5 Warning Signs Your Answering Service Might Be Hurting Your Practice

Medical answering services are essential to modern practices for triaging patient calls, delivering urgent messages at night, and allowing receptionists to focus on imperative tasks during business hours. An effective answering service solution can help practice managers, providers, and staff improve the overall patient experience and increase patient satisfaction.

Unfortunately, some medical answering services are susceptible to manual errors and environmental challenges. Routing mistakes and connectivity issues can negatively impact both patient and provider satisfaction.

Here are five warning signs your medical answering service might be negatively impacting your practice:

1. Poor Provider Satisfaction

Your providers’ wellbeing is essential to their satisfaction, livelihood, and ability to best care for patients—yet provider burnout is on the rise. Key contributors to burnout include receiving non-urgent calls after hours, getting unnecessary interruptions while caring for patients, and dealing with other communication challenges that interfere with providers’ daily workflows.

Contacting providers at the wrong time is a common mistake. When the answering service makes an error and contacts your provider at midnight on their Saturday off or interrupts their time with a patient for a non-urgent or routine message, it brings down the provider’s satisfaction and makes it more difficult for your practice to retain top talent.

Providers who are unable to work at their best due to unnecessary interruptions and complicated communication workflows may experience burnout and decide to leave your practice. Losing providers reduces patient satisfaction, lowers revenue, and increases your recruitment and onboarding costs.

2. Declining Patient Experience

It’s important to let patients know they are being heard and cared for, not ignored, yet missed and lost messages are another common issue with medical answering services.

If your answering service loses patient messages, fails to take thorough notes during a call, delays sending urgent messages, or sends messages to the wrong provider, your patients will begin to feel frustrated and undervalued.

3. Negative Impacts on Your Practice’s Reputation

To your patients, your answering service is a representative of your medical practice. Errors and poor patient encounters with live answering service can be harmful, and even detrimental, to your practice’s reputation in providing quality patient care.

It is imperative to ensure that your answering service—which many patients do not know is a third-party service—is delivering the quality of care and experience you want your patients to expect from you. Keeping your patients satisfied and confident in their care is the key to patient retention.

4. Fluctuation of Practice Operating Costs

Your medical answering service may be costing you much more than you originally intended. Many answering services have hidden fees and charges based on call volume and duration, causing practices to spend much more on the service than was budgeted. For a more accurate account of how much your medical answering service is really costing you, look at your month-over-month charges and take note of the fluctuations. Hidden fees can add up quickly when practices don’t pay close attention and consistently follow up on billing.

5. Inability to Support Patients During Emergencies

Healthcare can’t stop when inclement weather, natural disasters, or other emergencies happen. Keeping lines of communication open between your providers and your patients is essential, especially during times of uncertainty. Your medical answering service must be available and connected to take patient calls and route messages correctly and quickly at all times.

If your medical answering service depends on live operators, a natural disaster or similar emergency could make it impossible for agents to receive or answer your patients’ calls. You can learn more about identifying risk to prepare for unprecedented circumstances from our related blog post and our Medical Practice Disaster & Emergency Preparedness Checklist.

Not all medical answering services provide the same level of service and support.

Use the factors above to assess your current medical answering service vendor and decide if it’s time to look for another solution that can better protect your medical practice.

Consider how an automated medical answering service solution can help strengthen your practice.

The right answering service solution will provide a consistent patient experience, reliable connectivity, accurate message routing, and appropriate escalation while supporting work-life balance for your providers and eliminating variable costs.

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

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 Importance of Patient Education

Patient education is more important than ever in today’s value-based care system, which focuses on patient outcomes beyond the four walls of your healthcare organization. For a growing number of hospitals and practices, the key to educating patients and ensuring they have a good understanding of their care recommendations is simple—effective patient and family communication.

Why prioritize patient education?

The best way for healthcare organizations across the nation to understand the importance of patient education is by exploring five key reasons why patient education should be a strategic priority:

  1. Hospital Reimbursements
  2. Chronic Illness Prevention
  3. Healthcare Cost Reduction
  4. Clinician Time Savings
  5. Patient Experience Improvements

 

1. Hospital Reimbursements

The COVID-19 pandemic led healthcare organizations to rely heavily upon value-based care reimbursements, accelerating the shift toward patient-centered care.1 Now, providers are increasing patient education efforts to ensure they continue to meet the standards of value-based care.

CMS Value-Based Programs for Provider Payment

The Hospital Readmissions Reduction Program (HRRP), Quality Payment Programs (QPPs), and Value Modifier (VM) Program are a few examples of value-based reimbursement programs. These are designed to:

  • Tie payments to quality and cost-efficient care.
  • Increase the use of healthcare information.
  • Drive improvement in health outcomes.

