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The Increasing Role of Surveys in Reimbursement, Profitability, and Quality Care

Posted on February 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

Delivery of high-quality, patient-centered care has become the hallmark of the medical industry. The most commonly used indicators for measuring the quality of care are patient satisfaction and the patient experience. How patients feel about their experience is critical to overall practice success because it has been proven to impact health outcomes, patient retention, and medical malpractice claims.

The emerging standard for measuring patient satisfaction is the use of patient surveys. Patient satisfaction surveys are not only important when required for reimbursement, but also for practices focused on improving their patient-centered care (that should be everyone). A well written survey can be a very powerful and reliable tool. It can provide more information about what is going on in your practice. It demonstrates that your practice is working to improve. It shows patients that quality is your focus.

What are the key reasons that every practice should start implementing patient surveys?

Patient Surveys Increasingly Drive Reimbursement

Because both practice and hospital reimbursement are increasingly tied to health outcomes and patient satisfaction, patient surveys have become the go-to guide for improving the patient experience.

Currently, CMS (the Centers for Medicare and Medicaid Services) uses the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients feel about their hospital experience. They then take those results and compare them to hospitals locally, regionally and nationally and assign them a score. Those scores have been a big part of the Hospital Value-Based Purchasing program for nearly six years.

This past year, we have seen the implementation of MACRA. Under MACRA, physician and hospitals patient satisfaction scores are calculated. By 2019, these scores will impact Medicare reimbursements.

It is highly likely that this trend towards survey-based reimbursement will continue to grow. Even if your practice is not currently required to use patient satisfaction surveys for reimbursement, it is probable that you will at some point in the future. By sending out surveys now, you can get a better handle on changes that need to be made to secure high scores for future reimbursement.

Patient Surveys Increase Profitability

High patient satisfaction levels impact a practice’s profitability for reasons beyond just reimbursement. Studies have found a significant correlation between high patient satisfaction and the overall profitability of a practice. Consider this:

  • A good patient experience significantly lowers your risk of a malpractice suit. In fact, for each drop in satisfaction score, a provider is nearly 22 percent more likely to be hit by a lawsuit.
  • One surprising effect of an improved patient experience is reduced staff turnover. Because a better patient experience often involves implementing more efficient and effective processes, staff are able to work in a more pleasant environment. One provider saw their turnover rate drop 5 percent after efforts to improve the patient experience.
  • A good patient experience leads to lower patient turnover. This one is more obvious. Today’s consumer-minded patients are looking for a great experience. One study found that practices with poor patient-physician relationships are three times more likely to move to a new practice than those with good patient-physician relationships.

It’s easy to see why the use of a patient survey to track and improve the patient experience is quickly becoming best practice. As Joe Greskoviak, president and COO of Press Ganey explained, “We are seeing a shift in the way organizations look at the engagement of their patient populations. The ability to use patient experience as a competitive and strategic differentiator to gain market share is a valuable tool,” Mr. Greskoviak said.

Patient Surveys Lead to Quality Improvement

As dozens of studies have found, there is quantifiable evidence that tracking the patient experience leads to quality improvement in multiple ways. These studies have found that:

  • A good patient experience improves both prevention and disease management. In one study, diabetic patients increased their ability to self-manage their disease and, subsequently, improved their quality of life simply due to a good experience with their provider.
  • Positive patient experiences lead to a higher likelihood of care adherence for the patient. This is especially true for those with chronic conditions who meet regularly with their provider.
  • Patients who have a good patient experience and a positive view of their provider have better health outcomes compared to patients that have poor patient experiences. Heart attack patients who were highly satisfied with their practice saw significant improvements over their less satisfied peers one year post-attack.

Understanding how your patients feel through patient satisfaction surveys is an invaluable tool. These surveys can be as important to the success as your healthcare credentials. If implemented and used properly, a patient survey can help you increase profitability, healthcare outcomes, and reimbursement.

