Medical Practice Management Ideas for Physician-Owned Clinics

Frazzled Medical Practice Manager dealing with many requests

“33% of Medical Group Management leaders plan to automate patient communications in some way due to staffing shortages.”1

 

If you’re a physician or practice manager, you’re likely tasked with medical staff schedules, bills, and patient responses.

With Hippocractic determination, you may have set out to provide value for patients and make a difference in your community. But how can you manage all these administrative duties while treating patient conditions?

Implementing effective medical practice software may improve your patient outcomes. With employee shortages and urgent requests affecting speed to care, we put together a list of ideas you can implement today. Let’s take a look at a few medical practice examples that others have found useful for improved workflows.

Medical Practice Management Examples

Larger Medical Group Medical Practices

Larger medical group management needs have a few differences compared to smaller, physician-owned clinics. They typically include multiple specialists, a large clinical staff, medical partnerships, and offices scattered throughout a city, county, or region. 

For example, Mid-Atlantic Nephrology Associates (MANA) had eight office locations which served twelve hospitals in their metropolitan city. With multiple locations, managing on-call physician schedules and patient requests were a challenge. Inefficient communication resulted in providers being contacted at the wrong time. Shared logins and passwords became inaccessible due to security lockouts, and practitioners were unable to share secure images and messages to accurately treat patients.

The needs varied from communicating the latest power outage to who was on which dialysis unit, where, and when. The practice managers did not have full control over the schedules, and there was no way of knowing when a schedule was updated. They were unable to match who was on call when and at which location.

After getting everyone on a unified communication system, the nephrologists were able to see lab results right away. Group texts were sent to the whole care team and medical staff, so they knew what to expect in case of early closures or emergencies. To improve patient response times, all practice managers received a backup notification when a provider didn’t respond within 48 hours. In this way, patient messages were never missed.

By putting these medical practice communication systems in place, the providers didn’t have to worry about their schedules being disrupted while off the clock. The organization was able to get everyone on the same page. The practice managers had full control over the schedules again, allowing them to update on the fly while syncing to each location and provider.

Physician-Owned Clinics and Specialties

Building reliable systems for a small practice now can help you when it’s time to scale. Aside from medical billing and medical supply inventory, an optimized communication flow between providers and patients forms the backbone for a physician-owned clinic’s success. 

Smaller medical practices often use medical answering services to inform patients and other specialties of holiday hours, weekly office times, and who to contact for which request. Much like the large group practice example, yet with fewer locations and reduced staff size. 

For example, one medical clinic needed to let patients know their Monday through Friday hours, lunch break from 12-1 PM, and who was on call for the weekend. They needed a way to check messages and follow up without the doctor being paged for non-urgent matters. For inpatient and outpatient critical lab results, physicians needed to access that information quickly and get notified about it.

After implementing custom voicemail prompts for inpatient and outpatient labs, office hours, and urgent versus non-urgent requests, patient callbacks improved. Timely messages were routed to the right on-call specialist. The office manager was able to login to the system each day through a secure app or web browser to verify and track messages. Any edits to the schedule went into effect immediately with their specific medical communication software.

Medical Practice Management Ideas

Effective and updated communication is instrumental for operating a medical clinic or group practice. You can have one provider and two part-time staff all the way up to and beyond 100+ physicians, nurses, medical assistants, and locations. Large or small, you may share these medical practice communication strategies with your medical team and administrative decision-makers, and see if it leads to positive outcomes.

Fundamental Medical Practice Management Thoughts

Consider who your frequent patients are versus one-time patients. What does the patient journey look like? Are there ways to enhance your process and decrease human error, such as billing needs, messages, and phone calls? 

From before check-in all the way to post-acute follow ups and pharmacy prescriptions, reminding patients, and communicating with them along the way alleviates confusion. Establish a clinical workflow plan for responding to patients, inquiries from other specialities, and care team members. Let’s take a look at a few ideas for implementing these practice management strategies.

Custom Medical Answering Service Software for Medical Practices

Use a custom voicemail message related to your type of medical specialty. Setting up automated calls and notifications can reduce nurse and physician administrative burdens, allowing them to effectively receive updates, read patient charts, and respond appropriately.

A few medical specialty examples:

  • An obstetrics and gynecology clinic may need to include call flow questions related to the number of weeks pregnant, patient’s doctor, and a reason for the call.
  • A nephrology clinic may need to ask about BUN, creatinine, and potassium levels before routing the call to the right provider. This allows time for the physician or nurse practitioner to pull up the patient’s chart or other remote patient monitoring stats.
  • A surgery center may need to route a call based on the patient’s surgeon, patient location, and reason for the call, such as post-acute treatment instructions. They may need to provide message prompts for an attending anesthesiologist schedule.

Providing patients and additional providers with clearly defined instructions ensures the message gets to the right person. Taking time to set up communication flows correctly can save medical practices hours of time later.

Applying Telehealth Solutions in Medical Practice Management

Does using a video telehealth visit mean I offer free medical advice? Not if you’re helping patients. Traditionally, clinics could only bill for in-person visits. The COVID-19 pandemic thrust virtual services into the forefront, changing how the Medicare Physician Fee Schedule works via telehealth.2 For billable hours and unique codes, check the most recent CMS policies regarding virtual services.

“Telehealth services can be provided to new and established patients via smartphone if the smartphone allows for audio-video interaction between the physician and patient.”3

With secure telehealth messaging, family medicine practitioners and other medical specialties can utilize video appointments for patient follow-ups. Video technologies may be used by the whole care team, and a primary care doctor and surgeon could hop on a simple video call to discuss their patient’s next steps. For a clinical psychologist or behavioral health center, this could be an effective way to form alignment between a therapist and physician.

Secure Medical Text Reminders

How do you handle patient no-shows? What if patients are ignoring your phone calls and not logging into their portal? Perhaps patients frequently call the office for non-urgent matters or office hour information—all of which could easily be automated. 91.1% of patients surveyed in one study mentioned secure medical text updates helped them avoid calling the office.

