical answering services are upfront about their fees, but practice leaders and managers seldom realize how many fee-based events they’re actually being charged for on each single after-hours call or message. Varying types of hidden fee-incurring events include:

  • Taking the call or message.
  • Relaying that message to the right clinician.
  • Relaying the clinician’s instructions back to the patient.
  • Recording and logging the conversation as a whole.
  • Recording and logging each communication.

These events can incur minute fees that can account for an unexpectedly substantial amount of overtime.

What is the real cost of your answering service?

Take a skeptical look at your answering service’s monthly invoice to understand the hard costs. Think through how your current answering service effects patient safety and satisfaction, as well as your providers’ satisfaction. Is your answering service a compliance risk? Can it harm your professional reputation? At the end of the day, these are the costs that put your practice, providers, and patients at risk.

What is the best solution to eliminate the costs and risks of your answering service?

In the age of digital communication, automated tools are commonly used to eliminate human error, simplify communication processes, and streamline accurate connections. These advantages are perhaps most valuable in a clinical environment. An ideal medical answering service solution can sync with the most up-to-date shift schedules, protect providers’ caller IDs, escalate urgent messages, and save non-urgent messages for regular business hours.


Let’s discuss how your practice can benefit from the right answering service solution.

The Role of Patient Engagement in Remote Patient Monitoring

remote patient monitoring

Remote patient monitoring (RPM) allows healthcare providers to monitor patients outside of the clinical setting. Particularly important for the management of chronic diseases, RPM is helping improve patient outcomes and reduce healthcare delivery costs.

Why Patient Monitoring is Critical

It is important to remember that patient monitoring is essential, especially when it comes to combating chronic diseases. By 2020, it is estimated that more than 40% of all the adults in the US (roughly 157 million people) will suffer from at least one chronic health issue such as diabetes or asthma; almost a quarter (81 million) will live with multiple chronic conditions.1

One of the best ways to treat chronic conditions is with regular and consistent treatment. However, the average American struggles with care plan adherence. Roughly half of all-American patients do not take their medication as intended; one out of five prescriptions are never actually filled. Medication non-adherence is estimated to cause 125,000 deaths per year. Poor medication adherence results in 33-69% of medication-related hospital admissions, with medication nonadherence costing the industry as much as $300 billion in direct and indirect costs every year.2

As of 2019, the Medicare fee schedule attaches reimbursement to general physiological remote monitoring of chronic conditions. This new schedule recognizes the value of patient-reported outcomes and RPM in improving health outcomes and reducing healthcare costs. According to KLAS Research, one-fourth of healthcare organizations say RPM reduces emergency visits and readmissions.3 Further, 13% of organizations report RPM improves medication compliance, 17% cite quantified cost reductions, and 25% report greater patient satisfaction.4

To effectively treat chronic illnesses, patients must adhere to a strict treatment regimen: taking their medications as prescribed and regularly attending follow-up appointments. As well as being a waste of clinical resources, a patient’s failure to attend their scheduled appointments (no-shows) often can be an early warning sign of care plan non-adherence.

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Text-First Approach to Patient Monitoring

Using cancer clinics as an example, many implementations of RPM and patient-reported outcome systems are tied to in-clinic appointments or discharge, but not all include routine outreach.5 In other instances, self-reporting RPM systems may be cost-prohibitive or lack integration with the hospital infrastructure required to support clinical workflow.

Healthcare organizations can leverage text messaging to collect data for remote patient monitoring and gather patient reported outcomes with simple surveys. Healthcare organizations can text a link to a secure web survey to assess wellness, pain levels, specific measures (e.g. blood glucose levels), or potential medication side effects.