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. Learn more about the Patient-Provider relationship survey here.

E-Patient Update: Clinicians Who Email Patients Have Stronger Patient Relationships

Posted on January 26, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I don’t know about you, but before I signed up with Kaiser Permanente – which relies heavily on doctor-to-patient messaging via a portal – it was almost unthinkable for a primary care clinician to share their email address with me. Maybe I was dealing with old-fashioned folks, but in every other respect, most of my PCPs have seemed modern enough.

Few physicians have been willing to talk with me on the phone, either, though nurses and clinical assistants typically passed along messages. Yes, I know that it’s almost impossible for doctors to chat with patients these days, but it doesn’t change that this set-up impedes communication somewhat. (I know – no solution is perfect.)

Given these experiences, I was quite interested to read about a new study looking at modes of communication between doctors and patients in the good old days before EHR implementation. The study, which appeared in the European Journal for Person Centered Healthcare, compared how PCPs used cellphones, email messages and texts, as well as how these communication styles affected patient satisfaction.

To conduct the study, researchers conducted a 16-question survey of 149 Mid-Atlantic primary care providers. The survey took place in the year before the practices rolled out EHRs offering the ability to send secure messages to patients.

In short, researchers found that PCPs who gave patients their email addresses were more likely to engage in ongoing email conversations. When providers did this, patients reported higher overall satisfaction than with providers who didn’t share their address. Cellphone use and text messaging didn’t have this effect.

According to the authors, the study suggests that when providers share their email addresses, it may point to a stronger relationship with the patient in question. OK, I get that. But I’d go further and say that when doctors give patients their email address it can create a stronger patient relationship than they had before.

Look, I’m aware that historically, physicians have been understandably reluctant to share contact information with patients. Many doctors are already being pushed to the edge by existing demands on their time. They had good reason to fear that they would be deluged with messages, spending time for which they wouldn’t be reimbursed and incurring potential medical malpractice liability in the process.

Over time, though, it’s become clear that PCPs haven’t gotten as many messages as they expected. Also, researchers have found that physician-patient email exchanges improve the quality of care they deliver. Not only that, in some cases email messaging between doctors and patients has helped chronically-ill patients manage their conditions more effectively.

Of course, no communication style is right for everyone, and obviously, that includes doctors. But it seems that in many cases, ongoing messaging between physicians and patients may well be worth the trouble.

5 Ways to Keep Patients from Feeling like a Number

Posted on January 17, 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

Think about the last time you felt upset at work. What was the root cause? Did you feel ignored? Overlooked? Unappreciated? If so, you are not alone. Studies have found that two out of three workers feel unappreciated at work and 65 percent would prefer a better boss over a pay raise. Everyone wants to feel that they matter. It’s simply part of our nature as social beings. This need to feel valued is not restricted to the work environment. In fact, studies find that it extends far beyond the office walls to retail, service, and—yes—healthcare experiences.

The Patient-Provider Relationship Study confirmed this—noting that practices can no longer rely on their excellent clinical care to keep patients coming back. Patient dissatisfaction is at an all-time high, prompting patients across the generations to switch physicians.

Between 43 and 44 percent of millennials and Gen Xers will switch providers in the next few years. It’s not just the younger generations, even baby boomers are restless—20 percent are likely to find a new physician in the next three years. While patient dissatisfaction is a complex issue with multiple solutions, one of the easiest and most effective treatments also has the lowest cost to practices—making patients feel valued.