Image of Secure Medical Text phones sending messages

What kinds of texts are best to send?

For medical practice management, here are a few suggestions:

  • Appointment reminders including day and time of appointment.
  • Virtual check-in reminders before arriving at the medical office.
  • Quick ad hoc video visits as part of a patient follow-up session.
  • Reminder to login through the organization’s portal for the detailed physician notes or AVS (After Visit Summary).
  • Prescription refill reminders.
  • Group texts to medical staff for updated closures or emergencies.

Using a patient text solution, Ridgeview Rehab Specialties was able to reduce its no-show rate by 12.6%, generating an average of $175 per visit.4 This is one example of how streamlining medical practice communication can improve patient care outcomes and reduce hefty administrative costs. 

Need more ideas? Take a few minutes to read through these customer success stories. It might be the next step in your journey to effective medical practice management. 

1MGMA Staff Members. (2022, March 23). Outsourcing, automation may provide help to short-staffed practices. Medical Group Management Association. https://www.mgma.com/resources/resources/operations-management/outsourcing,-automation-may-provide-help-to-short

2CMS (2022). List of Telehealth Services. Centers for Medicare and Medicaid Services. https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes

3AAFP (2022). Coding Scenario: Coding for Telehealth Visits. American Academy of Family Physicians. https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-telehealth/coding-scenarios-during-covid-19/telehealth.html

4PerfectServe Success Stories. https://www.perfectserve.com/success-stories/ridgeview-rehab/

Improving patient satisfaction and care with better communication

With the rise of value-based care, patient health outcomes are more important than ever. Healthier patients make a significant contribution toward increased reimbursement rates, but health outcomes are only part of the equation—patient satisfaction matters, too.

But that’s often easier said than done. With declining patient loyalty and the advent of consumerization in healthcare, patient satisfaction is difficult to achieve. It means your organization must make every effort to earn and retain a reputation for quality care that builds patient trust.

Technology plays an important role in keeping patients satisfied with their care. Dated solutions or disjointed patient care experiences can send them searching for smoother, more accessible, and more modern interactions.

In 2019, Hospital for Special Surgery (HSS)—America’s premier academic medical center focused on musculoskeletal health—wanted to elevate patient outcomes and experiences by improving care team communication across the organization. To do this, they implemented PerfectServe’s enterprise Clinical Collaboration solution.

PerfectServe brought significant improvements to care delivery workflows while also reducing stress and frustration among care team members. Not surprisingly, better clinical communication, more efficient care delivery, and happier clinicians contributed to improved patient satisfaction.

In fact, Press Ganey survey results from the quarters before and after PerfectServe’s go-live showed increases in the following categories (on a 0-10 scale):

  •  “Hospital rating” increased by 2.3 points.
  • “Hospital recommend” increased by 0.9 points.
  • “Staff address emotional needs” increased by 1.2 points.
  • “Response to concerns” increased by 1.2 points.

Faster Clinical Response Times

Critical Lab Results

Before PerfectServe, HSS relied on a manual process for delivering critical lab results—the lab tech had to call the ordering provider and ask them to log in to Epic. Leaving a voice message was not permitted, as a live verbal exchange was required to satisfy HSS’s internal protocols.

But physicians’ hectic schedules and fluctuating workloads meant delays in this process were common. Precious time was lost, and the risk of patient harm increased.

But now, once a critical result is verified, PerfectServe automatically delivers an alert to the appropriate provider using its proprietary Dynamic Intelligent Routing® technology. With all relevant information and patient context in the message, the provider can acknowledge and act upon the message right from their PerfectServe inbox—no phones, no callbacks, no delays.

After implementation, HSS looked at 1,100 critical lab alerts and noted an average 42% improvement in acknowledgment times. The quickest turnaround—from verification in the Laboratory Information System to provider acknowledgment—was just seven seconds. That’s less time than it takes just to dial a provider’s phone number.

PerfectServe also tracks when each result is received, read, and either accepted or declined by the recipient. Accepting closes the loop, while declining sends a message back to the lab for follow-up. Messages that are unacknowledged after six minutes are automatically escalated to the next provider in line.

Specialty Consult Requests

HSS also relies on PerfectServe’s Dynamic Intelligent Routing to automatically direct requests for neurology and stroke protocol consults. Regardless of who’s on-call or what kind of schedule changes have happened at the last minute, the right provider receives the request almost instantly.

Since implementation, PerfectServe has helped contact preoperative medical doctors over 8,000 times, with 80% of urgent messages read in less than five minutes. Similarly, HSS’s neurology department has received over 500 consult requests, with 85% retrieved in five minutes or less.

Sepsis Notifications

HSS uses PerfectServe to send out sepsis alerts using a two-part workflow:

  • The nurse alerts a physician assistant (PA) about a possible case. Then, if necessary, the PA alerts the responsible physicians (Modified Early Warning Score [MEWS] and Pediatric Early Warning Signs [PEWS]).
  • If needed, an alert is sent to the Sepsis Response Team and automatically escalated every minute until a doctor responds.

Since going live, nearly 700 messages have gone out to the MEWS and PEWS groups, and only nine of those have been further escalated to the Sepsis Response Team. PerfectServe’s ability to quickly and preemptively initiate the MEWS and PEWS teams is largely credited for keeping the sepsis alert number low.

Rapid Response Teams

Additionally, PerfectServe reduced HSS’s rapid response wait times to less than two minutes. These are scenarios when a patient’s clinical condition may be worsening dramatically, so fast intervention is critical. A review of the “signal one” alerts (similar to code blue) determined that PerfectServe reduced the median response time from two and half minutes to just 40 seconds— an improvement of 73%.

Staff Response Times

Additional analysis found that PerfectServe enabled HSS PAs to read 96% of initiated conversations from the PACU and inpatient floors in under 15 minutes. These were part of 8,000-10,000 monthly conversations where the average response time was less than 3.5 minutes.

These efficiency gains freed clinicians’ time and contributed to HSS’s improved Press Ganey survey results. Scores for both the “Response to concerns” and “Staff address emotional needs” categories rose by 1.2 points on a 10-point scale.

