Is a Swiss Army Knife the Best Solution?

Is a Swiss Army knife the best tool to have in the tool kit? Is it in fact the tool kit? I recently had a debate with someone about this question and I could see how one might think that the venerable brand is the one…the only. Indeed, when I think about my first Swiss Army knife – I remember day-dreaming about how I’d use all of the tools that come included. A “complete package” for anything I might encounter – from fixing a picnic table to tunneling out of Alcatraz, and maybe even opening a bottle of wine as well.

There is no doubt that this ultimate utility tool has captured the imagination of generations; but where does the utility end? Is the all-in-one really the way to go even for the ultimate outdoor enthusiast?

It occurs to me that some companies in the robust and varied healthcare software industry are the software analog to the Swiss Army knife. I’ve seen digital advertisements for systems that seem to claim they solve every problem under the sun. It would be great if they did with the daunting challenges we are all working on in healthcare. Watching the insurance climate as well as the changing landscape of patient expectations, I wake up every morning thankful that I am involved in an incredibly dynamic sector. I also wake up increasingly skeptical that anyone can build an all-in-one tool like a Swiss Army knife that will really perform as advertised.

My focus – and the focus of our amazing team at Everseat – continues to be matching up supply and demand – which is a fancy way of saying “we do scheduling.” Specialization does not mean a narrowing focus. On the contrary – we provide custom applications and processes for every single provider we encounter because the genius of digital solutions is that they are adaptable to meet the needs and the goals of the user. Some of our customers use Everseat to share information about late cancellations; and others use it to increase access to every-day appointments via their website. We relish the opportunity to get inside the chess game each customer is playing about how to expand access and increase efficiency at the same time. We are experts at making it easier for patients to get the appointments they need, and helping the practice to maximize the use of a very busy schedule.

I loved my Swiss Army knife. In fact, I still take it with me on trips with my boys where anything is possible and you never know which tool you may need. But in healthcare technology, I am grateful that provider organizations and practice management platforms continue to turn to specialists like Everseat seeking innovative partnerships. I admire ambition but I am skeptical of any company out there claiming that their system does it all. We do what we do best. We see that it makes an immediate and a lasting difference for patients and providers alike.

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Riding in the Fast Lane Towards Patient Satisfaction

The best experience I have ever had with valet parking happened to me while visiting a major healthcare system in New England last week. And it got me thinking: I wonder if the entire process of being a patient could be as well designed as the system this terrific institution has set up for parking your car.

I was visiting this particular medical center to talk with members of its leadership team about improving operating efficiency and patient satisfaction by deploying some new digital tools and strategies we have developed at Everseat.

Valet is nice – and I think most people are used to seeing this at certain restaurants and hotels. Valet parking for doctor’s appointments is thoughtful and is surely appreciated. People are generally on edge, maybe emotional and likely not 100% healthy. Wonderful idea. I have also seen valet at LifeBridge Health (an Everseat client) in Baltimore.

So – this medical center in New England has a particularly phenomenal valet parking service for cars that pull up to the front door; but what struck me about this otherwise familiar experience was the check out. When I handed the cashier my valet ticket, she scanned it with a handheld device, and this process automatically triggered a notification to the garage attendants who were a quarter-mile away. No phone call. No college kid taking my keys and sprinting across the campus. A simple ping. A signal. A digital notification that carried all of the information required to have my car brought right to me. How clever!

A bit of a devlish smile crossed my face. What if making an appointment here was just as easy as getting your car back after you were finished seeing your doctor? That is exactly the conversation we had been engaged in – and this institution clearly has both the patient experience and the use of smart technology top of mind. Everseat, I demonstrated to the leaders of a variety of service lines from primary care, urology, neurology and many others, is a software platform that helps notify nearby patients when a physician they want to see has an open appointment. A simple ping alerts patients that need to get in to see their primary care doctor, dermatologist, OBGYN, neurologist, physical therapist, or anyone else important to their health. You get the point. Could we help these thoughtful administrators create a system of patient access that was as seamless and satisfying as the way their valets go about reuniting patients with their cars? The answer is yes.

I left the meeting feeling optimistic – the leadership of this medical center saw the value in the Everseat software platform and how it would enhance their ongoing work on improving efficiency and access. When my ticket stub in the hands of the cashier triggered a digital notification to the garage crew that I needed my Ford Fusion back, I knew the odds of my success helping these healthcare leaders meet their goals were very good.

Thoughtful ideas are everywhere. This group is taking valet parking to a new level, and something tells me that their patients are very appreciative.


