Austin Area Obstetrics, Gynecology and Fertility OB/GYN had a major problem with turnaround time for phone calls, as the practice had more phone calls coming in than resources available to return the calls in a reasonable amount of time.
Additionally, the practice was spending an unnecessary amount of time in the rooms obtaining basic intake information that could easily be provided by the patients if they were able to enter their health history online prior to the appointment.
This extra step of gathering basic information cost valuable time that could be spent on the reason for the visit, often causing the appointment to extend beyond the allotted time, creating a backlog and unnecessary wait times.
“We needed to find a way to improve efficiency during the appointment to allow physicians to see more patients per day without being bogged down in data entry,” said Jinous Rouhani, CEO of Austin Area Obstetrics, Gynecology and Fertility OB/GYN. “Additionally, we encountered data entry errors from outdated driver’s licenses and other invalid demographic details, such as health insurance, which caused delays in burdens such as returned mail, delayed claim payments and increased patient balances.”
The practice turned to its EHR vendor athenahealth’s patient portal to solve these problems. The portal can reduce unnecessary telephone communication, provide quicker response time to requests (lab results, prescription refills, etc.), and offer the ability for patients to pay their bills online and update their health history information, she said.
The portal, dubbed athenaOne, enables staff to post results directly to the patient portal with instructions on next appointment requirements, repeat tests and changes to the care plan. This type of patient communication is especially useful for normal results that do not require a conversation, but rather a confirmation to the patient to continue “as is,” Rouhani explained.
“Also, patients having the ability to pay their balance online has resulted in quicker turnaround time for collections and reduced the age of patient balances,” she said. “Patients can pay their bill in a secure method, which reduces phone calls to our collections department. This has also freed up valuable collections staff time, to refocus on pursuing insurance claims and appeals.”
There are many patient portals in the health IT market today. They are most commonly associated with electronic health records systems companies. Vendors of portal technology include Allscripts, Bridge Patient Portal, Cerner, Change Healthcare, CPSI, eClinicalWorks, Epic, Greenway Health, Medfusion, Meditech, NextGen Healthcare and RelayHealth.
MEETING THE CHALLENGE
Complete adoption of the process was key to making the patient portal a success, Rouhani said.
“This meant that every staff member had to be onboard with our new solution,” she said. “Our entire practice was thoroughly trained on ‘selling’ the method to our patients and equipped to assist patients and answer questions. Prior to adoption of athenaOne, we diligently communicated to our patient population about what to expect with the portal and reinforced how it would enhance their time in communicating with the providers and support staff.”
As patients contacted the office for appointments, scheduling staff strongly encouraged online registration to complete their profile before the visit. Staff did encounter the occasional hurdle, with some patients not completing their profile as instructed.
“To drive patient adoption, we installed computers in the waiting area and had staff available to personally walk them through the portal to help patients realize the simplicity of the process,” she said. “We also created laminated cheat-sheets that were placed strategically around the waiting room with a step-by-step process on how to register via the portal.”
Over time, more patients registered online before appointments, which eliminated the need for the computer stations in the waiting area.
“From the clinical aspect, we informed patients during their visit that they will receive an email telling them to visit the portal to view their results, and in addition they could also view their visit care summary,” Rouhani said. “This helped reduce unnecessary phone calls, especially for normal results, and further provided patients documented confirmation of their care plan from their recent visit.”
With a 98 percent patient portal adoption rate, the number of phone calls has drastically decreased, allowing staff to better use resources in a more efficient process and providing staff the ability to return other phone calls in a more timely manner.
Patient collection time has reduced because patients are paying their bills quicker and in a secure online method via the portal.
And then there is ease of information ownership, Rouhani said.
“When patients can access their lab result or receive direction from their provider via direct portal message, they feel more empowered and can more easily recall details and instructions, improving outcomes and reducing confusion,” she said.
ADVICE FOR OTHERS
“The best advice is to obtain 100 percent compliance from all staff members, from nurses to doctors to patient operations,” Rouhani advised. “If you have just one person on your team not enforcing the process, you will not be as successful.”
Also, patient communication is key as well as staying diligent in the process, she added.
“It is vital to provide patients with as much information as possible before such a major change,” she said. “We found that patients are more accepting if they know what is coming, what to expect, and how it will benefit their experience with their physician and the practice.”