WELL COVID-19 Vaccine Tip Sheet

WELL™ Health Shares Top Tips for Guiding Patients Through the Covid Vaccine Process

Healthcare providers are under tremendous pressure to vaccinate eligible patients with the new COVID vaccine coming as early as next week. Whether you are a WELL Health customer or use a different platform, we are committed to helping healthcare providers succeed in guiding patients through the COVID vaccine process.

WELL Health’s clinical advisor, Terrance Lee, MD, MPH — a board-certified emergency medicine physician and Chief Medical Information Officer of the Beth Israel Deaconesshelped create these recommended tips and workflows.

[DOWNLOAD] COVID-19 Vaccine Communication Playbook

This WELL Health tip sheet offers tactical tips and language to guide patients through the COVID vaccine process, including education, appointment scheduling, no-show management, and adverse event monitoring. These tactics can be used with any patient communication tool but work natively with the WELL™ Health communication platform.

Tip 1: Reassure Patients About Vaccine Safety

To sort through multiple channels of information, patients may need reassurance and guidance about the vaccine’s safety, efficacy, and importance.

Example:

The COVID vaccine is now available. This vaccine, which has two doses, is critical in saving lives, stopping the spread of coronavirus and ending the pandemic. You can learn more about the COVID vaccine and its safety at {insert appropriate link}. We will soon be contacting patients who are eligible to receive the vaccine. In the meantime, please read about its safety or text us with any questions or to speak to your healthcare provider to learn more.

Tip 2: Educate Patients About Eligibility, Safety & Doses

Some eligible patients may resist receiving the vaccine when first approached. Leverage your patient communication tools to educate patients about eligibility, why it is critical to receive the COVID vaccine, and what they can expect (i.e. number of doses).

Example:

You are eligible to receive the COVID vaccine, which comes in two doses. It is critical that all eligible patients are vaccinated in order to save lives, stop the spread of coronavirus and end this pandemic. Click here {insert link} to learn more about the vaccine and its safety. Would you like to schedule an appointment to receive the COVID vaccine: Dose 1 or speak to a healthcare provider to learn more? Type 1 to schedule, 2 to speak to your healthcare provider and 3 to decline.

Tip 3: Update Appointment Confirmations & Send Reminders

Update your appointment confirmations to include instructions related to the COVID vaccine, what patients should do if they experience COVID symptoms, how to utilize the virtual waiting room, and safety protocols related to COVID.

Example:

Action: Send a confirmation immediately following the booking of an appointment.

We look forward to seeing you for the COVID vaccine Dose 1 on {insert details}.  If you have questions or need to reschedule, please call or text us. 

Action: Send a reminder 24-to-48 hours before the appointment.

We look forward to seeing you for the COVID vaccine Dose 1 appointment on {insert details}. If you have an elevated temperature, cough, sneezing, or other flu-like symptoms, please reschedule your appointment. Text us back if you have questions.

Action: Send a day-of reminder 2-to-4 hours before the appointment.

We look forward to seeing you today for the COVID vaccine Dose 1 appointment on {insert details}. Text us back if you have questions or cannot make your appointment today.

Tip 4: Collect & Respond to Adverse Events / Side Effects

Within 24 hours of the first and second dose of the COVID vaccine, follow up with patients to collect information about — and respond to — any adverse events.

Example:

Action: send within 24 hours after vaccine dose one and two.

We are following up to see how you feel after receiving the COVID vaccine. Have you experienced any soreness or redness at the site of injection? Or have you experienced any other symptoms?

(depending on patient response)

You’ve indicated a common response to the vaccine, if your symptoms worsen or if you develop new symptoms please contact your healthcare provider.

(depending on patient response)

Thanks for sharing. We will have a member of our staff contact you within 24-to-48 hours. If your symptoms worsen, please contact your healthcare provider. If you are experiencing a medical emergency, call 911 or go to the nearest hospital.

Tip 5: Schedule the 2nd Dose Appointment Quickly

To improve the likelihood of the patient returning, schedule the second dose appointment during or immediately after the first appointment. If needed, remind patients of the importance of the second dose.

Tip 6: Follow Up With No-Shows or Refusals

Uncover the cause of no-shows, mitigate the negative impact, and reduce the likelihood of no-shows in the future. 

Example:

We did not see you at your scheduled appointment for the COVID vaccine today. Would you like to reschedule? (Y/N?)

(based on patient response)

Can you tell us why you are declining? Please select from the list below:

I would like to discuss more with my healthcare provider

I am awaiting more safety information

I am worried about the side effects

I already received my vaccine someplace else

Other

I’d rather not say

Tip 7: Monitor Patient Responses & Gather Information to Supplement Reporting

Monitor patient responses to identify and reach out to at-risk segments.  Use the information gathered during this process to supplement the data you will share with the FDA, pharmaceutical companies, and public health agencies.

More about the Tip Sheet:

The WELL Health COVID Vaccine tip sheet is intended to enable providers to optimize patient response rates. Tips and sample language are offered in “good faith” based on publicly available information at the time of publication. As more information becomes available, these tips and sample language will be updated. 

