This article was originally published in Becker’s Hospital Review.
Across the health IT industry, leaders are balancing pressing concerns like increasing call volume and the need to maximize revenue with limited resources. And nice-to-have initiatives just don’t cut it anymore, with those that don’t drive revenue left on the cutting room floor. So how do you balance building for the long term with the pressures you’re managing right now?
In the webcast Digital Health: On Air, leaders in a variety of roles have shared the challenges they’re facing – and the strategies they use to achieve success in spite of them. Here are some of their takeaways:
Take an incremental approach
In healthcare, “change can be very, very challenging,” says Arz Raheem, Sr. Director of Digital Transformation at Montefiore Health System. “[But] I think, after many years, healthcare is open to the change that is needed. And even if that’s iterative, that’s fine.”
Investing in a large-scale transformation project might be off the table for your organization right now. That’s okay, according to Raheem and Tarun Kapoor, MD, Chief Digital Transformation Officer at Virtua Health. And it can even be an asset.
“In our hypercompetitive market, speed to impact is worth a lot,” says Kapoor. “And so you have to think about, ‘What is the problem that the consumer is facing in this specific situation? How can I make them successful?’”
At Virtua Health, Kapoor’s iterative approach created real clinical impact. Realizing that some patients weren’t responding to colonoscopy reminder outreach, he took a step back. “Traditionally, we say, ‘you have a care gap. Come into the office so we can talk to you about this care gap.’ Instead, we said, ‘we know you might not have time to come in right now. Can you do a Cologuard® test at home?” After this more tailored outreach to a specific subset of patients, Virtua Health got thousands of home tests back and found nearly 300 patients with positive results.
Instead of taking months to work toward a larger project and hit a number of defined milestones, Raheem says, he’s also seen results from an agile approach where projects are smaller-scale and can be expanded later, if they’re successful. An important caveat: “Be brave enough to kill it if there’s no value.”
Bring varied stakeholders to the table
So, what’s the most important ingredient in this iterative approach?
“We try and find people from operations; finance; security; compliance and legal; who are open to change, who can be our champions,” says Raheem. “[Then] we can take good ideas from ideation to implementation and make sure that we’re creating value,” he says.
Gathering this multi-stakeholder group and approaching challenges from this lens requires a culture shift, says Raheem, from the traditional health IT implementation model.
“Technology has had, in my opinion, a culture of more preservation and maintenance. I say, ‘I’m going to try small things. I think I’m onto something and want to show you what I’ve got.’ But if you don’t have the right support, great ideas will die on the vine.”
At the same time, this “coalition of the willing” across different areas of expertise is especially important for Raheem, who serves one of the country’s leading academic medical centers, to avoid introducing risk with an agile approach.
“We’re agile, but we have to be extremely careful about how we implement change and how we’re introducing new technologies because we’re in an environment that is heavily regulated,” he says. So, “if you don’t have that support, then speed to impact doesn’t really happen.”
Pinpoint your pain points
Another way to create outsize success? Pinpoint very specific use cases for new technology, like Main Line Health.
First, Main Line Health identified that their call volume was too high for staff to handle. Having already successfully transitioned to a centralized call center and offloaded some calls to an external resource, they needed another lever to help patients get to the right place without waiting on hold.
Next, they identified that a majority of incoming calls were to schedule mammograms and DEXA scans. “The largest service line supported by central scheduling is radiology and imaging,” said Noreen Friel, Director of Call Center Operations. “And we’ve been trying to increase access to our digital front door and enable patients to schedule themselves.” With a defined scope of the types of calls they wanted to assist with self-service, they were able to quickly add a call-to-self service workflow for patients that would allow scheduling for mammograms and DEXA scans by SMS if the patient desired.
Since adding in the self-service option for these types of calls, Main Line Health has saved 900+ hours in a single year while still getting patients what they need. Pointing to the success of the project, Friel says: “We already had self-scheduling, and we kept it pretty simple. So it was implemented very fast.”
Look for hidden barriers
As your health system is evaluating what’s necessary for the short-term and where to focus for the long term, Elizabeth Woodcock, DrPH, MBA, FACMPE, CPC, founder and executive director of the Patient Access Collaborative, encourages looking for hidden access barriers.
Hidden barriers, says Woodcock, exist throughout the patient experience and can often be resolved to create more equitable and smooth access to care. These barriers could include:
Better patient access or transformation of the experience doesn’t have to be out of reach if your health system is focused on containing costs through this year and next. Consider low-cost changes that could address these hidden barriers, such as:
Woodcock says that the number one best tool leaders can have for transforming patient access is to “really, really listen.” And as part of this listening, understand that finding hidden barriers requires more creative thinking than simply consulting patient feedback surveys, as these are often a “biased sample” of only patients who have been reached in the right way and in the right language, Woodcock says.