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How Tech-Savvy Practices Reduce No Show

How Tech-Savvy Practices Reduce No Shows

You know that last-minute cancellations and no-shows are costly for you and terrible for patient care and satisfaction. Most practices — some still using legacy scheduling systems and attached to old processes — are just living with the frustration and revenue loss of this chronic problem, chalking it up to a “cost of doing business.” But some tech-savvy practices are mitigating or even solving the challenge.

Let’s take a look at some of the creative approaches these practices are taking.

Reminders, Reminders, Reminders
It happens — patients forget their appointments. That’s where appointment reminders come in. Practices have seen moderate success in reducing appointment no-shows by adding text, email, or phone reminders to the scheduling process. Most automated reminder systems can be customized to deliver messages via any modality that is right for your patient population.

Telemedicine and Phone Visits
Another reason patients no-show? Accessibility. Common barriers include limited transportation options and illness of a family member. One solution when patients simply cannot get to you may lie in the embrace of telemedicine.

Today, 48 states and Washington, D.C., provide some form of Medicaid reimbursement for telehealth services, and 32 (plus D.C.) have some form of private payer policy in place. Some reports indicate that seven million will use telemedicine services in 2018 (up from just 350,000 in 2013). It’s about better service quality, and getting started may not be as costly as you think.

Appointment Management and Scheduling Software
By the time 2020 rolls around, two-thirds of U.S. health systems could be offering digital self-scheduling, and almost as many patients could be booking their medical appointments online.

Self-scheduling is beneficial to patients and providers alike. Patients feel it’s easier to manage their appointments and can do it from their mobile device, and providers save time and money by fielding fewer phone calls. Plus, as the telephone ceases to be the primary tool used on smartphones, scheduling appointments by a touch of the screen is going to be the new normal, and for many, it already is.

Simply put, practices that take advantage of technology like appointment reminders, telehealth services, and self-scheduling systems offer better patient service, and are better able to reduce missed appointments.

Want to learn more about how digital tools can help you reduce costs and make scheduling more convenient for your patients? Contact us today.

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Top 5 Inefficiencies in Hospital Operations

Top 5 Inefficiencies in Hospital Operations

In the face of sweeping changes to care delivery due to the Affordable Care Act, concerns over hospital efficiency and access to services are unsurprising. Indeed, though more Americans are insured today than ever before, over 20% report that nonfinancial barriers have led to “unmet needs or delayed care,” with accessibility to hospitals cited as one of the primary reasons. That’s despite the fact that admissions are, in fact, continuing to go down.

So, what’s going on here? The answer is complicated.

Shortage of clinicians
The dearth of primary care doctors and nurses was anticipated, and solutions have been suggested and tested, including the greater use of physician assistants and nurse practitioners to handle lower-level care decisions. But by some estimates, the shortage will become even more pronounced in the next five years — upwards of 20,000 missing primary care providers by 2020, and as many as 90,000 by 2025.

With 16.4 million newly insured and sometimes chronically ill patients now covered under Obamacare, bottlenecks of quite sick people are likely to continue to occur in hospitals across the country. And a clinician shortage affects more than just efficiency. For obvious reasons, well-staffed hospital departments see lower patient mortality rates and higher care quality scores, too.

Poorly-managed patient flow
For over a decade, smooth patient flow has been recognized as one of the most critical factors in preventing overcrowding, delays in care delivery, and maintaining efficiency in hospital settings. Yet data shows that hospitals, particularly emergency departments, remain overcrowded and marked by lengthy average wait times. Part of this is certainly attributable to the ongoing provider shortage.

Lengthy hospital stays, or delayed discharges
Whether because patients aren’t being discharged as soon as they can be, hospital inpatients are sicker than ever before, or planning and coordination among specialists is poor, the length of the average hospital stay has been gradually increasing, standing in 2015 at just under five days. These longer stays aren’t just costly, running between about $1,800 and $2,300 patient per day — they also cost hospitals beds, resulting in fewer spots for inbound patients.

High readmission rates
Despite the provisions of the ACA’s Hospital Readmission Reduction Program, which implements Medicare payment reductions for hospitals with too many readmissions, the number of hospitals being penalized for 30-day readmissions were higher in 2015 than in prior years.  What’s causing this “u-turn” or “revolving door” syndrome? According to a report by the Robert Wood Johnson Foundation, avoidable readmissions often occur because inpatient care quality and care coordination is poor.