More about WELL Health:

Automations are self-configurable in the WELL™ unified patient communication hub. Message triggers, text, and timing can be customized to suit the needs of your individual practices.  ♥

Be on the Alert! Telehealth does come with challenges: 3 ways to make your life easier

We continue to struggle in the second wave of the COVID-19 pandemic, and we see and understand how telehealth is a critical part of care. This recent pandemic ushered in massive telehealth adoption by doctors and patients looking to avoid the risk of infection while continuing to provide care to patients. Providers and health plans are urging CMS and Congress for expanded and permanent policy changes to support long-term use. But for many doctors (who were reluctant to embrace change), the pivot came with angst and a learning curve to integrate telehealth throughout their medical practice. In other words, they were afraid.

A recent WELL™ Insights data report indicates telehealth appointments will continue to account for 15 percent or more of appointments through the end of 2020 and beyond, making it essential to streamline the process of coordinating telehealth care between the doctor and the patient.

To make it all worthwhile for you and those you serve, here are three ways to make your life easier in the new normal.

1. Enhance the patient experience by integrating telehealth with your patient communication and EHR System. Consider unifying your healthcare communication under one hub to simplify matters for your patients and staff. You will get a greater return from your telehealth and EHR technology investments by going this route. WELL Health provides a two-way digital solution to unify the full lifecycle of patient interactions, making all this much easier to implement. WELL integrates seamlessly with the leading EHRs and your existing clinical and administrative systems. It is a simplistic method of use that can make all the difference as your telehealth efforts increase. WELL’s telehealth integration automatically populates visit links from your telehealth vendor in automated messages. Patients receive multilingual conversational messaging through their preferred channel of communication. As you have experienced, change must always be managed. WELL’s communication hub allows you to direct and encourage patients to use your patient portals, payment platforms, and other telehealth services. You will receive concrete data analytics on patient communication so you can deliver the messaging that drives financial and clinical results. And that is what you want.

How it all works:

  • Scheduled virtual appointments in your EMR, generate a link to give your patients access to their appointments.
  • WELL syncs with your EMR and identifies telehealth appointments as well as the patient-facing link for a visit.
  • Using a smartphrase, WELL inserts the visit link into an automated appointment reminder sent in line with all other communication through WELL, which eliminates manual outreach and data entry by your staff.

2. Collect receivables more quickly when you integrate telehealth with your billing cycles. The bottom line is you need to stay on top of your receivables so you can have the necessary resources to offer the best experience and treatment for your patients. As medical practices slowly rebound from pandemic revenue declines, implementing strategies to improve collections is critical. Telehealth systems like WELL enable you to gently prompt patients to pay for services in advance of appointments to decrease your staff’s intake time and accounts receivable follow-up. Advanced payments help increase your cash flow and shorten revenue cycles. WELL expedites your payments with API integrations that pull patient information from your EHR in real-time.

How it works:

  • Patients receive billing notifications by text message from your office number with a convenient link to a secure payment portal.
  • When you prompt patients to act – to confirm an appointment, pay a copay, or clear a past balance – they are more likely to comply and keep appointments, which improves receivables.
  • WELL’s two-way texting allows patients to respond quickly and more frequently to questions and ask questions without the need for staff phone calls.

3. Improve continuity of care by expanding your telehealth services to include follow-up and urgent care. Do you realize how much your patients value your opinion to continue to get the best care for their lives? With hospital emergency rooms overburdened with record COVID-19 and flu cases, it is increasingly essential for practices to offer additional telehealth solutions to alleviate the strain on the healthcare system and reduce your patients’ exposure to the coronavirus. Instead of your patients turning to an online telemedicine provider or an urgent care clinic for medical consultation or assessment on mild to chronic conditions, consider maintaining continuity of care and improving the patient experience by expanding your telehealth services to include your patients’ urgent care and follow-up needs.
When your patients bring these needs to you, it strengthens the doctor/patient relationship and prevents visits to your competitors. It keeps you in the loop about changes in your patients’ health since patients often forget to inform their doctor about visits to other providers. You stay in control while continuing and strengthening the relationship between caregiver and patient.
How it works:

  • Start by focusing on frequent health issues quickly resolved with a video or telephone consultation to triage patients to determine if your services meet their care needs.
  • Realize some patients may have turned to outside providers because they cannot physically get to your office or may be unaware of the breadth of your services.
  • Ask your patients for feedback, address any issues, and educate your patients on the positive changes through your patient communication. Your patients will need to feel comfortable with any new technology or protocols used to enhance their care.
  • As patients become familiar with your expanded telehealth services and rely on you for extended care, you can grow your telehealth offerings to solve other health issues.
    It is evident from patients and providers that virtual care is here to stay. Ensure you have the systems in place to deliver a virtual care experience that is optimal for patients while enabling your staff to spend more time on complex tasks.

To learn more about why all of this is important to our medical practice’s success, reach out to a WELL representative.

Cerner aims to simplify patient communication with WELL Health

Through WELL, Cerner offers new capabilities designed to help unify and automate previously disjointed communications; enhance patient engagement

Cerner Corporation, a global healthcare technology company, today announced capabilities focused on helping providers improve patient engagement and satisfaction through intelligent and automated communication powered by WELL Health Inc. The move is designed to help providers continue to transform the healthcare experience with added emphasis on timely and meaningful patient communications. By teaming with WELL Health, Cerner is offering health care organizations a modern way to communicate with patients, simply by texting back and forth.

