Why the Consumerization of Health Care Lies in Better Communication

When you look at any coffee shop, grocery store line, or city street, you will see consumers glued to their phones. So it comes as no surprise that as health care organizations look for ways to improve outreach to their patients, they look first to Health Insurance Portability and Accountability Act (HIPAA)—compliant texting services. And why not? Adding texting “consumerizes” their practice with new patient outreach, but ensuring the practices are secure, and therefore HIPAA-compliant, helps prevent what could be up to $1.5 million per year in HIPAA violation fines.

As the chief executive officer of a company with a HIPAA-compliant communication platform for both secure texting and phone calls, I’m thrilled to see health care organizations embracing this technology. What I’d like to see even more of, however, is providers using secure communication platforms as a springboard for creating better preventive care models, better patient education, and faster care delivery. And make no mistake about it—secure texting can help open the door to all these things.

Don’t believe me? Consider these facts:

• Texting is well beyond critical mass. Nearly two-thirds of Americans own smartphones, and 97% of those have used text messaging.
• Physicians have integrated smartphones and tablets into their work lives. By the end of 2015, it is projected that 89% of physicians will have smartphones, and 80% will own and regularly use tablets.
• Communication bottlenecks cost providers too much time and money. Health care providers waste an average of 91 minutes every day using outdated technologies that do not allow asynchronous communication with patients and other care team members/physicians, costing a hospital as much as $1.75 million every year in lost productivity ($900,000 of which could be saved with secure texting).
• Providers are failing to record critical aspects of their patient interactions. In a study of after-hours telephone medicine systems in a family medicine department, only 5% of charts with telephone calls included telephone notes, leading to medical errors.
• Communication issues are one of the biggest reasons for medical errors. Approximately 74% of treatment delays and sentinel events are caused by poor communication.

As you can see, communication is key: communication between physician and patient, communication between primary care physicians and consulting specialists, communication between attending physicians and members of the on-site care team, and, of course, communication between physicians and caregivers. HIPAA-compliant texting platforms offer so much more than just sending an occasional note or appointment reminder. They promise a secure way to pull all your organization’s communications together.

Some secure texting providers offer integration with electronic health record (EHR) systems, which puts key clinical information at the fingertips of everyone participating in a conversation. The platform captures the time spent on the phone or on text messaging with patients so it can be recorded and billed. Secured documents, such as forms, postoperative instructions, and educational material, can be easily sent to patients. And when a consult is needed, systemwide directories are able to show who is on call, which specialists are in network, and how to get in touch quickly.

These may sound like small steps. But these features are big innovations for health care because they allow physicians to not only get paid for their work but also to communicate securely with everyone involved in a patient’s care asynchronously. With asynchronous communication, everyone gets the same information in real time, eliminating games of “telephone tag.”

Here are 3 specific scenarios for how asynchronous communication could play out in the modern health care practice:

Urban hospital uses texting to improve patient outcomes in chronic condition care:

A major hospital in an urban area is well known for its work with the poor and disabled in its community. In particular, they have a large population of elderly patients with severe dementia and Alzheimer disease. To address the challenge, they created a staff of registered nurses to visit patients in the field. Asynchronous texting allowed nurses to confer with the physicians in the office about the condition of the patients in real time, enter changes into patients’ records, and report to the families about changes in care plans or prescription treatment, all while still on site. Conversely, the families/caregivers could contact the care team via text when they had questions, the results of which were also recorded in the EHR.

The result is a patient population that is much more engaged in its own care, leading to fewer emergency room visits and costly hospital readmissions.

Texting program allows a physician practice to shift the patient education/outreach to its new nursing staff and create a whole new prevention service:

A physician practice that has a large population of patients with chronic conditions, such as heart disease and diabetes, decides to take a more preventive approach with care. They hire several nurses/nurse assistants to handle patient outreach and to field patient questions. This program is a hit with patients and their caregivers, who often just have quick questions that need to be answered.

The program has a number of benefits for the patients and the practice. First, the new staff is busy checking in on patients over the phone proactively, with plenty of demand for its services. The program helps reduce the number of “friction points” patients encounter in getting care. Patients are more likely to call to have their emerging needs addressed. The improved access also cuts down on total interaction times and lowers the number office visits for minor matters.

With a secure communication tool, the practice staff can easily send text messages with links to educational material and care plan data. This dramatically helps decrease readmissions from patients who had recent hospital visits. Patients going into surgical operations and procedures are doing so better prepared, thanks to having understandable educational materials beforehand and a staff member willing to explain it to them when needed.

