Population Health Starts With Access to Care

As the healthcare industry shifts to value-based care models, providers are being asked to manage outcomes for their patient population while also managing a sustainable business. Under the value-based model, better outcomes lead to increased reimbursement, but there is a key point that healthcare providers and systems need to keep in mind: Outcomes start with access.

If patients don’t get the care they need—especially those with chronic conditions that require regular treatment—population health outcomes will not improve. Multiple studies have cited the influence access to care has on preventable hospitalizations. Patients with limited access to care, whether the barriers are geographic, financial, or cultural and linguistic in nature, are more likely to delay necessary care and, down the road, be hospitalized for their condition.

One study based out of California found that patients with limited access to care suffering from at least 1 of 5 chronic conditions—asthma, hypertension, heart failure, pulmonary disease and diabetes—were significantly more likely to be hospitalized than patients with good access to care. Another study focusing on Medicare beneficiaries found similar results. Patients with limited access to care incurred greater costs through preventable admissions. By investing in access to care, providers will not only significantly move the needle on their patients’ health outcomes and downstream costs, they can meet their population health goals.

Access and quality are inseparable, so providers prioritizing population health goals can find success by starting from a solid foundation of patient access. So how can providers streamline access to care and directly influence population health? The answer lies with sophisticated patient engagement technology.

With 96% of US adults owning a cell phone, using mobile-first technology to improve access with patients across their healthcare journey has gained significant traction in recent years. Many providers already utilize text messaging for basic tasks such as appointment reminders. But there are a slew of other ways that the power of mobile technology can be harnessed to increase patient access to care and meet population health goals. Some examples of how mobile-first tech can be used to improve care access include:

Automating patient outreach. Patients demand quicker access to care, easy communication with their physicians and higher quality outcomes—and providers want to make this a reality. However, in the largest US metropolitan areas, patients still wait an average of 24 days to access care. Today’s new breed of mobile-first patient engagement technology confronts that challenge and increases patient access by keeping patients engaged throughout their care journey with automated outreach.

Nearly 2 years ago a top obstetric and gynecologic (OB-GYN) practice in North Florida and South Georgia implemented patient engagement technology to increase access for their patients. Patients were often waiting 20 minutes or more on hold to make at an appointment at the busy practice. If a patient had to cancel or reschedule their appointment, calling into the practice and waiting on hold often proved too inconvenient. Patients would no-show rather than stay on hold to find a new open slot. Furthermore, the OB-GYN practice was constantly playing phone tag with referred patients, trying to find time to get them on the phone and determine the best appointment slot.

After deploying patient engagement technology that integrated with their electronic health record (EHR), the Florida OB-GYN practice was able to drive results in access to care. A text-first approach to communication reduced their phone volume dramatically, allowing patients to confirm, cancel, or reschedule their appointment without waiting on hold. Additionally, automating outreach to referred patients meant they were able to see a 25% increase in referred patients, connecting women to needed healthcare services. By extending the capacity of their staff, and offering a new level of convenience for the women they serve, the practice significantly increased access to care. Bringing more women in for care means they are now getting the preventive and ongoing services they need to get and stay healthy.

Offering online scheduling. Patients are healthcare consumers, and they increasingly crave the same type of consumer-level experiences they are used to in other walks of life. Just think of how easy it is to schedule a flight, book a hotel, or buy a movie ticket online with a few simple clicks. Scheduling an appointment with a doctor should be no more difficult for patients.

Providers can ensure access with web scheduling widgets that empowers patients to make appointments anytime and anywhere. The technology allows patients to seamlessly schedule their own appointments while offering real-time availability via a website or mobile. And once the appointment is made, the provider's schedule is automatically updated.

Providers can also send their patients actionable reminders via a 2-way system that improves upon traditional text appointment confirmations. Clinics can create customizable messages that patients engage with just as they would any other text message, enabling them to reply, reschedule or join a waitlist. Giving patients a more convenient and more flexible scheduling process helps them get the care they need, when they need it.

