By Chinmay Singh, co-founder and president, Asparia.
Every medical group today is expected to demonstrate competence and results in population management. Increasingly, pay-for-performance contracts demand that groups utilize data, clinical coordination, and connected technology to improve patient care and patient outcomes. Information in the electronic health records (EHR) is often the glue that binds these initiatives together, enabling the dashboard for what individual patients need and a repository of data that can be analyzed for an entire group.
However, there is a notable gap in EHR capabilities that has been overlooked, up until now. The individual patient’s clinical data should be tapped and used to manage patients when they are not in the doctor’s office – to ensure adherence to manage treatment for chronic illness, for preventive tests and screenings, and for ongoing medical care.
Often called “patient access” functions, these communications today are fragmented, one-way, and for the most part, ineffective. How does the medical group notify the patients who need a particular vaccine? And how do they know that these patients may have actually received the vaccine elsewhere? What happens when preventive tests are due, and the patient doesn’t schedule or maybe doesn’t keep the appointment? What happens when patients are supposed to come back for a follow up in a year, and they don’t?
It’s not for lack of trying that these situations occur. Patient access departments use telephone calls, reminders by mail, e-mail and even texts, with no appreciable increase in consistency in the reduction of no-shows or patient compliance. Patients have good intentions of keeping their appointments, but life intervenes. It’s an inconvenience to them to have to call to re-schedule, and often they just let it go. Staff spending time calling each patient is tedious, time-consuming and expensive – and without a means to keep patients on track, quality of care suffers. Conditions that could have been detected early, may be only found when they are much more serious and expensive to treat. Illnesses that are preventable happen because the test or vaccine wasn’t received. The group’s costs of care go up, and outcomes go down.
Additionally, operational expenses rise. Staff time is wasted in trying to connect with patients by “old school” methods, and each no-show costs the office an average of $200. At a 7-20% no-show rate, a 100-provider health system has revenue leakage of about $10 million a year.
The solution is to adapt new technology like chatbots for example as a way to enable two-way automated communication with patients that taps the data in the EHR, and then communicates with the patient to ensure that the required actions are taken. Intelligent chatbots have modernized the doctor’s office and make convenience equal to that of dealing with the bank or online travel. This is what consumers expect today, and this is what they should be able to experience in health care.
Electronic health record companies such as Epic, NextGen, Athenahealth, AllScripts, Centricity, DrChrono and others have already incorporated these chatbots into their systems. Although awareness of this capability may be low, it is easy and inexpensive to integrate and use. This integration enables “zero friction” implementation and operations; staff do not have to undergo training to learn a new system and can continue to work within the EHR. With no data duplication, the EHR remains the single source of truth for patient data and interactions.