Reducing Readmissions

Because PerfectServe also provides HSS with a system-wide answering service, covering roughly 175 clinics, all the organization’s clinics have a built-in workflow for post-operative patients.

When one of these patients calls an HSS clinic, PerfectServe enables an immediate connection to a clinical nurse practitioner with the press of a button. Regardless of the reason for the call or the level of urgency, giving post-operative patients quick and easy access to a provider is a key part of care plan adherence and avoiding potential problems.

Better Communication, Better Care

Reducing obstacles that impede fast, accurate communication can go a long way toward improving patient care and satisfaction. Manual, inefficient workflows have been around for so long that they can sometimes seem like the only option. But for every delayed communication cycle, misdirected consult request, or unactioned critical lab result, there are countless potential ramifications that can negatively impact patient outcomes.

Thankfully, technology exists today that can automate clinical workflows, remove error and confusion from the communication process, and ensure that care team members are free to focus on keeping patients happy and healthy. Isn’t that the way it should be?

Reach out to learn more about how PerfectServe can transform the way your organization cares for patients while making your clinicians’ lives significantly easier. You can also download the HSS case study to learn more about their experience with PerfectServe.

How Remote Patient Engagement Solutions Reduce Readmissions

“Clinicians often perceive these initiatives as additive work that doesn’t seem to provide immediately obvious benefits to patient care. Executives tend to emphasize how important patient flow is to the organization’s efficiency and finances. But that doesn’t address clinician concerns, and they struggle to fully invest in these initiatives.” -Nursing Executive, Advisory Board1

Digital Patient Engagement: How to Address Challenges in Adoption

Misalignment and miscommunication of strategies lead to challenges among healthcare professionals and their team culture. A reluctance to adopt new technologies may have consequences, such as reduced patient response times, physicians being alerted or notified when they’re not on call, or non-urgent messages being delivered in the middle of the night when they should be held until normal business hours. If used well, however, these remote patient engagement tools can drive a variety of positive patient outcomes.

Medical directors, managers, and hospital leaders may grapple with physician resistance to digital patient engagement platforms. Their hesitancy might include the following questions: 

  • How can medical practitioners engage and connect with patients outside of brick-and-mortar facilities? 
  • Will remote patient engagement solutions actually improve value-based care outcomes and reduce patient readmission rates, or is this another technology fad? 
  • Can virtual visits and updated monitoring systems be turned into billable hours?

A plethora of new virtual patient technologies are being introduced in the marketplace. Hospital and clinical healthcare administrators are looking for ways to reduce patient readmissions and eliminate wasted costs. Yet, providers may see these new technologies as an added burden to their daily, in-person patient engagement workflows. Swamped with increasing demands and pay-to-perform incentives, patients may get lost in the shuffle, especially those who require chronic care management or specialty visits.

Both patients and providers may have a lack of awareness when it comes to ehealth engagement technology.2 Let’s look at a brief history and understanding of patient engagement, and how you can walk away knowing what strategies you should consider implementing for your medical organization.

What is Remote Patient Engagement in Healthcare?

Remote Patient Engagement Defined

Remote Patient Monitoring (RPM) is a broadly defined term which includes a range of digital tools that track a patient’s health. The information is sent back to healthcare professionals or caregivers to determine effective treatments. A few tech examples include heart monitoring devices, glucose meters, surveillance monitors, and digital reporting logs.3 

Remote patient engagement is the use of these tools and devices to communicate and follow up with patients in a secure, timely manner. These medical bands and devices are commonly used by physicians and practitioners to monitor chronic conditions and post-surgery assessments. Dieticians, therapists, and wellness coaches use these tools for preventive, proactive, and rehabilitative health plans.

Patient Engagement Before 2020

About 60 years ago, some of the first remote telemedicine technologies were developed by NASA to track the health of astronauts.4 As telehealth technology expanded, private companies and the government invested money and research into different healthcare delivery methods. Enter the Health Insurance Portability and Accountability Act (HIPAA) in 1996 and the Affordable Care Act (ACT) in 2010, which allowed more coverage for patients with chronic conditions. This opened the door for accessible and reimbursable patient visits that utilize remote patient monitoring and telehealth technology.

Patient Engagement After 2020

The consumerization of healthcare has accelerated, but the trend was in motion well before the COVID-19 pandemic. This fueled demand for healthcare organizations and providers to communicate more frequently with their patients and families. Sharing healthcare information digitally can accelerate speed to care, and 77% of patients are willing to do so if it positively impacts their care.5

In a recent interview, PerfectServe Chief Medical Officer Dr. Rodrigo Martínez shared that patient engagement technology adoption is a main need for healthcare organizations to stay relevant over the next decade:

Image of a doctor with a quote from Dr. Rodrigo Martínez

Patient Engagement Digital Platforms

The types of digital platforms that facilitate patient engagement vary widely. Some offer niche-specific chronic care and treatment, like Health Recovery Solutions, which tracks biometric activity, such as blood pressure and oxygen levels. Amazon has even joined the game with their Halo Band, which measures movement and sleep tracking. According to one study, 69% of respondents use smartwatches for chronic care management.6

List of Common Patient Engagement Devices

Like Gene Roddenberry’s tricorder in Star Trek, new medical devices are developed every year. One company invented DxtER™, a device designed “to prove the concept that illnesses can be diagnosed and monitored in the comfort of one’s own home by consumers without any medical training.”7 It was created to diagnose up to 34 different health conditions. While it’s not fully launched in the consumer marketplace, healthcare organizations and trained practitioners do use similar medical patient engagement devices.

Medical devices typically go hand-in-hand with a digital monitoring system for patient care, and for physician and nurse communication. Common devices used for patient engagement may include:

  • Wearable bands (Smartwatches, Fitbit, etc.)
  • Glucometer
  • Pulse oximeter
  • Electrocardiograph
  • Blood pressure cuff
  • Digital scale
  • Smartphones
  • Tablets or Laptops
  • DxTer Tricorder (Yes, inspired by Star Trek.)