Fortunately, technology makes it is easier than ever to go beyond patient handouts to provide quality education to patients in a cost-efficient and time-efficient way. Rather than sinking staff time into manual patient outreach, providers can educate patients through automated text messages. Targeted messages can link to educational blog posts, videos, and other online resources, delivered directly to patients’ cell phones to encourage better outcomes.

2. Chronic Illness Prevention

Another takeaway from COVID-19 was the increased health risk associated with patients with chronic conditions. A study from 12 states reported that 73% of people hospitalized for COVID-19 had at least one underlying chronic condition, and rates of hospitalization increased as the number of conditions increased.2

Even before the pandemic, 90% of the nation’s healthcare expenditures were for people with chronic and mental health conditions, and chronic conditions accounted for 7 of the 10 leading causes of death in the US.2 One of the most successful ways to combat chronic illnesses is through self-management supported by patient education.

Many prevalent chronic conditions, such as heart disease, diabetes, and arthritis share common challenges associated with self-management, which include:

  • Dealing with symptoms and disability.
  • Monitoring physical indicators.
  • Managing complex medication regimens.
  • Maintaining proper nutrition and exercise.
  • Adjusting to psychological and social demands.
  • Difficult lifestyle adjustments.
  • Engaging in effective interactions with health care providers.

Relationships between patients and their healthcare providers, friends, family, and community are fundamental to the self-management of chronic illness. Self-management programs and education tailored to specific groups with various delivery strategies have proven successful at improving health outcomes in targeted populations.3

3. Healthcare Cost Reduction

Unnecessary patient readmissions cost the US government roughly $17 billion each year.4 To combat the alarming rate of readmissions, CMS created the Hospital Readmission Reduction Programs in 2012, which penalizes hospitals when too many patients return within one month of treatment.

Nearly a decade later, federal records show that CMS will penalize 2,545 hospitals in 2021 for having too many Medicare patients readmitted within 30 days.5 That’s nearly half of the nation’s hospitals! But how can organizations cut down on readmissions and avoid penalties without incurring additional expenses on follow-up resources?

Patient education can help providers inform and remind patients of the proper ways to self-manage care and avoid nonessential readmissions. Better education can also help patients understand the care setting most appropriate for their condition and avoid unnecessary trips to the hospital.

For example, an uninformed patient might seek treatment in the Emergency Department (ED) for a minor issue, when an Urgent Care Center would be much more appropriate. The ED is one of the most expensive healthcare settings, and should be reserved only for critical events—not for nonurgent care.

Educating patients on how to follow self-care recommendations and when and where to seek treatment helps support faster recovery, reducing readmissions and expenses.

4. Clinician Time Savings

The Association of American Medical Colleges (AAMC) has reported that the US will face a shortage of more than 100,000 physicians by 2030.6 As the shortage grows, our physicians grow increasingly short on time. As it is, the average doctor sees 20 patients per day.7

This means patient visits must be short, which can be problematic for several reasons. To start, shorter consultation times have been linked to poorer health for patients and increased burnout for doctors.

Patient Health

Short appointments make it difficult for patients to communicate with their doctors and for doctors to ensure patients fully understand the next steps they should be taking in their care plan. But how can healthcare organizations bridge the gap when time is finite and physician resources are dwindling?

Following up post-visit to provide patient education and reminders is an effective way to help patients self-manage their health. For example, HIPAA-compliant text messages can reach patients directly and can be automated to make outreach easy for care teams.

Physician Burnout

42% of all physicians report experiencing burnout, which can lead to reduced energy, depersonalization, depression, and physician turnover, as well as patient safety accidents. For sources and more information on clinician burnout, read our Clinician Burnout Report.

To help doctors free up their time to reduce stress and avoid burnout, healthcare providers should focus on increased patient education. Informed patients ask fewer and more pointed questions during appointement and can take steps to avoid uneccessary readmissions.

 

5. Patient Experience Improvements

Ongoing patient education improves self-efficacy and delivers better patient results by helping them adhere to medication and treatment regimens, identify abnormal symptoms, and decide what steps to take when issues arise. Each outcome enhanced by patient education also improves the patient experience (and HCAHPS scores) .

Pre-appointment education can help patients know what to expect and where to go, reducing uncertainty and anxiety. Post-appointment education can help patients recover properly with fewer complications. Across all stages of the patient journey, keeping patients informed and educated improves outcomes—from patient satisfaction to quality of life—the true purpose of value-based care.

Check out our blog on how to improve the patient experience to learn more.

