The ongoing shift to value-based care is leading providers to develop more meaningful and long-term relationships with their patients. Paired with patients’ increased desires to text their doctors’ offices and receive texts from their clinicians, healthcare organization senior leaders are beginning to realize the many benefits of utilizing patient communication for practice growth.
In Falls City, Neb., one of the top priorities for IT executives at Community Medical Center (CMC), a 25-bed critical access hospital, has been to leverage patient relationship management technology to advance patient-provider relationships, improve practice success and meet their long-term value-based care goals. One such strategy involves increasing the volume of text messages between practices and patients, says Ryan Geiler, advanced clinical applications and analytics director at Community Medical Center.
One of the key drivers for this push, says Geiler, was when healthcare organizations received clarity last year regarding the use of text messages to send protected health information (PHI). It was at last year’s HIMSS conference when Roger Severino, the director of the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS), stated that healthcare providers may share PHI with patients through standard text messages. Providers must first warn their patients that texting is not secure, gain the patients’ authorization, and document the patients’ consent, according to the OCR.
“The OCR said that texting is no different than email as long as you get consent, so if patients [are aware] that it’s not encrypted, you can [send messages],” says Geiler. He notes that getting providers to buy in has been somewhat difficult for his organization since “everyone is very nervous about security and making sure you have the right [phone] number.” Nonetheless, doctors are starting to come around to the idea more and more of late, he says.
For example, Geiler explains, he and others are using a population health platform to pull data on diabetic patients who are due to get their A1C levels checked. Then, they can use the hospital’s Solutionreach text messaging tool to alert these patients that they’re due and remind them to make appointments.
In the past, CMC could have as many as 300 diabetic patients who were due for an A1C check revolving at any time, and as a result, the organization’s A1C “poor control” measure—those diabetic patients who had a hemoglobin A1C of greater than 9 percent—was not very good, sitting at about 40 to 50 percent, Geiler admits.
“So we started blasting messages to our diabetics, and through that concentrated communication, we have gotten the number down to [under 100] patients who are revolving and due for A1C checks. And our poor control measure is down to just 17 to 19 percent,” as a result of the text messaging, Geiler says.
Patient outreach, according to Geiler is a key factor in providers’ value-based care transitions because for the most part, when they see patients, they are already sick and the last thing they want to hear about when they are sick with the flu is that they need a colonoscopy done, for instance. “Scheduling well visits when people are not sick and using those outreach tools keeps providers happy since they don’t have to talk to patients about a mammogram every time they come in sick.”
And diabetic patients are just one example of how outreach efforts are working at CMC. Geiler, who is in charge of the hospital’s quality reporting, notes that the organization’s overall colonoscopy exam rate was previously as low as 22 percent, which he acknowledges “is awful,” but since deploying these outreach strategies, the rate amongst all providers at the hospital is now more than 50 percent.
Meanwhile, for pneumococcal vaccines, the delivery rate was around right around 50 percent before using these outreach tools, but now every CMC provider is above 75 percent, with some as high as 85 percent, says Geiler.
Geiler notes that the population health data is still being used in a reactionary sense, despite the organization’s ramped-up outreach efforts. But there is still a considerable amount of work to be done, he acknowledges. He offers an example of being able to track the flu in different pockets of the community when it pops up, which CMC is currently doing by getting a geographic street view of where positive flus are coming from.
“About 75 percent of our patients that got the flu did not have immunizations, and even though we have been tracking where positive flus are coming from, we are usually on a two-week delay.” The goal for this year, he states, is to use the data to isolate the flu and get people immunized—or at the least, get the city’s daycare centers on board with the hospital, “so that when there is a [flu outbreak] occurring, we can easily pinpoint it.”