A Guide to the Complete Digital Patient Experience
Tackling Challenges of Healthcare During COVID-19
The COVID-19 pandemic impacted healthcare unlike any other industry, changing the way care is delivered and received almost overnight. As the virus spread across the nation and quarantine measures were put into place, patient volume plummeted. Rather than risk exposure, patients opted to delay or forego care. At the same time, providers had to prioritize treating sick and high-risk patients over non-critical and elective visits. Practices reported a 55 percent decrease in revenue and a 60 percent reduction in patient volume on average.
To prevent from closing, providers were forced to leverage new tools to reach patients and ensure critical cash flow. Telehealth adoption skyrocketed: During the first quarter of 2020, the number of telehealth visits increased by 50 percent, compared with the same period in 2019. With rapid consumer and provider adoption of telehealth, experts predict that virtual care services could be extended beyond virtual urgent care, growing to a $250 billion revenue opportunity.
The mainstreaming of telehealth is giving rise to new digital health tools that avoid unnecessary physical contact or human intervention.
Contactless care describes a patient experience delivered in a way that avoids unnecessary
person-to-person contact, similar to experiences in many other industries such as banking, aviation and retail. Broadly, contactless care leverages digital (“contactless”) technologies and tools to serve up healthcare and health-related services for everything from appointment scheduling and check-in to virtual consult and online payment. Technology-enabled workflows support patients along each step of their journey while eliminating crowded waiting rooms, high-touch areas, wait times and travel. In these and many other ways, contactless care meets consumer demand for ease, access, convenience, transparency and speed.
Contactless technologies not only benefit patients but providers as well. Some leading health systems, including Memorial Health in Ohio, are offering a contactless experience via a self-service digital check-in platform that allows patients to register, check-in and pay remotely. Automating administrative intake processes streamlines workflows, reduces errors and saves hundreds of staff hours. It also allows medical assistants and other staff to work on more important tasks.
Even though pandemic restrictions have lifted, and vaccinations are underway, there remains a lot of uncertainty about the future, and outpatient visits aren’t expected to return to normal until the end of 2021. The pandemic has demonstrated the relevance of contactless care and presented an opening to evolve care delivery and the patient experience – not just for urgent care needs but for the entire patient journey.
The Benefits of Contactless Care
Even before the pandemic, going to see the doctor could be complicated or even overwhelming depending on the patient’s life circumstances. The patient may have a condition that makes it difficult to leave the house or might have to travel to another city to see a specialist. A parent who works from home may struggle finding childcare or taking time off work. As a result, many patients skip or postpone medical care.
Contactless care can help improve health outcomes by delivering safe, timely and consistent care that’s also accessible and affordable. Digital technologies meet patients where they are, helping overcome barriers to care and keeping them connected with their providers in a way that’s not just convenient, but also personal. By putting patients at the center, contactless care can help drive higher levels of engagement and satisfaction that empower improved outcomes.
Keeping patients safe from preventable harm is fundamental to the practice of medicine and the delivery of quality care. Patients who trust their providers to care for them and who feel confident they’re in a safe environment will have a more positive experience of care. A Press Ganey report found that organizations with high marks on safety and quality measures have higher patient experience scores, which help improve financial outcomes.
COVID-19 has put hygiene and safety top of mind. The days of long wait times in crowded waiting rooms are in the past. Despite social distancing measures, nearly half of Americans said they or a family member had delayed or skipped needed medical care because of the pandemic, and 30 percent of surveyed adults reported fear of transmission of COVID-19 as the reason for delaying care.
Putting off preventive care, skipping important diagnostic procedures or avoiding the emergency department puts patient outcomes and long-term health at risk. Contactless care allows providers to offer routine and follow-up care, prescribe medications and make behavioral health and other referrals with no physical contact, protecting patients and staff.
Whole Person Care
Behavioral health disorders affect nearly one in five Americans, yet these issues go untreated about 50 percent of the time. Low treatment rates can be attributed to a number of factors, including:
- Screening methods
- Lack of specialty training in behavioral health
- Limited appointment times
- Administrative burden on staff
- Discomfort among staff and patients having to discuss personal matters
Integrating behavioral and physical healthcare, an approach often referred to as “whole person” care, is more important than ever. Leveraging virtual care tools, primary care providers are empowered to act as a team leader, coordinating services provided by other caregivers to meet their patients’ multidimensional healthcare needs from a single location.
COVID-19 has had a devastating impact on mental health and substance use disorders (SUD). The fear of illness, death of loved ones, social isolation, job losses and an uncertain future has led to a tripling of mental health issues, with as many as 4 in 10 adults reporting symptoms of anxiety and depression during the pandemic. A report from the U.S. Centers for Disease Control and Prevention (CDC) also found that many adults, including young adults, are experiencing negative impacts on their health and well-being, including increases in their drug and alcohol use, worsening chronic conditions due to worry about the pandemic and suicidal ideation. As a result, demand for mental health and addiction treatment services has increased 52 percent while capacity has decreased, as many organizations were forced to cancel programs and reschedule or turn away patients.