Patient Education and Engagement Support Value-Based Care

Value-based care has required healthcare providers throughout the nation to prioritize patient education and patient engagement as strategic imperatives. To learn more about how a thoughtful, patient-centered communication strategy can provide ongoing patient education while enhancing the patient experience, download our white paper, Engaging Patients to Support Value-Based Care Initiatives.

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Sources:

  1. The move to value accelerates in 2021, spurred by lack of fee-for-service payments during pandemic, Morse, S., Healthcare Finance, Dec. 23, 2020: healthcarefinancenews.com/news/move-value-accelerates-2021-spurred-lack-fee-service-payments-during-pandemic
  2. An Ounce of Prevention Is Still Worth a Pound of Cure, Especially in the Time of COVID-19, Hacker, K., et al., Preventing Chronic Disease, Vol. 18, E03, CDC, Jan. 2021: cdc.gov/pcd/issues/2021/pdf/20_0627.pdf
  3. Self-Management: A Comprehensive Approach to Management of Chronic Conditions, Anekwe, T., et al., American Journal of Public Health (AJPH), Dec. 7, 2018: ajph.aphapublications.org/doi/10.2105/AJPH.2014.302041r
  4. Preventable Readmissions Cost CMS $17 Billion, Reardon, S., RevCycleIntelligence, Jan. 13, 2015: revcycleintelligence.com/news/preventable-readmissions-cost-cms-17-billion
  5. Medicare Fines Half of Hospitals for Readmitting Too Many Patients, Rau, J., Kaiser Health News (KHN), Nov. 2, 2020: khn.org/news/medicare-fines-half-of-hospitals-for-readmitting-too-many-patients/
  6. Research Shows Shortage of More than 100,000 Doctors by 2030, Mann, S., Association of American Medical Colleges (AAMC), Mar. 14, 2017: aamc.org/news-insights/research-shows-shortage-more-100000-doctors-2030

How to identify and address physician burnout

physician burnout

Across virtually every sector, professional burnout is quickly becoming an urgent issue for employers. Burnout is particularly common in fields like social work, teaching and medicine.
Physicians report higher burnout rates than almost any other profession, and studies show it’s getting worse.

According to a report in Mayo Clinic Proceedings, 54.4 percent of physicians indicated that they experienced at least one symptom of burnout in 2014. That’s up nearly 9 percent since 2011.

The study also shows that physician burnout isn’t directly related to any particular region of the country — it’s an industry-wide problem and requires an industry-wide solution.

physician burnout stat

Symptoms

Burnout can cause depression, alcohol abuse and even suicide, and with physicians’ suicide rates among the highest of any profession in the country, it’s essential that everyone inside your organization be on the lookout for signs that a colleague is experiencing burnout.

Causes

There are many causes of professional burnout, such as having a poor work-life balance, but physicians tend to have a few distinctive contributing factors — including administrative tasks like recording notes in the EMR and trying to coordinate care outside of their organization — which make them uniquely susceptible to burnout.

Spending too much time in the EHR

Electronic health records (EHR) have completely changed physician workflows, but physicians often report — and studies show — that they spend too much time in the EHR and not enough time with patients.

In fact, a 2016 time motion study shows that for every hour a physician spends with a patient, he/she spends nearly two hours in the EHR. The study also reports that physicians spend only 27% of their time in direct patient interaction.

Coordinating care across providers

Physicians understand that patient care extends far beyond the four walls of their organization, and they often take responsibility for helping coordinate care across the patient’s care continuum.

Unfortunately, the EHR can’t always connect physicians to members of the patient’s care team outside the organization or on-call physicians, so coordinating care adds another layer of frustration as physicians engage in an extended game of phone tag. In relying on EHRs for clinical communication, healthcare organizations have built communication islands that limit care collaboration and waste physicians’ time.

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Prevention

Preventing burnout takes a combined effort between the physician and the organization, but the first step to preventing physician burnout is simply acknowledging the problem.

Burnout is a taboo topic across industries, and to truly address it, we have to make cultural changes that make it easier for physicians to admit they’re experiencing symptoms of burnout and seek help when they’re feeling overwhelmed.

Giving the proper care to patients requires that physicians take care of themselves as well. When physicians are starting to feel mentally and physically tired, it’s necessary to take some time off to reconnect with friends and family and reevaluate their diet and exercise regimen.

physician burnout quote

For healthcare organizations, finding ways to free up physicians from administrative tasks can help stabilize their work-life balance. Scribes, for example, can help physicians focus on their face-to-face interactions with patients and spend less time documenting in the EHR.

Additionally, a clinical communication and collaboration platform can make it easier and quicker for physicians to coordinate care inside and outside the organization, giving physicians more time to focus on the patient.