Knowing these tools are available is one thing. Applying them in a way that enables patients to communicate with a physician or nurse is another. So how can a healthcare organization use patient engagement strategies to their full advantage?

Patient Engagement Strategies: Reach Patients Before They Get Readmitted

According to CMS, the Hospital Readmissions Reduction Program (HRRP) “encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.”8 With 6 in 10 adults in the U.S. having been diagnosed with a chronic disease, patient engagement tools and workflows will remain a priority for healthcare organizations.9 An awareness of these needs, combined with actionable foresight, may reduce these readmission events.

Do You Have a Patient Engagement Strategy?

Create a plan to measure your patient outcomes, not just quick, transactional clinic visits. Identify which remote patient engagement solution is best for your providers—something that is easy to train and implement. Being proactive versus reactive with these tools could boost physician, nurse, and patient morale. 

What are the common goals your healthcare organization wants to achieve? Knowing this information can act as a filter for your patient engagement strategy plans.

Patient Engagement Example for a Chronic-Condition Specialty Practice

patient and doctor texting back and forth with medical messages

If you are a specialty practice, build common message templates related to your patient’s frequent needs, which, when delivered to the patient, allow them to respond and transition to a remote video visit initiated by the right on-call provider. Here is one example for a 65-year-old patient with a recent kidney disease diagnosis and low GFR:

Physician’s Office: “Thank you for calling Green Valley Nephrology Clinic. Our hours are 9 AM through 5 PM Monday through Friday. If this is an emergency, please hang up and dial 911. Otherwise, press one to leave a message, press two to schedule an appointment, etc.”

Patient: (Presses one) “Hi Doc. This is George. I’m calling about my test results and the blood draw you did for my kidneys. I can’t remember my login to look at it, and I’m not good with computers. Do I need to go to the hospital? I’m peeing more than normal and I have some swelling in my legs and feet. Let me know.”

Physician’s Office: (Call routes to the on-call physician. Message alert pings Dr. Shaeffer, the on-call nephrologist. He decides to send a text message back through a secure, front-office number that masks his personal cell phone). 

Dr. Schaeffer: (Via text message) “Hi George. I received your message. Do you have a few minutes to hop on a video call? I will send you a link.”

Patient: Yes, sure. Send me the link.”

Dr. Schaeffer: (Physician sends secure link.) “Here you go. [hyperlink]”

Patient: “Oh, there you are—got it. I see you now. Thanks for sending me the link. Wow, technology these days! So, do I need to go to the hospital?”

(Video conversation continues with patient and on-call specialist).

Scenarios like the conversion above may occur for any established, chronic-care patient and their physician. Let’s look at a few tips you could implement for your healthcare organization, so more patients like George can receive better care.

4 Ideas to Increase Patient Engagement

  1. Send frequent—but not too frequent—text reminders that are beneficial for the patient. Some examples include appointment reminders, critical lab results, treatment reminders, and clinic feedback questions. Let them know you care by using automated touch-points which save time for both medical practitioners and the patient in day-to-day interactions.
  2. When assessing chronic conditions, see if there is a way the patient can message you securely or log in to their health record to view the same data.
  3. Communicate a plan for the office staff and medical practitioners so they know what messages and protocols have been set up. This includes things like lab results, inbound voicemails, and which messages are critical versus non-critical for patient healthcare outcomes. 
  4. Coordinate schedules so all patients know at least one on-call practitioner can answer their questions. Updates to these schedules can be automated from the provider or administrative staff through a simple app, without chasing down a Google calendar or paper spreadsheet at the office.

For more ideas on how medical groups are using patient engagement strategies, see a demo of PerfectServe’s solutions for your medical practice or hospital.

1Nursing Executive Center. (2020). Engaging Frontline Staff in Patient Flow: Two tactics to engage clinicians’ hearts and minds [White paper]. Advisory Board. https://advisory-prod.azureedge.net/-/media/project/advisoryboard/shared/research/nec/success-pages/2020/engaging-frontline-staff-in-patient-flow.pdf

2Safi, S. Thiessen, T. Schmailzl, K. (2018). Acceptance and Resistance of New Digital Technologies in Medicine: Qualitative Study. JMIR Publications, 7(12). https://doi.org/10.2196/11072

3Delvecchio, A. (n.d.). remote patient monitoring (RPM). SearchHealthIT. https://searchhealthit.techtarget.com/definition/remote-patient-monitoring-RPM

4Gruessner, V. (2015, November 9). The History of Remote Monitoring, Telemedicine Technology In recent years, healthcare reforms and federal legislation has pushed forward the spread of telemedicine technology and other technological advancements. mHealthIntelligence. https://mhealthintelligence.com/news/the-history-of-remote-monitoring-telemedicine-technology 

5(2021, June 15). New Data from HIMSS Shows Rapid Digital Health Adoption Necessitates Personalized Patient Technology. HIMSS. https://www.himss.org/news/new-data-himss-shows-rapid-digital-health-adoption-necessitates-personalized-patient

6Neslon, H. (2021, January 22). Condition-Specific mHealth Devices Best in Chronic Care Management. mHealthIntelligence xtelligent Healthcare Media. https://mhealthintelligence.com/news/condition-specific-mhealth-devices-best-in-chronic-care-management

7DxtER™ A New Kind of Consumer Medical Device. Basil Leaf Technologies. https://www.basilleaftech.com/dxter/

8(2021, December 1). Hospital Readmissions Reduction Program (HRRP). CMS.gov. Centers for Medicare & Medicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program

9(2022, January 24). Chronic Diseases in America. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm

PerfectServe’s Clinical Collaboration Solution Reduces Care Team Toil

To meet patients’ rising expectations and the growing demand for value-based care, healthcare organizations must support care team members at every turn. Limiting their stress and frustration in daily tasks can go a long way to reduce feelings of burnout and costly turnover.