“WELL Health is focused on what patients expect today – near real-time, personalized communication on their terms. We aim to move beyond the days of playing phone tag, leaving voicemails, and expecting patients to continue showing up,” says Guillaume de Zwirek, CEO and founder, WELL Health.

“WELL supports patients to text their health care provider like they would text a friend. For a provider’s staff, WELL is designed to unify and automate disjointed communications across the organization, helping to reduce unnecessary stress and limiting potential errors.”

Why texting patients matters

More than 5 billion people spend nearly a quarter of their day on their mobile phones. In fact, in the last few years, the number of active cellphone subscriptions exceeded the number of people on earth. Giving patients the same person-centric digital experience in health care as they receive from other industries has become increasingly important. Teaming with WELL Health, Cerner is focused on making technology more useable for health systems and patients by meeting consumers where they are spending their time.

Cerner patient communication hub

These new capabilities, incorporated into Cerner’s patient portal HealtheLife℠, act as a patient communication hub that extends beyond email. It is designed to help unify communications from the myriad of different systems and apps accessed throughout the patient care journey into a single text message conversation. Combined with advanced notifications and appointment reminders, organizations will be empowered to leverage automation to help improve the patient experience.

“Cerner is committed to helping providers create the engaging, comprehensive health care experiences patients expect and deserve,” says David Bradshaw, senior vice president, consumer and employer solutions, Cerner.

“We are focused on strengthening our clients’ ability to build meaningful relationships with patients, drive enhanced care experiences and deliver greater value through efficient and intelligent messaging.”

Automating patient communication

Organizations can use the new features to automate patient communications like delivering critical health information, sending flu shot reminders, rescheduling appointments, scheduling virtual visits, and prompting patients to set up needed medical transportation. Additional benefits to patients and providers are expected to include:

  • Decreased time spent scheduling and communicating with patients by using automated workflows that reply and route based on patient responses.
  • Reduced staff time spent on billing and payment collections by auto-notifying patients when new bills are ready for payment.
  • Improved patient satisfaction, retention and acquisition through timely communication and reduced hold queues, missed calls and email delays.

Consumer experiences have never been more important than in today’s environment, as patients desire more digital health solutions and providers engage in value-based contracts where satisfaction is paramount. Today’s patients expect the same person-centric digital experiences in health care as they receive from other industries and may be more likely to switch providers after a poor experience.

There are over 100 unique ways providers can use the new capabilities to aid in providing timely and informative communications with the goal of helping reduce the possibility of error or delays. Through automated and intelligent communications from WELL Health, Cerner aims to help clients improve patient satisfaction and enhance staff efficiency through meaningful engagements.

What happens when COVID and cancer treatment collide?

For 73 year-old Bonna Nelson, 2020’s unpredictability took her from a routine annual mammogram to sitting in a breast cancer surgeon’s office within days.

Receiving her diagnosis in June, Nelson initially sought care at another University of Maryland Medical System affiliate before transitioning 90 minutes away across the Chesapeake Bay for further treatment. Now in radiation therapy at the University of Maryland Greenebaum Comprehensive Cancer Center, Nelson chose to fast-track her treatment because of the pandemic, not in spite of it.

“Who knows what the future may bring,” she says. “I wanted to undergo treatment while the doctors and facilities were available and open to treat.”

A few months earlier, LaVera Davis, a patient at the NorthShore Kellogg Cancer Center in Illinois, had a mastectomy nearly 18 years after her first bout of cancer.

Speaking about her experiences handling both the pandemic and her treatment, she says “it’s a strange experience to constantly wonder – even sitting in a waiting room — if the chair had been cleaned and if I had done what I needed to do before arriving in order to protect others.”

When everything comes under scrutiny

With a cancer diagnosis, there’s always an added sense of caution when looking at actions once thought as normal.“It changes you. It changes the way you think forever,” says 50 year-old breast cancer patient Lisa Taylor.

Under current conditions combined with the risk of being immunocompromised, uncertainty becomes amplified a thousand times over.

The inability to control your surroundings when you leave the house is one thing. In any other time, seeing loved ones would’ve helped comfort patients, but not this year.

Taylor, diagnosed at the beginning of September, went to visit her teenager at university before starting radiation therapy. When she returned, she got a call saying she might have come into contact with COVID-19 on the visit, putting the schedule of her treatment plan up in the air.

Easing the burden on anxious patients

The pandemic has seen second and third waves in the U.S. But, as more time passes, we’re normalizing rather than cracking down. As a result, 67 percent of respondents in a survey from The American Cancer Society Cancer Action Network felt added amounts of anxiety towards keeping themselves safe as some social distancing measures were relaxed.

In that sense, telehealth has helped health systems give cancer patients another option for care. “It’s the best PPE out there!” says Dr. Jeff Metts, COVID-19 Incident Commander for Cancer Treatment Centers of America and Chief of Medicine for the Atlanta branch.

As opposed to in-person treatment, where stricter visitor regulations have been set, telehealth has also allowed patients to feel supported during visits.
“The stress of cancer treatment can cause someone to forget the conversation you had only moments before” says Metts. Because of this, Nelson says, “it was important to prepare for those appointments as I do for in-office visits. I prepared questions in advance and had my husband join me as a second set of ears and to take notes.”

