By Rick Halton, VP Product and Marketing, Lumeon

First published in HIT Consultant – 10.19.2020. Full article available here.

The concept of ‘Patient Access’ has evolved significantly. We all remember the good old days when patient access was an inbound responsive model – patients dialed into a call center phone number and were connected “round-robin” to the next available staff member with their call script. Then outbound voice and email messages and patient appointment reminders became common, and now access centers have begun to deploy more advanced communication channels such as natural language voice response, texting, patient portals, online booking, and webchat.


Challenges Abound

While these technological developments all promise a great deal of potential, they also present some profound challenges. Firstly, they rely on the patient adopting these new channels – sometimes called “crossing the chasm” – a well-studied phenomenon. In one example, the founder of EHR vendor Epic, Judy Faulkner, recently noted the surprising fact that only 0.5% of Epic users are actually interested in managing their own health records, putting into question the usefulness of the patient portal. Secondly, multiple disparate communications options can rapidly make the experience fragmented and confusing. Thirdly, multi-channel access centers create an enormous inbound funnel, risking becoming swamped with inquiries. Most recently, we’ve seen the COVID-19 virus overwhelm many access centers globally.

Like a bridge across the chasm that needs sturdy pillars, robust communication channels serve as infrastructure pillars for the patient journey. However, the real challenge is that access centers today cannot effectively navigate patients along a care journey and rapidly adapt that journey to new, evolving care paths. Today, patients are left to flounder in a maze of communication options, rather than navigate automatically along a directed, thoughtful care journey.

Patient expectations are also changing – they now prefer the types of consumer experiences they’ve grown accustomed to through other industries, such as eCommerce, banking, and retail. Patients will naturally gravitate towards the path of least resistance, to healthcare providers who guide them along a convenient and relevant care journey. Those who do this best will offer the world’s best care experiences. Patient access leaders are beginning to realize that they cannot merely keep hiring more staff – so they look towards new software platforms to help them take control and automate the patient journey.


The Cost of Fragmented Experiences

The financial cost of fragmented care is undeniable. Studies from Harvard have shown that high care fragmentation for chronically ill patients leads to $4,500 in higher healthcare spending, which can be $10,400 for those with the most fragmented care. Moreover, the cost of fragmentation from a patient’s perspective is more than can be measured by a dollar figure. At best, it can negatively impact their overall patient experience and satisfaction. At worst, it leads to less effective care and poor outcomes as care transitions fail, and care becomes less coordinated.

New digital interaction channels present a growing opportunity to improve patient access experience and outcomes considerably. But how can health systems reap the benefits without having to increase their investment in staff significantly?


Designing Patient Journeys

Addressing patient experience fragmentation requires a change in thinking. We need to think longitudinally about the patient experience, from the first contact to recovery, rather than inbound versus outbound interaction. And by automating that experience, we can ease the burden on staff, assist them in engaging with patients at the right time, and deliver a more meaningful, relevant experience.

Imagine using a website, like Amazon or Southwest Airlines, where no one had thought about the purpose, goals, or end-to-end experience. It would likely result in fewer sales and frustrated customers. Similarly, patient access leaders must now take control of the end-to-end patient experience, pooling their resources to enable longitudinal, proactive journeys.

Let’s take a closer look at what a coordinated, patient-centric journey looks like – it’s a combination of a patient journey, a trigger, decisions, personalization, and the coordination of tasks:

  • Firstly, what kind of journeys might we consider? Within Patient Access, we consider many journeys such as referral, appointment reminders, booking, rebooking, care transitions, reminders, instructions, advice, etc.
  • Additionally, initiating each patient journey will be a trigger, which might be a referral, booking, order, admission, discharge, or transfer.
  • Finally, the patient journey should also be personalized to patients’ needs and preferences depending on the specialty, appointment, procedure, demographics, compliance, health risks and acuity, pre-existing conditions, or comorbidities.

Now, depending on the patient, each journey will be aware of and automatically coordinate the different resources and capabilities needed, such as across roles, skills, appointment slots, and tasks that need to be completed.

Taking appointment reminders as an example, providers might start with an automated appointment reminder, then enable the patient to reply “reschedule” rather than simply “cancel.” Once they have confirmed attendance, they might get an eform prior to the appointment that asks them to describe their health status or goals in more detail. This information could be relayed to the care team in advance of the appointment, saving important time in the consultation. Following the hospital appointment, a referral could trigger an invitation to the patient to book an appointment and then subsequent follow-up appointment reminders could be sent. Gathering this kind of information prior to and after teleheath appointments can also be impactful in making the best use of patients’ and physicians’ time.

To do this, health systems need a single platform to take control: coordinating and automating both tasks and communication across the patient journey. For example, with a patient referral journey, the health system would efficiently manage the appointment scheduling process by coordinating appointment reminders, canceling, rebooking, bumping, health risk surveys, consent, patient preferences, and promptly collecting health plan details for pre-authorization. Each journey type also needs to incorporate a programmable workflow so it can rapidly adapt to changing circumstances.

Healthcare providers should follow the lead of airlines – a prime example of effective coordination, automation and orchestration. An airline has a single system to automate the customer journey across ticket purchasing, check-in, rebooking, loyalty, and customer service. The entire airline customer journey is coordinated from start to finish, only escalating to the contact center where necessary. Patient journeys should be just the same.

Find out more about Lumeon’s patient access solutions here.