Going Home Isn’t The End
When a patient leaves the hospital the last thing they want to do is go back. Yet, re-admission happens all of the time. Studies show that one of the most common reasons for this is insufficient communication between healthcare providers and patients.
In a pressure-cooker work environment like a hospital it’s almost understandable for doctors to focus less on their bedside manner and more on working through their case load. Almost.
Honestly though, it’s not fair to lay the blame for the lack of communication solely at the feed of physicians. There are systemic inefficiencies that lead to communications breakdowns between doctors and patients as well.
Re-admission rates are important metrics for hospitals, and becoming even more so, because it is one of several factors tied to Medicare reimbursements. Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) is a standardized survey given to patients following hospitalization. One of the contributing factors to a facility’s score is re-admission rate. Hospitals that don’t earn satisfactory HCAHPS scores could be subject to a 1.5–2% reduction in Medicare reimbursements. This may not sound like a significant number, but it can easily equal millions of dollars for a single facility.
So if communication between providers and patients affects re-admission rates, where are the communications stumbling blocks in this dynamic?
Help is Just a Call Away
“Don’t bring me problems, bring me solutions,” said every manager ever.
Ok, maybe that’s a bit of a stretch, but you have to admit that it makes sense. For someone dealing with multiple, constantly moving parts, sweating the details isn’t a very effective use of time.
Whether it’s a mobile or a landline, the telephone is one of the most ubiquitous communications tools in existence. Healthcare providers looking to maximize the capabilities of communication technology should definitely plan to incorporate phone-based communication in some capacity.
In the spirit of the adage above, here are some voice-enabled solutions to common communications problems that can contribute to hospital re-admission.
1. Follow-Up Care/Instructions
Problem: Going home is probably the best part of any hospitalization. But just because you get to go home doesn’t mean that you’re out of the woods yet. Typically, there is a laundry list of things that need to be done at home to ensure progress on the road to recovery.
This can include a medication regiment, physical or occupational therapy exercises, or follow-up appointments with your general practitioner. Depending on the course of treatment, follow-up care can be complicated. Failure on the part of both healthcare professionals to effectively communicate this and patients to fully understand what’s required can lead to re-admission.
Solution: There are a couple of different ways to utilize automated care instructions. The first thing to do is to determine which post-care instructions are the most common. The patients that require that information could then take advantage of a voice application containing those instructions. The system could either make outbound calls to discharged patients or allow patients to call in whenever they needed a refresher.
Outbound calls could be automatically linked to a patient’s medical record so that the system pulls the correct set of instructions. Similarly, with inbound calls a patient would only have to verify their identity to receive their follow-up care information. Any system tied into patient medical records needs to be HIPAA compliant so take extra care to ensure your solution fits the bill.
2. Medication Usage
Problem: The phrase ‘medication regimen’ in itself suggests a level of complexity above and beyond simply “take one pill, three times daily.” Although even that can be challenging for some. Whether it’s creating a new routine, even for a short period of time, or simply forgetting that there is medicine to take, some people have difficulty taking medication.
Solution: Whether it’s remembering to take or refill a prescription, failure to do so could have detrimental effects on a patient. Designing an application that can help patients with these tasks is totally feasible. It would be possible to call patients with a pre-recorded reminder to take their medication, or to send a text message that simply asks whether they took their medication. Using an application like this could also help keep track of when refills are needed.
It’s possible to build a custom application for these types of processes, or leverage a service like Pleio, which offers a similar solution.
3. Adherence to Treatment
Problem: Some aspects of treatment are easier to follow than others. Maybe taking a pill once a day is much easier for a patient than doing leg exercises. Understanding what treatments are effective and the context that enables a patient to adhere or abandon a prescribed treatment is helpful not only for a patient’s long-term prognosis, but also to improve treatment plans for others with the same or similar ailments. Without this type of information providers can’t make informed decisions going forward.
Solution: Post-hospitalization treatments are not limited to medications. Speech, physical, occupational, and other therapy departments may wish to track patient adherence to treatment plans. To ensure optimal progress a voice application can serve patients with reminders to perform exercises or to check to see if they did their exercises that day.
4. Missed Appointments
Problem: Missed appointments create a whole slew of problems for healthcare providers, and aren’t just related to hospital re-admission rates. Although, obviously, they can be a contributing factor there as well. A missed appointment is a bygone opportunity to adjust a patient’s care plan.
Certainly for medical researchers, the failure of test-subjects to show up can be extremely frustrating. And for the family health practice, missed appointments create headaches for doctors and staff alike.
Solution: Short of making house calls, the best way for healthcare professionals to understand how a patient is progressing is through a follow-up visit. Using a voice application to help schedule, re-schedule, verify, and remind patients about up-coming appointments can save both time and money for healthcare facilities that deal with a high volume of patients.
A voice application can even be used in tandem with self-service web portals and other technologies to ensure all communication channels are covered, and that reminders can be sent regardless of how the appointment was booked.
5. Patient Feedback
Problem: Medicine is such a complex profession that many patients are intimidated by doctors and don’t think or know that it’s ok to ask questions. They may not even know what questions to ask. With this as a baseline perspective in many cases it can be challenging to get useful patient feedback. If doctors don’t know what their patients think about their care, then how can they be expected to improve?
Solution: Hospitals that want more granular patient feedback than what is generated by the HCAHPS survey can easily reach out directly to patients with their own survey. Advanced survey technology can deliver the same survey through multiple channels, allowing providers to leverage voice in combination with SMS/MMS and the web, giving patients the convenience to respond via their preferred medium.
6. Health Status
Problem: Just because someone follows their treatment plan doesn’t mean it’s working. For some patients it would be helpful for doctors to monitor their progress daily. Are things progressing, regressing, or staying the same? Few, if any, physicians have the time for that kind of individualized attention, however. In this instance there’s a breakdown between the utility of information and the ability of both parties to communicate easily.
Solution: In the absence of daily appointments, the best way to get a status update from patients is to ask them. A voice application can easily solicit this information from patients. For instance, it could be designed to send a text message to a patient asking for a pain index on a scale of 1 to 5. That data can then be added to the patient’s medical record, making it easier to identify recovery trends.
This type of application would be very useful when used in conjunction with data about patient medication usage and adherence to other treatment regimens.
7. Linguistic/Cultural Differences
Problem: Linguistic or cultural differences can exacerbate any of the above problems even further. While it may seem that patients understand a doctor’s instructions while under the direct supervision of medical professionals, that may not continue to be the case at home without that oversight.
Solution: All this talk about voice applications is great, but what happens when a non-native English speaker tries to use one? Even if you don’t think you need multi-language support at the outset, it might be necessary to add later. Doing due diligence at the outset and opting for a platform that can support multiple languages and a vendor that has experience deploying multi-language voice solutions is the best course of action.
All of these examples illustrate a need for clear and effective communication between healthcare providers and patients. Taking the extra time to make sure patients understand and follow their post-hospital care plan can pay dividends, in terms of both patient well-being and the bottom line.
Because time is so limited, taking those precious seconds and investing them in automating this type of communication deserves some consideration. The ability to save time and improve communications simultaneously isn’t outside the realm of possibility with the right tools.
Automation can streamline many common communications issues that healthcare professionals face. At the same time, when deployed strategically these types of applications can also provide critical information for patients and physicians alike. Better patient outcomes go hand-in-hand with improved patient-facing communication.