Patient Engagement: Improve Communication, Improve Care

November 2016

Healthcare providers say communication is necessary to improve routine care, reduce hospital readmissions and better patient satisfaction scores.

West surveyed 383 healthcare professionals to

learn more about how doctors and healthcare

teams communicate with patients. Findings revealed

that physicians, hospitals and health systems are

all focusing on increasing patient engagement

communications to improve healthcare delivery. This

indicates healthcare professionals believe they can

engage patients, influence behaviors and improve

health outcomes by sending targeted outreach

messages. About half of the survey participants

were physicians or their staff, and the remaining

half of respondents represented hospitals and

health systems. Respondents from various roles

and organizations agreed that communication is

necessary to improve routine care, reduce hospital

readmissions and better patient satisfaction scores.

Healthcare providers say more communication is the key to improving care and patient experiences – and they are backing that claim up by increasing outreach and engagement efforts.

A whopping 95 percent of hospitals and health

systems are using engagement communications to

avoid hospital readmissions, according to the West

survey findings.

It’s easy to see why. Readmissions are bad for

patients and they carry substantial penalties. In the

time period between October 2016 and September

2017, Medicare will withhold more than half a billion

dollars in payments from hospitals that incurred

penalties based on readmission ratesi. These

penalties affect about half of the hospitals in the

United States.

Hospitals and health systems are aware of the

fact that poor communication following a patient’s

discharge from the hospital is a problem, and they

are interested in fixing it. The West Healthcare

Practice survey revealed that half (50 percent) of

acute care professionals feel that a lack of follow-

up on a hospital’s end is a leading factor that

contributes to readmissions. Another 32 percent say

that insufficient communication after discharge is at

least partly to blame for readmissions.

The idea that hospitals should do more to support

patients after they have been discharged from the

hospital is shared by patients, too. Patient feedback

collected through Medicare’s HCAHPS (Hospital

Consumer Assessment of Healthcare Providers

and Systems) confirms that patients who have been

hospitalized feel there needs to be more hospital-

led communication post-discharge, with half of them

saying they were confused about some part of their

care instructions after leaving the hospital.

Hospitals and Health Systems Improve Communication to Reduce Readmissions

Hospitals Penalized for Readmissions

2,597 hospitals in the U.S. will face readmission penalties over the next 12 monthsi.

Between October 2016 and September 2017, Medicare will withhold more than half a billion dollars in payments from hospitals.

These penalties affect more than half of the hospitals in the United States.

To avoid future penalties, 95% of hospitals and health systems are using engagement communications to reduce readmissions.

Post-discharge communication efforts help to

improve patient satisfaction scores. Two of the 32

questions on the HCAHPS surveys specifically

ask about discharge information. These surveys

measure patients’ perspectives on hospital care,

so to protect financial interests, it is important

for hospitals to score well on these surveys. The

majority (83 percent) of hospital and health system

providers understand that money is at stake,

saying they believe patient satisfaction will play a

substantially more important role in their hospital’s

success over the next five years. And, nine out

of ten acute care professionals believe sending

patients automated reminders and encouragement

to follow care plans after they have been discharged

from the hospital improves patient satisfaction.

The West survey revealed that three quarters (77

percent) of hospitals follow up with at least one out

of every two patients discharged from their facility.

The number one reason hospitals contact patients

after they have been discharged from the hospital is

to remind them about follow-up appointments – 86

percent of survey respondents claim they do this.

The second most common reason given for

contacting patients after discharge is health

monitoring. Nearly three-quarters (73 percent) of

surveyed hospitals check in with patients post-

discharge to collect information about the patient’s

condition and give specific care instructions.

Providers and Patients Point To Follow-Up

of acute care professionals feel that poor follow-up by hospitals is to blame for readmissions.

of acute care professionals say that insufficient follow-up after discharge is at least partly to blame for readmissions.

of discharged patients are unclear about care instructions.

50%

85%

32%

1/2

Patient Satisfaction Impacts Reimbursement

of hospital and health system providers believe patient satisfaction will play a bigger role in their hospital’s success over the next five years.

When hospitals send automated post-discharge

communications to monitor health, they can also

ask probing questions that will give them insights

into how they are performing in the patient

satisfaction category.

Survey results showed that 53 percent of hospitals

connect with patients regarding medication

adherence, 38 percent contact patients about

medication reconciliation, 23 percent follow up to

provide wellness information, and 21 percent reach

out to patients to communicate about billing.

