WELL Referrals Management reduces patient leakage


As many as 50 percent of patient referrals are never completed.

Sometimes it’s due to a communication breakdown between doctors and patients. Sometimes patients simply forget to schedule or keep a referral appointment.

The result is that patients don’t get the care they need. And they are more likely to be readmitted to the hospital and have worse outcomes than patients who attend specialist appointments.

When patients fail to complete their referral appointments, hospitals suffer too. For nearly half of health systems, patient leakage results in more than 10 percent of annual revenue losses. Moreover, incomplete referrals mean slots go unused in specialists’ schedules. Analysts predict that by the year 2023, there will be a shortage of more than 65,000 specialists. Leaving unused time in their day wastes valuable resources.

We launched WELL Referrals Management to improve the referral workflow and reduce patient leakage. Our platform helps office staff schedule appointments and helps patients keep them. Coupled with WELL’s powerful automation engine and appointment reminders, it creates a concierge patient experience.

Improving patient referral workflow

WELL created its new Referrals Management system to automate the referral communication process. Here’s how it works:

  • After a provider places a referral order in the EHR, the patient receives an invitation to book an appointment. WELL sends it through the patient’s desired communication method (text, phone, or email) from the referred specialist.
  • If a patient responds yes, the specialists’ office can continue the conversation via text, call, or email to set up the appointment.
  • If a patient gives no response, the message can be repeated. This is where WELL’s powerful automation engine really shines. You can configure messaging to be sent out at custom intervals depending on the needs of your practice.
  • If a patient says no or doesn’t respond to the final message, WELL will send this response back to the EMR, closing the referral. From there, staff can personally reach out to the patient to schedule the appointment. As few as five percent of patients actually respond no.

Powerful automation engine

After patients schedule their appointment, WELL sends automated appointment reminders at custom intervals. The value of completely configurable messaging cannot be overstated. Your staff doesn’t need to lift a finger to keep patients engaged in their care and more likely to show up for their appointment. No batch uploads. And no waiting for your patient communication vendor to answer your support ticket.

Additionally, because WELL offers conversational texting, patients can respond with questions. Chatbots answer common questions, such as “Where are you located?” When patients have more in-depth questions, staff can easily enter the conversation as needed.

Benefits of improved patient referral workflow

WELL Referrals Management can reduce staff workload significantly. Staff spend countless hours on the phone trying to reach patients to schedule their referral appointments, sometimes calling multiple times for a single appointment. WELL Referrals Management eliminates these calls, reducing staff workload significantly.

Our messages have a 99.9 percent delivery rate. They’re never waylaid by a patient not picking up the phone or being on vacation. Even when patients miss a call, WELL reaches out multiple times to ensure a patient receives the message. The improved consistency makes your patient referral workflow even more effective.

Appointment reminders have the potential to reduce no-shows by more than 50 percent. For example, Mountain View Medical Center in Oregon reduced no-shows by 54 percent after implementing WELL. Eisenhower Health in Southern California saw similar reductions in no-shows.

Automating the initial outreach allows your staff to focus on the most critical patients and quickly close the referrals that don’t require followup. WELL Referrals Management helps stop patient leakage and frees up your providers and staff to do what they do best — care for patients. ♥

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Messaging systems: from automation to conversation


Wherever there are appointments, there are no-shows. In healthcare, they’re a big problem. According to Jamie Gier, chief marketing officer at SCI Solutions, missed healthcare appointments cost the industry a whopping $150 billion per year in the United States alone. A recent review of studies found a no-show rate of 23% across all specialties. And some especially unlucky practices report that their patients miss around 40% of their appointments.

No-shows hurt patients as well as healthcare providers. The biggest problem is that patients are not getting the care they need.

Missed appointments can also cost hospitals and doctors’ offices in hidden ways. No-shows often signal that patients are not properly engaged. We’re potentially losing a patient, from a customer perspective, to another health system.”

The reminder system

Hence the reminder system. At this point, there’s a strong body of evidence that shows that reminder systems really do work. They don’t eliminate no-shows, but they can reduce them significantly. Meta-analyses conducted in both 2016 and 2012 found overwhelming evidence that SMS reminders improved patient attendance in a variety of circumstances.

Despite the effectiveness of text reminders, many offices still call their patients manually. They may be trying to maintain a personal touch, turned off by the cost, or simply wary of automated reminder systems. “The old process is more personal, better in that that you’re forcing yourself to engage in a conversation,” said WELL’s chief strategy officer, Joe Tischler. And the evidence suggests that it’s an effective method: to name just one example, a 2017 study found that only 3% of patients who received a live voice reminder missed their appointments, compared to 24% of patients who only received a voicemail.

But that’s assuming you get a live person on the phone, not an answering machine. And according to Kenneth Hertz, a principal consultant with the Medical Group Management Association’s consulting group, you’re just as likely to end up in an endless game of phone tag. “For those practices that are still relying on person-to-person communication, it’s so asynchronous that it’s impossible,” he said.

Moving to automation

As effective as manual phone calls can potentially be, they consume too much time and labor to make them effective for most practices. Enter first the auto-dialer, then the automated text message. The issue is that neither is bidirectional—a patient who needs to talk to a live human will still need to pick up the phone and call—and they’re primarily intended to keep slots filled, not increase engagement. “It’s more a convenience for the doctor,” Tischler said. “There’s not a lot of value in it for the patient.”

The problem with generic text reminder systems is that they’re just replacing the old telephone-call reminders. What we need is to reimagine the entire process. We have to have a way to securely message back and forth.

Toward conversation

There’s a new generation of platforms, like WELL, that are designed to do precisely that. Rather than being a simple transaction (“Press ‘Y’ to confirm”), WELL’s text reminder is an initial contact that’s designed to open up a conversation between patient and healthcare organization.

“Oftentimes patients forget things; they don’t know what their status is; they have to check up on terms they don’t understand after they come back from the doctor’s office,” said Yifeng Hu, associate professor and chair of Communication Studies at The College of New Jersey and a senior lecturer in the Mailman School of Public Health at Columbia University. For patients who need clarification or just want to talk to a live human, the new conversational model is a boon. But it’s also better for medical staff, who can use the opened conversational door to take care of pre-appointment paperwork, insurance clearance, and patient questions.

“If you continue the conversation, you can alleviate more workflow, so that patients have as much of the work done as possible before they come to the doctor’s office,” said Tischler. The conversational platform may also recapture a lot of what’s lost when you pick up a phone and call your patient. As Hu pointed out, there’s evidence that what’s called “computer-mediated communication”—essentially, chatting through an electronic device—can actually be more productive and fulfilling than talking face-to-face.

What conversational chat offers is this continuous blanket method for people to access healthcare at their convenience, at their choosing. Patients feel like they have more access to their care, and it happens on their time.

“There’s got to be an easier and more direct way for us to do it, where if I have a question I can just get it addressed,” said Hertz. “If I could have that kind of dialogue [over text], I’d be thrilled.”♥

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