Controlling Proactive Communications in Healthcare

Patients and caregivers are more involved in making healthcare decisions today than ever before. This is due to rising healthcare costs, increased access to information via the Web, distrust of information from pharmaceutical companies and increased media focus on healthcare issues. In addition, a growing number of patients wish to interact with their primary care physicians through multiple lines of communication including phone, email, SMS, web portals and social media.

Widespread use of these customer service channels is beginning to proliferate across the healthcare industry. Therefore, healthcare organizations must invest in those technologies that enhance these channels to optimize interactions. By automating frequent and relatively simplistic information exchange in healthcare, proactive communications can reduce the expense and effort of keeping patients; providers and payers in close contact and deliver significant benefits to all stakeholders in healthcare. Proactive communications is the combination of outbound technologies and processes that enable enterprises to send targeted and interactive messages to customers, notifying them of changes in scheduling, the availability of relevant products and services, and whether certain bill payments are due or account balances are low. They enable consumers to preemptively make adjustments to their schedules or accounts before genuine issues arise. The most common types of proactive communication channels used in customer interaction are voice, messaging, email, and web chat. The following are the definitions of the various channels most relevant to proactive communications solutions.

 

TRENDS IN HEALTHCARE

Quality, cost and access are the critical issues in healthcare today. Healthcare providers and payers are facing challenges to deliver quality care in the face of rising pressures from an aging patient population, reductions in reimbursement for prescription medications, the potential emergence of compulsory member enrollment, increased administrative overhead and rising healthcare costs. The following provides a deeper level dive into the trends shaping the healthcare market:

·      Improving the quality of care – Increased transparency of clinical outcomes and patient satisfaction are vital to improving the quality of care patients receives. This is driving the need for greater reliance on technology to address these issues as well as improve care directly. Better automation of standards in care through the use of technology such as Electronic Health Records (EHRs) and clinical decision support tools will improve quality of care, by ensuring that patient information is instantly accessible, and that a standardized treatment approach is met. Increased communication between providers and patients / members also improves health outcomes, as appropriate outpatient follow-up care can reduce the chance of readmission to the hospital.

·      Mitigating the rising costs of healthcare – A growing, aging population is increasing the length and therefore cost of treatment, which combined with the expectation of a higher quality of life, is further straining the healthcare system. This is compounded by increasingly educated customers demanding treatment with therapies that can, at times, be novel and expensive. Prevention and health education could lower future healthcare costs, but these strategies are overshadowed by acute and current healthcare requirements. In addition to these factors, nearly one third of every dollar spent on healthcare is currently spent on administrative, rather than clinical functions, representing a key area where current costs can be evaluated and reduced. Healthcare stakeholders are becoming more reliant on technology to increase efficiencies in the healthcare system and to help manage costs.

·      Increasing access to care – Access to adequate healthcare presents an even greater concern to uninsured patients in countries where health insurance is not universal. Furthermore, many individuals are underinsured and forgo preventative care due to the costs involved. In the long run, this is more expensive for healthcare systems than providing effective preventative care; patients are waiting until their illnesses become more advanced before seeking care, requiring more intensive and expensive treatment. This drain on resources means that patients are facing longer waiting times when scheduling appointments in part due to the increased demand for services. As a corollary, co-morbidity rates and the prevalence of chronic diseases are expected to increase, further exacerbating the strain on healthcare resources.

USE CASES FOR PROACTIVE COMMUNICATIONS IN HEALTHCARE

Currently, when providers need to communicate with their patients they rely on two primary channels: personal phone calls and direct mail. In today’s market these outbound methods simply are neither economical nor efficient. Taking advantage of proactive communications to streamline and improve clinical and healthcare business processes lead to better utilization of limited healthcare assets and cost reduction. This frees up resources and increases access to care for a greater number of those patients. Proactive communications in healthcare is typically used today for administrative and clinical support, as highlighted below:

·      Administrative support – Proactive communications is typically used for functions such as collections, member enrollment, patient registration, welcome calls, and information retrieval and customer surveys.

·      Clinical support – Proactive communications in this area is used for vaccination scheduling, appointment scheduling and reminders, prescription refill and medication support, identity verification and outbreak alerts.

·      Preventative care and wellness management – Proactive communications has not been widely used in this area to date, however, a ramp up is expected over the next few years as providers and payers try to pre-empt chronic illnesses and help improve the health of members and patients over the long-term.

THE BENEFITS OF PROACTIVE COMMUNICATIONS

Improving communication between patients, providers and payers will improve the quality of care, help reduce costs and increase access to care for patients. Proactive communications allows healthcare professionals to use their time more effectively elsewhere. In addition, it makes it possible for patients to be reached at times that are most convenient for them. Patients may indicate times they are most likely to be reached; these times may not be convenient for the doctor’s office to place a call. If a patient prefers lunchtimes, evenings, or weekends, this can be supplied by the phone (via outbound IVR), SMS or email with relative ease. The pervasiveness of mobile devices has created the foundation for successful proactive communications programs administered by healthcare organizations. The idea being the member or patient can be reached via outbound IVR or SMS. Moreover, the increasing number of smartphones has given members and patients more access to different channels including email, web chat, video and social media. In comparison to personal phone calls and direct mail (the two primary channels of outbound communications in healthcare today) proactive communications provides numerous benefits including: immediacy, prompt feedback, identification and verification and low cost of repetition.

 WHAT CAN BE DONE?

Optimize the backend – Effective proactive communications require access to customer data. Healthcare organizations should ensure the smooth flow of data between the back-office and application layers. It’s important that members and patients only receive outbound notifications that are actually relevant, otherwise this can alienate them as customers. In order to facilitate the most relevant communications, healthcare organizations should ensure the alignment of backend databases.

Consider introducing preventative care and wellness management – Collections are certainly the most popular use for proactive communications in utilities. However, further cost savings abound for utilities companies that creatively deploy proactive communications. Outage warnings, for instance, reduce incoming call volumes and raise customer satisfaction levels.

Segment customers and create segmented strategies – Payers and providers that can analyze the nature of a customer can then devise the most effective means to reach them. They must therefore find out member and patient channel preferences during different times of the day. For members or patients that simply need a reminder an automated message via outbound IVR, email or SMS will be sufficient. For members or patients that need to conduct a transaction, outbound IVR, a chat session or email will likely suffice. For those members and patients facing more complex issues, the organization can use outbound dialing to ensure an expert or live agent will be on the call to provide assistance.