But, cumbersome workflows often hinder clinicians’ performance and make a difficult job even harder. Inefficiencies limit their satisfaction by taking up time that would otherwise be spent on patient care, which is their most important job—the job they do best. Over time, this promotes burnout and even lower satisfaction levels in a cycle that can lead to less-than-optimal patient care.

This has all been exacerbated by the pandemic, which has added even more stress and uncertainty to clinicians’ daily lives. As a result, more clinicians than ever are leaving the profession entirely.

Improved Communication at Hospital for Special Surgery

In 2019, Hospital for Special Surgery (HSS)—America’s premier academic medical center focused on musculoskeletal health—decided to improve their clinical communication workflows. The processes they had in place were effective but time consuming, and the inefficient or suboptimal workflows were a drag on care team productivity and morale.

With 3,500 users spread across 175 clinic locations going in and out of surgery and using a mix of owned and shared devices, fast and effective communication wasn’t always possible. HSS wanted to make communication more efficient and less frustrating for care team members.

Since PerfectServe’s automated answering service was already successfully deployed in HSS’s owned clinics, the organization decided to expand the system footprint to their acute care setting by implementing PerfectServe’s enterprise Clinical Collaboration solution. After implementation, results were carefully monitored and reported in two primary categories: provider satisfaction and nurse satisfaction.

Improved Physician Satisfaction

Before PerfectServe, contacting another care team member meant physicians had to log in to the HSS intranet, search for the correct pager number, send the page, and then wait for a response. To put it simply, efficiency isn’t guaranteed when a process has this many manual steps.

But with PerfectServe, all a user needs to know is the name—or perhaps the role—of the person they want to contact (e.g., Sports Attending On Call). PerfectServes’s Dynamic Intelligent Routing® handles everything else automatically, providing almost instant communication between care team members.

Dynamic Intelligent Routing allows physicians to quickly contact the right clinician at the right time by accounting for multiple variables like date, time, service line, urgency, and more. Physicians no longer waste time sifting through directories and call schedules looking for pager numbers—they only need to follow PerfectServe’s simple guided workflows.

Each month, PerfectServe now seamlessly and dynamically references 1,819 users, 5,915 schedules, 7,060 notification rules, 3,069 contact rules, and 6,863 routing rules to deliver all clinical communications quickly and accurately—all while freeing up physicians to focus more on patient care.

Improved Physician Satisfaction

Before PerfectServe, contacting another care team member meant physicians had to log in to the HSS intranet, search for the correct pager number, send the page, and then wait for a response. To put it simply, efficiency isn’t guaranteed when a process has this many manual steps.

Improved Nurse Satisfaction

By using the PerfectServe app on their smartphones, nurses can reduce the number of devices and hardware in their toolbelt. At HSS, they use it primarily for texting since that’s less intrusive than initiating a phone call, but they also use it for sharing photographs securely. In any given month, HSS nurses send several hundred messages with attachments—predominantly images—from shared iPhones.

Nurses at HSS still utilize workstations on wheels (WOWs), but because PerfectServe is embedded directly within the EHR environment, they can send messages without jumping between applications. In terms of real-world results, another large hospital that uses PerfectServe’s EHR embedded messaging functionality has seen a 322% decrease in the time required for nurses to initiate communication.

Results

The functionalities of PerfectServe allowed HSS to eliminate more than 1,700 pagers. Before, when pages were received, there was no way to triage them based on the level of urgency. But now, clinicians can prioritize their responsibilities at any given moment with urgency designations included with every message. A page also keeps the sender in the dark about delivery status. With PerfectServe, it’s easy to see if a message has been delivered and read—nothing falls through the cracks.

Pager replacement also helped HSS realize a cost savings of over $200,000 the first year and will prevent another $80,000 from being spent every year moving forward (attributed to the recurring costs of pager maintenance and upkeep).

HSS now uses PerfectServe as the single source of truth for on-call schedules. The platform enables clinicians to quickly update their availability and preferences, and changes are visible to all users in real time. This allows communications to be routed according to the up-to-date schedule being referenced. Out of roughly 10,000 unique communications between HSS nurses and physicians assistants each month, the average time for message acknowledgment is just 3.3 minutes. If messages weren’t being routed quickly and correctly, this communication cycle time would surely increase.

Reducing or eliminating the friction that makes it difficult for care team members to do their jobs is a critical part of improving their overall satisfaction. Manual workflows that lead to costly delays have been baked into care delivery for far too long. But the good news is that smart technology can help—and it already exists today.

Reach out to us to learn more about how PerfectServe can improve your care teams’ satisfaction to reduce costly burnout and turnover. You can also learn more about the results HSS has seen with PerfectServe by downloading the full case study.

Clinical Communication Tools Governance Guidelines

As clinical communication tools continue to evolve, governance around:

  • Which users use each system for each message type,
  • Acceptable response times and standard deviations, and
  • Non compliance

…measures are critical. Learn a few best practices for applying governance around your platform.

PerfectServe Accelerates Speed to Care with Faster Delivery of Critical Lab Results

When minutes—or even seconds—can mean the difference between optimal care and patient harm, critical lab results must be delivered to the responsible party as fast as possible. But delivering crucial information quickly can also create a positive ripple effect throughout your organization.

When results come in quickly, patients receive the care they need sooner, and they’re more likely to see positive outcomes and have a satisfying experience. That’s significant because as value-based care becomes more prevalent throughout the industry, these metrics can have a powerful financial impact on your organization. Simply put, better care means higher reimbursement rates.

Improving workflows for critical lab results can also elevate provider satisfaction. It’s no surprise that cumbersome processes take a toll on care team morale. Tasks that involve switching between applications, searching through provider directories, and a seemingly endless number of clicks are a drain on their time, energy, and patience. Reducing the administrative workload and “click fatigue” can go a long way toward decreasing burnout and its wide-ranging effects on your organization.

One such workflow that simply isn’t up to snuff for many organizations is the delivery of critical lab results. Manual processes cause frequent delays, which makes it hard to close the loop efficiently.

