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Transforming patient access within a health system involves innovating and creating implementation strategies.
Those tasks are increasingly falling to a new title: the transformation officer. Gartner analyst Laura Craft is seeing the title used more frequently at healthcare organizations to describe a role with a wider focus than digital. If often includes innovating on processes and experimenting with emerging technologies to reimagine how an organization operates.
As Edmondo Robinson, chief transformation officer at Christiana Care Health System in Wilmington, Del., put it, transformation is separate from innovation, but innovation is crucial for fostering ideas that result in digital transformation down the road.
"Transformation takes all the learnings from that innovation, concepts around implementation, and leverages change management to transform the organization over the long haul," he said.
A group of transformation officers spoke recently at the 6th Annual Thought Leadership on Access Symposium (ATLAS) in Boston where they provided specific examples of how they've led transformation and enhanced patient access workflows within their health systems.
Reducing high no-show rates
Montefiore Medical Center in New York City struggled with patients not showing up for doctor's appointments.
Adrin Mammen, associate vice president of patient access transformation at Montefiore Medical Center, said she took a tactical approach to the issue, and explored the organization's appointment reminder service, which offered text and voice reminders to patients.
She noticed that patients who received text message appointment reminders had fewer no-show rates than patients who received voice reminders, yet only 5% of patients were signed up to receive text reminders.
Edmondo RobinsonChief transformation officer, Christiana Care Health System
"We knew we had to shift more people over to texting," she said.
Mammen said her strategy was to marry two technologies together, an appointment reminder service and a slot utilization service to fill provider appointment schedules. The organization used the technologies to design a program that sends text reminders to patients, and if they cancel, makes the appointment available for another patient on a waitlist or scheduled farther out.
Additionally, if the patients have a higher proclivity to miss an appointment, they are sent more reminders prior to their appointments.
The organization began the no-show reduction effort at the beginning of 2019 and is continuing to transition patients to text reminder services, according to Mammen. So far, the organization has seen a 0.5% reduction in its patient no-show rate, from 17.5% to 17%.
Emphasizing the amount of wasted time that comes from no-show appointments resonated with the organization's providers and frontline associates, and was one factor that caused the technology to be adopted, Mammen said.
"As we move toward Q4, I'm optimistic we'll have a major impact on our no-show rate," she said. "This has not just been one strategy, this has truly been innovation, thinking outside the box, and using a multipronged, phased strategy to whittle away at our no-show rate."
Maximizing bed space
Hartford HealthCare in Hartford, Conn., took a more large-scale transformative approach to issues the health system was experiencing.
Hartford HealthCare struggled with length-of-stay issues, as well as underutilization of bed capacity in certain acute care settings, said David Whitehead, chief strategy and transformation officer.
To address the issue, Whitehead said Hartford HealthCare built a care logistics center that moved patients across the care system and enabled the system to optimize the bed space available. The center controls every bed within Hartford HealthCare, he said.
"We've seen some marked improvement in our in-network rates," Whitehead said. "That was the incentive overall: We wanted to make sure the patients that were coming into our access points stayed within our system of care -- that we had full care coordination for them."
Moving forward, Whitehead said the organization will be looking toward AI within the care center to enable predictive capabilities for needed and open bed space.
Building online check-in at urgent care facilities
When Christiana Care Health System built out its urgent care business and decided to add online check-in capabilities, Robinson said it was crucial to get buy-in first from the frontline staff.
Addressing the people, culture of the workplace and workflow prior to making transformational changes was crucial to the effort's success, he said. Having an open dialogue and conversation with employees who will be affected by the change, reinforcing the importance of their roles within the organization and leading the change is vital, he said.
"It wasn't about the technology, it was about the people," he said. "When you have those types of conversations, now the culture of that business unit starts to change and adjust."
When the organization built online queuing into the workflow, it succeeded because the "foundation was ready," he said. Christiana Care Health System shifted its patient volume from nearly all walk-ins, to nearly 50% online check-in.
"The team was ready to take on and implement those digital and technological changes," he said.