Post-Discharge Communication Trends

77 percent of hospitals follow up with at least one out of every two patients discharged from their facility.

Of the hospitals that reach out to patients after they’ve been discharged:

contact patients to deliver follow-up appointment reminders.

contact patients to monitor their health status.

contact patients regarding medication adherence.

contact patients about medication reconciliation.

contact patients to share wellness information.

contact patients to communicate billing info.

86%

73%53%38%23%21%

Physicians are directing a bulk of their outreach

toward routine care and prevention. Specifically,

80 percent of physicians are using engagement

communications to improve routine care. And, more

than half (52 percent) of medical practices say

they are highly committed to prevention-focused

outreach that gets patients into the office for

routine services and promotes prevention behaviors

as a part of daily life.

Medical practices reveal that when they do reach

out to patients and encourage them to schedule

routine exams or services, the results are very

favorable. For 45 percent of physicians, outreach

converts into appointments at least half of the

time. That means at least one out of every two

sent messages results in a patient visit for those

providers. Another 38 percent of physicians are

able to convert around 20-50 percent of outreach

attempts into appointments. Ultimately, nine out of

every ten physicians gain increased patient visits

when they perform even a minimal amount of

outreach to promote routine care.

It is not surprising that physicians are prioritizing

prevention-themed communications. Not only does

routine care play an important role in keeping

patients healthy, it is an area of healthcare that

is underutilized and, when cultivated, can grow

revenue for practices. Americans currently use

routine care at only half the suggested rateii.

Encouraging patients to schedule preventive care

services that they are eligible to receive – often at

no cost – can add up to thousands of preventive

screenings a year and hundreds of thousands of

dollars in additional revenue. The fact is, wellness

visits drive increased revenue and they improve

health outcomes for patients, so there are good

reasons to campaign for them.

Physicians Zero in on Routine Care

Preventive Care Promotion is Effective

Nine out of every ten physicians say outreach promoting routine care generates appointments.

45 percent of physicians convert outreach into appointments half of the time.

38 percent of physicians convert outreach attempts into appointments between 20-50 percent of the time.

Physicians Embracing Prevention-Focused Outreach

of physicians use engagement communications to improve routine care.80%

Participation In Routine Care Is Too Low

Americans only use routine care at half the suggested rate.ii

Ochsner Health System, a large Louisiana-based

health system, learned first-hand about the

financial impact of prevention-driven engagement

communications when it implemented an automated

phone notifications program. Ochsner sent

notifications to a group of 3,137 patients with recent

orders for a colonoscopy or upper endoscopy.

Ochsner knows people are reluctant to schedule

these preventive screenings even though they are

covered under the Affordable Care Act. Ochsner’s

messages urged patients to push a button on

their phone to initiate the process of scheduling

an exam. After only one month, 578 of the 3,137

patients contacted had scheduled a screening —

a conversion rate of 18.4 percent. Overall, the

preventive screenings from the two-month calling

campaign generated $684,930 in revenue, based

on the national average of $1,185 for procedure.

For Ochsner and its patients, the financial and

health outcomes made this campaign more

than worthwhile.

When thinking about engagement campaigns for

routine care, medical practices should consider

implementing seasonal prevention campaigns.

More than half (64 percent) of medical practices

say they haven’t executed a campaign of this

nature. However, the 36 percent that have are

seeing success.

Ochsner Health’s ROI

Ochsner Health System generated $684,930 during a two-month preventive care campaign.

18.4% of patients (578 of 3,137) contacted by Ochsner scheduled a preventive screening.

MetroHealth, for example, executed a program that

identified patients that needed immunizations. By

sending parents an automated message reminding

them to get their children vaccinated, MetroHealth

prompted about 40 percent of those contacted to

get their children immunized. Messaging costs were

less than 1 percent of gross revenue generated

from additional visits. By taking MetroHealth’s

approach, medical practices can easily generate

revenue by executing an engagement campaign

aimed at patients who are in need of flu shots.

Similarly, Willow Bend Pediatrics conducted a

seasonal campaign to relieve pressure on their

schedule. The practice wanted to encourage

parents to schedule back-to-school exams and

sports physicals during the summer months to

avoid an overload in the fall. Using automated voice

notifications, Willow Bend added 267 more June-

August appointments than they had scheduled the

previous year. That translated into an estimated

revenue increase of $43,770 for the practice.

