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4 Tricks to Help Busy Practices Stay Organized

Posted on June 13, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Over the past several months, we’ve been discussing how to use surveys to find out what your patients think of you—and then how to make the necessary changes. In addition, we’ve been looking at some of the most common complaints uncovered in patient surveys. These include:

* Excessive wait times (read more about that here)
* Inadequate communication (read more about that here)
* Disorganized operations

Today we are discussing the importance of keeping your practice moving smoothly and efficiently. No one likes going to a doctor’s visit only to find that they are running behind, have forgotten you were coming, or have lost your patient records. And yet that happens all too often.

Office managers and physicians are constantly balancing a huge number of tasks, including patient problems, staffing challenges, budget planning, payroll, and more. Unless you consciously strive to improve the organization and efficiency in your practice, you end up spending a whole lot of time putting out fires instead of preventing them from happening. This inevitably leads to more stress for you, lower productivity for staff, and poor satisfaction from patients.

With today’s consumer-focused patients, it’s imperative that you keep your office running like a well-oiled machine at all times. Otherwise, they are likely to simply move their business to the practice down the street instead. So here are a few tips to make juggling all the balls in your life a little easier.

  1. Schedule time for planning.
    One of the best ways to make sure you’re staying ahead of everything is to plan out your day in advance. Do you have a shipment of new supplies arriving? A new employee to train? Emails to be created? In this industry, every day brings something new. In order to make sure that nothing interferes with the patient experience, you’ve got to plan ahead. The best way to do this is to actually block off some time on your calendar where you decide what needs to be focused on—a simple 15-30 minutes each day is usually all you need. Many people find that the end of the day is a great time for this. That way you can be prepared for whatever the next day may bring.
     
  2. Batch your tasks.
    When doing your planning, give batching a try. Batching is when you select similar jobs and schedule them to be completed in one setting. Productivity experts have found that when we batch tasks, we are more focused, efficient, and, ultimately, more productive. We simply work better when we can focus on one thing at a time. Many large tasks can be batched by day. For example:

    • Mondays—Staff communication and training
    • Tuesdays—Payroll, billing, and other financial tasks
    • Wednesday– Marketing to get new patients (running ads, managing online presence, etc)
    • Thursday—Patient outreach to get returning patients (newsletters, social media, etc.)
    • Fridays—General administrative tasks and planning for the following week

     
    Of course, there will be times when things come up that need your attention. Be flexible in addressing those issues.

  3. Maximize efficiencies.
    Your practice should make life easier for patients. This means that you need to take a close look at everything from appointment scheduling to the check-in process to the way patients move within your facility to see if there can be improvements. Consider:

    1. Implementing an online scheduling tool, where patients can schedule their own appointments. This will help cut back on time on the phone.
    2. Using an automated wait list to fill last minute cancellations. Using a system to automatically send out an email or text message blast to everyone wanting to be seen sooner can free up time for staff and fill those exam rooms.
    3. Making your reception area easy to locate and clear of clutter so that patients can use it to sign forms. You may also try using a digital check-in process with a tablet or computer.
    4. Reviewing the flow of your practice. Patients should move from the waiting room to the exam room and back without much confusion. This is done best when they always move in a single direction—much like a highway.
       
  4. Take advantage of technology—but be wise.
    There are a lot of things still being done manually in an office that can be put on “auto” instead. Everything from recall to appointment reminders to birthday messaging and more can be done in a way that doesn’t require daily supervision from you. We have so many amazing technologies that can help us stay organized. Apps, calendars, to-do lists, and so on. It is important, however, to not let technology distract you. Did you know that every time you switch between tasks, you lose around 15 minutes? So every time you check email, for example, in the middle of another task, you lose precious amounts of productive time. Instead, set aside a time when you check your email (or complete other tech-related tasks) each day and stick to it. Perhaps you do it first thing in the morning, after lunch, and before leaving. That way you do not waste tons of time.

Ultimately, every practice wants to deliver exceptional patient care, and a big part of that is practice organization and efficiency. Ask yourself, “Is my office making a real effort to improve processes and make life easier for patients?” If not, implement procedures to do so. It will have a lasting, positive impact on both office staff efficiency and overall patient satisfaction.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

Early Lessons from the Front Lines of Value-based Care: How One APM Has Impacted Community-Based Oncology Practices

Posted on June 11, 2018 I Written By

The following is a guest blog post by Dr. Charles Saunders, CEO, Integra Connect.

The Oncology Care Model (OCM) – an alternative payment model introduced in July 2016 by the Center for Medicare and Medicaid Innovation – launched with the ambitious goal to further delivery of higher quality, more coordinated cancer care at a lower cost. Participants include 184 practices representing approximately one-third of community oncologists in the US. They receive a so-called “MEOS” (monthly enhanced oncology services) payment of $160 per beneficiary per month for the duration of a qualifying 6-month chemotherapy period, plus the opportunity to earn a share of savings if they exceed a target threshold. In return, oncologists are expected to take on increasing accountability for patient outcomes and well-being, while also generating sustainable cost savings across all co-morbidities and care settings, into the patient home.

