7 communication strategies to address gaps in care

Gaps in care cost patient lives and health systems close to 500 billion dollars a year.

A gap in care is the discrepancy between recommended best practices and the care that is actually provided — essentially, when patients don’t get the care they need.

For example, poor treatment adherence is a well-established gap in care. And medication non-adherence accounts for approximately 125,000 deaths in the U.S. per year.

Innovative verbal and digital communication practices can help health systems bridge this and other gaps in care.

1. Frame risk communications

The information patients receive about their health impacts the decisions they make — such as whether to take their medication as prescribed or attend a routine screening. Hence, deliberate communication around risk can help reduce gaps in care.

Dr. John Paling, founder of The Risk Communication Institute, suggests the following approaches for framing risk communications:

• Statistics are better than vague terms. Instead of telling a patient they are at a “high risk for liver disease,” say, “Roughly half of men who drink more than 8 ounces of alcohol a day for 20 years develop cirrhosis.”
• Present data with visual aides. Sometimes it’s easier for a patient to visualize their risk of developing a condition if they see a line graph showing a steady risk increase associated with their behavior.
• Be consistent when comparing. For example, don’t mix fractions and percentages, and use absolute numbers.
• Give both sides of a statistic, such as chances of survival and chances of death.

2. Incentivize good health with patient-centric communication

Patient-centric communication touches on a patient’s personal values beyond their health, such as family, self-esteem, and personal growth.

A patient-centric communication style may involve motivational interviewing strategies. Use the OARS acronym: Open-ended questions, Affirmations, Reflective listening, and Summarizing. This helps nurture potentially straying patients by fostering more empathetic patient-provider interactions.

This style of communication can help close gaps in care. In patients whose providers received patient-centric communication training, odds of adherence increased by more than 150 percent.

Consider a patient who takes medication for a heart problem. They may say, “I can never remember to take my pills.” The doctor can then affirm the patient is capable of taking control of their health, engage in reflective listening, and suggest a routine that easily fits into their lifestyle.

3. Use texting to reduce gaps in care

Text messages can help healthcare organizations bridge gaps in care in two ways. First, texting patients can improve treatment adherence. For example, research on patients with coronary heart disease showed daily text reminders increased medication adherence by almost 3x and improved blood pressure outcomes. Second, text message campaigns can be sent to specific patient population groups. The messages can prompt them to enroll in risk-based programs or provide patient education specific to their condition.

4. Improve patient communication with technology

Health systems miss more than 30 percent of all phone calls. And it’s estimated less than 20 percent of those callers leave a voicemail. This leads to information gaps, no-shows, and negative phone experiences. In the short term, it may cause patients to reevaluate where they get their health care. There are two consequences to this: The health system loses a patient. And the patient experiences a gap in care as they look for a new provider and wait for an appointment or potentially neglect care altogether.

Reduce hold times and improve show rates by implementing a conversational text messaging patient communication platform. Four out of five smartphone owners want their healthcare providers to text them, and 90 percent of texts are read within three minutes. Texting patients — and making sure they can text you back — eliminates the frustration and missed calls of relying on the phone.

5. Guide the conversation

More and more patients are doing online research prior to doctors appointments. While online information is a great source of patient empowerment, it can also cause tension and disagreements with providers when it comes to concluding a diagnosis or treatment plan.

Steer patients in the right direction by sending patient education by text message. Patients will feel at ease openly discussing the topics at hand, and not blindside providers with questions or concerns.

6. Reduce no-shows to reduce gaps in care

Numerous studies have shown that some form of appointment reminder, especially text messages, helps close gaps in care caused by appointment non-adherence.  In a 2016 study including 186 pediatric clinic patients or parents, those who received a single text reminder were 15 percent more likely to attend their appointment. WELL clients have seen even greater improvements with customized cadence of appointment reminders. For example, Eisenhower Health reduced its no-show rate by 71 percent.

A customizable appointment reminder system can help your patients get in the door while also preparing them with relevant pre-appointment instructions.

7. Coordinate care with unified communication

On a single day, a patient with a chronic condition may have an appointment with a specialist, get a scan, have blood work done, pick up a prescription, and receive a patient survey. They could receive multiple calls and messages from different numbers about these services. The result is confusion and “message fatigue” — contributing to gaps in care.

Instead, ensure patients receive all correspondence in a single text thread. Send from a secure, trusted source — a number from within your health system. Not only does this build trust — patients know who’s texting them — but also it allows you to combine messages into a single text. The better patients understand their care, the easier it is for them to follow through. ♥