Here are five simple tools a provider can use to help patients feel they are important:

  1. Acknowledge. Nothing makes patients feel like they are on the conveyor belt of medical care more than being ignored. There is a reason the grocery king, Walmart, pays to have people simply greet you as you enter and leave the store. Humans like to be acknowledged. Consider having different front desk staff assigned as the office “greeter” along with their regular duties. A quick, “Welcome John! I’ll be right with you” along with a genuine smile can go a surprisingly long way towards patient satisfaction.
  2. Remember. Try to remember small things about each patient. One way is through use of their name. Another great time to show a patient you remember them is on their birthday. Eighty five percent of Americans say that they feel special when others celebrate their birthday. It is easy to automate a personalized birthday email or text message that keeps you connected outside of the office.
  3. Respond. Medical offices are busy. There’s no way around it. But when a patient reaches out, it is important to respond as quickly as possible. The ability to two-way text with patients is handy here because it allows you to acknowledge (see #1) a message from an out-of-office patient while still being present with patients in the office.
  4. Listen. It can be easy to brush past comments or questions from patients. In fact, research shows that the average patient is interrupted within 18 seconds of their visit. Instead of assuming that you know what a patient is going to say, wait patiently until they finish speaking. Devote your energy to looking at them and focusing on them while they talk.
  5. Thank. Patients are the reason you are in business. Every position in a medical office is made possible because of patients. During the hectic everyday rush, it can be easy to forget this simple fact. Try shooting off a personal “thank you” email or text (or even a handwritten note). The good news is that research shows that showing gratitude not only improves the well-being of those you thank, but your own well-being as well.

It is often the small things that can make the biggest difference to patient satisfaction. In the era of consumer-centric patients, it is important to help patients feel like more than just another number. Following these five simple steps will bring practices closer to that goal.

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. Learn more about the Patient-Provider relationship survey here.

WorkFlow Wednesday: Patient Satisfaction and West’s Patient Experience Survey

Posted on July 5, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Providers can improve patient experiences and revenue. So much of what improves satisfaction is outside the clinical setting.  West’s Insights and Impact Study titled “Prioritizing the Patient Experience” examines the gaps in patient value perception in the current healthcare marketplace.

West recently conducted a survey of patients providers to get more insights into what patients and providers value.  With value based payment models and consumer focused health providers are increasingly motivated to provide high quality service. Today’s patient is more aware of choice in provider options and will shop around for a provider that matches their needs.

Patients and Value Based Care Provide More Awareness of Choice in the Healthcare Marketplace

Patient experience using current technology and workflows is the space West has been working in for 25 years, including patient reminders for large hospital systems. As a company that specializes in patient experience, they used an outside firm to get insight about how well provider and patient perceptions were aligned. It was impressive to see an engagement company practicing what they preach and being proactive about feedback and improvement.

The most interesting takeaway from all of the statistics and research and report is that we know what the drivers of a good experience are. If you ask patients and providers what their motivation are answers are not usually aligned. This gap in what providers and patients value in terms of healthcare experience can cost providers revenue and patients. Patients value a high level of communication and transparency about cost of care more than providers believe.

Looking at the study, 78% of patients with a Chronic condition are likely to say that their provider cares about them as a person. Personally I’ve experienced this with my son that has a Chronic condition. We researched providers to ensure that we had similar values about communication and follow-up. Social Media groups like mom groups on Facebook have a lot of feedback about provider value. I know his provider gives great care and cares about him.

Patients with a Chronic Condition are Likely to Receive Personalized Care.

My Takeaways From the West Report

  • Current Systems do not always create a seamless workflow. Smooth workflow and patient communications improve patient experience.
  • Patients really want to know about what to expect in appointments. Sending a notification about costs including copays and obligations improves patient satisfaction.
  • Wait times are a huge cause of concern for patients. Electronic messaging or text information about waits can improve patient satisfaction even in cases where delays cannot be avoided.
  • Making payment as easy for patient as possible improves patient healthcare experience. A reminder about a bill with information about how to pay will improve practice revenue and patient experience.
  • Simple workflow improvement and automation improves clinical outcomes and patient retention in an increasingly consumer aware healthcare world.
  • Providers can focus on using the technology to better measure that for further strategy for improvement.

