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When it comes to communicating with patients, nothing beats the immediate connection of text messages. While email and phone calls face diminishing open and answer rates, 90% of text messages are read within 3 minutes.1
Combine the timeliness of texting with the relevance from patient context, and you have a powerful tool to communicate with a patient when and where it matters most. In this post, we will examine the opportunities to engage with patients across the spectrum of care, improve outcomes, reduce costs, and improve the patient experience.
Changing Patient Expectations
The healthcare industry has shifted from volume to value, working on the Triple Aim of improving patient populations, individual patient health and satisfaction, and reducing costs.2 At the same time as patient satisfaction is being linked to reimbursement, patient expectations for their healthcare experience continue to increase.
Patients, now responsible for a greater financial share in their care, are approaching their care experiences with consumer expectations. Patients expect convenience, personalization, and involvement in their care anytime, anywhere. With patient experience and satisfaction now moving targets, healthcare organizations need ways to engage patients in their care and to continually assess the success of their efforts.
Unfortunately, improving health system performance toward Triple Aim results has led to worrying rates of clinical burnout. With technology often cited as one of the leading causes of burnout, we are now seeing healthcare organizations focus on the Quadruple Aim, including provider experience and satisfaction.3 The Quadruple Aim recognizes the importance of usability, effective care processes, and improved clinical workflows to achieve Triple Aim results.
The patient engagement strategies below are designed with the Quadruple Aim in mind, reducing administrative burden with patient, population, and diagnostic-specific automations to engage with patients across the care continuum.
How a patient experiences their healthcare encounter begins long before the patient even steps through your door. From their perception of your website and scheduling processes to your preparation and intake processes, patients are looking for modern, seamless, and informative experiences.
Healthcare organizations looking to transform their patient experiences can begin by engaging with patients before their scheduled appointments, including:
- Care Preparation Instructions – reminders to fill or take prescriptions or start pre-operative instructions based upon procedure-specific pathways
- Appointment Reminders – reminders of the date, time, and location of an upcoming visit with detailed wayfinding instructions
- SDOH Support – leveraging social determinants of health (SDOH) data, reminders can include coupons for transportation to reduce no-shows
- Patient Intake – send patients a link to electronic forms to support off-site check-in
In addition to automating preparation and intake, you can leverage automations to keep patients “in the loop” day-of-procedure. For example, scheduling delays can trigger a status message to patients to re-align their arrival time.
Hennepin Health, in partnership with Lyft, recently targeted patients with a history of clinic no-shows, allowing them access to a corporate Lyft account to get patients to their appointments. At the end of the 12-month trial period, no-show rates decreased an aggregate 27%, clinic revenue increased by $270,000, and ROI was 297%.4
Although the factors that influence a patient’s experience vary widely based on the reason and length of stay, we can follow the broad strokes of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to identify a patient’s perspective on their care experience.5 The 18 substantive questions included in the survey focus primarily on communication with doctors, nurses, and staff during care and at the critical point of discharge. Outside of this, questions focus mainly on environmental factors such as cleanliness and sound level.
PerfectServe’s clinical collaboration solution is designed to enable fast, efficient communication that enhances care and improves the patient experience.
Integrate Nurse Call, Alert and Alarm Notifications
We centralize communication across multiple systems onto a single platform to simplify clinical workflow while eliminating extraneous noise. Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient directly. If the call button is non-urgent (such as a “water” request), it can automatically route to the Patient Care Technician, reducing nurse interruptions. Patients benefit from reduced ward noise and faster response times – critical factors in HCAHPS scores.
Family members play a crucial role in supporting patients during their stay at the hospital and in encouraging compliance with care plans. Healthcare organizations are recognizing the importance of supporting families as part of the patient experience as well.
With pre-configured pathways, families can feel more comfortable leaving waiting room areas knowing that they will receive an automated message with patient status and return time. If a patient’s family member calls into the main hospital call center and are connected to the appropriate nurse, the nurse can return the call with one click. To ensure the correct on-call nurse is contacted in the future, the return call number is hidden.
Post-Discharge Assessments and Surveys
Following the most recent round of Medicare readmission penalties levied against 2,583 hospitals, preventable hospital readmissions continue to be top-of-mind.6
According to a study published in BMJ Quality & Safety, patients reporting high satisfaction and good provider communication were less likely to be readmitted.7 Decreasing preventable readmissions requires that patients understand and adhere to their care plan, that pain is managed, and that follow-up care is scheduled and attended in less than two weeks.8
Leading hospitals are leveraging text-first interactions to monitor care, assess pain, and send care plan reminders (such as filling or starting a prescription). Questions can be delivered one-at-a-time to encourage response or patients can be prompted to a secure web form for a full survey or to share detailed personal health information. Frequent check-ins not only increase patient satisfaction but also allow clinicians to escalate concerning responses to a secure chat session or phone call.
Park Nicollet Methodist Hospital adopted a text-first follow-up program that included a series of customized follow-up questions to assess a patient’s risk for readmission. 70% of questions sent via text message receive a response rate from patients. The PerfectServe dashboard collects and analyzes every patient’s response and nonresponse, segmenting the patient population into risk categories and automatically flagging patients that need immediate follow-up.
Park Nicollet’s results showed that patients who received and responded to text messages were 32% less likely to readmit than those solely contacted by phone. (These results are risk-adjusted to account for the relative complexity of each patient’s conditions.)
Patient Satisfaction Surveys
The goal of any patient satisfaction survey is to gain honest insight into the patient experience. Although the HCAHPS survey has incentivized improvements in patient experience, the response rate for patients has been on the decline, down to just 26.7% from July 2017 to June 2018.9 Administered 2 to 42 days after discharge, surveys do not yield the timely data hospitals need in order to act on patient satisfaction.
Given the high impact of HCAHPS results on a hospital’s financial performance, there is an opportunity to survey patients before the CMS to mitigate issues and improve patient satisfaction in advance.
To make patient satisfaction surveys actionable, healthcare organizations need easy, customizable surveys that target specific patient populations and encourage meaningful dialogue. Surveys can be automatically triggered after the healthcare encounter while the experience is fresh on the patient’s mind. Deploying text message surveys and text-first surveys is a cost-effective approach to obtaining these coveted patient insights.
Patients indicating dissatisfaction present a service recovery opportunity – contacting them to show concern and learn more about their experience will not only inform systemic improvement opportunities but also will likely change the patient’s impression of the organization.
PerfectServe allows hospitals to reach patients and/or families in real time before, during, and after care to better engage, activate, and assess patients in their care experiences. Post-discharge assessments present an opportunity to evaluate patient satisfaction and address patient concerns while there is still time to directly improve their satisfaction.