OCM Performance Period 1 Results Exposed an Unexpected Misalignment   

As part of the OCM program, CMS tracks practices during 6-month intervals – so-called “performance periods” – then shares results back about one year later. In February 2018, practices participating in the OCM program received visibility into Performance Period 1 (PP1) data, including savings achieved, aggregate quality score, and effectiveness of identifying eligible patients. While most practices were unsurprised by their performance scores, many did not anticipate the extent to which CMS would recoup MEOS payments that it deemed paid in error. The most common scenario involved patients with co-morbidities who, while receiving chemotherapy and related services, also visited other providers regularly. Therefore, the oncology practice did not represent the required plurality of E/M codes for that beneficiary. It was not uncommon for practices to be asked to return up to 30% of the sum they had been paid – a major financial hit.

Lack of Data Hinders Practices’ Ability to Accurately and Proactively Identify Beneficiaries

In May 2018, practices received their Performance Period 2 (PP2) Attribution Lists, which summarized which CMS beneficiaries met OCM eligibility criteria, which episodes were attributed to each respective practice, and episode start dates from January 1, 2017 through June 30, 2017. Unfortunately, because there is a significant lag between actual Performance Period and delivery of CMS findings – delayed up to nearly a year after each performance period has ended – OCM participants were unable to retroactively apply PP1 learnings to PP2.

Why is this especially problematic? Practices are faced not only with MEOS recoupments for erroneous payments but, with only a 1-year window to submit claims, are often unable to bill in full for patients who were missed. Indeed, there are many opportunities to miss appropriate patients, as practices needed to have an accurate view of: 1) all beneficiaries; 2) those with a qualifying diagnosis; 3) those with a new chemo episode; 4) those not only prescribed an oral agent, but those who subsequently filled it; 5) those not in a hospice; and more. Given all the dimensions to track and measure, practices without advanced tools face delivering enhanced services that they cannot correctly bill for.

Best Practices from Community-Based Oncology Practices Include Robust Data

What best practices arose to get attribution right? A vanguard of OCM practices realized that they would need to take proactive steps to enable near real-time visibility into their patient populations, embracing the tenets of population health management. Below is an example of the best practices adopted by several of these community-based oncology practices:

  • Increased transparency into oral chemotherapies: Existing practice protocols did not open an episode when oral agents were prescribed, since there was no in-office administration. To address this, the practice introduced a rule-based algorithm to identify all OCM eligible patients, including those who had been prescribed orals. In addition, they enlisted a combination of automated and personal follow-ups to validate qualification and ensure orals had been filled.
  • Avoidance of duplication: To identify missed billing opportunities while also reducing the risk of duplicated claims, practice leadership invested in a robust analytics tool that enabled personalized queries at the patient level. These reports compared eligibility against their practice management report to identify gaps, from unpaid and unbilled to denied.
  • Targeted patient intervention: To balance the practice’s financial and clinical objectives while optimizing OCM performance, the practice introduced complex care management services and employed a series of triage pathways. This approach ensured engagement with attributed beneficiaries and decreased avoidable high-cost events among at-risk patients, such as inappropriate ER visits and inpatient stays.
  • Optimized treatment choices. As part of its commitment to ensure each patient received the most effective treatment for his or her disease, the practice provided increased transparency around the availability of equally effective generic or biosimilar drugs. They also supported better end-of-life planning for patients facing second or third-line therapies not expected to provide any clinical benefits, but that could significantly degrade remaining quality of life.
  • Continuous performance improvement: To track the effectiveness of these quality improvement initiatives, the practice leveraged its analytics tool to monitor resource utilization and care management performance, then intervened to address outliers in real-time.

In short, to optimize performance under the OCM, practices are beginning to leverage the data to which they already have access – both clinical and financial – to risk-stratify their patient populations; identify OCM eligible patients; and gain near real-time visibility into quality and cost performance. Practices are also investing in better data integration and analytics that enable rules-based identification of eligible patients.

Population Health Analytics Help Practices Be Proactive and Succeed Under the OCM

Oncology is on the forefront of value-based care adoption and these early experiences from the OCM have provided a guide for other specialties. Based on their early results, what has come to the forefront is the need for a combination of comprehensive data management and robust analytics, coupled with the principles of population health management, which enable practices to step up and take control of the cost and quality for their attributed populations.

Overcoming Data Silos Within The Health Care Ecosystem

Posted on May 30, 2018 I Written By

The following is a guest blog post by Dave Corbin, CEO of HULFT.

While there’s a barely an industry or sector that hasn’t been heavily influenced or redefined by the onslaught of data, in healthcare the impact is especially acute. Health care industry players are now having to negotiate a delicate balance between exploiting the opportunities that come with the deeper insights and actionable intelligence, with managing the growing technical complexities that arise.

Let’s face it – the health care sector is renowned for the depth of its silos. It’s a significant and wide-ranging challenge. It starts in the closed world of drug R&D to a generation of providers still using fax machines (remember those?) to share patient medical records. In theory, we’d all agree that improved health data exchange is a win-win for everyone involved (providers, policymakers, patients, etc.) In reality, before we can even begin to leverage the vast troves of data from electronic medical records (EMRs), we need to overcome two key issues.

