Engage Patients: 16 Creative Healthcare Strategies
Hospitals can go beyond Meaningful Use requirements to make patients happier and healthier and the bottom line better. Consider these ideas.
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Healthcare professionals on a quest to improve patient engagement solely to meet Meaningful Use mandates miss an opportunity to improve consumers' health and their bottom line in lots of other ways.
In 2013, the government began penalizing hospitals based on readmission rates. Penalties and the reasons for these fines will increase over the next few years. Value-based payments encourage providers to embrace patient engagement, too.
But government regulations can go only so far. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which includes 32 questions across nine areas of a patient's stay, standardizes consumer ratings of care. Patients respond on topics such as pain management, nurse communication, and doctor communication. Many patients are ignorant of why they're in the hospital, the reasons for their prescriptions, or underlying conditions such as high blood pressure or high cholesterol. People with chronic conditions take, on average, only half the prescribed dose of their medications, and 50% don't follow medical advice.
When medical professionals spend more time with patients, their health improves. When a doctor tells a patient to stop smoking, for instance, the patient is 30% more likely to do so. But chronic conditions account for 75% of healthcare costs, with obesity and diabetes dominating the medical landscape. Practitioners are hard pressed to find time for more tasks.
Web and mobile technologies are removing some of those time constraints from busy practices, automating tasks while creating a personal touch that improves patients' lives. Patients feel special and appreciated when they believe that they are being saved time or money, or that the hospital makes the effort to ensure their comfort. Some hospitals have a "no ignore" rule, for example, that mandates nobody passes a room with a nurse's light lit without going in to see what the patient wants. Anybody can grab an extra blanket or ice chips, and the patient is comforted by the immediate attention.
Communication is a critical component of engagement, whether it's during a hospital stay or with healthcare providers. In fact, 82% of consumers want access to medical records, 77% wish to book appointments online, 76% prefer to renew prescriptions electronically, and 74% would like to receive appointment reminders via email or text, a 2013 Accenture study found.
As a direct result of adopting electronic communications, several healthcare providers in the study saw engagement increase. Using surveys and anecdotal evidence, practices determined patients preferred email and online access to more traditional methods of communication. In addition, no-shows decreased, so offices could reschedule other patients or spend more time with those in the office.
Though the majority of consumers want to view their records electronically, only about one-third currently track their diet, exercise, or vitals using apps or personal health monitors. As more providers explore using these tools, especially among patients with chronic conditions, that number is expected to grow, especially if they are integrated with electronic health records or dashboards for easier review.
There are many ways to engage patients that can improve their health and help your medical establishment run more smoothly, too. Click through our slideshow for tips that range from providing patients with tablets to serving bilingual consumers.
After installing Patient Prompt, Cardiovascular Institute of the South reduced no-show appointments by 25%, said administrator Hailey Fontenac. The appointment reminder software, compatible with most practice management and EHR systems, contacts patients via text, email, or voice and quickly updates the scheduling system based on patients' comments. As a result, service improves; patients whose appointments had been scheduled for a later date can be moved up, and staff doesn't wait for no-shows to appear.
Researchers at Rollins School of Public Health and the Department of Health Policy and Management at Emory University evaluated the effect of electronic health records on 170 people with a serious mental disorder and comorbid medical condition who were being treated at a community medical health center. They were randomly assigned an EHR or usual care. During the one-year trial, patients accessed the electronic record a mean of 42.1 times. Eligible preventive services received increased to 40% at the 12-month followup from 24% at baseline, whereas it declined in the usual care group to 18% from 25%, according to an article in the American Journal of Psychiatry. The authors' conclusion: "Personal health records could provide a relatively low-cost scalable strategy for improving medical care for patients with comorbid medical and serious mental illnesses."
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For six months, National Taiwan University Hospital provided telehealth services to 141 patients with cardiovascular diseases. The hospital's Telehealth Center collected data on their hospital visits and medical expenditures before and after they received telehealth services. Admission rates for both seniors and younger patients dropped "significantly," the hospital said. By using telehealth services, nonsenior inpatient costs per month fell from $814.93 to $217.39; senior rates dropped from $954.78 to $485.06.
Meaningful Use 2 mandates that more than 5% of patients communicate with healthcare providers via secure electronic messages. Increased messaging saves on phone costs and pleases patients with its convenience and immediacy. Patients and families at Children's Medical Center in Dallas, for example, averaged 480 messages per month over six months in 2013 -- a volume expected to increase. Cleveland Clinic has eliminated some unnecessary office visits with messaging and improved communication between healthcare professionals and patients or their families, Dr. David Levin, the clinic's chief medical officer, told Healthcare IT News.
In rural Kentucky, portals allow family members to stay engaged with older relatives' care. Patients and their families access EHRs and secure messaging, and they review healthcare materials on chronic conditions and illnesses. Portals provided by offices such as Danville's Family Medicine Clinic and Big Sandy make it easier for those who are hard of hearing to connect with medical professionals via secure messaging, and they allow authorized relatives to stay aware of elderly relatives' conditions.
When Geisinger Health Plan rolled out a telehealth program to help caseworkers support heart failure patients after they left the hospital, the program was so successful it was soon extended to diabetes and hypertension patients. The telehealth service reduced readmissions by 44%, according to the Danville, Pa., healthcare provider, and it helped build better relationships between patients and Geisinger professionals.