Delays in care

Elective surgery delays have caused huge backlogs as OR volume dropped close to 35 percent from March to June. When Davis’ mastectomy date was pushed from March to April, she notes her doctor advocating for her to get the date she did as something that helped reassure her during this process.

Early detection

Had Lisa Taylor been scheduled for her annual mammogram earlier in the pandemic, she would’ve strongly considered delaying it, citing her almost-canceled annual physical in May. Her past mammograms had all been clean. How likely was it that this year would be any different?

Thankfully, she went in on time for her mammogram scheduled for July. A 6 millimeter mass was found, biopsied, and later confirmed to be early stage breast cancer. The tumor had an Oncotype DX test score of 0, meaning skipping chemotherapy was actually the safer option. Her friend, who happens to be a breast cancer surgeon, called her “a poster child for early detection.”

The shadow curve

Then, there’s the opposite scenario. The pandemic caused screening rates and appointment volumes to plummet across specialties. Metts believes this is where the “shadow curve” comes into play.

Coined by CTCA President and CEO Pat Basu, the term describes the results of undiagnosed and untreated diseases due to missed preventive care. “This means more cancers going undetected and more that will become fatal,” says Metts.

According to the same survey as above by the ACS CAN, nearly 80 percent of patients receiving active treatment said they experienced delays in their health care. Whether they know it or not, their cancer could return or progress, with 20 percent of respondents sharing this concern.

Getting used to new protocols

A breast cancer diagnosis is already difficult in its own right, but during a pandemic? An even greater challenge to contend with amidst all the changes to treatment protocols.

Taylor mentions confusion caused by new pricing schemes for telehealth services, as well as misunderstandings between her and hospital staff about whether her husband could wait with her before and in-between appointments.

Sometimes, Nelson says it’s as simple as not being able to hear and understand conversations when wearing masks.

Other times, it’s the mundanity of “answering the same questions every single time about being tested, travel, contact,” says Davis.

Speaking of tests, in comes the infamous COVID-19 nasal swab test to top off all the other cancer-related ones. “I can’t ever have that done again,” Taylor says vehemently.

The social aspect of cancer treatment

Empathy and human connection have long been shown to positively impact healing.

Despite Nelson, Davis, and Taylor all taking a breast cancer diagnosis in stride, all also discussed how the lack of an in-person social network has challenged them throughout the course of their respective treatments.

In any other situation, they would be able to go out with friends to a movie and get their mind off things for sometime. They would’ve had visitors at their bedsides, holding their hands.

“My chemotherapy was different this time around,” says Davis. “Because of social distancing, I communicated less with other patients than during the last time I went through this when we talked more…and hugged.” ♥

7 ways WELL protects patient health information

 

There’s no shortage of headlines on data breaches in healthcare.

Once again, federal agencies warn that cybercriminals are unleashing ransomeware attacks against the U.S. healthcare system designed to lock up hospital information systems. These and other frequent revelations erode consumer trust in health systems to protect patient data. And they send a chilling warning to chief information officers — protect PHI or risk millions in fines and litigation.

Health systems rely on third-party vendors for care delivery and coordination. But they present an additional vulnerability. Any weakness in their security is a weakness in yours.

“Healthcare has always been a target of cyber security threats, most recently shown by the spike in ransomware attacks to U.S. hospitals and healthcare providers. WELL remains committed to deploying and enforcing the latest security measures to protect the integrity, confidentiality, and availability of the data we receive and store,” says Sam Jo, WELL Chief Information Security Officer. “Protecting our customers and the patients they serve is and always will be a top priority for us.”

#1 Security starts with people

Research published in the Journal of the American Medical Association found that more than half of data breaches in healthcare were triggered by internal negligence. Carelessness. At WELL, we take this risk to heart. We conduct security and compliance training upon hire and regularly throughout the year. Additionally, prior to receiving access to systems, employees must complete additional compliance and best practices training. They also must acknowledge their understanding of our acceptable use policies.

#2 Maintain an information security management program

WELL guards patient health information carefully and remains fully committed to deploying and enforcing the latest information security frameworks. We will protect the integrity, confidentiality, and availability of the data we receive.

We maintain a comprehensive written information security program that covers all aspects of our information security practices, policies, and procedures, including all 19 domains of HITRUST.

#3 Develop with security in mind

The WELL development team employs secure coding techniques and best practices from The Open Web Application Security Project (OWASP) as well as SANS. Each of WELL’s developers receives formal training in secure web application development practices. We also use a peer-review model to ensure code complies with stated objectives.

Additionally, WELL’s code base is scanned at minimum on a quarterly basis, and the security team is tightly integrated with the development process to ensure secure coding practices are being followed.

#4 Store and encrypt data

WELL has a robust program for storing and encrypting data. We store data in the US in two distinct geographic regions and run databases in a private subnet. That means they’re not exposed to the internet, and access is restricted to the WELL application and authorized personnel. WELL also encrypts data in transit and at rest, and performs nightly backups.

WELL maintains a documented vulnerability management program. It includes periodically scanning, identifying, and fixing security vulnerabilities on servers, workstations, network equipment, and applications.