The first is data security. According to the 2018 HIMSS Cybersecurity survey, the majority of respondents, 75 percent, experienced a significant security incident in the last 12 months. The threat landscape has grown in complexity and volume and it’s critical for health care organizations to invest in privacy-by-design defense mechanisms such as encryption, security analytics, and multi-factor authentication to protect valuable patient data. For seamless data sharing to become the norm, everyone in the ecosystem must be vigilant about data protection and online privacy.

The second is interoperability – the extent to which different IT systems, software applications, and devices can exchange data and interpret that shared data. Or, to be more specific, making EMRs more “portable” so they follow a patient’s journey. After all, care is happening at multiple venues – it’s happening in hospitals, rehab facilities, long term care facilities, hospices, and more.

My own knee surgery started with the orthopaedic surgeon, who referred me to external providers that would supply me with MRIs, blood tests, and EKGs. The day of surgery included not just the surgeon, but an outside surgery center and an anaesthesiologist, all requiring separate contracts. The net result was that my medical information for a relatively routine surgery was spread over five locations and many data types.

Without an enforced standard of interoperability, data exchanges can get complicated and time-consuming, which then hinders not just the flow of information but patient care. We can do better by reducing data complexity for the patient, doctor and service providers.

Speed, security, and accessibility when it comes to health data management and sharing don’t have to elude us. A holistic approach to health data security and ecosystem interoperability can be achieved in partnership with an intuitive data logistics platform that scales to evolving data complexities and cuts development time. This can help lead your organization to transcend healthcare’s many silos often without the need for a major overhaul of existing IT system. And that’s a powerful prescription.

Dave Corbin is CEO of HULFT, a comprehensive data logistics platform that provides both the secure back-end data transfer and integration technologies to help health care organizations form a foundation for an overall enterprise data strategy that makes data more accessible and useful. HULFT is a proud sponsor of Health IT Expo, a practical innovation conference organized by Healthcare Scene. Learn more here: hulftinc.com.    

The Bad and the Ugly of Prior Authorization and How Technology Will Fix It

Posted on May 16, 2018 I Written By

The following is a guest blog post by Karen Tirozzi, VP of Solutions, ZappRx.

Specialty drugs, which are usually defined by their complex instructions, special handling requirements or delivery mechanisms, are typically priced much higher than traditional drugs and cost more than the average American family’s salary. These medications are priced higher for a variety of reasons such as manufacturing costs, smaller patient populations and patient services like IV administration or at-home care required to support patients who will take these medicines.

Due to the costly nature of these treatments, payers insist on a comprehensive prior authorization (PA) process to ensure qualified patients are receiving the medications they need. The PA process involves cumbersome paperwork and fax machines and are a huge burden to physician’s and their staff. Physicians have even resorted to hiring extra, dedicated staff just to process these prescriptions as nurses, NP’s, PA’s and medical assistants tend to fall victim to the prior authorization nightmare. According to a recent study, it is estimated that $85,276 was spent on personnel costs to address billing and insurance issues associated with prior authorization, which is approximately 10 percent of practice revenue.

To put just how inefficient the PA process into perspective, a recent AMA survey of 1,000 physicians providing 20 or more hours of care a week, showed that doctors receive an average of 37 PA requests a week, which took an average of 16.4 hours to process. Extrapolate 16.4 hours a week over a year and clinicians are spending around 41% of their time annually doing paperwork, making calls and or sending faxes just to navigate PA and get medications to their patients. It includes enrollment forms and signatures from the patient, which can be done while the patient is in the office, however, it’s often done through mail, which slows down the process even more. Providers also have trouble ensuring they have the right forms for the insurer’s preferred specialty pharmacy, as sending to the wrong pharmacy also causes delays. Providers are tangled in faxes and phone calls for weeks on end so that all parties have all the information they need to approve just one prescription. In 2018, how is it that the medical community still heavily relies on fax machines to process information and deliver life-saving drugs to patients.

A Brighter Future

Digitizing the entire prior authorization process will significantly reduce the administrative burden on clinicians and get patients their medications in a much more streamlined manner. Healthcare providers should be able to, in one place, order a specialty prescription, see the paperwork and signatures needed and follow its progress until it reaches the patient’s hands. The healthcare industry needs to start utilizing the technology available today to streamline workflows and decrease operational expenses, which in turn, can help save patients’ lives.

By embracing technology, clinicians can also leverage the rich data sets generated to better understand their patients’ needs, trends within the space they’re treating and ultimately, improve patient care. Data can also be used by pharmacies to understand how their medications are trending within the market and catch any snags that may cause delays. The potential for pharma companies to use this level of information to provide insights and improve products in real-time is invaluable.

Let’s take the next step

Inherently risk adverse and with siloed stakeholders, healthcare must begin taking steps toward change. With what the space has at its disposal from a next-generation technology standpoint, there is no excuse to remain chained to the fax machine.

The good news? Providers, pharmacists and biopharma have options to improve this cumbersome process today. Forward thinking innovators are beginning to break down silos and uncover new methods with technology to streamline the prior authorization process and get patients their specialty medications in days, not weeks.