Well developed workflow can ensure that physicians have fewer patient surprises. Rather than waiting for an HCAP you can proactively collect data and brief surveys on specific topics before you are doing emergency triage. Contact recently discharged patients via an automated phone message or email. Have the questions tie back to HCAP survey questions so they can see what they will get.

What can systems do? Select Key measures for patient satisfaction.

What can physicians do? Tell patients that what to expect.

West is following their own advice and getting feedback about the value of communications and technology The survey is a connector for patients and for technology companies in the HealthIT space. Great ideas about Workflow improvement and best practice for business from West.

The report can be accessed online here and these key takeaways and is a great read for providers.

When Scribes Don’t Pay Off

Posted on June 30, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Since scribes first hit the scene, there’s been a lot of debate about the benefits of having them in place, as well as what duties they should handle.

Critics have suggested that using scribes only sidesteps the need to look at larger industry issues. On the other hand, some physicians have found scribe support to be a big relief. Many have reported that scribes have reduced their paperwork and reestablished their face-to-face connection with patients.

Those happy doctors include Peter Leavitt, primary care physician with Bend, OR-based St. Charles Family Care. Dr. Leavitt told a local newspaper that using the scribe cut the two hours per day he spent entering notes into the EMR by 40 percent.

But Leavitt won’t have scribes available much longer. St. Charles Health System, the PCP practice’s parent organization, has decided to drop scribe support for primary care offices on July 1st. The health system said that the $480,000 it invested in scribes didn’t produce enough benefits to justify the expense.

Starting in spring of last year, St. Charles has gradually brought a total of 20 scribes on board.  In an effort to test out their impact, the system brought scribes to only four of the clinics.

St. Charles hoped that rollout within the primary care practices would boost physician morale, increase patient throughput and give doctors time to improve their chart notes and documentation. As it turned out, however, adding the scribes didn’t accomplish what execs had hoped.

Yes, the roughly 20 doctors who used scribes seem to be happier once they came on board. But the scribe experiment seemed to fail by other measures. The clinicians were only able to see one-half patient more per day, which didn’t meet execs’ expectations. What’s more, documentation didn’t improve, in part because scribes can’t perform key functions like ordering tests, Leavitt suggested.

What’s more, the health system ran into some unexpected obstacles. In particular, some patients refused to let scribes stay in the exam room, and others would only share private information with the doctor once the scribe left the room.

It’s impossible to say whether the results seen by St. Charles would be duplicated elsewhere. After all, there are a ton of potential confounding factors which could have influenced the results of this trial, including the nature and level of training the scribes had received and the extent to which the clinics‘ existing processes could support workflow improvement.

Though we’ll never know for sure, it could be that if the scribes had a better education or the workflow around documentation was improved, St. Charles would have gotten better results. And it could be that the EMR is so hard to use that even scribe use couldn’t put a dent in the problem.

Regardless, we don’t need to know much to conclude that the health system may have significantly undervalued the benefits of physician satisfaction. I don’t know what dollar value execs assigned to the happiness of doctors, but even a raw number based on physician recruitment costs and the time needed to train them on your EMR would might capture such benefits.

Meanwhile, I’d argue that the metrics St. Charles used to measure scribe value – patient throughput and improved documentation — may or may not be the best way to approach the problem. I’d love to see a similar pilot rolled out which measures success strictly by patient and doctor satisfaction levels.  After all, you can’t lose by making physicians and patients happy.

Patient Loyalty, EHR Adoption, and EMR vs. EHR

Posted on December 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


This is interesting to consider. I’m really not sure how you can measure this result. I think this will eventually be true, but I don’t think we’re there yet. In theory everyone wants their doctor to have an EMR. However, they really just want more services for themselves as patients. That’s very different from what an EMR provides today.


My we’ve come a long ways. Now we’ll see how many organizations end up switching EHR software because they rushed their EHR implementation.


I prefer EMR and I think most doctors do as well. Although, $36 billion has a way of changing things.