Ultimately, Woodcock points out, searching for and addressing hidden barriers is worth it. “Our most vulnerable patients’ voices are not being heard. And because of that, they’re fighting to get in our system.”
Take a look at cybersecurity basics
The rising threat of cyberattacks means it’s impossible to focus on iterative, impactful changes without a strong security infrastructure. And the very digital transformation that helps create these changes creates more risk, according to security expert Brent Williams.
“Healthcare is a target-rich environment,” he says. “Think about the datasets that are out there – it’s really powerful in terms of stealing identities. In the last 10 years, malicious actors have definitely noticed that, as the digital aspect of the healthcare business continues to grow.”
A core component of a secure health system, according to Williams, is a company culture of security. “The term I use is ‘business as usual.’ Security, when it’s done well, should just be part of the fabric of your processes, your technology, your business,” he says. To enable this culture, he recommends:
“It’s the same weaknesses over and over,” like unprotected VPN endpoints or login pages, that lead to significant cyberattacks, says Williams. “So I keep coming back to the basics.” And over time, Williams says, “the team starts to get a bias toward, ‘oh, this is working well.’”
While the added scrutiny needed for cybersecurity at today’s health systems can be stressful, says Williams, this basic hygiene can protect against costly and disruptive cyberattacks and allow your health system to focus on other impactful initiatives.
Conclusions
The CIO is at the center of a number of challenges, from serving more patients with fewer staff to remaining competitive without overspending on expensive digital tools. But amidst these challenges, you’re still responsible for directing your organization toward long-term success.
The experts featured in season 1 of Digital Health: On Air are creating immediate impact with long-term potential with:
If you’re interested in topics like these or would like to hear more from these speakers, follow Digital Health: On Air on Spotify or subscribe for a monthly episode digest.
Guest post by Renee McKibben, RN, BSN, Regional Operations Director at Maury Regional Health. This article was originally published in Becker’s Hospital Review.
A key strategy for access leaders looking to reach more patients is to think “EHR Plus.”
At Maury Regional Health, we serve patients across eight counties in southern and middle Tennessee, with a lot of variance in how they want and need to access care. We have patients in rural areas with less reliable internet, and we also know that patients have high expectations for their consumer experience.
To be able to provide the access that our patients expect, Maury Regional Health uses the EHR as the key source of truth and expands the channels available to patients through integration.
Three key pieces of our “EHR Plus” strategy:
1) Keep the EHR the source of truth.
Everyone from our staff to our technology and access leaders is aligned in keeping Oracle Cerner our source of truth.
When we evaluate any technology additions, we look for FHIR API connectivity with our EHR to communicate using the most up-to-date information and write back any changes such as scheduled appointments.
In fact, our goal is that our staff don’t even realize all the different vendors we have attached to Oracle Cerner – they simply see it as the EHR. One example is our patient engagement platform. Patients see the messages and self-service options as communication from MRH, and staff see all updates in Oracle Cerner.
What to consider: Especially when short on staff, it’s not sustainable to ask staff to jump through hoops or double-document information. A new system must be deeply integrated to reduce, not add to, the tasks completed day-to-day by staff.
2) Choose additions to the EHR strategically to offer new modes of access.
At Maury Regional Health, we serve an incredibly diverse population with all sorts of technology infrastructure. We know that healthcare isn’t necessarily accessible to everyone out of the box, and we need to match our technology both to what’s available to our patients and to their expectations for their care.
One common request from our patients was the ability to communicate by text message – it’s more convenient for many of our patients and is more accessible if someone doesn’t have reliable internet connectivity.
On the system side we also needed the ability to reach more of our patients at once, such as when a provider is out sick.
By adding on the ability to ingest information from Oracle Cerner, text the patient, and bring back their responses into the EHR, we were able to match our patients’ expectations and give them better access to our services. We’ve been able to create a consumer experience our patients want, while also recognizing $500,000 more in revenue by reducing no-shows across key departments.
What to consider: It’s worth strategically expanding your tech stack to give patients access to their care in the way they want it. Look for opportunities to improve the experience for a wide variety of patients, as well as staff.
3) Prioritize real-time customization integrated with the EHR.
With multiple specialties and sites spread across eight counties, Maury Regional’s access technology needs to offer real-time communication and updates. Healthcare isn’t one-size-fits-all, and customization is a huge priority for all of the products we integrate with our EHR.
For example, we have a lot of demand for our specialists who have very limited availability. It’s crucial that we’re able to prepare patients for those appointments and make sure the care is completed successfully, so patients aren’t delayed waiting for the next available slot. Different specialists and types of appointment might have sequenced diagnostic tests, specific patient forms, or other information that requires very clear communication to the patient.
With our access tools, tight integration with our EHR and customizability of the tools makes sure that the patient gets the right communication, at the right time, specific to their care journey and the way they want to communicate with us.