About Karen Tirozzi
ZappRx Vice President, Solutions, Karen Tirozzi, leads a fast growing team that is focused on transforming the specialty pharmaceutical prescribing process. With a focus on client success, Karen and her team are innovating technologies to automate traditionally manual and cumbersome processes in an effort to save clinicians time and resources, and deliver lifesaving drugs to patients in a timely manner.  Having spent more than 15 years in the industry, Karen’s unique background in HIT and clinical social work serve as the basis for her ability to deliver successful programs in highly disruptive healthcare services and IT companies.

How to Improve Communication So You Can Improve Satisfaction

Posted on May 9, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

In attempts to boost revenue, practices often find themselves mired in the complex tasks of generating marketing, improving scheduling, reducing inefficiencies, and more. And while these practice management pieces are important, sometimes we make things more complicated than they really need to be. When it comes down to it, the foundation of a financially-healthy practice is simple—keeping your patients happy.

Happy patients are the patients that show up—and come back. They’re the patients that refer you to their friends. They are the ones who leave those all-important online reviews. They truly are the bread and butter of your practice’s bottom line. Research backs this up—multiple studies have found a direct correlation between revenue and patient satisfaction. In fact, one study found that those healthcare practices delivering a “superior” customer experience achieve 50 percent higher net margins than those providing just an “average” customer experience.

Use Surveys to Uncover Problems

Obviously, creating a happy patient base is key to a successful practice. But how do you know if your patients are happy? Well, you ask them—in person, in focus groups, and online. The most effective way to gather this data, however, is through surveys. Surveys are an easy and efficient way to find out where you may be falling short.

And since a study in the Journal of Medical Practice Management found that 96 percent of all patient complaints are related to customer service rather than care or expertise, every person in your practice can be involved in making improvements.

Some of the most common complaints of patients include:

  • Excessive waiting times
  • Inadequate communication
  • Disorganized operations

Last month, I discussed the importance of reducing excessive wait times. You can read that article here. In this post, we will be exploring how to avoid those communication problems that lead to low patient satisfaction.

There are two main areas where communication tends to break down within a practice—between staff members and between the practice and the patient. How can you improve?

Communication within the Office

From the front desk to nurses to doctors and even to the billing department, it is critical that everyone within the practice works as a team to support your patients. Failure to do so leads to errors, confusion, and unhappy patients. Unfortunately, experts estimate that problems take place in 30 percent of all intra-team healthcare communication. There are some ways you can combat poor intra-office communication.

  1. Daily team huddles. A daily huddle meeting is not a full staff meeting. It is a quick (10-15 minute maximum) meeting where each member of your team gives a status report. It’s a great way to align your team and know what to expect that day. Do you know an incoming patient is celebrating a birthday? Just graduated? Do you have holes in your schedule? All of these types of issues can be addressed during a quick huddle.
  2. Escalation processes. While critical care specialties have an acute need for escalation processes, every practice can improve their communication by implementing a designated process for difficult or complex situations. Decide which situations in your individual practice may warrant extra care. Lay out a plan for handling and monitoring these situations. Include the way you refer patients to other offices and communication between practices as part of this process.
  3. Use of a standardized communication tool. While your daily huddle is a great way to get everyone together each day, it is also important to have ways to communicate in real time as new issues arise. Healthcare is definitely a dynamic environment—constantly changing throughout the day. The best way to make sure everyone stays on the same page during the busy day is through the use of an instant messaging app to make communication accessible at all times.

Communication Between Provider and Patient

The vast majority of providers work hard to communicate with patients. But the sad truth remains—patients struggle to remember your instructions. One study showed that patients only recalled 40 percent of the information they were given. Even worse, around half of what they did remember was actually remembered wrong. This means that the way information is conveyed to patients is just as important as the actual information communicated. There are a few tips to improving your communication with patients.

  1. Use open-ended questions. When speaking with a patient, make sure to ask questions that leave room for patients to expound on their thoughts. Yes or no questions often leave many things undiscussed.
  2. Read non-verbal cues. Much of the communication that takes place between a patient and their provider occurs through nonverbal communication. So pay close attention to the patient’s face and their body language. After explaining something to your patient, do they look confused? Are they worried? If so, there is a good chance they will not follow your instructions. Follow up based on the body language of each patient.
  3. Use the teach-back method. One of the best ways to ensure your patients have a good grasp of the things you’ve taught them is to ask them to teach you. This may take an extra few minutes, but can have a lasting impact on patient outcomes (and satisfaction!).
  4. Continue communication between visits. Communication does not end when a patient leaves the office. Continue sending educational tips and encouragement through regular newsletters, social media, and email.

Communication is one of (if not THE) most important component of the patient-provider relationship. It is also the cornerstone of the financial success of every practice. Effective communication helps practices and patients better understand each other and develop a closer bond. It makes for not just healthy—but happy—patients.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

Addressing Common Patient Frustrations: Wait Times

Posted on April 11, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Experts agree that it is critically important that practices keep their finger on the pulse of patient satisfaction—and one of the best ways to do this is through patient surveys. However, the question remains: what should a practice do if a survey reveals there is a problem?