Needed Delivery Improvements at Hospital for Special Surgery

In 2019, Hospital for Special Surgery (HSS)—the premier academic medical center in the United States focused on musculoskeletal health—decided it was time to target exactly this kind of workflow for improvement. With 3,500 users spread across 175 clinic locations going in and out of surgery and using a mix of owned and shared devices, fast and effective communication was not always easy.

Since PerfectServe’s automated answering service was already successfully deployed in HSS clinics, the organization decided to expand the system footprint to their acute care setting by implementing PerfectServe’s enterprise Clinical Collaboration solution.

The need for improvements was especially poignant when it came to delivering critical lab results. In the previous workflow, once a result was verified, a message was sent through PerfectServe asking the ordering provider to call the lab, at which point the provider would be verbally asked to review the results in the EHR. HSS policy dictates that providers must get live verbal confirmation that critical results are available, meaning a lab tech could not simply leave a voicemail and move on.

The process could take anywhere from a few minutes to a few hours, depending on the provider’s schedule and availability when the message was received (e.g., during surgery, which would cause a delay.) If the requesting provider was unavailable, the lab would have to use the call schedule to track down the attending, hoping that there hadn’t been any last-minute changes to the schedule.

HSS is an innovative, forward-thinking institution known for providing exceptional patient care, but this scenario highlights a common problem in healthcare, whereby nuanced or complicated workflows are either not integrated into the larger technology ecosystem or integrated in a way that doesn’t make the clinician’s life any easier.

Patient risk is always a concern when vital information isn’t delivered, consumed, and actioned in an efficient manner. Lengthy delays can lead to sentinel events that might otherwise have been avoided. But beyond the worst-case scenarios, delayed treatment can lead to further issues down the line that require even more care.

Manual workflows also mean your team might have to spend several hours each week looking up phone and pager numbers while trying to track down the correct physician—all to relay a simple message. That’s time they could otherwise spend on responsibilities that improve patient outcomes and organizational performance.

It’s also frustrating for providers who are most fulfilled when they’re allowed to perform at the top of their licensure. The longer staff are forced to deal with these types of inefficiencies related to administrative tasks or inefficient workflows, the more likely it is they will experience some level of burnout.

A manual process can have a detrimental impact on your organization as well. Productivity slows when staff members are sidelined with inefficient communication methods, which can lead to adverse outcomes, including lower-quality care and longer lengths of stay.

Clinical Collaboration Creates Astounding Results

HSS saw—or worried about—those same consequences stemming from their imperfect critical labs workflow. But by tightly integrating their Laboratory Information System (LIS) with PerfectServe, HSS now delivers critical lab results to the most appropriate provider almost instantly.

Lab technicians no longer have to search through the internal system for phone or pager numbers to contact the right provider, and there’s no more waiting around for a return call (that may not come). Now, once a result is returned in the LIS, PerfectServe automatically delivers it to the responsible party who can take action.

The workflow is simple. After a result is verified in the LIS, it’s automatically flagged and sent to the appropriate physician via Dynamic Intelligent Routing®. The recipient varies, but it might be the requesting physician, the scheduled on-call, or the sub who’s filling in thanks to a last-minute schedule change. Because communication is linked with scheduling, Dynamic Intelligent Routing sends the message to the correct physician the first time, every time. If the first recipient doesn’t acknowledge the message within six minutes, it’s forwarded to the next provider in line. This process continues until the message is acknowledged.

The lab is also equipped with two tracking monitors that update in real-time so lab personnel can easily discern whether each result has been received, read, accepted, or declined.

Overall, PerfectServe’s Clinical Collaboration solution transformed the delivery of critical lab results at HSS from a manual process that took minutes (or hours) into an automated process that’s completed in just a few seconds.

Now, in the amount of time it might have taken a lab tech to dial a provider’s number, PerfectServe automatically determines who the appropriate provider is and sends them the alert—all within one screen, and in a message format that gives the provider all of the relevant patient context they need.

After implementation, HSS looked at 1,100 critical lab alerts and noted an average 42% improvement in acknowledgment times. Further analysis showed a 92% compliance rate for 2,685 results. The fastest turnaround time for this process—from appearing in the LIS to being acknowledged in PerfectServe—was just seven seconds. Similarly, hematology saw 84% compliance for 856 results, with the fastest turnaround time of eight seconds.

Beyond Critical Labs

Taken as a whole, PerfectServe’s role in clinical communication and care coordination reduces time to treatment in many areas—not just critical lab results. This improves the quality of care and patient satisfaction across the board while also reducing care team toil .

By integrating with other systems and applications to create automated workflows, PerfectServe allows nurses and lab technicians to focus on patients by removing the burden of tracking down physicians.

Similarly, providers’ days don’t have to be interrupted with pages, phone calls, and tedious searches through the EHR for information. Instead, they can quickly access the lab results they need from their PerfectServe inbox and take any necessary action. This eliminates common obstacles and frustrations to help reduce burnout and turnover.

Reach out to us to learn more about how PerfectServe can help your organization transform its communication and provider scheduling practices. You can also learn more about the results HSS has seen with PerfectServe by downloading the case study .

Ochsner Health Drives Physician Engagement, Reduces Burnout With Better Schedule Management

The subject of healthcare burnout is not new. In fact, according to the KLAS “Clinician Burnout 2021” report¹ published in December, burnout levels are higher than ever, with the pandemic being a prime contributor:

For physicians in particular, KLAS notes that one of the biggest contributors to burnout is having no personal control over their workload. Taking care of patients is rewarding, but doctors aren’t robots—they need to rest and recuperate, and during times of elevated stress, they need to know there’s a light at the end of the tunnel.

At the recent ADVANCE 2022 conference hosted by the American Society of Anesthesiologists, New Orleans-based Ochsner Health presented research and findings² that demonstrate how PerfectServe’s Provider Scheduling powered by Lightning Bolt can help to stem the tide on burnout and loss of control.

