Patient & Consumer Innovation Summit 2023

Change Management Is Essential for Addressing Self-Scheduling Barriers

Most barriers to patient self-scheduling relate to organizational/change management rather than the technology itself. To alleviate barriers related to change management, organizations can do the following:

What Do Provider Organizations Need from Vendors to Be Successful with Self-Scheduling?

• A willingness to solve enterprise scheduling and integration challenges: It is difficult and inefficient for organizations to aggregate information when there are multiple scheduling, registration, and billing solutions.
• Transparency around technology capabilities and provider resource requirements: Due to outdated technology and a lack of necessary resources, provider organizations are often unable to fully utilize their current systems to effectively facilitate self-scheduling.
• Options for automated triage and patient self-service systems: Provider organizations are looking to divert patients from unnecessary appointments and guide them to appropriate resources.
• Enhanced communication and improved data utilization: Organizations expect vendors to proactively inform them of potential issues and provide insights to aid in optimizing usage.

What Do Vendors Need from Provider Organizations to Successfully Support Self-Scheduling?

• A partnership approach: Vendors and provider organizations should collaborate to identify essential features, establish KPIs, and address issues holistically across the continuum of care. Provider organizations using the same software should also collaborate with each other.
• Effective communication and education within the organization: Provider organizations should notify their clinicians and care teams about available self-scheduling features and educate patients who prefer traditional scheduling methods on how to use the system.
• A strategic approach to self-scheduling: Provider organizations should help vendors (1) focus on high-demand appointments with minimal prerequisites and (2) engage provider groups that are receptive to self-scheduling.

Best Practices for Starting with Self-Scheduling

Across multiple industries, consumerism and digital scheduling are shifting more control to customers, and the healthcare industry is starting to follow suit. Provider organizations looking to start with self-scheduling should keep the following best practices in mind:

• Use top-down leadership to choose a technology partner that offers an enterprise scheduling system.
• Develop the technology so that appointment types are standardized; set up rules with physician preferences.
• Ensure appointment names are clear and simple for patients to understand and differentiate.
• Provide multiple options for existing and prospective patients to schedule appointments, including a website, an app, or texts.
• Allow patients the ability to review and correct information after booking an appointment.
• Provide waitlist access when necessary.
• Use automated reminders, and allow for cancellations and rescheduling.
• For long-term success, it is critical to get and maintain organizational, clinical, and administrative buy-in; support users to prevent them from regressing to old habits.

Patient-Focused Technology/Capabilities

• Access to timely results: The immediate release of most test results and healthcare information.
• Appointment reminders: Electronic communication informing patients of upcoming healthcare appointments.
• Care team messaging: The ability for patients and caregivers to send and receive electronic messages with their healthcare provider and staff. Includes generative AI–drafted responses for healthcare providers and staff.
• Find a provider: Tools that allow patients and consumers to locate specific providers who can meet their immediate care needs. May include the ability for patients and consumers to view and compare providers’ profiles (e.g., background, specialties, quality measures).
• Online bill pay: Ability for patients to pay bills online. May include bill details/explanations or the ability to view account details, including itemized costs (not just amount due).
• Patient information accessibility: Providing patients with easy digital access to all of their personal health information and records.
• Patient self-assessment: Process by which patients evaluate themselves through a questionnaire or self-guided test.
• Payment plans: An agreement between the patient/consumer and the healthcare organization, where payment for service is spread across a defined period of time.
• Post-visit communication: Patients’ ability to communicate with care team through various means following a scheduled episode of care. May include post-visit follow-up (outreach and tracking tools that check in with patients after a procedure to ensure they are recovering and to schedule follow-up appointments if needed), care gap reminders (analytics tools that help caregivers identify lapses in ongoing care for individual patients and automate outreach), or care-plan adherence reminders (outreach and tracking tools that remind patients of tasks and request confirmation upon completion).
• Prescription refill request: Patients’ ability to electronically request that refill prescriptions be forwarded to appropriate pharmacies.
• Price transparency: Financial information that helps patients and consumers understand the cost of a healthcare service before receiving care.
• Remote patient monitoring: Solutions that acquire, store, transmit, and display electronic health information from patients who are outside of conventional clinical settings (most often at home). Data may include biometric device readings (e.g., vital signs, weight, blood sugar, oxygen levels) and patient-reported data (e.g., mood, comfort level, medication adherence).
• Self-registration/check-in: Patients’ ability to fill out registration forms remotely or at a kiosk. Can also be used for pre-registration forms, screenings, consent forms, surveys, family history information, etc.
• Self-scheduling: Patients’ ability to schedule appointments online without live assistance.
• Telehealth: Platforms that facilitate interactions between patients and providers in lieu of face-to-face visits. May include virtual visits (typically real-time video visits) or remote patient monitoring (see definition above).
• Text-to-pay: Payment system that allows patients and consumers to pay for healthcare services from their phone via text.
• Timely patient education: Tools that deliver timely education content and instructions relating to a patient’s care at any stage in the care continuum. May include previsit education/instructions, on-site education, discharge education/instructions, or wellness education.
• Triage/system checker: Tools in which patients can enter their symptoms and biodata to receive a set of likely diagnoses and associated triage advice, which directs them to appropriate medical services.
• Wayfinding: Knowing one’s current location in a building/environment and understanding how to get to another location.