It is of utmost importance that any issue found in a survey be studied and addressed. Interestingly, the vast majority of patient irritants do not relate to the quality of care at all. In fact, a study in the Journal of Medical Practice Management found that 96 percent of all patient complaints are related to customer service rather than poor care. Some of the biggest complaints include:

  • Excessive waiting times
  • Inadequate communication
  • Disorganized operations

Over the next few months, we will be digging in to each of these topics in depth. Today we will start with the top frustration of patients: excessive wait times. These long wait times, often associated with poor time management, are also some of the major criticisms reported by respondents of the Patient Provider Relationship study. Check out some of these numbers:

  • Sixty-eight percent of patients say that the wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

The problem is only getting worse. Average practice wait times have risen by 30 percent since 2014. Unfortunately, the common patient response to long wait times is simply to change practices. Around one in three patients say they are likely to find a new medical practice in the next couple of years. So how do you reduce long wait times?

  1. Understand how long is too long. Studies have found that about 20 minutes is the maximum amount of time a patient is willing to wait before becoming frustrated. Unfortunately, it is estimated that 53 percent of physicians say patients at their practice typically wait for more than 20 minutes. If you are not sure where you stand in terms of wait time, carefully track your wait times, both in the waiting room and the exam room. There are a variety of programs and apps that can do this for you. Or if you’d prefer to go old-school, you could acquire a supply of timers. When a patient checks in or is taken to the exam room, simply press the START button. Keep an eye on the timers and recognize when a patient has waited longer than is optimal.
  2. Provide clear communication. One of the easiest fixes for long wait times is often overlooked—communication. Eighty-six percent of patients say that if they were told in advance about a long wait time that they would feel less frustrated. So make sure to let patients know if the doctor is running behind schedule. You can also consider shooting off a quick text message to incoming patients if your office is running very late. If you are tracking wait times, make sure to acknowledge the inconvenience and apologize when the wait goes longer than 20 minutes. This would minimize frustration for nearly 70 percent of patients.
  3. Improve front desk workflow. Melanie Michael, lead author of a study that looked at interventions for lowering patient wait times found that one of the critical factors in reducing wait times was the front desk management. She noted, “[At one practice], we found that these people were trying to answer phones, field questions from patients in the waiting room, check patients in, secure insurance info, and many other tasks.” Automation of these tasks enables practices to get patients seen by the physician faster and more efficiently. Appointment reminders, scheduling, and check-in are all processes that can (and should) be automated.

Wait times are directly correlated to the satisfaction of patients. If your patient survey finds that people are feeling annoyed about the wait at your office, make changes now. If you wait too long, you may find you have no patients left.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

Easy Tips to Understand and Leverage Patient Survey Results

Posted on March 14, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Multiple studies have shown that surveys are critical to the economic health of medical practices. Experts say that using surveys to improve the patient experience can be a strategic differentiator for practices.

To read more about the increasing role of surveys in reimbursement, profitability, and quality care, check out this post from last month.

Once you’ve started sending out regular patient surveys and getting consistent responses, it’s time to take action. In order to get the most out of a survey, it is critical to analyze the responses and implement changes based on the results. Here are a few tips to get started.

Figure out how many survey responses are needed.

Any time a survey is sent, there must be enough responses received to have a “statistically significant” result. Obviously, if only one or two patients respond to a survey, those answers will not be a true picture of how patients view a practice. What is considered “statistically significant?” This will vary by practice size.

Start by finding out how many active patients visit your practice—for now, don’t count any inactive files. Of course, it would be amazing if every single patient responded to the survey, but that is pretty near impossible. Instead, each practice must decide what margin of error is acceptable to them personally. The greater margin of error found to be acceptable, the fewer responses needed to be statistically significant. For example, if a 10 percent margin of error is okay with you, only 100 out of 3,000 patients need to respond. If, however, a three percent margin of error makes you more comfortable, you would need 810 responses out of 3,000.

Use the following table as a basic rule of thumb when deciding how many responses are needed:

Leverage technology to calculate the hard numbers.

In order to easily understand survey results, responses need to be converted into percentages or averages (depending on question type) and formatted in a way that makes it easy to compare responses. For example, it doesn’t mean much that 281 respondents said that they had a poor experience. If, however, that number is converted into 40 percent that had a poor experience, it is much easier to recognize a problem. Survey answers should be imported into a system that analyzes the results and converts these into simple statistics. Fortunately, it is common for the platform used to originally send the survey to do this automatically. Many will also include trends over time, highlighting if problems are worse or better during certain times of the year. If the survey-sending platform does not include an analysis tool, there are a huge number of programs (including free tools) that can accomplish this task. Even programs like excel work perfectly fine for this.

Take action.

Great—you’re starting to get a feel for what patients think. But now what? Far too many practices collect incredibly valuable information only to sit on their hands and ignore it. But for a practice to really thrive, it is crucial to set goals and objectives based on survey results. After all, patients are communicating what they want. It’s up to you to see how you can accommodate their needs.

My favorite goal creation method can be remembered by the word SMART.

  • Specific– Select a specific goal, being as clear as possible.
  • Measurable– Decide how you will measure the success or failure of your goal.
  • Achievable – Do you have the time, money and resources to complete the goal?
  • Relevan– Not every goal will improve your business. Pick one that will make a real difference.
  • Timely  Set a realistic deadline for goal completion.