#5 Simulate threats

WELL is Veracode Verified and works with third parties to conduct penetration tests at least annually. These tests mimic an outside attack to ensure a full view of our environment. “WELL is committed to delivering secure code to help organizations reduce the risk of a major security breach. Companies that invest in secure coding processes and follow our protocol for a mature application security program are able to deliver more confidence to customers who deploy their software,” said Asha May, CA Veracode.

#6 Manage risks

The WELL risk management process aims to promptly address any potential risks that could affect the business and assets of the company. WELL utilizes the NIST framework for internal risk assessments. We also employ independent external auditors and consultants to perform risk analysis of WELL’s security posture.

#7 Prepare for the worst

Even with all of the correct security safeguards in place, incidents happen to even the most reputable organizations. WELL maintains a trained Incident Response Team which includes members of all integral functions across the business in order to quickly address potential incidents. The team meets regularly and has a clearly defined approach for handling potential threats.

Choose a vendor that takes security as seriously as you do

WELL serves many of the leading enterprise health systems, including Cedars-Sinai, Houston Methodist, and NYU Langone. Their security standards are the best in the business.

Deepak Chaudhry is National Health IT & HITRUST Leader at BDO, whichc conducted WELL’s HITRUST audit. He said, “WELL’s security program is particularly impressive, and security has clearly been a primary focus since the company’s beginning. WELL has made sure to consider the end-to-end data flow process, and they’ve conscientiously deployed all the necessary controls to best address safety, privacy, and potential risk.”

“We protect the patient information we receive as if it’s our own, because we have that responsibility,” Jo says. “Our environment and processes are built and maintained with a full understanding of the weight and sensitivity of the information we handle, and knowing we need to protect against the many threats that exist within information security.”♥

How better digital communication can improve population health management

Looking to part with the idea of “sick care,” a growing number of hospitals prioritize the proactive approach — population health management.

We owe a majority of our health status to factors outside the domain of traditional medical care. Social determinants of health, or SDOH, include environment, race, gender,  genetics, education, and income. 

CHCs and FQHCs have always been intrinsically aligned with population health management. For other healthcare organizations, it’s taken time for mindsets to shift. 

Value-based care incentivizes a proactive approach

With the rise of value-based care contracts, reimbursement is tied to patient outcomes rather than fee for service. This incentivizes proactive approaches — the foundation of population health. For example, closing gaps in care could save health systems up to 500 billion dollars a year

Unfortunately, the sickest five percent of Americans contribute to 50 percent of total healthcare costs because they don’t receive the care they need at the right time.  Earlier intervention for a large majority of these sick patients will improve outcomes and reduce costs. 

Digital communication plays a key role in patient outreach and engagement for population health management strategies. 

Identify at-risk groups

In order to address gaps in care, health systems must identify vulnerable groups based on population health risk factors by optimizing the data stored in the EHR. With the help of a patient communication hub that integrates with the EHR, specific gaps in care can be found and targeted through personalized patient outreach.

For example, use data to identify patients who are not up to date on vaccinations and create targeted population health message campaigns around receiving vaccinations to close the gap in care.  

Help patients manage their care 

Texting has established itself as a flexible, convenient, and effective way to engage patients in their care. Especially for chronic care management and treatment plan adherence, texting has the power to educate, inform, support, and guide patients in their health care journeys. Similar to immunizations, texting can promote population health and address medication non-adherence, low preventive screening rates, and improvements in chronic condition risk factors. 

A 2017 study from researchers at Washington University in St. Louis found conversational messaging improved the rate of self-reported medication adherence. Patients received reminders to take medications and were prompted to explain reasons for missed doses. If problems arose, providers could triage the situation in real-time. 

Increase access through transportation 

Some patients can’t receive care because they just can’t get to it. Transportation issues, including lack of a vehicle, contribute to nearly 30 percent of no shows. As a result, more than 3.6 million individuals forego medical care each year, according to the American Hospital Association. This particularly affects the elderly, who listed transportation as the third most common barrier to accessing health services. 

Help patients get to the door by arranging the ride through a ride-share program. With a patient communication platform, automation allows patients to request and coordinate a ride all via text.  

Leverage telehealth

Telehealth increases access to care while reducing ER visits, rehospitalizations, and the total cost of care. For example, Frederick Memorial Hospital created a telehealth program geared toward population health improvement, piloting it on a group of 150 high-risk patients with chronic conditions. Within two years, the program cut ER visits and the cost of care for program participants by half and reduced rehospitalizations by 90 percent. 

The importance of reducing unnecessary ED utilizations in population health management can’t be understated. Patients continuously finding themselves in in-patient settings and ERs drive up the cost of healthcare. Preventable ED visits amounted to 8.3 billion dollars as of 2019, an increase of nearly four billion dollars since 2010. Increased readmissions and ER utilization also display a decline in health outcomes rather than an improvement — something value-based care won’t reward. 

Engage patients post-discharge

Thirty-day hospital readmissions have come to the forefront as a value-based care outcome metric. Research shows that when patient activation measure (PAM) scores — a way to assess patient engagement — are higher, the odds of hospital utilization within 30 days of discharge decreased by 18 percent. 

Lower stages of PAM indicate patients do not feel an active role is important in their health care and are not confident in their knowledge to make health-enabling decisions. Giving patients an avenue to ask their questions and receive any education, support, or guidance needed during recovery periods can improve PAM and hospital readmissions as well. 

At WELL, we believe digital patient communication is the key to better population health management. 