Other clinical communication modalities are not as effective or efficient. Only 20% of emails are opened.  Patient calls from the clinical staff have a very high administrative cost. In comparison, text messaging is extremely quick to administer and 90% are read within 3 minutes of being sent.6

PerfectServe’s text-first patient engagement solution can automate the collection of RPM data and other patient-reported outcomes. Survey responses that pass a predefined threshold are automatically escalated to expedite early intervention. All messages support two-way text messaging with healthcare professionals and the option to invite patients into an encrypted channel for secure chat. PerfectServe customers report:

  • 70% ongoing response rate for patient health status
  • 0.9 point reduction in A1C
  • 12.6% reduction in no-show rate
  • 32% reduction in readmissions

Empowering patients to participate in remote monitoring activities improves patient care plan adherence and patient satisfaction alike. The net result improves outcomes and reduces costs.

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1https://www.nationalhealthcouncil.org/sites/default/files/AboutChronicDisease.pdf

2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234383/

3https://www.healthcaredive.com/news/remote-patient-monitoring-cuts-hospital-admissions-er-visits-report-finds/539073/

4https://www.healthcaredive.com/news/remote-patient-monitoring-cuts-hospital-admissions-er-visits-report-finds/539073/
5https://www.curetoday.com/publications/cure/2019/spring-2019/patient-heal-thyself-those-who-self-report-symptoms-may-live-longer

6https://www.voicesage.com/blog/sms-compared-to-email-infograph/

Elevating the Role of the Nurse to Support Value-Based Care

nurse value-based care

As healthcare has evolved toward a value-based payment model, we have seen many changes in how healthcare is delivered and by whom. We have seen progressive healthcare organizations embrace value-based care, shifting toward an interdisciplinary approach to care that leverages population health management, social determinants of health, and patient engagement to improve outcomes across the spectrum of care.

The role of the nurse elevates with value-based care. Nurses provide more patient-centered, efficient, and cost-effective care, from pre-appointment and intake to discharge and follow-up. In the primary care setting, progressive providers have increased patient access by conducting nurse-only patient visits during which registered nurses document patient histories, order lab or other diagnostic tests, and determine patient acuity.

To meet the increased demands of value-based care, nurses must work to the top of their licensure. Studies conducted several years ago indicated that, on average, nurses spend as little as 25% to 30% of their time at the bedside.1 On top of clinical workloads, nurses are responsible for care coordination and communication among an expanding care team. As the concept of the care team expands under value-based care to include nurses, physicians, therapists, and home care workers across multiple hospital and acute and primary settings, nurses struggle with the inefficient workflows associated with legacy communication devices and numerous clinical and communication systems.

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The key to supporting the elevation of the nurse is the elimination of activities that do not directly contribute to the health and well-being of patients. The incorporation of innovative technology can assist in this effort. For example, advanced communication technology can help nurses communicate efficiently with other members of the care team including those off-site, such as home health nurses and healthcare professionals at specialized hospitals, skilled nursing facilities, and wound care clinics. HIPAA-compliant secure text messaging can also take over many of the time-consuming communication tasks to prepare or follow-up with patients. The ideal solution helps reduce non-clinical tasks to allow nurses to focus their time on only those patients who need additional care.

PerfectServe’s clinical communication and care coordination platform addresses the inefficiencies of work processes and administrative tasks to allow nurses to assume a more significant role under value-based care, including:

  • Care Team Coordination – Collaborate with providers inside and outside the network. Connect with on-call care team members as a group, or by name or role such as “On-Call Cardiologist,” ensuring a nurse can reach the right physician at the right time to improve outcomes without the inefficiencies of referencing call schedules or playing phone-to-pager tag with physicians.
  • Pre-Appointment Patient Communication – Automate the communication of day-of-procedure information, appointment reminders, and wayfinding to prepare patients for upcoming appointments or procedures.
  • PostAppointment Patient Communication – Automate post-discharge communications to reiterate the care plan, send timely reminders (such as follow-up scheduling and prescription pick up), and assess patient health status and satisfaction with text-first survey questionnaires. Nurses can prioritize follow-up time to only those patients in need of clinical intervention.
  • Time-Critical Updates – Rather than force nurses to log into the EHR to check for results or orders, critical updates (orders and critical lab results) are pushed to the nurse and other care team members to speed up care coordination and delivery.
  • Real-Time Charting – A mobile, easy-to-use interface to access patient information and take notes, with text shortcuts, voice-to-text, and intelligent field mapping to reduce duplicate data entry.
  • Nurse Call, Alarms, Alerts – Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient.