Let’s consider a real-life example. A common survey question for healthcare practices is, “How long did you wait to be seen?” If the score comes up as higher than ideal (typically more than 20 minutes), improvements are needed.

This is where SMART goal setting comes into play.

  • Specific—Set a specific goal. For instance, “Our goal is to lower wait times to 15 minutes.”
  • Measurable—Decide how to measure the result. Will you be timing the waits yourself? Will you send out a follow-up survey?
  • Achievable—Set goals that can realistically be accomplished. If your average wait time is over an hour, for example, trying to adjust that to just 15 minutes is probably not currently achievable. Try to set smaller improvements and over time you can reach your ultimate goal.
  • Relevant—Look at the goal you’ve created. Will lowering wait times improve your business? Don’t set goals that won’t really have an impact on your long-term success. In this case, reducing wait times will have a positive impact on your business so it is a relevant goal.
  • Timely— Set a realistic time frame. It probably won’t happen in a week, but you may not want it to take a year. Three months may be the right timeframe to make improvements. Check back at that point to see if you achieved your goal.

As practices consistently strive to make changes based on survey results, the patient experience will improve dramatically. Because setting specific improvement goals is so important to practice success, over the next few months I’ll be addressing some of the most common patient frustrations uncovered on surveys. I will include SMART goals to improve these frustrations and boost patient satisfaction.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

It’s Time to Rethink Patient Matching

Posted on February 28, 2018 I Written By

The following is a guest blog post by Wes Rishel in partnership with Verato.

Henry Ford famously said, “If I’d asked them what they wanted, they would have said ‘faster horses.'” When it comes to patient matching – the cornerstone of health information interoperability – we seem to be asking for faster horses. But what we need is a totally new approach.

The “horse” here is probabilistic patient matching. Probabilistic algorithms match two patient records by comparing them directly to each other and determining the probability that the two records belong to the same patient. Basically, if the demographic data (like name, address, and birthdate) looks very similar across the two records, then a match is made.

These algorithms have been the preferred approach to resolving and matching patient identities since the 1980s. But today’s healthcare landscape is very different from that of the 1980s. Healthcare organizations are no longer simply providers or payers – there are now Health Information Exchanges (HIEs), Accountable Care Organizations (ACOs), care management companies, and even health systems with their own insurance plans.

There is now a larger push to share and exchange patient data between all of these organizations and with state and federal agencies and do analytics on a massive scale for research and population health. And we can anticipate an explosion of patient data coming from many new sources, including patient portals, patient engagement applications, telemedicine applications, personal health records, and Internet of Things (IoT) medical devices.

All of these factors make today’s patient matching challenges much more difficult than those of the 1980s, and yet we’re applying the same matching approach we used three decades ago. The consequences are drastic: up to one in five patient records are not accurately matched within the same health care system according to CHIME, and as many as half of patient records are mismatched when data is transferred between health care systems according to the ONC.

As a technology adviser over the years, I frequently advised governmental and private entities with over a million patient records that, as flawed as it was, probabilistic matching was their only choice. But probabilistic matching has clearly reached its limits. Even large and expensive efforts within healthcare organizations to improve and tune probabilistic algorithms achieve only incrementally better results. It is time to move on from the “horse.” We need a totally new approach.

A completely new approach in healthcare is a familiar approach elsewhere

It is time to emulate Henry Ford and find a completely new approach to patient matching. But it is also important to recognize that Ford didn’t actually invent the car. He didn’t even invent mass production, which had already been applied in other industries. His contribution was the vision that applying mass production to automobiles would open up a whole market, the gumption to gather the investment and execute, and the stubbornness to ignore naysayers.

So it is with patient matching. We simply need innovators that have the vision to apply proven identity matching approaches to the healthcare industry – as well as the gumption and stubbornness necessary to thrive in a crowded and often slow-moving healthcare IT market.

Many industries – including retail and financial services – already have viable and proven solutions to match and link their customer records, and these are the solutions we should look to as an industry to solve our own patient matching challenges.

Most proven solutions hinge on cross-correlating the demographic data from customer records with demographic data from third-party sources, including public records, credit agencies, or telephone companies. Importantly, this third-party demographic data includes not just current and correct attributes for a person, but also out-of-date and incorrect attributes – like previous addresses, maiden names, and common typing errors for birthdates or phone numbers.

By referencing these comprehensive sets of third-party demographic data during the matching process, these “Referential Matching” approaches can significantly outperform probabilistic matching algorithms. For example, Referential Matching can match one record that contains a maiden name, old address, and birthdate with another that contains a married name, new address, and phone number. Both of these records match to the same person in the third-party reference database, which has the entire set of demographic attributes for that person. In essence, this third-party reference database acts as an “answer key” for demographic data.

Results from this approach were recently published in Journal of AHIMA 88, “Applying Innovation to the Patient Identification Challenge” by Lorraine Fernandes, RHIA, Jim Burke, and Michele O’Connor, MPA, RHIA, FAHIMA. This article reviewed how Healthix, the largest public health information exchange (HIE) in the nation, used a vendor built on referential matching architecture to resolve 54.1 million MRNs down to 21.9 million unique identities. These 21.9 million unique individual records are now clear and available to meet key clinical and operational needs.