Poor communication
At the root of poor patient flow, lengthy stays, and high readmission rates may well be inefficient communication among care teams. A survey from the Ponemon Institute of more than 400 providers found that poor communication is costing upwards of $11 billion industry-wide. What is causing communication breakdowns? Some point to shortcomings in or total lack of technology — inadequate pagers or wireless connectivity, for instance.

Others blame cumbersome processes, like those around patient admissions and transfers. The same Ponemon survey revealed, for example, that more than half of the amount of time required for admitting one patient (51 minutes) was wasted on communication inefficiencies. And it’s not just communication between doctors, nurses, and other medical staff that’s affecting the bottom line. Poor communication between patients and providers has been shown to lead to costly readmissions.

In the face of a multifaceted problem, where do solutions lie?  One option may be found in focusing on the “handful” of conditions that are the costliest in terms of time and money to treat, the top five being septicemia, osteoarthritis, complication of device implant or graft, newborn infants, and acute myocardial infarction. Scheduling optimization, including the use of better tools to help schedule outpatient procedures and manage patient flow from department to department, presents another avenue of improvement. Regardless, options would be best sought quickly given the number of newly insured patients sure to enter the market in years to come.

To learn more about models of care efficiency and tools that can help improve care delivery, contact Everseat.

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How to Determine ROI for Health IT Investments

How to Determine ROI for Health IT Investments

It’s an encounter that nearly every independent physician has had by now at least once: the sales pitch for a tech solution that will improve the way the practice runs. The promises are big — simplicity, efficiency, “painless” billing, seamless appointment-booking — and as the medical technology industry continues to grow, it seems likely that the capabilities of these products will, too. It’s certainly growing: EvaluateMedTech’s World Preview 2015 forecasts that worldwide sales will reach over $477 billion by 2020.

Another familiar moment for doctors? The sticker shock when glimpsing the price tag on a shiny new EHR, patient portal, or online scheduling tool. For example, HealthIT.gov quotes the cost of purchasing and installing an EHR at as high as $70,000. But by some estimates, implementing an EHR could cost over $163,000 for a single doctor. And that’s before factoring in software licensing, training, and maintenance fees, not to mention unforeseen costs. Patient portals, too, are expensive to initiate, yet can ultimately encourage your patients to be more engaged with their care.

With all this money — and time, for training, onboarding, and testing — the inevitable question arises: Is this new technology I’m about to invest in worth it? Or, to put it another way, how can I determine the return on my investment? Though every software product and service out there is a little different, it is possible to calculate the ROI of your tech investment by considering the following framework.

Identify cost centers the technology is meant to alleviate — and calculate how much those pain points are costing you today.
What functions of your practice are the most time-consuming — and ultimately the costliest? Is it fielding patient phone calls on your scheduling line? Or are bottlenecks in your recordkeeping process disrupting the flow of patient paperwork? If you’re already keenly aware of where operational inefficiencies lie in your practice, then begin to investigate just how much these inefficiencies are costing you on a monthly and yearly basis. Knowing where a new solution is needed and knowing how much a given process is costing you now gives you a measuring stick against which to compare any costs associated with a new technology.

Make a reasonable estimate of what costs will be post-implementation.
Of course, vendors selling you EHR technology and other software will promise the moon, including low costs for getting up and running, then maintaining the system they tout. You’ve heard it before: “cut your collection time in half,” or “reduce average hold times to less than 30 seconds per caller.” Remember, companies want your money and your signature on the dotted line, and if their reps think that quoting phenomenal results will put the pen in your hand, they won’t hesitate to tell you about the absolute best performance scenarios they’ve got. So remember to apply a healthy dose of skepticism to whatever sample numbers you’re being given. That said, those numbers aren’t a bad place to start when you sit down to make your evaluation of how a given piece of software will affect your monthly and yearly costs.

Don’t forget to factor in time.
Many doctors on the other side of a tech adoption process don’t take into account how much time it takes to prepare for, implement, and train staff on its use. During the ramp-up phase, you might be less productive than you were before you added the technology. Additionally, in the case of a new EHR implementation, depending on the size of the practice and technology used for converting existing patient records into digital files, it can take months (and staff overtime or outside help) to successfully scan and properly store every record. And remember — just because your patients’ data is saved in electronic form doesn’t mean that their paper files can be destroyed immediately. Depending on the state and the capability of your EHR to provide full copies of a patient record, you may still be required to retain paper records for up to five years.