By expanding the role and leadership of registered nurses and implementing improved processes facilitated by innovative technology, healthcare organizations can transform healthcare delivery, achieving improved efficiency and better outcomes at lower costs.

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1 https://www.healthleadersmedia.com/nursing/outsourcing-discharge-follow-calls-keep-nurses-bedside

Improve Patient Experience Before, During and After Care

improve patient experience

When it comes to communicating with patients, nothing beats the immediate connection of text messages. While email and phone calls face diminishing open and answer rates, 90% of text messages are read within 3 minutes.1

Combine the timeliness of texting with the relevance from patient context, and you have a powerful tool to communicate with a patient when and where it matters most. In this post, we will examine the opportunities to engage with patients across the spectrum of care, improve outcomes, reduce costs, and improve the patient experience.

Changing Patient Expectations

The healthcare industry has shifted from volume to value, working on the Triple Aim of improving patient populations, individual patient health and satisfaction, and reducing costs.2 At the same time as patient satisfaction is being linked to reimbursement, patient expectations for their healthcare experience continue to increase.

Patients, now responsible for a greater financial share in their care, are approaching their care experiences with consumer expectations. Patients expect convenience, personalization, and involvement in their care anytime, anywhere. With patient experience and satisfaction now moving targets, healthcare organizations need ways to engage patients in their care and to continually assess the success of their efforts.

Unfortunately, improving health system performance toward Triple Aim results has led to worrying rates of clinical burnout. With technology often cited as one of the leading causes of burnout, we are now seeing healthcare organizations focus on the Quadruple Aim, including provider experience and satisfaction.3 The Quadruple Aim recognizes the importance of usability, effective care processes, and improved clinical workflows to achieve Triple Aim results.

The patient engagement strategies below are designed with the Quadruple Aim in mind, reducing administrative burden with patient, population, and diagnostic-specific automations to engage with patients across the care continuum.

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Patient Preparation

How a patient experiences their healthcare encounter begins long before the patient even steps through your door. From their perception of your website and scheduling processes to your preparation and intake processes, patients are looking for modern, seamless, and informative experiences.

Healthcare organizations looking to transform their patient experiences can begin by engaging with patients before their scheduled appointments, including:

  • Care Preparation Instructions – reminders to fill or take prescriptions or start pre-operative instructions based upon procedure-specific pathways
  • Appointment Reminders – reminders of the date, time, and location of an upcoming visit with detailed wayfinding instructions
  • SDOH Support – leveraging social determinants of health (SDOH) data, reminders can include coupons for transportation to reduce no-shows
  • Patient Intake – send patients a link to electronic forms to support off-site check-in

In addition to automating preparation and intake, you can leverage automations to keep patients “in the loop” day-of-procedure. For example, scheduling delays can trigger a status message to patients to re-align their arrival time.

Hennepin Health, in partnership with Lyft, recently targeted patients with a history of clinic no-shows, allowing them access to a corporate Lyft account to get patients to their appointments. At the end of the 12-month trial period, no-show rates decreased an aggregate 27%, clinic revenue increased by $270,000, and ROI was 297%.4

During Care

Although the factors that influence a patient’s experience vary widely based on the reason and length of stay, we can follow the broad strokes of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to identify a patient’s perspective on their care experience.5 The 18 substantive questions included in the survey focus primarily on communication with doctors, nurses, and staff during care and at the critical point of discharge. Outside of this, questions focus mainly on environmental factors such as cleanliness and sound level.

PerfectServe’s clinical collaboration solution is designed to enable fast, efficient communication that enhances care and improves the patient experience.

