Oklahoma Heart Hospital Physicians had long ago implemented an automated appointment reminder system, but the no-show rate had reached a seemingly impenetrable floor.
The existing system had its share of difficulties. For instance, it consistently mispronounced physician names, leading to patient confusion. Furthermore, making changes and applying corrections was untimely, inconvenient and frustrating for system administrators.
More critically, however, was the lack of data transparency within the system. Manual reports had to be pulled and distributed before various clinics could know which patients had confirmed their appointment, requested cancellation, or perhaps never even received the automated reminder. In certain cases, the patient’s scheduled appointment had already passed by the time these reports could be reviewed.
Oklahoma Heart Hospital Physicians turned to patient engagement technology vendor Relatient to solve the problems. Relatient would implement an automated appointment reminder system, promising responsiveness and flexibility.
Further, Relatient had established APIs that would enable Oklahoma Heart Hospital Physicians doctors to incorporate patient responses to automated reminders directly into users’ daily workflow.
There are various patient scheduling systems available today. Some of the vendors of this software include Bridge, Kareo, Mend VIP, NueMD and Stericycle Communication Solutions.
MEETING THE CHALLENGE
Working with Relatient, Oklahoma Heart Hospital Physicians created a “Relatient Dashboard” that was accessed inside of the Cerner Millennium EHR.
“Schedulers would access this dashboard daily to identify patients who needed follow-up: those patients who requested a reschedule, a cancellation, or never received the reminder,” said Michelle Mullins, CIO at Oklahoma Heart Hospital Physicians. “Schedulers supporting more than 60 clinic locations could rapidly work down this automated list to ensure that no patients were lost in the shuffle, enabling Oklahoma Heart Hospital Physicians to both reduce the no-show rate and quickly fill appointment slots that became open.”
Indicators were added inside of the patient’s chart so users could instantly see patient responses to the various contact attempts. Oklahoma Heart Hospital Physicians caregivers eliminated questions about which patients responded to their automated appointment reminders and how they responded to them.
“Our performance improvement team calculated that reducing the patient no-show rate by one%age point could yield between $600,000 and $700,000 in savings annually for our organization,” Mullins said. “Based on this, they set a goal of reducing the no-show rate to 5%. Before go-live, the no-show rate was approximately 6.5%, sometimes even reaching into the 7% range.”
Almost immediately after implementing the new system, along with the Cerner-integrated dashboard, no-show rates began to fall. To date, they have stabilized at approximately 5.1%, never surpassing 6%, Mullins reported. This reduction saves Oklahoma Heart Hospital Physicians approximately $980,000 annually, Mullins stated.
“The new system, along with the Cerner integration, can turn all the raw data into meaningful information. But only an organization’s buy-in can turn that information into care-providing action.”
Michelle Mullins, Oklahoma Heart Hospital Physicians
“The benefits extend into areas we have not yet been able to quantify,” she added. “For instance, we anticipate increased savings created by the filling of appointment slots that more quickly opened due to the Relatient implementation. Most importantly, the new system has produced non-measurable gains in patient satisfaction as we are able to connect patients with humans in a timely manner to work out issues related to their appointment.”
ADVICE FOR OTHERS
“The gains Oklahoma Heart Hospital Physicians achieved would not be attainable without in-workflow integration as well as organizational buy-in,” Mullins advised. “Schedulers cannot contact patients that may be at risk of no-show if they are having to sift through multiple disorganized reports and spreadsheets, as they had been doing; they need an in-workflow solution that provides a precise listing of which patients need to be contacted and for what reason.”
But equally important, an organization must commit to not leaving patients behind, she added. A single patient that is lost-to-follow is not merely a figure that tallies into a no-show rate; they are a human life that is not receiving the care they need, she said.
“The new system, along with the Cerner integration, can turn all the raw data into meaningful information,” she concluded. “But only an organization’s buy-in can turn that information into care-providing action.”
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