When a physician is burned out, it has ripple effects throughout the hospital or practice. Left unchecked, physician burnout can have an extremely detrimental effect on the organization’s ability to deliver quality care to patients. Understanding what causes burnout and how we can address it is essential to the health of our physicians, patients and healthcare organizations.

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Higher MIPS scores and positive CMS adjustments

Technology helps us do so much more than we used to be able to do on our own. If there’s anything we’ve learned in the last decade of technological innovation it’s that “there’s an app for that” when it comes to just about any goal you want to accomplish.

This absolutely includes the financial goals you’ve set for your practice, which you’ve probably had to re-evaluate recently due to the uncertainty surrounding CMS payment adjustments under MACRA.

Healthcare IT (HIT) will play a major role in your MACRA compliance efforts. In addition to automating some of the more tedious processes the new regulations require, HIT can help physicians score high under the Merit-based Incentive Payment System (MIPS), which is necessary to receive positive payment adjustments from CMS beginning in 2019.

Here’s how HIT, especially tools that enables efficient and timely care team collaboration, can boost scores in each of the four weighted MIPS performance categories:

Cost

The processes and treatment plans used by clinicians to deliver patient care are directly tied to costs. In the face of potentially negative payment adjustments, it’s more important than ever to realize cost savings, a feat that will be heavily impacted by providers’ ability to manage chronically ill populations. Success in population health management is highly dependent upon efficient communication, collaboration and care coordination across all care team members and care settings. Communication workflows and unified communication tools need to be assessed and implemented to improve the speed and efficiency with which disparate care team members can communicate with each other to coordinate care.

Quality

Clinicians have a lot of personal freedom when it comes to the quality of the care they deliver. One of the more manageable ways to improve the quality of healthcare is to overcome communication obstacles that have long degraded and delayed care. Obstacles such as not knowing who to contact for a given situation; searching for and struggling to find contact information and leaving messages with intermediaries; never knowing if the right message will be delivered to the right recipient, thus suspending and disrupting care, etc., are easily overcome with the help of intelligent communication routing and automatic escalation tools.

Advancing Care Information (ACI)

EHR functionality is a key component of ACI, but an EHR’s capabilities to support care coordination are limited. Care team members in a physician’s network may or may not share the same EHR, and the need to seamlessly communicate with them — and those outside of the network who are even less likely to have the same EHR — is equally important. There’s an increased need to implement a system of secure communications that transcend disparate EHRs to ensure timely bilateral exchange of patient information. Interoperability is an important factor for the ACI performance score.

Improvement Activities

Clinicians who utilize patient-centered approaches to achieve better, smarter and healthier care will perform well in this category. Implementing tools that enable patient-centric communications is one step toward achieving a high score in the Improvement Activities performance category.

More than 600,000 clinicians will be responsible for reporting MIPS performance criteria for at least 90 days this year. MIPS reporting is complicated, complex and extremely important to understand because it will impact CMS payment adjustments beginning in 2019.

The threshold to receive a positive payment adjustment has been set very low for 2017, so there’s less financial risk for eligible clinicians in the first year. The clinicians who want to cross the low composite score threshold to receive the maximum positive adjustment possible in 2019 need to score high in the performance measurement areas of Quality, Advancing Care Information and Improvement Activities. Reporting in the Cost category will begin in 2018.

Care team collaboration and communication platforms like PerfectServe® help clinicians decrease costs and improve quality by eliminating inefficient and time-consuming communication processes that delay treatment. Our cloud-based architecture allows clinicians to transcend the communication capabilities of the EHR and securely coordinate care with disparate interdisciplinary providers regardless of their location; and the patient-centered communication capabilities neatly fulfills all of the criteria for the Improvement Activities performance category.

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Managing the surprisingly troublesome impact of real-time healthcare on clinical decision-making

We live in an age of instant gratification. From the texts we send friends and family to the orders we place on Amazon.com, we’ve come to expect immediate results: instant responses, next-day shipping, etc.

The idea of immediacy in healthcare communications is not new. In fact, in 2015, healthcare analyst Gartner outlined a vision for what it dubbed the “real-time health system”—a landscape where healthcare professionals will be constantly aware of what’s happening within their systems and with their patients.

As a person living in the digital age, you’ve probably experienced real-time awareness in other parts of your life: the repetitive dings of received text messages, the intermittent beeps of calendar alerts, the near-constant hum as your smartphone vibrates over and over to let you know your mother, children and cousins have uploaded photos to Facebook, Instagram and Snapchat. In fact, as I’m typing this piece, I’ve heard alerts for two personal text messages that I’ve yet to look at (the temptation is maddening), four work-related emails (that I did have to stop and look at), a notification that someone commented on a thread I replied to on Facebook and more.

