In today’s consumer-driven healthcare world, providers must constantly think about how to engage patients and improve the patient experience. Hospitals are rated on their HCAHPS scores, and a low score can reduce an organization’s Medicare and Medicaid payments.
Increasingly, patients are looking for a more personalized relationship with their providers and they’re likely to go elsewhere if they don’t get it. According to Deloitte’s 2016 Consumer Priorities in Healthcare Survey, 75% of consumers want providers who will include them in treatment decisions, and one in three want a provider who pushes them to be more actively involved in their care.
Three in five consumers also want their providers to be upfront about costs, though fewer than one in five said they asked about fees before agreeing to treatment. The other priority consumers consider is convenience in accessing care. In the Advisory Board Company’s Annual Health Care CEO Survey, 55% of respondents said they were extremely interested in boosting outpatient market share.
Ultimately, it boils down to how people feel about their hospital or physician experience. Do they understand what they’re supposed to do after discharge? Are they treated in a way that makes them open to hearing that information and following it? Does the hospital do everything it can to create a safe environment to help people get better?
“It’s not just amenities,” says Sarah Thomas, managing director at Deloitte, though better food and better interaction can go a long way toward making people happy. “It’s really improving the patient experience in ways that will improve the outcomes, too.”
Here are seven best practices for improving patient engagement and management.
1. Transparency: Patients are easily frustrated when they don’t know what’s going to happen next or how much a test or treatment is going to cost. Having an app can help patients prepare for visits and post-discharge care, but providers should look deeper at changes in processes and procedures that can enhance the patient experience.
“We still have some room for improvement around sharing likely out-of-pocket spending, both for the hospital and, if there’s a surgeon, then the physician’s charges,” Thomas says.
Providers also need to do the consumer research to understand where the pain points are for their population, as well as their staff, Thomas adds. A recent Deloitte study of the relationship between patient experience and hospital financial performance found that the happier the staff, the better the patient experience will be.
2. Open access scheduling: A patient who is sick or in pain doesn't want to wait weeks to see the doctor. If they can’t get an appointment soon, they may go to the emergency room, which is more costly any may not provide the specialized care they need. To meet consumer demand, many providers are turning to open access scheduling — leaving a chunk of their appointment slots open at the start of the day. The practice is a radical shift in the way doctors schedule, which traditionally was to fully book patients six weeks out.
“The whole concept of how we schedule time is being rethought,” says David Friend, chief transformation officer at BDO Consulting, which advises clients to set aside 20-50% of slots for same-day scheduling. “A lot of things we used to believe were true, like the doctor being fully booked and the operating room being fully booked, that that was the most efficient way to use them, when you really study it, you find it’s not true.”
With open access scheduling, patients are seen faster by physicians they know in a more specialized setting than an ER or retail clinic. Providers benefit, too, by filling slots left empty by last-minute cancelations.
3. Centralized registration: When a patient’s sees a provider, the first thing they’re asked to do is fill out forms seeking personal, health and insurance information. The problem is that they have filled the same forms out dozens if not hundreds of times before. To reduce redundancy and keep patients happy, smart providers are using centralized registration that maintains basic information and allows patients to fill in the gaps.
The practice saves money, simplifies registration for the patient and helps to identify new health issues sooner so they can be brought to the attention of medical staff, leading to a better patient outcome.
4. Standardizing care: While precision medicine and personalized care are all the rage, ensuring that treatments are evidence-based still matters. Guidelines that standardize clinical pathways, surgical checklists, order sets and treatment regimens can decrease variation and improve patient outcomes. The key is in personalizing the patient’s experience and making them feel that their care is unique.
5. Centers of Excellence: For some time now, the buzz words in value-based care have been “the right place at the right time at the right cost.” Patients want the best care possible at an institution with a proven track record on whatever ails them. If one hospital performs a thousand heart surgeries a year and another does three, it’s probably a safer bet to use the hospital that does a thousand. To take care of patients in the most efficient way possible — and increase the odds of happy outcomes and a good experiences — hospitals should focus on doing what they do best and selectively partner with other hospitals to handle other types of procedures.
“In manufacturing they call it a focus factory … getting very good at doing a limited number of things,” says Friend. “It’s still an emerging trend — maybe 10% of providers do it this way. But I think increasingly they’ll have to do it this way if they’re going to be competitive.”
6. Texting: Another best practice that is gaining ground, especially among younger doctors, is text messaging. In primary care, particularly, texting can be an efficient way to handle patients’ questions, reaffirm care plans and create a sense of immediacy in the doctor-patient relationship.
“This is a game-changer,” says John Bender, a family physician in Fort Collins, Colo., and board member of the American Academy of Family Physicians. “Giving my patients my cell phone number and texting with them definitely improves loyalty and makes them feel like a VIP.”
To some extent, texting is a product of necessity, as young people increasingly let phone calls go directly to their voicemail. “The beauty of it is that it allows for continuity of care in between visits,” Bender says.
Some physicians turn texting into a telehealth visit and bill for it. Others in alternative payment models like Comprehensive Primary Care Plus or an accountable care organization, where they’re receiving value-based payments as per member/per month fees with the insurer or care coordination fees, may use some of those funds to offset the costs of care between visits, Bender says.
And texting doesn't have to increase a physician’s workload. “I can say I’m going to spend some of my time on call using texting or I’m going to schedule a little lighter during the day, work 3 ½ days a week and then the other days I have my admin time and I can do more of this synchronous communication for non-emergent issues,” he tells Healthcare Dive.
7. Bluetooth-enabled apps: Another way that patient engagement can be disruptive in the future is with Bluetooth-enabled technologies and smartphone apps. Take blood pressure readings, for example. Bender says data consistently show that patients’ blood pressures at home are more reliable than those taken in the office. Prescribing medication based on an in-office reading could cause a patient’s blood pressure to drop, make them pass out or create new medical problems.
Most patients are comfortable sharing that information with their doctor, particularly if the tradeoff is better information about dosing and fewer office visits. The issue is how to access it, given problems like interoperability between EHRs and other health IT issues.
“I dream of a day … where I wouldn't even necessarily need to get a lot blood pressures in the office,” Bender says. “I might totally base my decisions — increasing the blood pressure medication, decreasing the blood pressure medication — on the data the patient is collecting on themselves at home.”