Referential Matching needs to make its way to the healthcare industry, and luckily it is already being used by many of the largest health systems, payers, and HIEs. But this is not enough. The costs of poor patient matching are too dramatic to keep pushing for faster horses: inaccurate matching decreases quality of care, has drastic implications for patient safety and privacy, costs millions of dollars of lost revenue each year to denied claims, and increases costs to our healthcare system due to systemic inefficiencies, redundant tests and procedures, and unnecessary IT and labor expenditures.

The healthcare industry should take a lesson from Henry Ford. The winning disruptive patient matching solution need not be created, but only adapted from other industries. As another wise man said, “discovery consists of seeing what everybody has seen, and thinking what nobody has thought.”

Conquering Medication Errors: Better Tools, Better Reconciliation

Posted on February 27, 2018 I Written By

The following is a guest blog post by Greg Anderson, Senior Business Advisor, Surescripts.

For years now, prescribing has been growing more complex. Between 1994 and 2014, the percentage of the U.S. population taking three or more prescription drugs nearly doubled, and as of 2014, nearly 11 percent had taken at least five prescription drugs within a 30-day period.

As important as these medications may be, every new drug prescribed introduces a new possibility for error. And this increased complexity is indeed having dangerous effects. Medication errors made by patients and their caregivers outside healthcare facilities doubled between 2000 and 2012, according to a 2017 study. That’s not even counting the estimated 40 percent of medication errors that spring from another source: inadequate reconciliation.

Accurate Reconciliation: High Barriers, High Stakes

Medication reconciliation can be a frustrating task in any setting. Compiling an accurate medication list can easily take 45 minutes when care providers need to not only consult with the patient, but also reach out to pharmacies, pharmacy benefit managers, other physician offices and family members to get the full story. Achieving accuracy is especially daunting in acute care settings, when time is of the essence and memory-impeding stress is heightened. Records of medications prescribed and taken are often far from complete, leaving care teams reliant on whatever history patients and their families can patch together.

A lot can go wrong when medications fall into the gaps. One study of hospital patients taking at least four prescription medications found that a majority of patients had at least one medication not identified upon admission, and 38.6 percent of these reconciliation errors had the potential to cause significant discomfort or adverse health outcomes. A recent study of 306 medically complex patients found up to seven errors per patient in medication histories.

When a healthcare provider misses a drug, consequences can range from treatment interruptions to incorrect treatment decisions. Inevitably, some of these medication errors lead to the most common cause of iatrogenic harm: adverse drug events (ADEs), which send nearly 700,000 people to emergency departments each year.

The Best Defense Against ADEs

Not all medication errors can be foreseen and eliminated, but there’s reason to believe we can greatly reduce the 10 percent of ADE-related emergency department visits that stem from medication errors. Researchers estimate that 50 to 70 percent of ADEs that lead to hospital admissions are preventable.  And there’s one tactic in particular that’s been shown to make a serious difference: consistent medication reconciliation, aided by access to electronic medication history. More than half of the medication errors in one 2008 study of primary care clinics could have been prevented with the help of electronic tools. That’s in line with the Agency for Healthcare Research and Quality’s findings that “anywhere from 28 to 95 percent of ADEs can be prevented by reducing medication errors through computerized monitoring systems.”

Recent studies in clinical settings have borne out insights like these. In 2016, the Cedars-Sinai Health System performed a study assessing medication history errors among older adults on complex medication regimens. Researchers determined that accessing pharmacy fill and PBM claims data for those patients via Surescripts Medication History for Reconciliation would likely have prevented 35 percent of admission medication history errors and 31 percent of resultant inpatient order errors. Those percentages rise when considering only severe errors.

By helping doctors avoid prescribing errors, effective medication history solutions can also help patients make fewer medication mistakes at home. Eliminate redundant or conflicting prescriptions, and you also eliminate opportunities for patients and their caregivers to become confused. Even in a world of increasing prescription complexity, we can work as an industry to reduce many types of medication errors. We just need the right tools to collaborate and to make informed care decisions together.

The Role of Practice Automation in Healthcare Communication

Posted on February 16, 2018 I Written By

The following is a guest blog post by Naveen Sarabu, Vice President of Product Management, AdvancedMD.

Practice automation was born out of the demand for quicker, more efficient manual processes. One of these manual processes is getting back to basics by using plain, old-fashioned communication – whether among members of a healthcare team, or between a physician and patient. Through automation we seek to deliver the right data to the right people exactly when they need it for the optimal provision of care. Likewise, we also seek to cut down on the manual processes that bog us down and add complexity. Many ambulatory practices struggle to find a solution that meets the complex demands of treating patients. Many admit that communication remains one of their greatest struggles – and miscommunication is one of the biggest frustrations for patients.

Doctors’ offices and hospital counterparts in the U.S. have shouldered $1.7 billion in malpractice costs due to poor communication—that’s 30 percent of all malpractice cases.