What to consider: Balance standardization with customization when selecting and implementing access tools. Ensure that your tools have the capability to use EHR data to customize patient communication to each person, while keeping the EHR up to date.
Interested in hearing more about Maury Regional Health’s approach? Learn more here.
Today, we announced the achievement of Oracle Validated Integration with Oracle Health Expertise. This recognition, along with our ability to deploy Luma’s platform directly from Oracle Cloud Infrastructure (OCI), demonstrates our deep commitment to the Oracle community and the success of our customers.
We’ve long heard from leading health systems that they have the powerful data and patient journey context they need to create great patient journeys, but they need a system to orchestrate and take action on this data set. Luma’s mission is to be that system of action, with next-level orchestration integrated into Oracle Health including:
More than a suite of capabilities, Luma’s platform is designed to guide each patient along their journey while keeping Oracle Health the source of truth.
Every health system wants to provide best-in-class patient journeys. We’re excited to have achieved Oracle Validated Integration with Oracle Health Expertise because it further demonstrates our commitment to the success of our customers. Luma supports our customers with experienced implementation, data-driven best practices, and personalized solutions that meet their patients’ needs. Additionally, Luma’s validated Oracle Cloud Build Expertise and ability to deploy the platform directly from Oracle Cloud fully support our customers leveraging Oracle Cloud Infrastructure.
Some notable successes by our customers integrating Luma with Oracle Health include:
We’re honored to be recognized by Oracle for our continued investment in providing integrated, end-to-end capabilities to our customers.
Utilizing an enterprise EHR system is like traveling on a cruise ship. You and hundreds of fellow passengers are on the same journey, for better or worse. The ship is designed to keep everyone onboard happy. You know which destinations lie ahead, but the schedule may be impacted due to weather.
But what if you want to stay a little longer in one port? What if you need to hurry up and meet friends at a different destination? What if you’re a little seasick and want to slow down? You’re out of luck. There’s no diverting the cruise ship from its set route, even when passengers aren’t on board.
We often observe this in healthcare. Many complex organizations benefit from the immense scope and scale of an enterprise EHR to care for a broad patient population, but one size does not fit all. Patient experience and engagement varies widely. Healthcare is a competitive market. In many regions, patients have a choice about where to seek care. Without IT tools in place to smooth the patient journey, this looks like:
Patients’ unique needs would benefit from speedboat flexibility to react to market conditions as they change. Enter patient engagement platforms: a solution that natively integrates with your EHR can implement new outreach strategies and realize results now.
In competitive marketplaces, this is not a luxury but a necessity. If you don’t have the ability to reach patients now, you risk losing them to a facility that can. How do we know? Because 87% of surveyed healthcare decision-makers agree that ability to compete in a marketplace is a driver for implementing patient engagement solutions (source). Fortunately, you don’t have to lag behind.
Fill the Cracks, Fast
What if your organization could start seeing changes in a matter of weeks?
Most systems are designed to work when everything is going right: when patients are fully engaged with all of their tools. In an enterprise health system, the multitude of available tools can flow through a patient portal for a streamlined patient experience. But data shows that more than half of patients aren’t using patient portals, even after receiving opportunities to register.
A platform approach to patient engagement can integrate into the native EHR and bridge some of the cracks with a medium that everyone uses: SMS text messaging.
Unlike enterprise EHR modules, API-integrated platform solutions can be implemented and launched within 45 days – enabling your organization to not just keep up with the Joneses, but surpass their assets.
Break Free from Boilerplate
Why are 89% of patients between the ages of 17-74 reluctant to use online scheduling options? Reasons include lack of access to internet, lack of awareness that options exist, low computer skills, and resistance to changing habits (source). It can be challenging to change their ways when limited to boilerplate messaging options and a set number of scenarios. To activate these patients and keep them within a healthcare network, organizations must be able to think outside the box – and step outside of boxes, too.
Partnership with a flexible patient success platform keeps patients on that journey. Over 1,000 messaging scenarios, and the ability to develop more, will accommodate your unique organization – and your patients – right from implementation.
Don’t Despair: Automate
When complexity abounds, organizations hesitate to adopt patient engagement technologies because their processes can vary wildly across the system. Specialities following different workflows keeps organizational knowledge siloed and ensures that valuable staff time is required to keep patients in-network. Many are surprised to learn that complexity doesn’t have to be a barrier to modernization. In fact, implementation of a platform is often an opportunity to simplify workflows and identify streamlined ways to automate tired processes. Administrators and staff alike are often pleasantly surprised to learn that people don’t have to manually undertake every step of the scheduling and intake processes.