Integrate Nurse Call, Alert and Alarm Notifications

We centralize communication across multiple systems onto a single platform to simplify clinical workflow while eliminating extraneous noise. Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient directly. If the call button is non-urgent (such as a “water” request), it can automatically route to the Patient Care Technician, reducing nurse interruptions. Patients benefit from reduced ward noise and faster response times – critical factors in HCAHPS scores.

Family Communication

Family members play a crucial role in supporting patients during their stay at the hospital and in encouraging compliance with care plans. Healthcare organizations are recognizing the importance of supporting families as part of the patient experience as well.

With pre-configured pathways, families can feel more comfortable leaving waiting room areas knowing that they will receive an automated message with patient status and return time. If a patient’s family member calls into the main hospital call center and are connected to the appropriate nurse, the nurse can return the call with one click. To ensure the correct on-call nurse is contacted in the future, the return call number is hidden.

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Post-Discharge Assessments and Surveys

Following the most recent round of Medicare readmission penalties levied against 2,583 hospitals, preventable hospital readmissions continue to be top-of-mind.6

According to a study published in BMJ Quality & Safety, patients reporting high satisfaction and good provider communication were less likely to be readmitted.7 Decreasing preventable readmissions requires that patients understand and adhere to their care plan, that pain is managed, and that follow-up care is scheduled and attended in less than two weeks.8

Post-Discharge Assessments

Leading hospitals are leveraging text-first interactions to monitor care, assess pain, and send care plan reminders (such as filling or starting a prescription). Questions can be delivered one-at-a-time to encourage response or patients can be prompted to a secure web form for a full survey or to share detailed personal health information. Frequent check-ins not only increase patient satisfaction but also allow clinicians to escalate concerning responses to a secure chat session or phone call.

Park Nicollet Methodist Hospital adopted a text-first follow-up program that included a series of customized follow-up questions to assess a patient’s risk for readmission. 70% of questions sent via text message receive a response rate from patients. The PerfectServe dashboard collects and analyzes every patient’s response and nonresponse, segmenting the patient population into risk categories and automatically flagging patients that need immediate follow-up.

Park Nicollet’s results showed that patients who received and responded to text messages were 32% less likely to readmit than those solely contacted by phone. (These results are risk-adjusted to account for the relative complexity of each patient’s conditions.)

Patient Satisfaction Surveys

The goal of any patient satisfaction survey is to gain honest insight into the patient experience. Although the HCAHPS survey has incentivized improvements in patient experience, the response rate for patients has been on the decline, down to just 26.7% from July 2017 to June 2018.9 Administered 2 to 42 days after discharge, surveys do not yield the timely data hospitals need in order to act on patient satisfaction.

Given the high impact of HCAHPS results on a hospital’s financial performance, there is an opportunity to survey patients before the CMS to mitigate issues and improve patient satisfaction in advance.

To make patient satisfaction surveys actionable, healthcare organizations need easy, customizable surveys that target specific patient populations and encourage meaningful dialogue. Surveys can be automatically triggered after the healthcare encounter while the experience is fresh on the patient’s mind. Deploying text message surveys and text-first surveys is a cost-effective approach to obtaining these coveted patient insights.

Patients indicating dissatisfaction present a service recovery opportunity – contacting them to show concern and learn more about their experience will not only inform systemic improvement opportunities but also will likely change the patient’s impression of the organization.

PerfectServe allows hospitals to reach patients and/or families in real time before, during, and after care to better engage, activate, and assess patients in their care experiences. Post-discharge assessments present an opportunity to evaluate patient satisfaction and address patient concerns while there is still time to directly improve their satisfaction.