At Ochsner, Lightning Bolt “significantly improves physician engagement and reduces burnout by creating fair and flexible schedules that support work-life balance—even during the COVID-19 pandemic.” The results presented by Dhruv Choudhry, M.D., lead author of the study and anesthesiology resident at Ochsner, are powerful:

1. Six months after implementing Lightning Bolt for a department of 60 anesthesiologists, a Press Ganey survey revealed that their average engagement score had increased by nearly 30%, from 3.3 to 4.2 out of 5. This was one of the largest increases across the Ochsner Health system.

2. Lightning Bolt drove this increase by granting more vacation days, reducing ungranted vacation days, and providing more predictability and flexibility than the prior staff-created scheduling system.

3. Compared to the previous manual scheduling process, which required 60 to 75 staff hours per month on average, Lightning Bolt auto-generates “the best schedule for the department” in just 14 hours. Collectively, that’s two and a half days of staff time saved per month and 30 days saved over the course of a year.

Anecdotally, Dr. Choudhry also reported that Lightning Bolt gives anesthesiologists  “one or two mornings and one or two afternoons off a month to allow for increased work-life balance so they are better able to attend events important to them.”

Talking more specifically about the pandemic, Dr. Choudhry noted that Lightning Bolt allowed Ochsner to quickly and seamlessly build schedules for COVID ICUs as they were opened. Physicians could also indicate in the system whether they preferred to work in the operating room or the ICU, which added a degree of control to an often-uncertain situation.

In addition to the results Ochsner presented at the conference, the organization has seen other notable improvements after implementing Lightning Bolt:

  • Auto-generation and publication of schedules through Lightning Bolt saves Ochsner roughly 720 hours per year versus previous scheduling methods.
  • Vacation request approval has increased by 55%.
  • Lightning Bolt has improved OR case handoffs, saving Ochsner $600,000 per year.
  • The use of reporting has allowed for greater transparency and helps physicians to better understand equalization rules. For example, it’s easy to demonstrate that weekend work is being evenly distributed to avoid any one person feeling like they’re shouldering too much of the load.
  • Integration with Epic On-Call Finder has improved transfer center operations and yielded better speed to care for patients.

Taken as a whole, Ochsner’s experience with Lightning Bolt is a strong endorsement of advanced scheduling technology and the many ways it can improve the lives of providers, staff, and patients. When providers have more control of and better visibility into their schedules, and when they know those schedules can be built equitably while accounting for their personal preferences, they are more likely to be satisfied at work. Greater provider satisfaction often leads to better patient care, better retention, and better metrics across the board.

We thank our friends and partners at Ochsner not only for presenting their findings, but also for reminding us that healthcare technology has the power to change, improve, and even save lives every day.

Ready to learn more about transforming your organization through better scheduling?

Citations

  1. Clinician Burnout 2021, KLAS Research Arch Collaborative, Jacob Jeppson, Dec. 3, 2021: klasresearch.com/report/clinician-burnout-2021-covid-19-increasingly-cited-in-rising-burnout/2080
  2. Using AI to create work schedules significantly reduces physician burnout, study shows, American Society of Anesthesiologists, Jan. 28, 2022: asahq.org/about-asa/newsroom/news-releases/2022/01/using-ai-to-create-work-schedules-significantly-reduces-physician-burnout

Develop a Clinical Communication Governance Strategy

Ensure the investment you’ve made is used and adopted as intended

Governance is an important tool organizations use to ensure that software implementation and adoption aligns with business goals and complies with external regulations. A good governance program offers a framework for achieving measurable progress toward organizational objectives and maintaining compliance standards.

Adding to operational complexity, organizations now operate in an environment defined by distributed networks, distributed teams, and cloud-based everything, and a rapidly expanding big data ecosystem that’s becoming increasingly difficult to control.

A good governance system addresses these issues and is designed so that assets such as clinical communication tools provide maximum value to healthcare organizations and patients.

To make governance work for your organization, we’ve developed a checklist to help you manage your Clinical Communication Governance Strategy.

Support Nurses Ability to Easily Communicate with Providers and Patients

Siloed communication infrastructure adds to nurse’s workload when they desperately need ways to reduce their administrative responsibilities. Empower nurses to communicate with each other, providers, and patients without logging in and out of several solutions to do so.

Reaching Providers and Patients’ Family Members Consumes Time

Nurses are responsible for multiple administrative duties on top of providing an upstanding standard of care for their patients that requires an abundant amount of collaboration and support.

Some nurses spend 33% of their shift interacting with technology and only 16% of their time on direct patient care.

Updating family members, getting a hold of the correct physician in a timely manner, communicating with respiratory, physical therapy, radiology in addition to coordinating with the nursing staff on their unit are just a few of the communications that happen throughout the nurses shift.

The time consumption initiating communications with different departments and providers could be precious time taken away from a patient’s care. A bandage may be left for the next shift to change, medications get administered later than ordered, patients miss a day of physical therapy because the nurse was unable to pull away from other tasks to help PT. Ultimately, the administrative burden nurses are under unfortunately can result in poor patient outcomes.

Tackling Nurse Communication Silos

Text, badge, EMR, email, phone – too much technology reduces efficiencies. When nurses need to login to the EMR for a critical lab result, phone a patient’s family member, use their badge to communicate with other nurses and then text the on-call provider regarding their patient, too much time is spent logging in and out of various solutions. Efficiencies can be gained just from reducing the number of technologies nurses need to use and reference.

The result – both improved nurse satisfaction and improved outcomes for patients. We want to reduce frustrations nurses encounter day to day, and streamline communication for all care team members.

With family members the inefficiencies are similar, find the correct number, call, no answer, leave a voicemail. Or find and call the alternate phone number and speak with a family member who has 20 minutes of questions, while the nurse is on the phone, the physician has returned the page and the nurse missed their call due to the fact that the nurse was on the line with the family member.

Clinical Communication Governance

Leading organizations have clear policies around communication response times, such as a routine message must be responded to in 60 minutes but an urgent message within 30 and STAT within 15. This becomes increasingly difficult without the right, and siloed, communication tools.

Text First Approach

82% of text messages will be read within five minutes of being sent—with an average response time of just 90 seconds.