Medical Bills, Patient Portal Insight and HIT Friends in Need

Posted on August 15, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

HIT Friends Support a Great Cause
Blogging and social networking are of course great drivers of information and thought leadership, and they can also be very effective in spreading the word of friends in need. I found out through these avenues about the healthcare challenges of three-year-old Little James, recently diagnosed with a brain tumor, and the fundraising efforts of Todd Stein at Amendola Communications to alleviate the burden of his mounting medical bills. You can read about his healthcare challenges here. Prayers and donations are immediate needs. I wonder if any organization out there might step up and match donations.

Speaking of Medical Bills
On a lighter note (sort of), I laughed out loud when I saw an explanation of benefits for my recent surgical procedure.

savings

Thankfully, I do not truly owe anywhere near that amount due to insurance coverage. I shudder to think how the uninsured pay for life-saving procedures they can’t afford. Yes, hospitals can work out monthly payment plans for anyone, but if an extra $50 a month means less gas in the tank to drive your kids to school … I now find myself tediously combing over statements from the hospital and explanation of benefit statements from my insurance company to make sure they match up.

More Healthcare Cost Transparency News
A company called Change Healthcare is getting into the cost transparency game, having just secured $15 million in funding to further develop its Transparency Messenger product, which, according to the company, compiles health plan and claims data to devise algorithms that determine cost of service. It then uses health plan holders’ or employees’ demographic information and personal preferences for care to look for savings.

Customer Service in Healthcare
In contrast to the financial distress that comes with unexpected medical procedures, I must share with you a thank you note from my surgical team. While I appreciate the gesture, I’m wondering if they’ve charged me for it!

thankyou

All kidding aside, this gesture highlights the increasing importance providers are placing on customer service. To learn more, check out “Why Customer Service Matters in the Healthcare Industry,” by James Merlino, MD, of the Cleveland Clinic.

Patient Portal
I haven’t yet logged back into my patient portal – thankfully having no need to right now. My last doctor’s visit prompted me to ask if I could access my latest pathology report via the portal. My doctor sidestepped the question and promptly presented me with a paper copy, which will likely be a good thing, as he and my dermatologist don’t seem set up to share patient information electronically. That seems to be a provider choice, and not necessarily due to poor portal design.

Speaking of patient portals, I highly recommend you take a look at Dr. Michael Koriwchak recent blog over at WiredEMRDoctor.com. “My First Year with a Patient Portal” gives us patients a better idea of what works and what doesn’t from the practice perspective.

EMRs Boost Patient Satisfaction, Loyalty

Posted on August 9, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Doctors may be bringing EMRs into their practices to get Meaningful Use payments, but it seems that their efforts will pay off in patient satisfaction as well.

According to a new study by independent research firms Aeffect and 88 Brand Partners, almost 50 percent of patients take EMR access into account when they consider choosing a  healthcare provider.

Fifty two percent of patients surveyed said that while t hey aren’t currently using EMRs, they’re interested in doing so. Another 24 percent are already using EMRs to check test results, order prescription refills and make appointments.

Consumers who prefer their doctor to use an EMR listed several reasons, including access to medical records (40 percent), accuracy of record keeping (18 percent) and quality of care (17 percent). On top of that, 39 percent of respondents said that EMRs are more accurate than paper charts.

What makes this data particularly interesting is that patents who have used an EMR are significantly more satisfied with their doctors overall (78 percent versus 68 percent). What’s more, patients who use EMRs reported higher satisfaction scores across many specific care attributes, including ease of access to information and clarity and thoroughness of communication, the researchers concluded.

Also, patients who use EMRs said that they felt they received a better quality of care (82 percent).

Providers, there you have it.  EMRs have filtered into the public consciousness so thoroughly that consumers are actually beginning to see them as a must-have when choosing a doctor. And more than that, almost three quarters of patients want access to the records, most likely through a user-friendly portal.

I’d call this good news. If practices are going to have to roll out an EMR anyway, it’s nice to know that patients will be excited about it, no?