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1 https://www.voicesage.com/blog/sms-compared-to-email-infograph/

2 http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

3 http://www.annfammed.org/content/12/6/573.full

4 https://patientengagementhit.com/news/do-rideshare-tools-reduce-transport-barriers-patient-no-shows

5 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Downloads/HospitalHCAHPSFactSheet201007.pdf

6 https://khn.org/news/hospital-readmission-penalties-medicare-2583-hospitals/

7 https://qualitysafety.bmj.com/content/27/9/683

8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369604/

9 https://patientengagementhit.com/news/hcahps-survey-non-response-bias-impacts-scores-practice-improvement

3 Ways to Improve Post-Treatment Compliance

text post treatment compliance

According to a study published in the Journal of the Royal Society of Medicine, patients tend to immediately forget 40-80% of information their care providers present to them – or, worse, remember incorrect information about care plans or follow-up care.1  In the era of value-based care, it’s important to find a way to ensure patient compliance with treatments to improve patient outcomes and avoid costly readmissions.

Engaging patients with messages and reminders sent as text messages offers healthcare professionals an opportunity to improve patient treatment compliance when, where, and how it would be most effective.

Treatment Plan Communication

Traditional approaches to care plan compliance include verbal discharge instructions and sending patients home with discharge documents and information. Digital interventions can improve compliance with care plans, including:

  • Providing a digital format of care plan information that can be referred to anytime, anywhere
  • Clear, action-oriented reminders of care plan instructions when and where they are needed during the recovery process. For example, if a patient is to begin an exercise regime on day 3, a reminder can be sent that morning with a link to specific instructions or videos walking patients through the exercise program.
  • Provide timely guidance, tips, or exercise recommendations to support patient self-care

Handling some of this important patient information via text message can support the care plan at precisely the right time while also keeping the lines of communication open so that patients can text back or call in if they have any questions or need further information.

Automated Medication Adherence Reminders

Medication adherence requires that patients fill their prescriptions, understand directions, and take medication on time. Adherence rates for chronic conditions is about 50%, accounting for up to half of treatment failures and 25% of hospitalizations each year.2 Adherence interventions strategies for medication includes directly faxing prescriptions to pharmacies and leveraging reminders and single-response survey questions (“Have you picked up your prescription from the pharmacy?”).

Text messaging doubled the odds of medication and improved overall adherence rates by 17.8%3

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Although there are many digital adherence technologies (DATs) that can automate reminders for medication, it’s important to support ongoing two-way engagement with patients, who may have questions or concerns about side effects, and to have a way to send survey questions to confirm compliance.

Surveys to Improve Compliance and Reduce Readmissions

In a recent survey, Dr. Ethan Basch, M.D., M.Sc., found that nearly half the physical and psychological symptoms of his patients went unreported.4 Improving patient outcomes requires capturing more patient-reported outcomes (PROs) in real-time to provide timely interventions.

After discharge and periodically through recovery, you can leverage automatic procedure-specific diagnostic surveys to assess progress and ensure understanding of the treatment plan. Patient-reported outcomes can be tailored to the condition or procedure in question, assessing general health as well as data specific to symptoms, side effects, or pain levels. For the management of chronic diseases such as diabetes, our own data suggests that securely surveying key health indicators can help improve a1c rates by 0.5 points or more.

Based upon patient responses and your defined rules, PerfectServe’s patient engagement platform will alert care team members if a patient requires follow-up. Based upon the familiarity and simplicity of text messages, the solution has the proven capability to reduce readmissions by as much as 30%.

“We have such a hard time getting some patients to answer a phone call, yet they will respond to assessments delivered by text. PerfectServe saves valuable time for our nurses every day and helps us reach those in need more quickly.” — Karen Loscheider, Manager, Triage Nurse, Park Nicollet Health Services

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In addition to encouraging patient reported outcomes, patient satisfaction insight surveys also help you gather and act upon feedback in time to make a difference on a patient’s overall satisfaction, which can help reduce the risk of patient leakage and improve HCAHPS scores.

PerfectServe’s Patient & Family Communication solution can help you deliver a thoughtful, targeted set of prompts to support post-treatment care to reduce readmissions and improve outcomes. Our solution is proven and is live in more than 10,000 care locations, facilitating more than 42,000 patient interactions every day.