Calculating the true cost of missed medical appointments

It’s 7:45 a.m. on Tuesday morning. You expect 211 appointments at your busiest practice location.

After careful forecasting of patient-to-staff ratios, you know you have the right amount of staff to deliver great care while containing costs. 

But then Mr. Fagan, who staff have just completed the prep work for, doesn’t show for his 8:15 appointment. Staff call to see if he just pulled into the parking lot. But no answer. They leave a voice mail and  tell the physician that he may not show up. 

An hour later, they call out, “Ms. Garibaldi?” to a full waiting room. Silence. Patients are visibly disappointed not to hear their name called. “Ms. Garibaldi?” staff call again. She missed her appointment.

Later in the afternoon, Mr. Ramos, Mr. Ballard, and a dozen other patients don’t show either. For each of these patients, staff go through the same time-wasting prep and abort rigmarole. All of this adds up to the cost of no-shows. 

The cost of overstaffing doctors and staff

Nothing shatters health care systems’ financial spreadsheets like patients who miss appointments. 

Instead of having the optimal number of clinicians and staff to serve that day’s patients, there are too many. 

With labor representing between 50 to 60 percent of operating revenue, excess capacity contributes to lower margins. An ongoing shortage of doctors and nurses and ever-increasing clinicians salaries compound the problem. 

Missed appointments, which result in overstaffing, can also take a toll on employee engagement and turnover, both which hit the bottom line. 

The emotional cost of missed medical appointments

Physicians are likely to become frustrated at the futility of both not being able to care for patients who need them and the missed opportunities of a no-show. Meanwhile, other staff might question the purpose of their work and grow disengaged. 

Employees who are not enthusiastic about their work have 18 percent  lower productivity and 16 percent lower profitability, according to Gallup. They are also more likely to leave, which increases recruiting and training costs. 

But health systems can make staff and patients happier while decreasing the cost of missed medical appointments by implementing text appointment reminders. 

When Vista Community Clinic (VCC) in southern California implemented WELL’s two-way texting platform, its no-show rate decreased 17 percent. Because more patients were canceling in advance, VCC was able to fill the empty slots. Instead of wasting time preparing charts for patients who weren’t going to make it, staff could focus on patients who would. After launching WELL, VCC’s average number of daily patient visits increased by nearly 14 percent.

The cost of rescheduling

The less patients attend their appointments, the more administrative work for staff.

The roughly eight minutes it took to originally schedule the no-show patient has to be repeated. These patients may also be less responsive (e.g., no call pick up, no returned voice mail) given they didn’t call to cancel their initial appointment. Now staff have an ever growing list of patients to call. 

This “call creep” (one call becomes two, becomes three) and associated labor expenses make up a significant part of the cost of missed medical appointments. 

Patients don’t love traditional phone calls either. As many as 68 percent of patients prefer the ease of online rescheduling. With WELL Self-Rescheduling, they can simply select a new appointment from their mobile phone almost instantly. This takes about one minute, saving time, hassle, and money. 

Actual lost revenue

Healthcare systems lose revenue when they can’t charge for services they didn’t render. When patients don’t walk in the door, cash walks out. 

Unlike a cancellation, where staff could backfill the appointment, a no-show is lost revenue. At an average cost of $265 per missed appointment and an average 18 percent no-show rate, a clinic that’s scheduled to see 22 patients but only sees 18 would lose a significant $1,060 in revenue per day.

Another example comes from a 2013 study on Estimating the Cost of No-Shows and Evaluating the Effects of Mitigation Strategies. In this study, no-shows at an endoscopy unit were found to “significantly decrease the expected net gain” of outpatient procedure centers. The daily loss due to missed appointments was 16 percent of net gain. 

The expenditures on personnel, rent, and equipment have to correlate with patient volume.

Patient reminders via text can help. Take Community Memorial Hospital in Ventura, California. Within two months of implementing WELL’s communication platform, its no-show rate dropped by 29 percent. This resulted in an estimated $1.2 million increase in annual revenue. 

The cost of no-shows in managed care

The cost of missed medical appointments can expose managed care organizations to treacherous financial risk. When spending on services and administration exceeds the fixed monthly fee, they are on the hook to pay for it.  

Unlike traditional fee-for-service systems where providers are paid for services, managed care organizations can’t pass along the cost, making the stakes higher. 

No-show rates for Medicaid patients are often higher than average due to SDOH and challenges accessing care (e.g., changing shift schedules, relying on public transportation, etc.). 

In a 2002 Journal of the American Academy of Optometry study, the Illinois College of Optometry eye clinics were found to have an average no-show rate of 25 percent. The rate for Medicaid patients was 41 percent

These no-shows jeopardize patient health, drive acute care utilization, and delay care across the system. For what could have been routine care, Medicaid patients may end up in the emergency room or be readmitted to the hospital because they missed a much less expensive follow-up appointment. 

As well as a far from ideal (and sometimes precarious) situation for patients, these scenarios also ensure that MCOs are on the hook for all associated costs. They are further financially penalized for ER visits and readmissions because these are Medicaid quality metrics that they’re failing to meet. 

Patient satisfaction is another metric that Medicaid payments are based on. Unsurprisingly, when patients have to wait an extended amount of time for an appointment, which no-shows create, they are usually not happy. Not to mention how delays can endanger their health. Over time, mumps multiply, tumors grow, vision spots proliferate. 