Optimizing existing capacity to see patients more quickly. Healthcare organizations are being forced to meet growing patient demand with limited resources. More and more patients demand care while workforce shortages loom and payers demand providers to demonstrate value. This means health systems must balance growing patient demand with sustainable approaches to optimize capacity.

Text-messaging appointment reminders are an essential element that increases attendance and prevents unwanted gaps in providers’ schedules. But not all appointment reminders are created equal. An effective appointment reminder makes it easy for patients to respond with questions, request to reschedule, or cancel an appointment by simply responding to a text message. Opening the lines of communication via smart appointment reminders gives healthcare organizations the data they need to optimize capacity while giving patients the level of convenience they expect.

Allowing for flexibility in visit format. In addition to the aforementioned smart waitlists that automatically fill providers' empty slots following cancellations, telehealth solutions help providers increase capacity as well. Telehealth—delivering health services using modern forms of communication such as video chat—not only increases patient access to care, it lowers the cost associated with individual visits, keeps patients regularly engaged with their own health, and, ultimately, improves health outcomes. The telehealth technology in place now helps build stronger relationships with patients, not more fragmented ones.

Most providers and patients alike would agree that a telehealth appointment is an excellent replacement for the alternative—no appointment at all. Three common scenarios for which telehealth improves access to care include:

Filling cancellations. If a patient cancels an appointment or alerts their provider that they are unable to attend due to factors such as a lack of transportation, patients eligible to meet via telehealth based on their appointment type or existing diagnosis can schedule a telehealth appointment with their provider instead. For the patient, a telehealth meeting is easy and can often take just minutes, which is particularly attractive for those who dread the time and effort it takes for an in-person visit. The appointment is initiated from the provider with a meeting link sent to the patient within a text message, meaning no downloads are needed from the patient’s side. After the meeting is completed, the video chat room is deleted and the recording is exported and stored in secure patient records.

Post-operation check-ins. Physicians typically check in with patients a day or two after a surgical procedure, but seeing them in person isn’t always necessary. Telehealth is perfect for this situation because it gives patients and providers an avenue to quickly connect, allowing patients to ask any questions they might have, and providers to make sure patients stick with their post-op regimen. It also saves the patient the time and effort it takes to drive to and from an in-person appointment.

Specialists for rural patients. Many providers give patients telehealth access to key specialists without forcing them to make a costly and time-consuming journey. For example, if a patient lives in a rural location, they may not have easy access to a specialist that can astutely help them with their specific symptoms or condition. In this case, a local community center could bring the patient in for a telehealth “visit” with a specialist, who may be located in a larger city a few hours away.

Targeting high-risk patients for ongoing engagement. Not all interactions with patients need to result in a physical in-person appointment or even a virtual visit. Some questions or issues can be resolved via email, secure chat or phone. Offering patients the option of a secure, electronic communication platform can help patients get their health concerns addressed without a trip to the doctor. This, in turn, keeps providers’ schedules open so they can more readily address higher-risk patients.

A significant portion of outreach to high-risk patients, such as those with chronic conditions, can be automated as well. This allows providers to communicate with these patients in between visits to ensure they’re staying on top of their health, whether it’s reminders for when or how often a patient should take their medication, or links to educational information that teaches them to deal with symptoms of their condition.

Continual engagement with high-risk patients keeps them involved in their own well-being and promotes improved outcomes. In years past it could take huge amounts of labor and man hours to reach out to every single patient with a chronic condition in an effort to make sure they’re managing it properly. But the advent of automated messaging that can be customized based on an individual patient’s specific condition significantly alleviates this challenge and helps these populations more effectively manage their health.

Success with population health—improving outcomes of entire groups of patients—requires that they first have access to the care they need. How this looks may vary slightly from patient to patient, considering everybody has their own unique individual needs. For providers and healthcare systems, technology exists that helps mitigate the challenges involved with getting more patients access to care without stretching resources thin. And the good news is, these solutions continue to evolve and improve over time, meaning the population health efforts of healthcare organizations across the country should continue to improve as well.