Becker's Hospital ReviewJuly 9, 2021
Facing constant pressure from high consumer expectations, shrinking margins and growing provider burnout, health systems need strategies that strengthen relationships and build sustainable long-term growth. Labor-intensive, inefficient processes for orders, insurance authorizations, and scheduling for imaging, diagnostic testing and other procedures often strain both the clinician and patient experience.
For two large health systems located in very competitive markets, RWJBarnabas Health and Baptist Health Care, addressing these challenges was a top priority in their partnership with R1 RCM. During a June webinar hosted by Becker's Hospital Review and sponsored by R1, moderator Joe Polaris, senior vice president of product and technology at R1, discussed with these panelists how optimizing health system processes can improve patient and provider experiences:
- Franco Grippo, assistant vice president of operations, RWJBarnabas Health Ambulatory Care Center (N.J.)
- Amy Purvis, corporate director of patient access, Baptist Health Care (Fla. and Ala.)
Five key takeaways:
- Optimized processes remove inefficiencies that frustrate patients and referring providers. Prior authorization requirements that delay care, lengthy scheduling call wait times and outdated technologies like fax communications contribute to inefficiencies in coordinated care. Automation of orders and prior authorizations remove these hurdles, smoothing the process for patients and providers alike. "If we can create a smoother experience for providers to coordinate care, that's one of the single most powerful levers we have to improve the patient's experience," Mr. Polaris said.
- Digital orders and automated authorizations streamline the scheduling process. Both hospitals have workflows that automate the order and authorization processes before patient scheduling, which avoids last-minute reschedules that waste time and resources. At Baptist Health Care, providers kick off the order and authorization process from a single interface, and at any time, can gain insight into where the patient is in the scheduling process, including if additional clinical documentation is necessary to obtain authorization. “The rules-based scheduling system drives the appointment to the proper location and equipment, regardless of whether scheduling is done by our schedulers or by the patient. We can turn the same rules into patient-facing, easy-to-follow language, which makes it possible for patients to self-schedule more complex procedures, such as MRI and CT scans,” Ms. Purvis said.
- Providers need to see how automated processes benefit them. Providers can initially be hesitant to implement new digital tools, workflows and processes. Both hospitals made sure they properly trained providers, didn't rush go-lives and took time to tweak workflows to address practice pain points. "Once [they] began to see the value in the tools and workflows for themselves and their patients, not only did they quickly adapt to it, but they also spread the word to other physicians," Mr. Grippo said.
- Patient satisfaction increases with optimized processes. Both hospitals have seen an increase in patient satisfaction as the automated workflows were put in place for orders, authorizations and scheduling. At Baptist, one major challenge for oncology patients had been uncertainty about what was happening next. "Through the tools we have, we have been able to schedule sequenced appointments so the patient can leave with an itinerary and know what their next steps are," Ms. Purvis said. Additionally, the increase in patient self-scheduling is not only convenient for patients but also allows patient access teams more time to focus on serving the patients who need personal assistance.
- Automation improves the revenue cycle and patient access. By automating workflows, RWJBarnabas Health has seen a positive change in referral patterns with an average increase of 43 percent in imaging referral volume from its practices over a three-year period. "Clearly, the referring physicians and patients were pleased with the processes and really valued the integration and scheduling for these appointments," Mr. Grippo said. At Baptist Health Care, scheduled procedure volume nearly doubled without increasing diagnostic schedulers, electronic order utilization increased to 77 percent, which is well above the industry average, and the health system saw 78 percent of authorizations turned around in a single day, rather than the average of five to seven days.
For both organizations, using streamlined, automated order, prior authorization and scheduling processes has helped strengthen relationships with referring providers in their highly competitive markets, while making it easier for patients to access the care they need.
To learn more about R1's approach to transforming experiences for patients as well as referring providers, click here.
Read the full article here.
Author Bio: Originally published in Becker's Hospital Review.