While there’s definitely a benefit to each of us knowing what’s happening in our expanded universe in real time—and we can easily draw a direct line to the benefits that doctors, nurses and patients would experience if they could communicate instantaneously while coordinating care—the influx of information is simply overwhelming.

And when alarm fatigue sets in, important messages get missed, the communication cycle breaks down and what was once a valuable resource becomes a liability. Overwhelmed and inundated clinicians cannot optimally use their invaluable expertise to make effective clinical decisions that deliver great health outcomes.

Aggregating, analyzing and managing the distribution of clinical information

Managing the flow of data and alert fatigue is a real challenge that clinicians and the IT teams that support them need to understand. Clinicians need “just the facts, ma’am,” so to speak, and they need to know which set of facts pertain directly to them and the patients for whom they are caring. Receiving more than enough information is not always a good thing, especially when the situation calls for fast thinking and quick decisions.

Investments made in technologies implemented over the past several years have enabled healthcare as an industry to generate very large amounts of digitized clinical information. The challenge is to aggregate this patient data in real time to generate new knowledge about a patient and distribute it in a way that does not inundate the clinician recipients with unnecessary information. Physicians and nurses should receive information they need in order to act in that moment. Everything else is noise.


Learn how a care team communication solution can enable your clinical integration strategy. Get a demo.


Implementing communication-driven workflows

Once new knowledge is made available and deemed relevant to a given clinical situation, it’s important to enable workflows that drive this information to the right care team members, who can take action in that moment. Hospital-based communication workflows must encompass all modalities, adhere to strict security mandates and facilitate reliable exchanges among clinicians across boundaries (e.g., acute, pre-acute and post-acute care settings). This kind of clinical integration is the future of healthcare communications.

If clinicians are inundated with unnecessary information, messages and alerts, combined with a communication workflow that creates barriers to a) finding the right care team member to contact, b) finding the contact method that the clinician prefers and c) knowing whether the intended recipient received the message, the workflow is flawed and is inhibiting the decision-making that leads to higher standards of patient care.

Leveraging clinical expertise

The personal judgment of experienced healthcare professionals is irreplaceable in effective, real-time decision-making. Technological advances are no doubt improving healthcare, but human intuition can never be replaced by a new device or software. However, that intuition can be inhibited by technologies if they are not strategically implemented and managed. In this sense, real-time healthcare could, ironically, be eroding quality.

To truly leverage the hundreds of collective years of clinical expertise housed in the minds of your hospital’s medical staff—the expertise that yields great outcomes—you must remove the barriers to effective communication. Collecting patient data in real time is an important part of that. But analyzing and aggregating that data into digestible, valuable pieces of information that can be easily shared and collaborated on is the follow-through that is often overlooked.

The gravitation toward instant gratification isn’t going away. And it’s important to understand that the concept doesn’t apply simply to generating patient data as healthcare events are occurring, but also to the ability to extract the significant portions and begin collaborating with the broader care team to interpret the data and derive a plan to deliver high-value care.

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What to expect from MACRA: The early years

MACRA legislation passed in April 2015. When the initial version of the rule came down, the industry collectively braced for declining revenues, the avalanche of administrative paperwork and the increase in overhead costs that would be required to comply.

When the final rule was issued in October 2016, the tempered requirements seemed to point toward fewer projected negative payment adjustments in 2019, the target year for MACRA’s first Quality Payment Program distributions, and the tension subsided a little.

Even with the new allowances in reporting and threshold scores, the MACRA structure makes clear that there’s an abundance of work to be done, especially around efforts to promote care coordination and communication.

Year 1: 2017-2018

Now that we’re already into 2017, the first official reporting year, tensions are rising again because, even though most physicians acknowledge they are going to participate, the majority have not yet plotted their course or defined a compliance strategy.

And if you’re in the group that hasn’t figured it all out yet, the good news is you’re not alone.

According to a recent poll conducted by The Health Management Academy, almost half of the physician and practice leaders who participated are not moving very quickly toward adopting value-based payment models. In fact, only 4% claimed to be moving “very quickly” while almost 40% admitted to moving “very slowly” toward value-based care.

Somewhat surprisingly, the same is true even for large hospital systems. These organizations are perceived to be the driving force, the ones moving the fastest toward the end goal of value-based care, and yet, per a similar poll, few of the large systems are moving very quickly.

Only 8% of large hospital systems polled are moving swiftly toward implementing value-based payment models. – The Health Management Academy, 2017

The Quality Payment Program, however, is going to be the catalyst for healthcare organizations, both large and small, moving more aggressively toward these models in the next couple of years.

The MACRA structure and how you fit in

By now, you know that reimbursements are going to be variable based on performance, even if you’re still practicing in a fee-for-service structure and, like most, have not yet begun practicing in the more advanced tracks.