New treatment plans are now more likely to work because patients understand their care plans better and are more likely to comply. Easy access to staff also means patients are more likely to get invitations to and make reservations for follow-up appointments. Medical mistakes are reduced because of better communication between caregivers, patients, staff, and physicians. And all the time staff spends with patients is recorded to patients’ EHRs and is billable to insurers and Medicare/Medicaid. The Chronic Care Management reimbursement for patient interactions now allows the practice to more than cover the cost of providing the extra staff they hired for patient outreach.

Statewide health system improves in-system collaboration and speeds care times:

It is a common problem for health systems that own several hospitals and a wide range of physician practices. How do you make it easy to keep referrals in the system? How do you track scheduling for rounds when so many practices are involved? This is an area where an enhanced platform with on-call scheduling truly makes the difference.

Under ordinary circumstances, critical time is lost before patient treatment can begin as hospital physicians and staff members work out which specialists are on call. They struggle with the arcane paper trail at the front desk while staff—often volunteer—puzzle through dozens of schedules to find the right physician to contact.

When secure texting is combined with on-call scheduling, however, the health system is able to combine all of its providers’ schedules in one central system. This is then searchable by any physician, who can use any device to find the right physician to consult, send requests to come to the hospital, or make appointment requests for the patient.

In-system referrals also increase, and patients are spared the task of having to chase multiple providers around for appointments. More patients make and keep their follow-up appointments, leading to better outcomes. Best of all, the extra service makes patients feel “cared for” within the health system, increasing brand loyalty.

Physicians are able to reduce the amount of time they spend on administration and getting messages out. Nurses and staff are able to get answers on patient care more quickly and are able to eliminate time they used to spend waiting for a large care team to weigh in on a change in patient status or treatment.

The upshot—HIPAA-compliant texting enables exciting new business models:

When communications are asynchronous and secure, patients can engage in real-time conversations with their care teams, and these conversations always make it into their records. Physicians can seamlessly create and dissolve care teams as a patient moves through a treatment plan. And all patients and providers can see just the conversations they need to see.

Perhaps most important, HIPAA-compliant texting allows health care providers to offer care in new, more easily accessed packages. It allows them to arrange resources with ease in the field, with partners, or on site. And when it comes to health care, the fewer the friction points, the better the outcomes.

So, in the end, I believe texting can be the key to care that is faster to access and also more preventive, effective, and profitable. I hope you agree. Let the future begin.

David B. Wortman is cofounder, chairman, and CEO of Diagnotes. An experienced executive and entrepreneur, he serves as a director, adviser, and chairman for several emerging technology and health care companies. Since 2011, Mr. Wortman has led the Diagnotes team through product development and funding to commercialization of the first fully integrated Health Insurance Portability and Accountability Act—compliant communication platform designed for health care organizations. Mr. Wortman also serves as chairman of SonarMed, a medical device company providing a real-time breathing tube monitoring system, and is a venture partner with Spring Mill Venture Partners, a venture capital firm focused on early-stage technology and life sciences companies. Mr. Wortman has successfully led a number of information technology enterprises, from start-ups to public companies. He served as chairman and CEO of Made2Manage Systems; CEO of Mezzia; cofounder of Pritsker Corporation; a director of Vastera, Cohesia, and Walker Information; and adviser to ImmuneWorks. Mr. Wortman holds engineering degrees from Purdue University.

References

• Smith A. U.S. Smartphone Use in 2015. Pew Research Center website. www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/. Published April 1, 2015. Accessed November 24, 2015.
• Epocrates. 2014 Epocrates mobile trends report. www.epocrates.com/oldsite/2014MobileTrendsReport/MT14_WP_03.pdf. Published 2014. Accessed November 24, 2015.
• The Imprivata report on the economic impact of inefficient communications in healthcare 2014. Ponemon Institute website. www.ponemon.org/local/upload/file/2014%20Imprivata%20Report%20FINAL%203.pdf. Published June 2014. Accessed November 24, 2015.
• Killip S, Ireson CL, Love MM, Fleming ST, Katirai W, Sandford K. Patient safety in after-hours telephone medicine. Fam Med. 2007;39(6):404-409.
• The Joint Commission. Sentinel event data: root causes by event type 2004-2014. www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2014.pdf. Accessed November 24, 2015.