Recently, Boston, Mass.-based Kyruus, a patient access solutions company, released its fifth annual “Patient Access Journey Report,” detailing patient access and behaviors. Kyruus surveyed 1,000 healthcare consumers across generations and geographies to understand how they prefer to search for, select, and access care.
Key highlights from the report include:
- The majority of consumers conduct online research when looking for new providers—60 percent of online researchers turn to a hospital, health system, and/or medical group website
- Almost 60 percent of consumers use the internet when searching for a new service or care site—most often performing a general internet search (e.g., via Google)
- The percentage of consumers that prefer to book online increased by 15 percentage points between the 2017 and 2021 surveys—this shift was most distinct among millennials and Gen Xers, baby boomers’ preferences have changed more slowly
Patients have more access to digital tools than ever before, what are some challenges associated with this?
I think that the challenges around digital tools for patients have really come about because the systems that we designed were designed around us to meet our administrative needs, more than design for ease of use for patients.
People learned how to use Zoom during the pandemic. My mother who's 80, can log into a Zoom meeting, but interacting online with her physician office is still a challenge because we designed the systems to meet our own needs rather than patient needs. What I've seen is that patients actually have a want and a need to use digital tools—they don't want to call us. They don't want to come in if they don't have to. They will use our tools and they will jump through hoops for convenience’s sake.
Since the pandemic, though, we've really learned that we have to make these tools better, more patient-focused, easier to use, and more intuitive. It was easier [in the past] to pick up a phone or come in than it was to download an app and verify this and do that.
Do you see any generational differences when it comes to patients leveraging digital tools?
I always challenge the fact that we think that older people can't adopt technology. I worked for 16 years at Henry Ford Health System in Detroit and people said, “Oh well, nobody in Detroit can use digital tools, you know these are all manufacturing people.” Well, these manufacturing people had robots on the line since the late 1960s and had PCs in their offices to do their accounting work or their engineering work. Just because they were retired did not mean they lost their technical acumen. I think that we have to get rid of the mindset that older people can’t use this technology. They can, we just need to make it usable and available to them.
We also used to talk about the digital divide in socioeconomic terms and now we've seen that start to collapse a little bit in lower income areas because they do have smartphones, but they might not have broadband or internet access in their homes. They might not have Wi-Fi in their homes, but they certainly have smartphones and a data package. With that, we know that we can reach them, and we then find the most economical ways to reach them and communicate with them because they might have limits on their data packages. I don't want to be the provider that says, “Oh, we've got all these great online tools. And by the way, we're going suck up all your data for the month.” So, we have to use and develop systems that reach them, and texting is one of the easy ones.
Overall, when I think about gaps, I don't think about it generationally. I do think about the gaps in terms of access to broadband and Wi-Fi.
Are there any other technologies you’re using to reach these underserved communities?
I'm really interested in expanding our capabilities around texting. Right now, we're doing it for what we call “reminded care.” What we're doing is sending out 300,000 reminders a month to people, and they are able to manage their appointments. We're reducing their no-show rates, they're coming in, and they’re responding.
The other area around that we’ve really started to look at is automated AI enabled chat and conversant chat. We’re doing this to start to manage populations of people who are managing chronic conditions and diseases. For instance, one of these ideas is an automated chatbot that's really very conversant that talks to a person who may be managing diabetes, checking in with them every few days to see how they're doing with their glucose values. If they have certain concerns or meet certain thresholds, they then get transferred over to a diabetic nurse or an educator, so we can stop things before they get out of hand.
But sometimes we just need to pick up the phone, so we've gone back, and we've looked at how we're answering the phones all across our network—350 practices and 17 hospitals—and we're going back and putting in new technology and also new processes to make it easier for people just to call us. Don't underestimate that [phone calls]. Sometimes you just need to talk to someone, and I want to make sure that we don't chase the new shiny ball when I have to make sure my foundation is in order around the basic stuff too.
What trends have you seen around in-person visits vs. virtual visits?
New Jersey shut down really fast and really hard. We shut down early and fast and we pretty much went all virtual for several months for most of our visits. I mean really, we had to, we were under an executive order.
Now since that has been lifted, we have seen the move back to in-person. I think our trends are pretty much common nationwide, virtual visits have declined some since the height of the pandemic and are now remaining at a steady state. There are always going to be people who want to want virtual care and who use it. But there will also always be some in-person care. We don't want to say we're going to be virtual all the time, it's never going to happen. People have relationships with doctors, not technologies. So, I have to make sure that I use this technology to strengthen that doctor-patient relationship, and not replace it. I don't want to replace the relationship that works. What I want to do is make it easier for both the doctor and the patient to keep in touch. We believe that in virtual care visits you will still have your in-person visits, but the number of touchpoints that one will have with your provider will increase because you will use virtual visits in between, so it could be a video visit. It could be an automated chat visit, or it could be a texting conversation. Visiting those touch points in between will increase but the number of in person visits will stay at a steady state.
How is digital transformation making the patient experience better?
What has it done for us? It has made us significantly reevaluate what we're building and why we're building it. Everyone has said for the last 20 years, “I've been doing this work. Oh, we're very patient centered.” What we've decided to do is, give it a little bit more than that lip service. Patients have to be a part of the design right from the start. We have to acknowledge our pain points, their pain points, and fix them.
We have to provide easy access to care—healthcare is too hard to access right now. We have to remove barriers around access to care. So, we have the patients at the table.
I'll tell you story. We ran about 20 vaccination sites across the state. One of them was a mega site that we did in conjunction with the state of New Jersey, where at the height of the vaccine rollout we were inoculating 8,000 people per day. We had online appointment scheduling, and if you remember, during the height of the rollout finding a vaccine appointment was really tough. It was really “The Hunger Games” out there, so we went to Facebook, and we joined all the New Jersey vaccine hunter Facebook groups. These were people in the community who were helping people find vaccines and vaccine appointments in their local communities. We went to them and said, “OK, what can we do to help you make it easier for everybody?” We sat down and listened to them, and we changed a lot of our online scheduling based upon their feedback. The volunteers scheduled thousands and thousands of people throughout the state to get appointments, it was really remarkable, but that's because we went to them and said, “You have help us here. What are we doing wrong? And they told us.”
Is there anything else you’d like to share that your team is working on in terms of digital transformation?
We’re looking at the blending of a call center with digital tools. You call the call center and maybe you’d really prefer to talk to an agent via text. Or maybe you want to just leave a message and have them call you back when they're free, or things like that. We're looking at how to bring things like inquiries from the website, from our mobile apps, from texting, and from all these other channels, into the call center so that they can triage the request, making it easier to get access to care.
