DIGITAL TECHNOLOGIES FOR PATIENT COMMUNICATION, CARE, AND WORKFLOW
|
|
FROM THE NACHC LENS
Health Centers Embrace Digital Solutions to Improve Patient Communication and Operations
Technology is a critical component of healthcare, and health centers are embracing it. It improves operations, workflow, patient communication, accessibility, and engagement. Using digital technology can help streamline staff workloads to prevent:
- Long hold times for inbound phone calls
- Dropped phone calls
- Appointment no shows
- Unfilled appointments
- Registration bottlenecks at the front desk
- Drains on limited staff resources
In 2019, GPW Health Center in Northern VA was thriving and growing, but it also experienced many of these pain points. “We knew our communication with patients needed to change and become much more efficient, responsive, and positive for both staff and patients,” says Evelin Manzanares, GPW Health Center’s COO. The health center explored and instituted different digital solutions that, over the course of four years, resulted in:
- A decrease in no show rates from 32 to 14 percent. This led to increased confirmations and appointment backfills.
- Reduced waiting room bottlenecks.
- Increased patient access to self-schedule appointments, any time.
- Growth in the overall patient population served by the health center.
- More time for care teams to follow up with patients who have more urgent care needs.
The health center first focused on patient communication and engagement. Working with Luma Health, the health center uses an SMS platform that integrates with its EHR to communicate with patients via text. Patients can send and receive messages, complete patient feedback forms, and post reviews directly onto social and web media platforms, receive test results and referrals, and submit paperwork.
Patients, including older patients, have been very responsive and the uptake has been significant. “We needed a digital platform that was simple to use, and that patients could easily access. They did not have to set up accounts or have email addresses which many did not have,” says Manzanares. As a result, staff resources in their 3-person call team could be reallocated to start an inhouse billing and collections team.
At Castle Family Health Centers, Atwater CA, data drives technology solutions. “We have a culture that focuses on cohesive teams. We strive to ensure our patients are receiving the highest level of quality care,” says Peter Mojarras, Castle Family Health Centers COO. “And yet, we still need to operate as a business to be sustainable.” The health center depends on data from quality care performance measures, no-show and missed appointments, and patient, staff, and provider feedback to guide their efforts for improvement.
Castle Family Health Centers knew they needed to make some changes to reduce their high no-show rates. They began to work with Artera to use the company’s SMS technology to strengthen its communication with patients. Now, through text reminders and recalls, patients can be contacted seven, two, and one day prior to their scheduled appointments. With the transition to SMS technology as a core component of patient communication, no-show rates for primary care services have decreased by more than half, from 30% to between 10-12%. In addition, the health center uses the software’s “campaigning” feature to send select text messages to priority patient populations to remind them they're due for a specific service or screening.
Other digital solutions used by these health centers strengthen workflows, operations and patient care:
- GPW Health Center is partnering with Collectly, a mobile billing system, to improve fee collections and payments. Patients now receive detailed billing statements via text messaging links.
- GPW is also partnering with Phreesia, a digital workflow software which enables patients to complete paperwork, insurance, co-pays, and health histories before their appointments.
- Family Castle Health Centers is working with InteliChart to engage 25-30% of patients to use its patient portal for pre-appointment forms and lab results.
- Through a foundation grant, Family Castle will soon be exploring how telemonitoring care programs that help patients self monitor blood sugar, blood pressure, and/or weight, can directly feed data into its EHR to manage chronic health conditions.
|
|
|
TURNING TO DIGITAL TECHNOLOGY SOLUTIONS
-
Know your pain points from (a) data like UDS, no show rates, quality care metrics and (b) staff, care teams, and patients. Let knowledge guide where you will create efficiencies.
-
Focus on user-friendly digital platforms that both staff and patients can learn and staff can support.
- Prioritize data security, HIPAA compliance, and interoperability.
-
Invest in staff education and training to help staff embrace new technologies and a culture where health IT and digital transformation can strategically improve care, patient communication, and access.
|
|
|
|
CDC’s PneumoRex VaxAdvisor App Helps Health Centers Build Confidence in Using New Pneumococcal Prevention Vaccine
|
|
When Prevnar 20, a new vaccine for preventing pneumococcal disease, was introduced earlier this year, the care team at Winding Waters Community Health Center, Enterprise, OR, was not confident in how it was going to incorporate the new vaccine into its current workflow for pneumococcal vaccination. “The new Prevnar 20 pneumococcal prevention vaccine is a complicated protocol, and we initially questioned who it was for and who would benefit from it,” said Mike Farley, PharmD, Winding Waters Community Health Center’s Clinical Pharmacy Director.
