Community Health Network, based in Indianapolis, Indiana, faced three engagement problems – a lack of automation, a lack of personal or disease-specific communications and tremendous variation due to point solutions.
Communicating with patients was completely driven by live telephone interactions. It was clear the health system needed a more automated solution for appointment reminders and other messaging, for important touchpoints, like when a patient leaves the hospital or emergency department, said Dr. Patrick McGill, executive vice president and chief analytics officer at Community Health Network.
“In addition, COVID-19 created another barrier to patient communication, as the office staff was saturated with other duties,” he said. “In the few automated solutions that Community Health Network did deploy, there remained a significant amount of manual touching for the communications.
“Nursing leaders are encouraged, on patients in their unit, to understand how their care and experience is going, if the patient has any acute needs, and how the staff are performing,” he continued.
“Throughout Community Health Network there was tremendous variation in the nurse leader rounding process. Every nursing leader seemed to do it differently, asking different questions, which left us with no way of tracking compliance and determining which leaders were actively rounding on their patients.”
Community Health Network was interested in a comprehensive, enterprise vendor to help solve all of these problems – lack of automation, lack of personalization and variation in practices.
In addition to programs that had a solution in place, Community Health Network wanted to expand its digital solutions consistently across the entire network. Transitioning to a single vendor with a single platform created efficiencies in execution and cost savings, and allowed for enterprise standardization versus each department or area having their own solution, McGill said.
“We are on track to prevent 2,992 inpatient days due to readmission.”
Dr. Patrick McGill, Community Health Network
Most important, it allowed for a consistent patient experience, he added.
The health system decided to turn to health IT vendor CipherHealth.
MEETING THE CHALLENGE
“CipherHealth technology was deployed in several areas – nurse leader rounding, patient appointment reminders, COVID-19 screening pre-appointment calls and post-discharge call-backs,” McGill said.
“In nurse leader rounding, we initially deployed a standard digital tool at one hospital for nursing leaders to round on patients in the unit and ask uniform questions with documented responses allowing for consistent follow-up, measurement of areas of opportunity, and increased patient satisfaction and engagement due to consistent leader interactions.”
It allowed more real-time “voice of the customer” to be captured, he added.
“In patient appointment reminders, patients are texted or receive an automated call based on their preferences five days and two days prior to their appointment,” McGill explained. “This allows them to conveniently confirm or cancel, and allows us to reduce no-shows. Having an automated system allows for reduced staff time on calling patients since this was an entirely manual process prior to the implementation of CipherHealth.”
The COVID-19 pandemic has introduced another need, which is to screen patients for COVID-19 symptoms prior to their arrival for an appointment. Prior to CipherHealth’s tool, this was entirely manual and took several hours per day of office staff to screen and confirm patients prior to their appointment. It also generated an increased call volume since many patients were not reached on the first attempt.
Then came post-discharge callbacks.
“After a patient leaves the hospital or ED, they’ll receive a call to evaluate their status, determine if they have any acute needs following the hospitalization or ED visit, and ask if they received all of the follow-up services ordered during their care,” McGill said.
“Prior to CipherHealth, these calls were manually completed by a nurse, using up significant time and resources. Additionally, we had different teams of nurses calling the patients and had varying but overlapping questions.”
The population health team, for example, had one set of questions, while the patient experience team had a completely different set.
“Finally, the questions were often generic and might not apply to a specific patient’s circumstances,” he added. “With the new solution, all these problems were solved – one team with disease-specific and standard questions managed automated calling and only needed to call the patient manually when a specific need was identified. This allowed faster person-to-person connections, as well as faster and easier issue resolution.”
The results achieved so far have been powerful across several KPIs.
“We saw a 1.2% reduction in no-show rates after implementing CipherOutreach,” McGill reported. “Across five hospitals, that nets out to an additional almost 40,000 appointments. We sent out 1.55 million patient reminders, with 1.2 million successfully reaching their recipients.
Our pediatrics specialty showed the highest engagement, with a 92% reach rate. Across all specialties, we received a response rate of 41%, with 94% of respondents confirming their appointments.”
Then there was the impact on annual revenue.
“With average net revenue per visit at $78, our reduced no-show rate equaled real dollars,” he noted. “With just shy of 40,000 appointments that otherwise would have been no-shows, we added an estimated $3.1 million to our annual revenue, just from reducing appointment no-shows.”
Further, the health system achieved lowered readmissions.
“Our patients who received post-discharge outreach were 32% less likely to be readmitted following their initial hospitalization or ER discharge,” McGill said.
“Between July 1, 2020, and December 31, 2020, we had 1,240 actual 30-day readmission inpatient days. Without leveraging post-discharge outreach, we estimate those inpatient days would have jumped to 3,220, meaning that on an annual basis, we are on track to prevent 2,992 inpatient days due to readmission.”
The health system also made progress on staff recognition and satisfaction. After battling the pandemic for a year, staff members are exhausted, so the health system has been trying to find every opportunity it can to honor their hard work. CipherHealth’s Caregrams functionality allows patients to nominate staff members deserving of recognition. So far, 1,000 staff members have been honored through Caregrams.
ADVICE FOR OTHERS
“First, find a partner that is – and will act like – a partner,” McGill advised. “There are many companies out there in this digital space selling solutions but not partnerships. Second, work with a partner that offers enterprise-wide solutions – inpatient, outpatient, ED, etc. Third, there is a balance between automation and customization. You need to find a partner that can do both.
“Any great partner will be willing to truly dive into the organizational struggles and develop solutions if they do not currently have an offering, although in our experience, many companies will say they do this in order to make a sale,” he concluded. “Do your homework and investigate.”