There are four participation categories, which fall underneath two broad tracks—the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) track.

The four MACRA Quality Payment Program participation categories. – The Health Management Academy, 2017

The two categories in the middle of the chart are bridge areas, and won’t apply to many providers right now, but they can be considered as stepping stones from MIPS to the Advanced APM track.

The MIPS track equates to fee‑for‑service, and most physicians will, at least initially, fall into this track. They’ll balance their steps toward embracing more downside risk by continuing to practice fee-for-service medicine, and so they must prepare to report performance metrics and have payments adjusted based on those metrics in 2019.

On the other end of the spectrum is the Advanced APM track. To reach “Advanced APM Qualifying Clinician” status, physicians must engage significantly in certain downside risk-bearing payment models. In this track, participating physicians will enjoy fewer reporting requirements and more financial incentives, while still being held accountable for delivering high-value care. The only way to sustain a profitable practice in this track is to eliminate wasteful workflows that result in inefficient and unreliable communication processes among all members of the broader care team, even if they are not directly affiliated with your practice.

Year 2: 2018-2019

In the first months of 2018, physicians practicing in the MIPS track—again, that will be most of you—will be required to report metrics in three performance categories based on at least 90 consecutive days of work. This should come as more good news, because if you haven’t started measuring yet, or you’re not impressed by your initial metrics, you still have time to pivot before the data is due in early 2018.

CMS will use that data to give each physician a composite score, which will determine the payment adjustment he or she receives in 2019.

The Quality Payment Program’s initially proposed rule was accompanied by disheartening projections in terms of payment adjustments, particularly for solo physicians and small practices. While the finalized October 2016-issued rule basically guaranteed that all physicians who submit any performance data will receive at least a neutral payment adjustment, physicians are still bracing themselves for less-than-average profit margins.

As MIPS is largely a budget-neutral program, less risk equals less reward. Since fewer physicians will be subject to negative payment adjustments in 2019 (see Image 3 below), fewer dollars will be available to distribute to those who perform well.

Only 20%—versus 87%—of physicians in smaller practices are projected to experience negative payment adjustments in 2019. – The Health Management Academy, 2017

Simply put, the best way to ensure your adjustment is as high as possible is to garner a high composite score.

Effectively coordinating care with your patients’ broader care teams as accurately and efficiently as possible to reduce waste and unnecessary overhead costs is a good first step toward achieving high scores in all four MIPS performance categories.

Back to the present

One of the goals of MACRA is to drive the costs out of treatment while still providing high-value care. Physicians will be in a much better position to deliver this dichotomy, and advance to a more rewarding reporting track, when the barriers to real-time care coordination have been broken down.

Seamless care team communication and collaboration among interdisciplinary, and often disparate, providers will be a foundation on which you can lay the groundwork for improved care coordination, which leads to less waste, improved efficiencies, and ultimately better outcomes, all of which underlie value-based care and the successful reduction of healthcare costs.

Source: “Making Sense of MACRA” webinar. The Health Management Academy and PerfectServe. March 2017. 

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The role of secure communications in your clinical integration strategy

If you could take one solution with you on your journey to clinical integration, what would it be?

Clinical integration is the unification of healthcare data, services and coordination across acute, outpatient and post-acute care. It portrays an environment where waste and inefficiency are all but eliminated from healthcare communications, costs decrease and care improves. It’s the future of medicine.

You wouldn’t be far off course if your first thought was to rely heavily on the EHR to support your clinical integration strategy. While the EHR is a valuable tool for sharing patient information within hospital systems and broader care networks, it lacks a fundamental quality that bridges the gaps between Meaningful Use and true clinical integration.

Fully realized clinical integration can only occur when the barriers of communication have been broken down, and interdisciplinary clinicians can accurately and reliably coordinate care in real time across organizational and geographical boundaries. As with most things related to healthcare communication and the sharing of information across disparate networks, securing those communications has been and will continue to be a primary focus for healthcare IT leaders. In an environment where healthcare organizations are driving toward an end-goal of clinical integration, enabling secure communications alone just isn’t enough.

To achieve clinical integration, clinicians need a solution that enables immediate, accurate, reliable and secure communications.

Immediacy in healthcare communication

Real-time communication is a crucial element of delivering high-value care. In the most critical emergencies, every second counts. The time that clinicians waste identifying the right on-call care team member to contact, and then trying to reach that person, can quite literally be the difference between life and death. Even in non-emergent situations, early detection and treatment are well-known effective preventers of worsening conditions.

Yet it’s all too common for inefficient and broken communication workflows to create time-consuming hurdles for clinicians to clear—sometimes even to just begin the conversation.