Automating manual processes of a physician practice enables the distribution of vital patient information in a fast, efficient, and accurate way. By leveraging an integrated physician-patient workflow system, physicians gain benefits of both accuracy and time in the sharing of clinical and billing information. This defines the next generation of the EHR: managing patient data among systems with authentic, automated data transfer and overall ease of use.

Task-based challenges

In a sense, many elements of communication, or information transfer points, are categorized as “tasks” by physicians. Obviously, every doctor in every office has his or her own way of organizing to-do’s. Rigid or cookie-cutter solutions can be more trouble than they’re worth for the busy ambulatory practice. The sheer volume of tasks and relentlessness of practice-specific workflow elements remain a huge burden to physicians and staff members. Without a straightforward means to categorize and execute frequently performed tasks such as prescriptions, refills, charge slips, notes, and orders, action items can fall through the cracks and leave room for errors.

Practices can address this by selecting flexible and customizable solutions that spell out all the moving parts of a practice and put them at the physician’s fingertips, much like an automated workflow analyst would. Visual tools like dashboards are helpful in presenting all tasks in a single snapshot, allowing physicians to manage to-do’s quickly and with ease to execute and communicate what must come next. Patient cards organized by specialty and workflow give physicians a snapshot of what’s really most important in a given moment. An integrated EHR dashboard not only helps physicians negotiate high-priority tasks of significant volume, it orients them to the vital patient information required for sound decision-making.

Impact of physician mobility on communication

A key asset of running a fully-automated ambulatory practice is the feasibility of team members accessing the same systems in real time, from any location. This has multiple benefits, including improved communication accuracy and workflow efficiencies.

“Many different user types [in my practice] from the nurse, to the office manager, to the biller, are all working with the same data on the same platform with real-time access. The seamless continuity is what I like about it,” said Larry J. Winikur, MD, pain management physician in Danville, Va.

Physician mobility is achieved through cloud-based technology and allows providers and staff members to communicate seamlessly from several practice locations: a home office, a patient’s home, the hospital or while traveling. It helps physicians respond to patient and staff messages quickly and stay on top of pressing work issues no matter where they are, preventing a backlog of tasks once they return onsite.

Surgical Specialists of Jackson (Miss.), treats more than 500 active patients, including those in rural areas. According to office manager Kristen Humphrey, having mobile capabilities as a result of complete practice automation has improved the quality of care the practice provides to patients. “When we have a physician seeing patients an hour away in a rural county, he takes the iPad and is able to log into the patients’ medical record and get any information he needs,” leveraging a seamless connectivity to the practice from our office in Jackson. “It makes life really easy,” Humphrey says.

Remote access also offers the feasibility of treating patients with video-based telemedicine, during hospital rounding, or home or hospice care. EHR mobile access is, without a doubt, a top priority for busy practices as they build out the future of their business.

The building blocks of patient engagement

As practices compete with other practices and larger health systems to secure and retain patients, these patients have developed a consumer-like healthcare mentality. Most patients want as much information about their condition as possible, so they can take a proactive role in their care. Patients want to engage with their physicians, by communicating openly and regularly about options and treatment decisions.

A fully-automated ambulatory practice utilizes patient engagement tools to secure satisfaction, retention, and referrals. Consider the ease with which patients can make appointments – online self-scheduling is a critical piece of functionality. Automated check-in tools such as an iPad kiosk are especially favorable to patients who can complete intake and consent forms electronically, eliminating the possibility of transcription errors that occur when data is transferred from paper to digital. A robust patient portal enables physicians to communicate with patients privately and efficiently; to share educational materials or share lab results.

Appointment reminders can also serve as simple communication tools that enhance not only the patient experience, but also the practice bottom line.

Dr. Winikur utilized a patient reminder system to help decrease costly no-show appointments in his busy schedule. The solution helped engage patients and reduced no-shows at his practice from about 12 percent to approximately two percent of appointments, which positively impacts his revenue.

The mobility benefits previously mentioned also allow physicians to demonstrate superior attention to patient needs. “I can pull up patient information no matter where I am in the world with internet access,” Winikur says. When patients receive a quick and effective response to inquiry, they perceive their doctor is in the office (even if he’s not!), which helps increase patient satisfaction.

Other important automated tools include post-visit surveys that enable patients to provide honest, timely feedback about the care they’ve received. These surveys can also trigger patients to post positive experiences to Google and social media outlets. In the event of a negative experience, patients can first communicate privately with the practice to resolve any potential problem or miscommunication.

The bottom line

In today’s competitive healthcare climate, patients have many options for their care. Practices that transition to cloud-based technology platforms with fully automated and customizable workflow elements show greater respect to the needs and time of their patients, increase revenues, and place greater value on their own needs and time. They also prove to be on the cutting edge of technology by streamlining processes and enhancing communication to deliver safer and more accurate care.

About Naveen Sarabu
Naveen Sarabu is Vice President of Product Management at AdvancedMD. Naveen has more than 15 years of experience developing innovative healthcare software solutions for the ambulatory, acute and accountable care organization (ACO) markets, including for Allscripts, Hill-Rom, and NTT DATA. Naveen received an MBA from University of North Carolina-Chapel Hill and an undergraduate degree from National Institute of Technology, Warangal, India.