“There are very real quality of life issues here,” Patricia Alafaireet, Director of Applied Health Informatics at the University of Missouri, said when discussing missed appointments at her clinic. “We’ve got to get these folks in.” 

Two straightforward strategies help reduce missed medical appointments. First, text patients appointment reminders. And provide them with the option of self-rescheduling by text. WELL intelligent patient communication hub offers both. Check out our ROI calculator below to find out how much you could be saving across your enterprise.

6 strategies to maximize digital health solutions

Physician use of digital telehealth solutions has increased by 167 percent in the last 2 years, a Merrit Hawkins survey finds. 

Let’s be clear: telehealth technology did, in fact, exist before 2020. But nothing pushes people to get on a bandwagon quite like a raging pandemic. Wariness of the technological lift fizzled as the necessity to serve patients and recover revenue came to the forefront. Combined with FCC grants and relaxed reimbursement regulations, digital telehealth solutions emerged as a clear answer to new demands placed on healthcare delivery. 

With no signs of the pandemic ending in the U.S., multiple reports show telehealth — poised to be a $250B industry — is here to stay.  As a result, more and more health systems are looking to implement a long-term telehealth solution. While this is currently happening because of immediate needs, telehealth’s versatile uses continue to grow. 

Each telehealth strategy should be different depending on the needs of the health system. Part of this is also about picking the right technology out of the many existing competitors. 

In order to make the most of this service for both you and your patients, consider these six strategies: 

Understand your patient population

It would be a shame to make a service available only for patients not to utilize it. Understand your patients and what they value. 

For example, successful telehealth adoption might require other complementary services or information such as language translation assistance. Providing support staff such as patient navigators may be eligible for reimbursement depending on the insurer and type of health system. 

For patients who lack wifi or webcams, some health systems allow devices to be used by appointment in clinic parking lots with free wifi hotspots.  

When live video isn’t possible and language barriers are a problem, store-and-forward (asynchronous) telehealth may be more suitable — and cheaper — for cases that aren’t urgent. 

Similarly, the needs of a small private practice doing mostly routine preventive care visits (well-checks, annual physicals, etc.) will differ greatly from a large health system servicing out-patient, in-patient, and emergency care. 

Make an outreach plan

On the note of patient adoption, inform patients of their options to receive telehealth services, especially if they weren’t easily accessible prior to the pandemic. One way to do this is through connected care services that can reach a large number of patients at once through text or email.  

Aim for seamless staff workflows

There will always be challenges when implementing new technology, but it doesn’t hurt to look for something that will cause minimal hassle. After all, maximizing telehealth means it doesn’t create more trouble than it’s worth in the long run.

When demoing products, look for ease-of-use. Specifically, seek out digital telehealth solutions that unify workflows. This means it integrates with your EHR and existing third-party vendors. 

Consider in-house telehealth support if possible

A recent KLAS report found that many health systems adopted telehealth solutions too quickly, without properly vetting them. This coupled with the existing challenges of successful implementations required significant tech support.

Additionally, daily operations such as data handling and claims are of timely importance as reimbursement under the CARES Act shifts.

Be warned of all-in-one digital telehealth solutions

It’s natural to want a one-stop shop when it comes to healthcare technology such as telehealth and supporting functions. In this case, quality usually always beats quantity.

Healthcare IT vendors who hastily added telehealth to their digital offerings performed poorly in the KLAS report. Instead, choose a product dedicated solely to providing the best telehealth experience possible

All-in-one solutions tend to compromise user experience and encounter frequent system crashes as the volume of patient visits increase

Look at the solution, but also at the company

Consider the company behind the solution to determine whether a long-term relationship is possible: 

  • Does it have tech and customer support teams? 
  • Do they explain their product in an easily understandable way? 
  • Does it provide data insights on how to reach goals and improve upon them? 

At WELL, we strive to help you make the most of your digital telehealth solution

Our dedicated patient communication hub enables seamless automated message delivery to maximize the value of existing digital telehealth solutions. 

WELL’s Telehealth Integration informs, reminds, confirms, coordinates, and links to patient appointments. This eliminates manual outreach and data entry by staff and reduces no-shows through conversion from in-person to virtual appointments. 

Patient centered communication in the digital age

Up to 80 percent of patient expectations aren’t met during doctor visits. Digital patient-centered communication is trying to fix that.

The average medical appointment lasts less than 11 minutes. And providers interrupt patients an average of 11 seconds after they begin speaking. Not surprisingly, patient-centered communication takes a back seat and concerns linger past the appointment. 

What is patient-centered communication?

Like the name suggests, patient-centered communication correlates with patient-centered care — one of the six elements of high-quality health care outlined by the Institute of Medicine. It aims to “acknowledge the whole person,” similar to the reasoning behind holistic medicine. This includes personality, history, lifestyle choices, and social context. As a result, both patients and providers gain a shared understanding of treatment goals. 

But how is that possible in just 11 minutes? 

Digital patient centered communication

More and more healthcare interactions happen digitally. Removing the personal touch of face-to-face conversations may seem counterintuitive to the reasoning behind patient centered communication — actively engaging patients in their own care. But, it can address all of the unanswered questions that stem from lack of time. 