The pandemic has brought to light the connection between a patient’s physical and mental health. It has emphasized the need to consider what’s happening outside the doctor’s office that can also impact their condition, such as sleep, diet, finances and relationships.
Poor physical health often impacts a patient’s mental health. For example, about one-third of people with a chronic condition experience symptoms of depression. And the more severe the condition and disruptive it is to everyday life, the greater the risk for depression. Similarly, if a patient’s behavioral health needs aren’t met, then controlling their physical health is difficult. People with severe mental illness or substance use disorders (SUD) are less likely to adhere to treatment regimens or seek follow-up care. As Dr. Bernadette Clevenger, a family medicine and functional medicine practitioner in St. Paul, Minnesota, observed: “What happens in your mind determines your behavior, and your behavior influences your physical health.”
Virtual care tools allow primary care providers to better deliver integrated or “whole person” care. These digital tools facilitate referral and collaboration via videoconferencing and messaging with a variety of specialists who can address the social and emotional factors that influence a patient’s health status.
However, identifying a patient’s behavioral health needs isn’t always clear cut. Many patients with depression or alcohol and/or substance use disorders are not forthcoming about their struggle. In fact, a JAMA study found that 81 percent of patients fib or withhold information about their behaviors to avoid being judged, and this can have a negative impact on patients’ health.
In order to ensure patients receive the most appropriate care, providers need new tools to reach and engage them. Digital health risk assessments are designed to save providers time while maximizing clinical workflows, reimbursement and patient engagement. Screeners are valid clinical tools that can be integrated into the digital check-in process and configured to match current screening workflows, identifying patients qualified for screening based on appointment type, provider, specialty, department and frequency.
Moreover, digital screeners help reduce the anxiety or embarrassment of sharing personal information with someone other than one’s doctor and are proven to identify more patients at risk for behavioral health issues when compared with manual screening methods. Patient information is automatically captured and integrated in real time into the electronic health record, saving time, improving data accuracy and reducing rework.
Combined with digital communications tools, such as texting, virtual care tools drive patient engagement, which leads to a patient not just being more in-tune with their care plan but ultimately improving outcomes. Contactless care technologies are foundational to delivering whole person care in a way that ensures practices can successfully identify, treat and bill for behavioral health while improving patient access and outcomes.
Before the pandemic, the healthcare system was already racked by skyrocketing healthcare costs, physician shortages and an aging population. COVID-19 was the tipping point that made it clear that the traditional way of delivering medical care was no longer sustainable. New contactless technologies are helping the industry manage these challenges and is proving to be an especially effective strategy for making care more affordable.
The high cost of healthcare is causing millions of people to delay medical treatment. A Gallup poll found:
- A third of those surveyed say their family couldn’t afford care in the past year.
- One in four say care was deferred for a serious medical condition.
- Roughly 33 percent report delaying care for a less serious illness.
- Lower-income adults are more likely to say they delayed care.
Moreover, a study by the American Cancer Society found that more than half (56 percent) of Americans surveyed report medical financial hardship and say they struggle with affordability, stress and skipping, delaying or stopping medical treatment. The authors of the report commented: “With increasing prevalence of multiple chronic conditions, higher patient cost-sharing and higher costs of healthcare, the risk of hardship will likely increase in the future.”
Contactless care can help curb healthcare costs. For one, it’s far less expensive. For example, the national median cost for a video consult or telehealth visit is $50 compared to $85 for a routine office visit and $130 for an urgent care visit. As a result, some insurers are encouraging members to take advantage of virtual care and lowering copays for those who do. It also saves patients money in terms of time (for example, being able to meet with a provider without leaving work) and distance traveled as well helping navigate them to the most appropriate—and often less expensive—care setting.
By delivering care on demand, patients’ concerns can often be resolved without the need for an expensive office visit or trip to the emergency department. One study of more than 5,500 patients who had a virtual consult with an emergency medical services physician revealed a 56 percent reduction in unnecessary ambulance transports and a seven percent reduction in unnecessary visits. Each avoided ED visit saves more than $1,389 per patient, a cost that doesn’t include extra charges, such as blood tests, IVs, drugs or other treatments.
In addition, research finds that digital communications tools, such as texting, play a key role in improving patient engagement and involvement with their treatment plans. From appointment reminders to scheduling, confirmations and check-ins, accessible active management of one’s health is a key factor in staying healthier and reducing care costs.
For providers, mobile check-in and telehealth consults save money by unclogging waiting rooms, streamlining workflows and freeing up admin time by, for example, allowing staff to engage in multiple asynchronous conversations at the same time instead of answering phone calls one at a time, listening to messages and returning missed calls. The impact of virtual care could save $10 billion annually in three key areas: annual patient visits, ongoing patient management and self-care. Reducing cost of care for providers enables savings to be passed along to patients.
In a world where consumers can have dinner delivered to their doorstep in an hour through a virtual assistant, watch a newly released movie from their sofa and pay bills with their smartphone, convenience drives choice and behavior. Compared to most other industries, however, healthcare has been slow to providing patients with the same easy, on-demand experiences they’re used to in almost every other area of their lives.