(Source: Geisinger/Facebook)
When Our Lady of the Lake Regional Medical Center got its first publicly reported HCAHPS score for nurse communications in 2008, the staff was horrified. Despite awards such as being named Hospital of the Year for 2008 and 2010, the Baton Rouge, La., healthcare provider was at the "bottom of the barrel," said Deborah Ford, RN, MSN, vice president of patient care services. After installing and using Press Ganey HCAHPS Insights, the hospital's nurse communication score improved 7%. In addition, Our Lady improved 19% in pain management, 24% in noise level, and 26% in medication instruction.
Medication non-adherence is the leading cause of preventable morbidity, mortality, and healthcare costs, according to the World Health Organization. To improve patient care and reduce healthcare costs, the Wilmer Eye Clinic at Johns Hopkins University tested an EHR integrated with Memotext, a voice reminder for patients to use their glaucoma medication. Patients who had taken less than 75% of doses correctly were split in two groups: one that received a daily Memotext reminder and one that did not. Daily adherence among patients receiving an automated reminder increased to 67%, an uptick of 31.4%.
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Catholic Health Partners gives its patients tablets equipped with Epic's MyChart Bedside. Patients use the app to order everything from ice chips and test results to more information about their condition. Early users of the system, which Catholic Health now plans to roll out to all its hospitals, said it helped them understand why they were taking specific medications, connect with work and family outside the hospital, and watch programs with visitors.
As the medical establishment encourages consumers to control more aspects of their healthcare, that control will extend to payments, some experts believe. Adventist Health System is considering melding its bill pay portal with its patient portal, Tim Reiner, vice president of revenue management, said in a Cerner blog post. "So, when someone wants to go pay their bill, they'll also be able to see their lab results and some of their other clinical data." Giving consumers clear insight into medical charges will further engage them, he said.
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St. John's Children's Hospital, part of the Hospitals Sisters Health System, equipped patient rooms with GetWellNetworks' GetWellTown, integrated with its EHR. Children use GetWellTown to access kid-oriented educational videos, TV programming, and the Internet. Families and patients also use the system to give staff feedback. About 45 minutes after nurses give patients pain medication via the hospital's Pyxis dispensing system, children are prompted to enter a pain level assessment on a scale of 1 to 10 via GetWellTown on their TV. Patients can then pick either a relaxation or education video to further manage their pain, and GetWell's Pain Management Pathway automatically notifies nurses of each patient's pain level through the EHR and Ascom phones. This helps nurses prioritize helping those patients in the most pain, and it has enabled the hospital to improve its patient satisfaction scores for pain control by 68%.
Physicians Interactive and McKesson Patient Relationship Solutions (MPRS) have teamed up to deliver Coupons on Demand to clinicians. In turn, providers can offer these cost-saving offers and adherence-support materials to patients. Access is available via the web and mobile devices, and brands can choose which healthcare professionals they want to reach, the partners said. Brands can access and monitor coupon and voucher ordering, distribution, clinician activity, and offer use. In turn, physicians can spend less time with sales reps without having to search online for discount programs, and they can continue to provide patients with savings on medications.
In 2013, 5,000 Grove Medical patients used the internal medical practice's patient portal to communicate with providers. Many like the convenience of being able to request medication refills, see lab reports, and schedule non-urgent appointments via the web. As part of a three-year program, many Type II diabetics who used the portal to report their glucose readings saw improved glycemic control, the practice said.
As part of a multi-year, multi-prong patient engagement initiative, Children's Hospital created online communities where patients and families can immediately find support when they hear upsetting news or face an unwelcome diagnosis. The Dallas hospital responded to families' request to connect with others in similar situations. The software also connects them with clinicians, medical information, and patient information. When it went live in November 2011, the Children's portal had about 5,300 active accounts. By January 2013, it had almost 10,000. Portal education and staff workflow tools added in January 2013 increased adoption from an average of about 345 new accounts each month to 1,000 in March and 2,200-plus in April. As a direct result of the portal, Children's Hospital receives fewer phone calls and enjoys operational efficiencies that allow the staff to spend more time with patients, the hospital reported. Appointment requests have grown to more than 100 per month. Most patients and families access their own records, eliminating the need for time-consuming and costly mailings and faxes. This year, the patient engagement initiative cost about $50,000 and is expected to save more than $80,000, Children's Hospital said. In 2016, expenses will remain the same, and savings will almost double, the organization predicted.
Happy healthcare employees take better care of patients, resulting in healthier and happier consumers. Sadly, only 13% of employees are engaged, according to a 2013 Gallup study. M.D. Anderson Cancer Center, which Glassdoor named one of the best places to work, encourages employees through formal mentorship programs, Forbes reported. In addition to competitive pay and benefits, other leading organizations offer volunteer opportunities, reward employees, encourage social interactions inside and outside work, and ensure they hire people who share the organization's vision and culture. This reduces employee turnover, dramatically cutting the costs associated with recruiting and training new hires.
As the nation becomes more diverse, practices are challenged to help patients whose first language is not English. Healthcare providers such as the Institute for Family Care use their patient portal to share results and health information and schedule appointments with Spanish-speaking patients. The provider also has signs in English and Spanish throughout its offices, and staff members encourage and help patients to sign up to use the portal when they come for appointments.
As the nation becomes more diverse, practices are challenged to help patients whose first language is not English. Healthcare providers such as the Institute for Family Care use their patient portal to share results and health information and schedule appointments with Spanish-speaking patients. The provider also has signs in English and Spanish throughout its offices, and staff members encourage and help patients to sign up to use the portal when they come for appointments.
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