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1 Roy P C Kessels, PhD. “Patients’ memory for medical information,” Journal of the Royal Society of Medicine. 2003.

2 Jennifer Kim, PharmD, BCPS, BCACP, CPP et al, “Medication Adherence: The Elephant in the Room,” US Pharmacist, 2018.

3 Thakkar J, Kurup R, Laba TL, et al. “Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis.” JAMA Intern Med. 2016

4 Ethan Basch, Md, MSc, et al. “Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment,” JAMA, 2017

Improve Well-Child Schedule Adherence with Patient Engagement

well-child feature image

The medical system has long adhered to the tenets of value-based care in the establishment of the periodicity schedule for well-child visits. The American Academy for Pediatrics (AAP) recommends formal screening for infants through adolescence to chart growth and development and to provide early interventions for illnesses and injuries, which provides benefit to both children and the healthcare system as a whole.

“While the end goal of health transformation should be achieving the triple aim of improved health quality, improved population health, and reduced per capita health care costs, this requires investing more, rather than less, in primary, preventive, and developmental care. At no age is this truer than for children, whose health trajectories have health cost implications over decades and lifetimes.” – Charles Bruner, Ph. D., et al1

Unfortunately, adherence the well-child schedule is suboptimal, with rates diminishing over time – as low as 41% by the time the child is 15 months old.2 For children over age 6, well-child visits help ensure continued health, including assessments on growth, weight, sleep, or signs of physical or mental health issues.3 For children with chronic conditions such as asthma, evidence suggests that low well-child visit adherence rates are associated with an increased risk of hospitalizations.4

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The reasons behind low adherence rates are complex. Modern families face multiple time constraints, may not know about ongoing well-child visit needs, or may face social or economic challenges that impact their ability to adhere to the periodicity schedule. Pediatric professionals focusing on improving adherence to well-child visits can take a multi-pronged approach:

  • Well-Child Visit Reminders: encourage adherence to well-child schedule with automated reminders or suggested appointment timeslots
  • Social Determinants of Health: focus health promotion materials on family, community, and social factors, including links to community resources, transportation coupons, etc.
  • Pre-Appointment: send appointment reminders and preparation instructions, helping reduce no-show rates
  • Lower Readmissions: follow up with children recently released from hospital after injury or illness with automated assessment questionnaires and care plan reminders
  • Wellness Education: provide pro-active wellness information and links to appropriate community resources or educational material on your patient portal.
  • Chronic Condition Management: identify and track children with special health care needs, sending care plan reminders, ongoing encouragement, and periodic assessment questionnaires to parents to expedite intervention

PerfectServe can provide you pre-scheduled communications as well as two-way messaging to help engage patients and their families in positive health outcomes. PerfectServe’s Patient & Family Communication tool leverages SMS text messages, social determinants of health, and pre-populated workflows to identify patients and families who could benefit from well-child visit reminders, educational materials, or SDOH support. Unlike emails or phone calls, text message communications benefit from high response rates, allowing you to reach out to parents when and where it matters most. Parents can schedule an upcoming well-child visit, answer a wellness survey, or ask a question, with automatic alerts sent to the care team if a patient may need preventative support or outreach.

Working with one of the nation’s largest healthcare systems, we sought to improve well-child schedule adherence rates for children age 0-3 years old. Prior to the program, many well-child visits occurred up to a month after they should have, impacting immunization schedules and early prevention programs. PerfectServe’s Patient & Family Communication tool sent parents a reminder about well-child appointments, leading to 13% more pediatric well-child visits, a tighter adherence to the recommended schedule, and more participation in visits beyond infancy. The program had the benefit of also raising postpartum depression screening rates from 30% to 70%.

Contact us to learn how we can help improve your well-child initiatives.