Dr. Farley, who oversees the health center’s vaccine inventory and education efforts, turned to the Centers for Disease Control and Prevention’s (CDC’s) PneumoRex VaxAdvisor app to help providers and medical assistants (MAs) determine which of the available pneumococcal vaccines were appropriate for patients. By answering less than five questions about the patient’s age and pneumococcal vaccine history, the app can recommend the specific pneumococcal vaccine the patient should receive.
Incorporating the PneumoRex VaxAdvisor App into Clinical Practice
Dr. Farley introduced the PneumoRex VaxAdvisor App first to providers and then to MAs during staff meetings. Staff downloaded the app and ran it through various fictitious patient scenarios. Staff easily and quickly adopted it into practice. When a patient's EHR flagged that a pneumococcal vaccine was due, staff used the app to determine which pneumococcal vaccine to use. “We went from never recommending Prevnar 20 to administering an estimated 40 a month, which is significant for a health center serving a rural frontier community. “The PneumoRex VaxAdvisor App helped address a vaccine hesitancy issue among our providers that resulted when a new vaccine offered another option and its adoption was not a big lift for staff,” said Dr. Farley.
|
|
Exploring Health Data Collection and Exchange through a Fast Healthcare Interoperability Resources Application
Fast Healthcare Interoperability Resources (FHIR) is the latest emerging standard for exchanging or transmitting health care data. A FHIR application programming interface (API) facilitates the exchange of healthcare data between different systems and applications. It is based on previous exchange standards and is available in all certified EHR systems. Still, it can be difficult to connect applications to, poorly mapped to local EHR data, and is still in early stages of development.
At the end of 2022, a federal rule went into effect, requiring certified health IT vendors to have a FHIR API that conforms to version 4.0.1 of FHIR. Now, if a patient moves from a health center in Phoenix, AZ to a health center in Brooklyn, NY, the patient’s health data can be shared between each health center’s EHR. This makes it possible to send and receive certain types of data from system to system even across the country.
“The policy requiring vendors to support the standard FHIR API is an important development in the ability for health centers to securely share health data with other healthcare organizations and to spur data-driven policies, projects and innovations,” says Raymonde Uy, MD, MBA, ACHIP, Physician Informaticist, NACHC. “And we are excited to be able to explore how health centers can effectively utilize it to improve the capture, transfer, sharing, aggregation, and analysis of healthcare data.”
NACHC is building tools to connect to APIs as part of its Vaccine Ambassador Program, a partnership with the National Health Care for the Homeless Council and the CDC. The program is working with 11 health centers to address vaccine hesitancy among people experiencing homelessness, people with substance use disorder, and people who engage in sex work with the goal of administering COVID-19 and other adult vaccines when able.
NACHC’s Clinical Informatics Team recently explored the feasibility of using its Vaccine Ambassador FHIR application to help vaccine ambassadors (community health workers, nurses, certified recovery specialists, and peers) record outreach. These include encounters, vaccinations, and other required data. It also enables them to transmit data collected outside the health center to health center EHRs and partners. The mobile digital solution eliminated the use of paper-based data capture to make data collection very easy and efficient for the ambassador, while representing the data using health data terminology standards.
“We are advising that health centers start by gaining knowledge on what the FHIR API is, how it can provide value to providers and patients, and what it will take to integrate and use FHIR based applications into their clinical workflows,” says Dr. Uy.
|
|
|
Visit NACHC’s new and improved website!
|
|
|
|
|
You’ll find resources designed just for health center care team members and administrators. Look for clinical care best practices and access to free e-learning opportunities, professional coaching, conferences, and much more: www.nachc.org
|
|
|
|
|
Gratitude List Exercise
Gratitude lists can help quickly ground you and help you remember what is working in your life, especially when you are going through a difficult time. And writing them down takes just a few minutes.
1) Find some quiet time - usually after you wake up in the morning or before going to bed.
2) Write five to 10 things that you are grateful for. These could be anything.
3) Be specific. Instead of just naming a person you are grateful for, write down a specific activity the two of you have shared.
Keep the list close at hand to refer back when you are having a tough moment.
|
|
|
|
© National Association of Community Health Centers. All rights reserved.
|
|
|
|
|
|
|
|