How Healthcare Providers Communicate with Patients is Evolving

Medical teams have several communication

methods to choose from when contacting patients.

While automated voicemails still reign supreme, the

ways in which providers communicate with patients

are evolving. The West survey revealed that, today,

both physicians and hospitals believe patients prefer

to receive voicemails ahead of any other type of

communication. About 50 percent of physicians say

patients prefer voicemails as their top method of

communication, 23 percent say text messages, 11

percent vote for email, 9 percent say patient portals

are preferred for messages, and only 5 percent

believe patients like snail mail communications.

Five years ago, 86 percent of providers said they

weren’t using text messaging at all to communicate

with patients. Today, 23 percent of physicians say

their patients prefer to receive text messages

over any other form of communication. And, a

large majority (80 percent) of hospitals and health

systems believe their patients are receptive to

receiving text messages about their care. They

also believe sending text messages to patients can

strongly influence patients to take specific actions,

like schedule a follow up appointment or pay a bill.

It’s clear the trend toward using text messaging

to engage patients will continue to become more

widely adopted.

64% of medical practices are not taking advantage of opportunities to promote seasonal services.

MetroHealth earned extra revenue by executing a seasonal campaign that converted 40% of outreach into immunizations.

Willow Bend Pediatrics implemented a back-to-school outreach campaign that generated $43,770 in 3 months.

Seasonal Campaigns Drive Year-Round Revenue

The Rise of Text Messaging

Five years ago, 86% of providers said they weren’t using text messaging at all to communicate with patients.

Today, 23% of physicians say their patients prefer text messages over other forms of communication.

of physicians say patients prefer voicemails.

of physicians say patients prefer emails.

of physicians say patients prefer using patient portals.

of physicians say patients prefer traditional mailings.

11%

50%

9%

5%

In comparison:

Communication with patients through online

patient portals is a trend that deserves

attention, because portal use is also on the rise.

Healthcare organizations tend to like portals

because there is a link between portal use and

patients paying for services. This could motivate

providers to steer patients toward using portals

for sending messages, scheduling appointments,

viewing lab results or submitting requests

regarding medications.

As healthcare providers look for ways to increase

communication, it’s only natural they also seek

more efficient ways to monitor their patients’

health remotely. The West survey revealed that,

as of now, only about one-third of hospitals and

health systems have the ability to receive patient

health information from at-home monitoring

devices and then respond in a timely, appropriate

manner. But, many are looking to adopt this

technology in the near future. In fact, 80 percent

of medical practices believe there is potential for

physicians to use wearable devices to monitor

the health of patients. This is a trend to watch as

communication between providers and patients

continues to evolve.

Trend Watch: Monitoring Via Wearable Devices

of medical professionals believe there is potential for physicians to use wearable devices to monitor the health of patients. 80%

Now that healthcare organizations have realized they can drive engagement and influence both behaviors and health outcomes by sending targeted technology-enabled communications, patients across the board are being issued calls-to-action by their medical teams. Hospitals and health systems are increasing communication, especially during the window of time shortly after discharge when they know patients are particularly vulnerable. Physicians are expanding communication efforts to more aggressively promote critical preventive care.

As the trend toward increased communication continues, the expectation is that patients will receive higher quality care and better overall experiences.

West’s Engagement Center solutions help

organizations effectively activate and engage

patients beyond the clinical setting. West’s

unique combination of technology-enabled

communications and clinically managed

resources are designed to improve patient

engagement by solving complex communication

challenges in four key areas along the care

continuum: Patient Access, Routine Care,

Chronic Care and Transition Care. By providing

innovative technology and delivering meaningful

and relevant communications, West enables

healthcare organizations to optimize the patient

experience, improve quality, maximize revenue

and reduce costs.

West is a leading provider of technology-driven

communications, serving Fortune 1000 companies

and clients in a variety of industries, including:

healthcare, telecommunications, retail, financial

services, public safety, and technology.

About West

i http://khn.org/news/more-than-half-of-hospitals-to-be-penalized-for-excess-readmissions Accessed Oct 2016

ii Source: Centers for Disease Control and Prevention. Preventive Healthcare. Accessed Sept 2016 http://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/preventivehealth.html

Sources

Learn more about how West is changing healthcare:

west.com/healthcare

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