Start Engaging Patients

 

1https://www.mentalhealthamerica.net/sites/default/files/Commentary%20on%20Value%20Based%20Care%20final%20Nov%202017%20pdf%20%28002%29.pdf

2 https://www.ncbi.nlm.nih.gov/pubmed/30305388

3 https://health.usnews.com/health-news/patient-advice/articles/2016-02-23/why-older-kids-need-well-child-checkups-too

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551592/ ; https://www.sciencedaily.com/releases/2013/05/130524104642.htm

Lessons Learned from an Important Voice in Cross-Organizational Communication

Charting the most efficient path for critical patient communications within a complex care team is a tall order. When a large and complex team of care providers must work together—which is not a rare occurrence—communication breakdowns are all too common.

Mary Hatcher
Mary Hatcher, VP of Product Development
PerfectServe

Preventing these complex communication challenges requires forethought about the solutions required to move information accurately and efficiently from one care provider to the next. Mary Hatcher, Vice President of Product Development at PerfectServe, recently authored a guest blog about on this very topic for Healthcare IT Today. Here are some of the key takeaways:

  • Complex communication challenges most often occur immediately after discharge, when a patient is moving from the hospital to another setting, or with patients who have overlapping chronic conditions that require multiple specialists
  • EHRs are not equipped to solve the communication issues that frequently arise during complex care transitions
  • Healthcare organizations need a standardized communication process with tools and infrastructure that connect all members of a patient’s care team
  • The use of web and mobile applications facilitates real-time communication and collaboration across different care settings

To learn more, read the full article titled “How Clinical Communications Technology Connects the Care Team In Complex Cases” at Healthcare IT Today.

New CEO Guillaume Castel: Joining PerfectServe is all about improving healthcare

Guillaume Castel banner with graphics

Like many industries today, healthcare is overflowing with data. As electronic health records (EHRs) have risen to become the industry standard for clinical data, so too has the number of technologies healthcare providers use to deliver care. These systems are live 24 hours a day, constantly creating valuable data to update doctors, nurses and other members of the care team about the status of their patients.

The caveat here is that this information is only valuable if it’s given to people who can act on it in a timely manner, and that’s why PerfectServe—with its portfolio of solutions and Dynamic Intelligent Routing capability—is raising the bar on system interoperability. By integrating with existing healthcare systems and facilitating the efficient and accurate exchange of vital information, PerfectServe is improving the delivery of care for patients and clinicians alike.

As we venture further down the path to true interoperability, PerfectServe is welcoming a new leader with wide-ranging experience in both the healthcare and technology industries. With his strategy, business development and operations acumen, Guillaume Castel, who became CEO of PerfectServe on July 1, will help to accelerate the company’s growth and market leadership. Like any good leader, Guillaume knows how to articulate a vision, and he sat down with us to share a few thoughts about his decision to join the company, what he’s learned about healthcare from previous roles and why PerfectServe is uniquely positioned to improve the healthcare industry.

Oh, and there’s some stuff about basketball and family, too.

Well, for starters, this is an exciting change for you! Can you share why you chose to join the PerfectServe team?

Having been immersed in a health organization—Inova Health System—for the last 18 months, and having served hospitals with the Advisory Board for the four years before that, I’ve seen firsthand where it’s possible to have the greatest impact in the healthcare industry. When I think about the trifecta of enabling communication across care teams, improving patient engagement and reducing costs for hospitals, I get really excited. PerfectServe is situated right at the intersection of those initiatives, so leading the company is the best way for me to impact all three at once.

Why make the switch from a healthcare provider to a healthcare IT company like PerfectServe?

My strategy was to go inside of a hospital to understand how it works, how people make decisions and to get a feel for what the most pressing needs are for healthcare systems. I’m more knowledgeable now after being on the front lines for a while, so to speak, but for my next step, I wanted to be in a position to effect more widespread change in the industry. I believe I can do just that at PerfectServe, and what’s particularly rewarding is that the hard work I put in here will only strengthen our dedication to doctors, nurses and other clinicians, as well as patients and their families. Finding purpose is easy when you’re helping people live better, healthier lives.

You’ve worked extensively in healthcare and technology, having previously been at Inova, the Advisory Board and Cisco. In a way, it seems like PerfectServe is an ideal place to bring all of that expertise to bear in one place. Would you agree?