Clinically integrated settings approach clinician-to-clinician communication with a sense of real-time urgency. That’s not to say that every message should be sent with an emergency status, just that the process of identifying the provider you need to connect to and the delivery of that message should be seamless and immediate.

Reaching the right care team member on the first attempt should be an important metric for all hospital systems. To keep performance numbers high in this area, you must ensure clinicians always know exactly whom to contact for any given medical issue.

However, most clinicians today initiate time-sensitive contact to the broader care team by thumbing through a lengthy paper-based on-call schedule, making a call, and then waiting to receive a response.

Real-time clinical communication and collaboration tools immediately deliver secure communications, and even allow the clinician initiating the communication to see in real time when messages are delivered and read.

Contact accuracy

Reaching providers on the first attempt is important, but it’s just as important to reach the right provider—the one who can act on the medical issue at that moment—via his or her preferred method of contact.

It’s not uncommon for providers to have a different preferred contact medium for every variance of their schedule. And it’s not uncommon for those schedules to change at a moment’s notice. Yet many hospitals, in both small and large systems, only print the schedule and patient assignment lists once per day.

Clinicians in this setting have no way of knowing if they are accurately reaching out to the right providers via the right contact method. Manually producing a list of whom to contact and how is a process riddled with opportunity for inefficiency and inaccuracy.

Dynamic Intelligent Routing™ eliminates those opportunities for communication breakdown. A distinct capability of PerfectServe, Dynamic Intelligent Routing analyzes workflows, call schedules and contact preferences, enabling clinicians to reach the right person at the right time with just the tap of a button.

Reliable communication workflows

If your clinicians depend on inaccurate call schedules or outdated, cumbersome processes to drive clinical communications, your communication workflow isn’t reliable.

When clinicians can immediately contact the care team member they need via that provider’s preferred contact method, communication workflows become reliable and trustworthy, which leads to high adoption and improved patient care, no matter the care setting.

From improved care coordination to reduced costs

Inefficient communication workflows not only interfere with the realization of clinical integration, but also they inflate healthcare costs. For example, if a radiologist identifies a critical result in an outpatient test, the radiologist needs to contact the patient’s PCP so action can be taken right away. If the communication is not immediate, accurate or reliable, the process breaks down and the delay could result in medical complications for the patient that end up costing more to treat.

Moving a patient safely through the admissions, treatment, discharge and post-acute care processes requires a tremendous amount of coordination, good communication and a sound clinical integration strategy. The tools you use to support that communication and collaboration will play an important role in your success.

See how an innovative partner rated Best in KLAS for Clinical Communications after four consecutive years leading the category can help ensure you’ve got the right solutions working for you.

Physician Engagement:
What It Is & Why It’s Important

Physician Engagement Definition | Measuring Physician Engagement | Improving Physician Engagement | Physician Engagement Best Practices

In healthcare, the impact of workforce engagement has similarities with other industries such as productivity, turnover, and financial performance. However, physician engagement also impacts the health, safety, and well-being of patients. The good news is clinical communication and collaboration solutions can address those common denominators and support key stakeholders.

What is Physician Engagement?

Engaged physicians take greater care of their patients, reduce medical costs, and are more efficient than their unengaged counterparts. The Health Care Advisory Board states that creating organizational alignment is one of the most challenging initiatives, but the most crucial to success—impacting cost, quality, and experience initiatives.


PHYSICIAN ENGAGEMENT DEFINITION
A strategy that focuses on streamlining communication, building relationships, and aligning physicians with the values, vision and mission of their organization and with other healthcare stakeholders to continuously improve care and the patient experience.


 

Why is Physician Engagement Important?

Physician engagement is critical for a successful patient care experience. When physicians feel a lack of association, it manifests itself in ways ranging from physician burnout to a poor patient experience.

Engaged physicians are 26% more productive than those less engaged, adding an average of $460,000 in additional patient revenue per year.

Physician employment does not automatically equal engagement. Communication and collaboration skills are a must-have regardless of the number of employed physicians. High levels of physician engagement have been correlated to increased productivity, the generation of more referrals, expanded influence amongst peers and medical staff, and a greater inclination to driving organizational strategy and change.


BENEFITS OF PHYSICIAN ENGAGEMENT
  Reduced referral leakage.
  Increased in-network referrals.
  Higher engagement of patient population.
•  Improved patient care delivery.
  Enriched physician development and performance.
  Decreased burnout and turnover rates.



Effective engagement strategies require a multifaceted approach. One that includes retention, clinical and cultural fit, onboarding, benefits, leadership development, formal recognition, and physician burnout.