According to NRC Health, providers are naturally focused on the care encounter but often mistakenly assume that patient satisfaction will result in loyalty. The group’s market survey revealed that despite being happy with their care, more than 80 percent of patients would consider switching providers for convenience factors alone. It stands to reason that because care is often episodic, patient satisfaction is specific to the encounter and doesn’t translate into a larger sense of brand satisfaction or repeat business. At the same time, repeat business isn’t always an indicator of loyalty either. For many patients, it may be a default decision because they feel they lack better options or are overwhelmed, constricted or confused by choices of service.
Healthcare organizations must rethink and redesign what convenient care looks like for the physical and virtual customer. Contactless care technologies can be instrumental in attracting new patients and retaining existing ones by improving access to care, making it both convenient and equitable while improving outcomes and keeping patients safe.
Access to medical care is essential to promoting and maintaining health, impacting a person’s physical, social and emotional well-being. Yet for many Americans, especially low-income patients and those who reside in rural communities, convenient access to care—even prior to the pandemic—has been a struggle. Common barriers to accessing healthcare services are related to time, transportation and location.
Many providers offer limited office hours and are closed evenings and weekends, making it difficult for patients to see the doctor outside of work or school schedules. Provider visits wait times can also interfere with receiving care, and not just in the exam room. A Merritt Hawkins survey found the average wait time for new patient doctor appointments was 24 days and even longer for family medicine appointments. Moreover, the social determinants of health also play a role. For example, many low-income Americans who lack reliable transportation, receiving medical care is even more difficult. According to the American Hospital Association, more than three million patients, including four percent of children, miss medical appointments each year due to transportation issues.
Another barrier to care is location. Fewer than 10 percent of physicians practice in rural areas. That means patients living in rural areas often face traveling long distances to see a doctor and may struggle with weather, environmental barriers, transportation, fuel costs and time taken off work and away from family responsibilities. Of the more than 7,000 areas in the U.S. with provider shortages, nearly 60 percent are in rural areas. A survey conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health found that while most rural Americans have insurance, nearly 25 percent say they don’t have regular access to care and haven’t been able to get the care they need.
More recently, the CDC reported that 41 percent of Americans delayed or avoided medical care out of concern about COVID-19. Avoidance of urgent or emergency care was highest among unpaid caregivers for adults, people with underlying medical conditions, Black and Hispanic adults, young adults and persons with disabilities. Lack of access to convenient care can cause patients to skip or delay care, leading to worsening conditions and lack of medication management—all of which drive up hospitalizations and healthcare costs.
Contactless care improves patient access and health equity by reaching patients remotely, where they are at home, work or school. In areas with physician shortages or lack of specialty care, such as rural areas, virtual care allows providers to see more patients across greater distances while mitigating the need for travel. Virtual care is also timely care that can be provided on-demand in real or near-real time so patients can be seen and treated sooner. Providing immediate access to healthcare services delivers on convenience, a key factor in patient acquisition and retention, while keeping costs down as well as ensuring patient safety during a time of fear and uncertainty.
The struggle against provider and staff burnout is real. A leading contributor to the stress is the overwhelming number of tasks physicians and staff are expected to perform daily. However, even a seemingly small 10 percent drop in workload can greatly reduce the experience of burnout. Contactless care technologies can help practices reduce the burden of stress and overwork by streamlining administrative workflows and facilitating care.
Almost half of a doctor’s work day is spent on administrative work, while only 27 percent is spent on direct clinical care. For each hour of clinical face-to-face time physicians spend with patients, an additional two are filled with administrative and clerical tasks. Automating administrative intake processes with digital check-in can lower the burden on providers and staff by putting documentation in the hands of patients, streamlining workflows, saving hundreds of staff hours and reducing data entry errors. Patients can use a personal smartphone or tablet to verify their insurance, sign consent forms and authorization releases, verify or update clinical information and more (without the back-and-forth of phone calls and faxes)—all of which updates in real time with the patient’s electronic health record.
While healthcare technology is necessary, it is not always easy to use or manage. When it comes to facilitating care delivery, technology often gets in the way of engaging directly with the patient. The answer is finding more comprehensive, efficient technology solutions that are interoperable, highly automated, easy to use and take into account the patient experience to improve adoption.
Virtual care platforms that are web-based and compatible with multiple browsers support care delivery by making it easy for patients, regardless of technical ability, to access their virtual appointment. Web-based applications also eliminate the need for patients to download an app or sign into a portal. Instead, patients are provided with a single clickable link to join the call. Making virtual consults easy on patients streamlines exam time and means providers don’t spend valuable time troubleshooting IT issues. Moreover, contactless solutions that allow physicians to document directly into the EHR while conducting a video consultation, without switching environments, support critical documentation needs without taking attention away from the patient.
As this industry-wide conversation evolves, this page will further explore how contactless care impacts the patient journey and offer keys to success in delivering accessible virtual care.
Learn how Epion Health can partner with you as your all-in-one technology solution to help you and your organization provide contactless care.