Even if they don’t say so during in-person treatment, patients always have questions. To meet this need, many patient interactions now happen electronically outside of appointment times through patient portals and patient-centered communication software

Numerous studies show positive patient communication correlates with higher patient satisfaction, improved health outcomes, and better bottom lines

A new avenue to connect

A 2017 Patient Education and Counseling study examined the content and sentiment of 193 messages from 58 message threads between patients and providers in a large health system. It found that while digital patient-centered communication had the potential to strengthen relationships, less than half of provider messages used language that would support this. 

Digital messaging can fill the void of increasingly short appointment times and facilitate communication. For health systems to not get left behind in the technological or customer service race, they need to know how to transfer patient-centered communication from the office to the screen. 

Make it easy for patients to open up

Some health concerns are embarrassing to discuss with someone you don’t know personally. But when patients don’t share, providers have a tough time accurately diagnosing illnesses and advising patients. However, research has shown that digital encounters — essentially having a screen as a stand in — help ease shyness and promote openness in patients who may have struggled in in-person healthcare settings.  

Giving patients the chance to ask questions digitally allows you to clue into concerns unsaid during a normal appointment. 

For example, if a patient wants to switch cholesterol management medications because of side-effects, use patient-centered communication to gauge personal preferences. Then, ask if the patient has another medication in mind already. If not, facilitate a conversation about finding alternatives that lessen the impact of the side-effect. 

Provide context and clarity

Sometimes all patients want is a little context. For instance, patients often ask what their lab results mean. An interpretation may be all they’re looking for. Providing clarity on care management in relation to daily lifestyle choices, such as eating habits, goes a step further toward patient-centered communication that proactively addresses future concerns. 

Even digital communication can show empathy

When a patient sends a text message, they deserve an answer fitting of the emotions it contained. For example, if the message shows a patient in distress, they deserve a personalized response. When a patient says, “Help, my mom’s meds aren’t working,” you wouldn’t respond, “Please schedule an appointment by clicking here.” Not very empathetic! Bidirectional texting enables patients to reach out with real concerns and staff to respond with compassion. 

It may take an extra few moments, but responding with encouraging and supportive language can make all the difference to struggling patients. In fact, several studies have shown compassion can improve treatment adherence and decrease medical procedure recovery times. There’s no reason this shouldn’t also apply to digital interactions as well.  

Patient-centered communication with WELL

At WELL, we believe that technology can revolutionize patient communication for the better. Our conversational messaging platform gives patients a voice in their care while creating lasting connections between health systems and their patients.

Reassure patients with touchless patient intake

 

 

Health system revenue recovery hinges on changes to the conventional patient intake process.

In late March, medical appointment cancellations reached up to 80 percent. Now, months after the first lockdown orders, more than half of US health systems are still under 75 percent of pre-pandemic patient volume, finds an MGMA Stat poll. 

Health systems need a new approach to recover even some of the over $200 billion dollars and counting in lost revenue from COVID-19

Patients continue to delay care

Patients fear contracting and transmitting COVID-19 while waiting in a waiting room or elsewhere in the healthcare facility.  

Just 31 percent of patients feel comfortable about the idea of going back to the doctor, finds a survey conducted by the Alliance of Community Health Plans. In addition, nearly 40 percent of respondents planned to delay future care as of May 2020. 

Unfortunately, delaying care results in disastrous outcomes. On the population level, preventive care measures — think vaccines, screenings, and annual physicals — dropped by as much as 94 percent in some specialties. The burden of this could be catastrophic as more cancers get diagnosed later and measles cases surpass normal levels. 

Touchless patient intake

In order to ensure social distancing guidelines are met, many health systems have asked patients to wait outside for their appointments. But without a system for managing patient intake, this creates operational inefficiencies as nurses and receptionists have to run in and out to just to keep the patient intake process going. 

But waiting outside the waiting room has potential. “If we can allow people to remain in their vehicles instead of congregating in waiting rooms, we can adhere to that social distancing to help decrease the community spread,” says Jane Arnold, Senior Vice President of Hospital Operations at UnityPoint Health

It simply requires automated patient communication. 

Virtual waiting room to facilitate touchless patient intake

What health systems need right now is a platform built to streamline the process of patients waiting outside of the waiting room when they arrive for appointments. WELL’s virtual waiting room feature is designed to do just that. 

“That is a huge benefit of WELL,”  says Dr. Cibu Panicker, a family medicine practitioner at Vista Community Clinic. “Because that’s really the only way we’re going to be able to treat patients while reducing the actual contact with other people.” 

The virtual waiting room allows patients to text their provider upon arrival and then wait safely in their car until the provider is ready to see them. It also accommodates digital patient intake forms and touchless payment options.

How it works

  • An hour before the appointment, the patient receives a reminder message with instructions to wear a mask and to text when they arrive. 
  • When the patient arrives at the provider location, they send a text indicating they have arrived. 
  • The provider sends an automated confirmation response, along with a link to patient intake forms if needed. 
  • Co-pays and balances can also be settled via text message through electronic payment options
  • The patient waits in their car until they receive a text message indicating that a room is ready.

At WELL, we make it our mission to help you help your patients

With a touchless patient intake process, health systems can progress with revenue recovery efforts while also ensuring patients are as safe as possible. 

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