A text first approach for all clinicians provides a single app to be used for nurse, provider, patient and auxiliary staff to ensure tight coordination of patient care. Look for a solution that also embeds into the EMR to improve clinical workflows. Nurses should be able to see a patient record from their mobile, the communication stream between care team members, critical lab results and any other pertinent details that will keep them abreast of their patient from any location—decoupling them from the nurse station.

Connect with our team to learn more.

HIPAA Compliant Texting: Tips on Patient Communication

With the number of smartphone users in the U.S. expected to cross the 300 million milestone in 2022, it’s now possible to connect with anyone at almost any time.1 This digital transformation gives healthcare providers, patients, and family members a great opportunity to communicate during and after care.

Here are some ways HIPAA-compliant secure messaging can help, especially during times when going to hospitals and medical practices in person isn’t always an option.

HIPAA Compliance Rules Explained for Healthcare

The rules for HIPAA compliance in healthcare prohibit medical providers—including physicians, nurses, and staff—within the practice from releasing protected health information (PHI) without the consent of the patient or guardian. All health organizations are required to train their staff annually on how to comply with HIPAA regulations. With the installation of HIPAA-compliant software like PerfectServe, providers can safely integrate patient communications in secure clinical messaging.

Healthcare Before HIPAA

Have you ever wondered what healthcare was like before HIPAA? Before the introduction of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the U.S. Department of Health and Human Services (HHS) did not have a National Health Privacy Law, and patients relied on laws in each state about patient privacy. HIPAA was created to set national standards to protect PHI from being disclosed without the patient’s consent or knowledge.2

Healthcare After HIPAA

After HIPAA was established, medical providers had new guidelines for protecting patient information, regardless of their practice size or specialty. Today, HIPAA requires all practices to attain patient consent forms to use PHI for healthcare delivery, payments, practice communications, and other uses of PHI for marketing or research purposes.3

How Does Secure Patient Communication Work?

Traditionally, practices and medical providers have been forced to use multiple platforms to achieve secure patient communications. Ensuring all information on multiple platforms is current and correct requires more staff and time. Now, they have options to streamline the workflow for health information, provider communication, reminders, HIPAA-compliant texting, and patient records all within one platform.

Voicemail and Phone Message Prompts

Different medical practices use voicemail and phone message prompts as conduits for communicating securely with their patients. But this method of communication is often cumbersome, requiring a lot of follow-ups and tracking, which leaves the door open for missing information. Practices have often found a positive response in patient satisfaction, appointment scheduling, and overall communication when switching to a streamlined and secure messaging patient platform.

Secure Medical Texting

Smartphones are veritable Swiss Army knives these days—they’re used for communicating, maintaining calendars, browsing the internet, wayfinding, and many other tasks or activities. To emphasize the immediacy of contact when smartphones are in play, one research article indicated that 90% of people read a text message within the first three minutes, whereas emails are often overlooked.4 Allowing communication between healthcare providers through secure HIPAA-compliant texting creates a win-win for not only the patient experience, but also the medical practice managers and hospital staff.

Secure Clinical Messaging for Better Patient Communication

PerfectServe provides HIPAA-compliant secure texting solutions to empower clinicians to text nurses, physicians, patients, and family members all in one app that can include attachments, videos, and more for communication purposes. As medical providers, it’s crucial to obtain accurate, up-to-date information and reminders for each of your patients.

Text Messages Help with Patient Reminders

One PerfectServe client, Ridgeview Rehab Specialties, was able to reduce no-show appointment rates by 12.6% using automated secure text messages to patients. Ridgeview reported 6,264 no-show appointments in 2016 and realized it was imperative to make a change using new technology to streamline messaging. Over two years, the switch to secure text reminders resulted in more patient engagement and fewer no-show appointments. Overall, the facility was able to reduce no-show appointments by 792 annually with an estimated revenue gain of $138,600.5

Providers Can Message Patients on the Fly

Having access to reliable connectivity across locations makes it easy to deliver timely communication and care. Providers can use secure video, voice, and HIPAA-compliant text messaging from specialty practices to the hospital staff while using a phone, tablet, pager, computer, or landline. Organizations with more advanced PerfectServe deployments have even embedded the communication platform directly within the EHR, which allows providers to cut back on time spent toggling between devices and other apps by up to 76.3%. Imagine being able to admit a patient into the ER, receive blood work, and contact their primary care physician all within one platform.

Integrations are another key differentiator that set PerfectServe apart from similar HIPAA-compliant texting apps. Unnecessary provider disruptions can be avoided by integrating schedules with workflow engines, and integration with the EHR to incorporate information like patient lists unlocks a wide number of valuable workflow capabilities. Integration with the nurse call system frees nurses from the bedside by giving them the ability to monitor and respond to patient alerts and requests from any location, especially if they’re equipped with smartphones.

PerfectServe provides secure messaging, connectivity from any location, accessibility on all devices, embedded EHR messaging, automated routing, and improved workflows all from one easy-to-use application.

For more information, read how secure text and video messaging helped other practices communicate effectively across the care continuum.

1O’Dea, S. (2021, March 19). Number of smartphone users in the United States from 2018 to 2025 (in millions). Statista. https://www.statista.com/statistics/201182/forecast-of-smartphone-users-in-the-us/

2(2018, September 14). Health Insurance Portability and Accountability Act of 1996 (HIPAA). Centers for Disease Control and Prevention. https://www.cdc.gov/phlp/publications/topic/hipaa.html

3Kibbe, C. (2001, March 8). What You Need to Know About HIPAA Now. Family Practice Manager, 8(6):43-47. https://www.aafp.org/fpm/2001/0300/p43.html

4Lane, N. (2010, June). Conversational Advertising. MobileSquared. https://mobilesquared.co.uk/wp-content/uploads/2017/12/Conversational-Advertising.pdf

5PerfectServe Success Stories. Ridgeview Rehab Specialities department reduces non-show rates by 12.6% with automated text messages to patients. https://www.perfectserve.com/success-stories/ridgeview-rehab/