 

Measuring Physician Engagement

Surveys

Consistently measure and invite physicians to share their needs and challenges to gauge physician sentiment and identify gaps within care teams and workflows.


Run monthly engagement surveys for insights into how physicians perceive your organization and its services. Using that information, closely examine the factors that contribute positively or negatively to engagement and create a plan to improve physician’s everyday experience.


 

Scorecards

Help physicians understand what is expected of them in a transparent way while measuring productivity and performance metrics.


“We feel transparency is extremely important in order to change behavior. The scorecard gives a comparison of provider to provider within the same specialty. And then it’s a provider to their individual practice. And then it’s that provider to the network.”

 Travis Turner, Mary Washington Healthcare


 

Dashboards & Reporting

Employ platforms that enable your organization to visualize sufficient, real-time data that drives organizational initiatives and empowers physicians to have the autonomy to course-correct quality to improve care delivery.


Develop an in-house practice transformation dashboard to show overall movement of your practice through the phases of your organizational initiatives. Here’s an example of a dashboard used in the special report Practice Transformation Analytics Dashboard for Clinician Engagement, published by Annals of Family Medicine.

physician-engagement-dashboard


 

Accountability Tools

Implementing a solution that provides your organization and physicians to practice accountability enables both personal, peer-to-peer, and clinical autonomy. Solutions that use read receipts, automatic escalations, and self-managed scheduling can foster opportunities for meaningful dialogue and potentially reduce burnout.

There are hundreds of ways to slice your data. Look back to your guiding questions to determine the most important KPIs for your organization’s unique goals and priorities.


Check out this snippet from our webinar with Mid-Atlantic Nephrology Associates to learn how they utilize our Tracking and Reporting capabilities for transparency and accountability across their organization.

 

Mid-Atlantic Nephrology Associates reduced operational costs by over $9k by modernizing practice communication for a network of more than 52 facilities, 50 providers, and 1,700 patients.

Improving Physician Engagement

Provide Pathways to Influence

Create physician-led channels to the executive suite to share their voice in decision-making to reframe the narrative of physicians being personnel, to being partners, by creating a forum for open dialogue between executives and physicians.


Invite physicians to join in leadership by developing a roundtable discussion. This fosters an environment where physicians know their voice is heard, helps identify leadership opportunities, and shows commitment to invest in formal and informal opportunities to develop physician leaders.


 

Launch a ‘North-Star’ Initiative

Workflows and systemic factors are universal and aren’t limited to one group of care providers. By demonstrating the intent of how multiple initiatives interconnect, it streamlines the number of things physicians are asked to do on top of their patient care routines. As an example, Figure 1 shows how the factors and behaviors that build a safer culture, drive positive outcomes.


physician-engagement-strategy-northstar

Note: Figure adapted from Bisbey et al. (2019)


 

Create a Data Strategy

Data should be used and not simply collected. An effective way to drive physician engagement is to build a comprehensive data strategy that improves transparency and helps physicians understand the objectives their organization is driving.


North Memorial Healthcare adopted an enterprise data warehouse (EDW) with visualization capabilities to enable physicians to get near real-time answers to their clinical quality improvement questions. The physicians could then see how their decisions affected length of stay (LOS) and how specific changes in clinical processes would improve LOS. By accessing the data, it was easier to convince physicians to make the needed changes.


 

Form Leadership Development Programs

Physician relationships with staff, background, outlook, and training are different from hospital leaders. This can create challenges in how rapidly physicians are able to respond to marketplace and regulatory change. Adopt intentional leadership development programs for physicians who are not only formal leaders but also informal leaders.


 

•  Hold annual leadership summits with executives and c-suite.
•  Establish physician champions to present peer-selected awards.
•  Kick off meetings with peer-recognized moments of excellence.


 

How Does Technology Improve Physician Engagement?

Physicians are trained to be patient care providers, not data-entry administrators.

Physician engagement in technology is critical for the future of care delivery, and physicians are eager for solutions that streamline clinical practice, allow more face-to-face time with patients and improve outcomes. The secret is to improving physician engagement in technology adoption is to illustrate why the technology is needed, involve physicians in the selection and implementation process, and provide data to show the benefit.

While there is apprehension about the impact of technology on payment, liability and quality of care, achieving more balance in providers day-to-day is possible with the right solution. When looking for a clinical communication and collaboration platform, look for solutions that have considered end-users in the build of their user interface and capabilities, interoperability across technology, and the capabilities to streamline workflows to increase operational efficiency.

In an environment that is inherently high stress, recognizing physician needs can empower them to implement new technologies. As a result, this can improve satisfaction levels, assist in making better care decisions, and support patient engagement and satisfaction levels.

Find out how the right solution can support your physician engagement strategy.