Be realistic about the degree to which the technology will be used.
One of the longstanding concerns associated with technology in the healthcare sphere is that patients and providers will shy away from use — for doctors because of fears that it may hinder their efficiency and communication with patients more than it helps, for patients because they don’t see the benefit, and for both because the technology may feel too difficult to learn. Indeed, Deloitte reports that while nine out of 10 doctors say they are interested in mobile health technology, only about 24 percent are actually using such tools. And the majority of Americans say they aren’t yet using a patient portal. So it’s important to be mindful of how quickly adoption will follow implementation.

Despite the cost and effort associated with a successful implementation, health IT tools are undeniably the wave of the future, especially as patients get more plugged in and their expectations begin to change. And there are major payoffs to using tools that work well — 79 percent of providers said that an EHR improved their practice efficiency. It’s critical to use the framework above to guide your decision-making about any new technology to make sure that the product is realistic to your practice and its unique expenses. There are also lots of good ROI templates and forecasting calculators out there these days that can help you navigate. If you’d like to talk more about low-cost ways to improve efficiency and patient satisfaction, we’re here to help, so reach out today.

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Missed Appointments Affect More Than Just Revenue

Missed Appointments Affect More Than Just Revenue

Most physicians and practice managers know that missed appointments are bad for business. How bad? Some experts say that these no-shows and late cancellations cost the American healthcare system more than $150 billion per year, and individual practices between $100 and over $1,000 per appointment, depending on specialty and location.

And these figures reflect just lost revenue, not the additional costs associated with lost staff time and sicker patients. Also hidden behind the numbers is the level of frustration experienced by patients who must wait longer to get an appointment because doctor schedules appear full, even though each day brings a few more unfilled seats.

Yes, last-minute appointment cancellations and no-shows drain your bottom line, but their implications lie elsewhere in your practice, too.

Patients don’t get the care they need
We’ve written before about the myriad of reasons why your patients may not be showing up for their doctor visits — money, nerves, or a lack of convenience or appointment availability all can play a role. And these missed appointments have very real, negative implications for their health.

The scope of the problem is enormous: Some 49 million adults skipped recommended care in 2012 because of cost alone.

Some studies have indicated no-show rates in community practices ranging from 5 percent to 55 percent. These missed sessions disrupt continuity and compromise quality of care for the patients who miss the appointments and for those who “would have been scheduled in those appointment slots,” according to Family Medicine.

Patient satisfaction takes a hit
It’s not just the cancellation or no-show who is negatively affected by a missed appointment — the health of other patients, not to mention their opinion of the practice, suffers too. That’s because every missed appointment could have been filled by another (potentially ill) person, increasing the length of time that patients have to wait to see the doctor.

Captain Kim Decker, chief of the Martin Army Community Hospital Healthcare Management Division at Fort Benning, Georgia, puts it succinctly: “An appointment missed by you is an appointment missed by two.” In other words, the person who misses an appointment is likely to need to re-book, and “whoever didn’t get an appointment initially is also still needing one.”

Frustration is more than understandable. The average cumulative wait time to see a family physician in 15 U.S. markets in 2014 was just shy of three weeks. One Consumer Reports survey of 1,000 Americans showed that “difficulty in getting an appointment when sick” ranked among the top five biggest complaints that patients have about their doctors.

Further, the problem may actually compound itself: some studies indicate that no-show rates increased and the “likelihood an appointment would be kept decreased” the further in advance an appointment was scheduled. In other words, missed appointments cause longer wait times, and vice versa.

Your staff loses valuable time
When patients do call to let a practice know that they won’t be able to make their appointment, the great scramble to fill the now-vacant appointment begins. If there is no good system in place to keep track of people on the waiting list hoping for an earlier appointment, the result could be duplicative phone calls, double-booking, or worse, patients could fall through the cracks.

Spending valuable time on a wild goose chase for patients is not cost-effective and takes front desk staff away from their other duties, including greeting and checking in patients as well as communicating with doctors and nurses about the status of the waiting room and more.

Interested in learning more about how to better manage your schedule and reduce missed appointments? Contact Everseat to discuss solutions available to you.

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What Today’s Patients Look for in Medical Practices

What Today’s Patients Look for in Medical Practices

For a long time, the old adage of “customer is king” didn’t really seem to apply to the physician-patient relationship. That’s changing, as reimbursement has grown more tied to patient outcomes and satisfaction in recent years. The importance of ensuring a good patient experience has never been more important.

Patients want great doctors, of course, but they aren’t qualified to evaluate your clinical skills, so they tend to judge you based on their experience as a consumer. And consumer expectations are changing rapidly, especially among young people, as one industry after another leverages the Internet to communicate and sell.