The perfect mix
Automation is a hot topic right now, but it’s important to deploy a strategy that keeps humans involved when necessary. Sometimes it’s best to simplify the easy stuff and leave the personal touch for when it’s needed most. Main Line Health saved 15,000 minutes of human time per month when they implemented Digital Call Deflection. Inbound calls could be diverted to conversational SMS text messaging, enabling the call center to focus on patient interactions that benefited from a human touch.
What next?
Learn how an out-of-box solution can reach and activate the 40% of patients who aren’t using your organization’s patient portal. Request a demo here.
Patient care extends well beyond the minutes that a clinician and patient pass in an exam room together. The ensuing visit notes are just one piece of the continuum. Healthcare systems have long integrated selections from a smorgasbord of technology tools to document care, optimize practice operations, and integrate patients’ financial journeys…with varying degrees of interoperability and success.
Moving into 2024, healthcare providers report momentum towards consolidating tech stacks, looking to existing solutions for add-on capabilities before evaluating new vendors. Many EHR vendors are expanding beyond their core functionality of care documentation with solutions across the patient care journey. But organizations should tread with care.
Enterprise EHR is not one-size-fits-all
Every organization has unique aspects that influence operation. The gap between patient expectations and system capabilities can be massive, presenting many opportunities for patients to fall into the chasm between.
What’s holding patients back? Research indicates that barriers to self-service include access to the internet, lack of awareness of services, low computer skills, and change in the habit of making appointments over the phone or face-to-face. But even for patients who engage with technology, a challenging process is likely to disenchant and deter. Patients expect a frictionless experience. Anything less will stand between them and a completed appointment. No pressure, right?
The good news is, in a competitive marketplace, healthcare systems have a huge opportunity to deliver a seamless experience to keep patients coming back.
Most systems are designed to work when everything is going right: when patients are fully engaged with all of their tools. But data shows that only about 20-30% of patients make it through a manual scheduling process to a completed appointment. In their wake, they leave the debris of administrative burden, network leakage, missed appointments, and ultimately: lost revenue.
To capture maximum value from an enterprise EHR, you will need supplemental capabilities and patient engagement guardrails designed to keep the other 70 – 80% of patients in network.
10 Ways that Patient Engagement Platforms Support Patient Retention
Simple, right?
Having all of these in place is great, but if they don’t integrate deeply with your EHR, your organization won’t reap maximum returns. Overworked staff can’t spend time tracking these things down manually. For true Patient Success, these workflows must be deeply embedded in a native EHR, automating processes with closed-loop referrals and EHR writebacks.
Navigating the happy path in the complex landscape of enterprise EHRs requires a thoughtful approach to patient engagement. By addressing gaps with personalized strategies, proactive waitlist management, and consideration of generational nuances, healthcare providers can guide patients seamlessly through their journey, leading to improved outcomes and increased value from their EHR investments.
RESOURCE: Learn more about how Luma integrates with EHRs like Epic to support patient retention.
OrthoNebraska is an innovator in orthopedic care, but accessing that care was challenging for patients. OrthoNebraska’s leaders knew they wanted to completely overhaul the patient experience and create a unified digital front door – not just look for a quick fix.
“We wanted a great consumer journey to deliver ease of access as well as quality care,” said Nikki Green, senior manager of patient access. “But we didn’t want to select a vendor that would create redundancy or be unable to scale with us as we grew.”
The first challenge to tackle: high no-show rates. Instead of requiring patients to call to change their appointments, which led to no-shows and thousands in lost revenue, OrthoNebraska envisioned becoming the first orthopedic practice in the region to offer self-scheduling.
Because OrthoNebraska treats such a wide range of conditions, “implementing self-scheduling seemed like a daunting task,” said Green. “We need to get patients to the right provider. The patient’s current needs, their age range, their clinical history, the approach they’re looking for – all of these factors affect scheduling.”
Deep integration with their Cerner EHR was a must-have. Other vendors OrthoNebraska evaluated weren’t equipped to match each patient with the right appointments and providers for them, according to Green.
Ultimately, Green and her colleagues chose Luma as the foundation for their digital front door.
After integrating Luma with their Cerner system, “we felt more comfortable giving that self-scheduling power to patients,” said Green. “We were able to trust that the technical build itself would direct patients to the right provider.”
The choice of a platform over a scheduling point solution has already allowed OrthoNebraska to solve more inefficiencies on their journey to a unified, simple patient experience.
“Our nurses are very busy, so patients calling with clinical questions would need to leave a message,” said Green. “With Luma, nurses can respond to patients via text while they’re multitasking, which has been huge for patient success and nurses’ job satisfaction.”
Green sees wins like these as the first steps in OrthoNebraska’s digital transformation.
“It’s exciting that huge improvements like self-scheduling are just the beginning. We’re confident that Luma will complement the initiatives we’ll tackle in the future.”
Want to learn more? Book a quick call with a Luma + Oracle Health expert.