Provider-Focused Technology/Capabilities

• Access to SDOH: Providers’ and care teams’ ability to access patients’ social determinants of health (SDOH) information, which consists of non-medical factors that influence health outcomes (e.g., birth, work, and living conditions; age; socioeconomic forces/systems that shape conditions of daily life).
• AI/chatbots & automated transcription: 
  • AI/chatbots: Computer programs utilizing AI to simulate and process human conversation, allowing humans to interact with digital devices as if they were communicating with a real person.
  • Automated transcription: Using AI to accurately and instantly convert live conversations between patients and providers into text.
• Care gap identification/reminders: Identifying discrepancies between recommended best practices and the care actually being provided to patients, then alerting patients about discrepancies (e.g., alerting a patient when they are overdue for a recommended screening, determined on age and other risk factors).
• Customer relationship management: Systems that manage and organize patient contact data, both for current patients and potential/acquired patients. These tools are also used for improving care collaboration.
• Customer segmentation/personas: Dividing a patient population into smaller, more-specific groups based on common characteristics (e.g., demographics, behaviors, diagnoses, communication preferences) to provide more personalized care.
• Online reputation management: All digital/online activities that shape consumers’ opinions of an organization or individual.
• Population health management: The health status and health outcomes of a group of individuals, including the distribution of such outcomes across the group.
• Prior authorizations: Approval from a health plan that may be required before a patient can receive a service or fill a prescription and have that service or prescription be covered by the health plan.
• Real-time patient experience improvement: Ability to gather, analyze, and react in real time to patient needs, thus improving their experience. May include patient satisfaction surveys/analytics, capabilities delivered through IPS tools, or digital rounding tools (to help staff formally and proactively check in with patients, families, and staff on a predetermined schedule).
• Referral management: Process by which a patient is referred to another clinician by their current healthcare provider.
• Telehealth: See definition under patient-focused technology/capabilities.

Key Principles of a Patient Engagement Strategy

The list below was created during KLAS’ 2018 Patient Engagement Summit and provides a foundation for patient participation, provider strategies, and vendor development.

• Patient-centric: Actively helped by their providers, patients achieve their own goals for their health and care.
• Personalized: Providers get to know their patients and provide a personalized experience, meeting patients where they are (for example, by taking into account social determinants and patient preferences).
• Connected: Providers maintain constant and meaningful communication with patients, patient families, and other caregivers. Care is well coordinated between all parties.
• Simple: Engagement tools and processes are as easy to use and convenient as possible for patients and their families.
• Timely: Care delivery and interactions happen on time. Information, including health data, is made available to patients in real time.
• Continuous: Patient/provider relationships extend beyond individual episodes of care. Care plans and other patient requirements (including financial) are documented and communicated and represent a pathway into the future.
• Measured: Providers continuously measure their performance in achieving their patients’ goals and in achieving their own organizations’ patient engagement goals, adjusting strategies as needed over time.

Key Fundamentals of Patient Engagement Technology

To help provider and vendor organizations achieve the principles to the left, patient engagement solutions and strategies should be built around the following fundamentals:

• Secure: Tools must be secure and compliant with all privacy laws.
• Integrated: Tools must be able to seamlessly integrate with necessary systems, such as EHRs, patient accounting systems, and other patient engagement tools.
• Multilanguage: Tools should offer multiple languages to ensure patients are able to engage in their care in their native language.
• Mobile friendly: Tools should be built with the mobile experience in mind, whether that involves native mobile apps or leveraging text messaging and other mobile capabilities.
• Personalized: Tools should be personalized to the patient; for example, they should be able to capture patient preferences, enroll and involve family and caregivers, and capture patients’ health goals.
• Transparent: Tools should give patients access to their own data and visibility into their health information and the decisions made on their behalf.
• Consolidated: Patients desire a one-stop-shop experience. Tools should minimize the need for patients to use multiple tools to engage in their care.
• Portable: Tools should give patients the ability to share their information with others (providers, family, caregivers, etc.)