So what, exactly, does that mean for you? Let’s look at some emerging trends to better understand what patients want from their doctors.

More Access and Greater Convenience

We’ve talked before about how people are working more hours per week than ever. That means it’s harder to find time to get to the doctor. Combine that with the fact that it takes an average of 18 days to get an appointment, and you’ve got a recipe for frustrated patients who might be forsaking appointments simply because they can’t find the right time to come in.

Patients want convenience — and younger patients in particular equate convenience with online access. That means they want to schedule an appointment, communicate with their doctor, see test results and other health information, and pay their bills from their keyboards or even their phones.

According to Salesforce’s 2015 State of the Connected Patient report, as many as 31 percent of responding patients said they place value on “the ability to book appointments and pay bills online when they’re choosing a doctor.” Among millennials (individuals aged 18 to 34), these numbers are even more pronounced: upwards of 70 percent said they were interested in the convenience of a mobile application that would help them manage their own care by scheduling appointments and viewing personal health information.

Appointments need to be convenient (i.e. available during times before and after business hours and on the weekends, for full-timers) and easy enough to come by. Practices that can’t provide easy access risk losing patients to those that can.

Access to Medical Records and Digital Services

Patients want the days of spending time, energy, and money to get copies of their medical records to be over — yesterday. They want 24/7 digital access to their medical information via a patient portal that would prevent them having to call the doctor’s office every time they need to get a look at their records. One survey of 406 patients conducted by TechnologyAdvice Research showed that over 60 percent said that access to digital services played a role in their selection of a provider, and over 30 percent wanted to be able to see test results online. Yet, in the same study, only one-third said that their providers actually offered such access.

A similar study by Intuit Health showed that nearly 75 percent of patients polled said that they wanted to be able to pay their bills and communicate with their doctors online. Further still, patients wish to be able to engage digitally not just with their personal medical records, but also with their doctors. And they want to do this outside of scheduled appointment times. The vast majority of patients — 93 percent, in fact — are more likely to choose a doctor who is willing to communicate via email even if they were charged for those email communications.

Time With the Doctor

Patients don’t want to feel rushed in the exam room — and neither do doctors. But with new patients flooding the system under the reforms put in place by the Affordable Care Act, the pressure to squeeze as many visits in to each day is overwhelming.

The problem lies, in part, in low reimbursement numbers for primary care physicians and particularly for practices that accept Medicare and Medicaid. When reimbursements are low, doctors must see more patients to survive — leading to jam-packed schedules and harried providers who crank through appointments as speedily as possible.

The result: as many as three in five patients feel like their doctor is rushing through their exams, according to one poll by NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health. Patients can tell when their doctor is eager to “get them out,” and this can feel especially upsetting when they are ill or frightened about a particular ailment. Rushing may also lead patients to feel concerned that they aren’t getting the most thorough care — all reasons someone might consider looking for a new doctor.

Good Communication and Empathy

No matter how much time we spend on our mobile devices and no matter how much technology reduces our need for human interaction, good bedside manner from doctors will always remain important to patients looking for the best care. In fact, as reported by one recent study, nearly 60 percent of people said that physician-patient relationships and physician personalities were “the most important factors in distinguishing a high-quality physician.”

The importance of clinical empathy hasn’t been lost on teaching institutions, either: Duke University’s oncology fellows are required to take a dedicated course on the subject, Massachusetts General Hospital offers an online course called Empathetics, and starting this year, the MCAT will include questions about human behavior and psychology for the first time.

Empathy doesn’t just lead to happier patients — it can lead to healthier ones, too. One 2012 study conducted by Italian researchers indicated that, of 20,000 diabetes patients, those who were treated by physicians displaying the most empathy ultimately had lower rates of complications than those who were treated by physicians who showed low levels of empathy.

So, what do we know? Patients want to feel that their doctors are accessible, and that their doctors care about their well-being. These desires can be addressed with technology — like patient portals, for example — and with adjustments in doctor behavior (since showing empathy can lead to better patient satisfaction, outcomes, and retention, it truly does pay to pay attention to it). In other words, remembering that patients are customers, too, can go a long way to ensuring that your empowered patients don’t choose to start visiting one of your competitors.

Interested in learning more about how to improve your patients’ experience with your practice? Get in touch with Everseat to discover a simple way to enable your patients to conveniently book appointments, simplifying your scheduling and reducing your number of unfilled slots.

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