Yes! If you think about my past two decades, I essentially spent the first 13 or 14 years with technology firms that were trying to deploy solutions to industries. I’ve had the opportunity to see instances where that was being done well and, frankly, other situations where there was room for improvement. Broadly, I’ve learned that verticalizing technology offerings is hard. My experience has given me a very clear sense of what good technology looks like, how tech firms are managed, how decisions are made and how product roadmaps are built. At PerfectServe, I’ll be combining that experience with my time going deep in the provider space, and I think both will be essential as we map out the next five years.

When you’re not entrenched in a hospital or doctor’s office every day, it’s a bit more difficult to imagine why quick, reliable communication is so important for members of the care team and for patients. How did your time at Inova Health System – a PerfectServe customer – influence the way you view our suite of products?

It is critically important in hospitals to get the right message to the right person at the right time. I knew this before I went to Inova, of course, but being immersed in that world every day really solidified the importance of efficient clinical communication. It was critical five years ago, and it’s even more important today because things have gradually become more complicated – there’s more data, more systems working in concert, more expectations from patients. Getting it right is really consequential because we can help health systems improve the way they deliver care and save lives, and we can improve the way patients interact with healthcare systems.

Coming at it from another angle, we’re also a really good vector for cost reduction. When you think of just one of the potential benefits offered by a platform like PerfectServe—decreased length of stay, for instance—and multiply the patient hours saved per bed across an entire organization, the savings add up quickly.

What do you see as the biggest opportunities or areas for growth for PerfectServe moving forward?

Terry and the PerfectServe team have done a fantastic job shaping the company’s vision and assembling a group of products that deliver tremendous value to healthcare organizations. Work has already begun integrating these solutions, and my main order of business is to support the team as they continue working to deliver a seamless user experience and reduce the number of systems these organizations have to manage.

Another major priority for the company is to articulate PerfectServe’s role in the next evolution of healthcare technology. As organizations are nearing the end of their EHR implementation initiatives, their focus must shift toward eliminating inefficiencies and reducing care delays. PerfectServe’s objective is to deliver technology that helps clinicians communicate and act in real time, thereby improving quality, patient experience, operations and the financial health of the organization. We’re very excited about the opportunity to take chaos out of healthcare with a care team collaboration platform that unifies systems and caregivers in their mission to improve health and quality of life.

I believe your wife is a physician, which probably gives you some additional perspective on the challenges doctors face practicing in today’s healthcare environment. What does your family think about your new role?

Yes, my wife is a physician and a professor, so I’m aware of these challenges on multiple levels. This familiarity has certainly contributed to my career trajectory and to my interest in PerfectServe’s mission.

As to your second question, my family, including my teenage son and daughter, are all pretty nonchalant about my career in general. I wouldn’t have it any other way – it keeps me humble!

Shifting gears a bit, you mentioned that you love sports and, in particular, basketball. Are you more of a college guy, or do you prefer the NBA?

I’ve been an NBA fan for the longest time, but once Zion Williamson arrived at Duke last season, I was hooked and watched a lot of their games. What he does is absolutely unreal – he’s an incredible talent.

Do you have a favorite team?

Yes! I’m a diehard Lakers fan. When I moved to the United States from France, I spent six months in Los Angeles and saw my first NBA game there. If you can believe it, Kobe Bryant was just getting started with the organization at the time – it’s been a while! I’m a loyal guy, so I became a Lakers fan after seeing my first NBA game in LA, and I did the same with the NFL after seeing an Eagles game in Philadelphia.

Well, I guess the only thing left is to welcome you to the PerfectServe team!

Thank you! I’m thrilled to be here. Terry and the team have done an incredible job listening to customers and building a solution that has a real impact on quality of care. I’m honored to take the reins and look forward to collaborating with Terry, the executive staff, the board of directors and all of our talented employees as PerfectServe continues to grow.