Could clinical laboratories use texting to improving patient compliance with the medical laboratory test orders given to them by their doctors?
California’s largest physician-owned medical practice has
employed text messaging to reduce patient no-shows. Just as other innovations such
as same-day walk-in clinical laboratory
testing and patient at-home self-testing made it easier for patients to comply
with physicians’ lab test orders, text messaging appears to help get more
patients through the doors and into doctors’ exam rooms.
At least that’s the experience at Riverside Medical Clinic
(RMC) in Riverside, Calif. The multi-specialty practice has more than 170
providers who see more than 400,000 patients annually. After struggling to
lower its 15% baseline no-show rate using a phone-only reminder system, RMC turned
to a two-way texting appointment reminder system from Santa Barbara, Calif.-based
WELL Health (WELL).
According to a case
study, prior to the texting
system implementation, no-shows were costing RMC more than $3 million per year.
“The problem we were trying to resolve was getting a hold of our
patients in an expedient manner without having to do redundant work,” Diego
Galvez-Ramirez, Associate Vice President, Patient Business Services at
Riverside Medical Clinic, told Healthcare IT News. “We wanted to
give time back to our staff. A big frustration was not having enough time for
staff to accomplish their duties.”
After RMC implemented WELL’s HIPAA-compliant text-based reminder
system, front office efficiency and productivity improved, and the practice
experienced a 33% decrease in appointment no-shows.
Additionally:
No-shows decreased from 15% to 10% within the
first month of going live across the enterprise.
Confirmed appointments rose from 29.45% to
94.45%, translating to a savings of more than $40,000 in two months.
91% of patients who confirmed via WELL presented
for their visit.
Phone volume at RMC’s two call centers decreased
by 4% to 6%.
Galvez-Ramirez suggests that healthcare providers—including
clinical laboratories and anatomic pathology groups—keep pace with the
realities of today’s connected world. “Most of the time, the cell phone is not
used to make phone calls,” he told Healthcare IT News. “You have to adapt
to the new ways that your patients want and are used to communicating.
“In our environment,” he continued, “you also have to be
quick to respond to your patients. No patient wants to spend unnecessary time
on a phone call. Being able to send them their appointment to their phone is
not a new concept, it’s an expectation.”
Based on an Axway survey of 1,200 smartphone users aged 18-60, the graphic above supports the view that text messaging is now the preferred method of communications for most people. Could clinical laboratories employ text messaging to lower patient no-shows and increase the proportion of patients who actually show up at a patient service center to provide a specimen in response to the medical laboratory test orders given to them by their physicians? (Graphic copyright: MakingCharts.com/Axway.)
The WELL messaging app draws a patient’s information from the
physician’s electronic
health record (EHR) system to configure the appointment reminder. This
includes appointment type, date/time, and location. Based on the patient’s
preferred method, the system sends reminder messages via phone, text, or e-mail.
As Healthcare IT News noted, WELL’s competitors in the
patient communication space include:
Texting Reduces No-Shows at Other Healthcare Networks
Other healthcare organizations also have replicated RMC’s
success in reducing its no-show rates by moving away from telephone-based
reminders.
An Athena Health
study examined 54.3 million patient visits in 2015 and found no-show rates
dropped to 4.4% when patients received a reminder text from their provider. By
comparison:
Athena patients who received a phone call
instead of a text failed to show up 9.4% of the time;
E-mail reminders resulted in a 5.9% no-show rate;
and,
10.5% of patients who received no form of
reminder message missed their appointments.
Is Texting Secure and HIPAA Compliant?
A 2018 poll conducted by the Medical
Group Management Association (MGMA) found that 68% of healthcare organizations
used text messaging to communicate with patients about appointments. But is it
secure?
An MGMA
article notes that according to HIPAA Journal,
“Recent changes to HIPAA
have introduced new rules relating to how Protected
Health Information (PHI) should be communicated and many healthcare
organizations and other covered entities are now at risk of financial sanctions
and legal action should an avoidable breach of PHI occur.” The MGMA goes on to
state that, “As text messaging is not typically a fully-secure channel for the
communication of PHI, practices must be vigilant when sending information via
text messages.”
With proper training and precautions, clinical laboratories and
pathology groups might want to add text messaging to their patient outreach
programs. Data indicate that doing so could improve patient compliance with the
medical lab test orders given to them by their physicians. Industry experts
estimate that for every 100 medical lab test requests written by providers,
only about 60% of patients show up to provide the specimens needed for a lab to
perform those tests. Improving on those numbers would help clinical
laboratories and patients alike.
AMA opposition to ICD-10 deadline moves HHS to reconsider, while leaving some transition-ready providers rankled
When it comes to implementation of ICD-10 in the United States, the “do it later” crowd seems to have convinced the Department of Health and Human Services (HHS) of the need to once again move back the compliance date for ICD-10. On April 9, HHS announced a proposed rule to defer implementation by one year, with a new effective date of October 1, 2014.
Clinical laboratories and anatomic pathology groups have a big stake in a successful transition from ICD-9 to ICD-10. Among other reasons, Medicare Part B claims for medical laboratory tests must be submitted with an appropriate ICD code [provided by the physician who ordered the lab tests] for the clinical lab or pathology group to be paid by the Medicare program. (more…)
Bigger challenge will be adoption of ICD-10 across entire U.S. healthcare system in 2013
Two disruptive events in the world of coding, billing, and claims reimbursement are about to engage the full attention of clinical laboratories and pathology groups. First is implementation of HIPAA 5010 forms for claims submission by all types of healthcare providers. This is scheduled to occur on January 1, 2012—just seven months away!
Second is implementation of ICD-10 codes. Federal law currently requires all payers and providers to begin using ICD-10 on October 1, 2013. On that date, the existing ICD-9 codes will no longer be used.
Trend could prove unfavorable to independent clinical laboratory companies
More physicians now join hospital-owned practices than any other type of practice. That’s one conclusion reported in a survey conducted by the Medical Group Management Association (MGMA). This is a trend that may have negative implications for independent clinical laboratory companies and pathology groups that provide medical laboratory testing to office-based physicians.
In the MGMA survey, higher compensation packages offered by hospital-owned practices were cited as one reason why growing numbers of physicians choose a hospital-owned practice. The survey also determined that physicians believe they will have a better chance for reimbursements in hospital-owned practice settings, compared to other practice models.
Nine of the 10 largest medical groups are located on the East and West coasts
When it comes to the list of the 20 largest physicians groups in the United States, Kaiser Permanente is at the top. With 7,000 physicians, Permanente Medical Group in Northern California is the nation’s largest. Number two is Southern California Permanente Medical Group, based in Pasadena, California. At number 20 is the University of Indiana School of Medicine with 1,481 physicians.
This list was prepared by the Medical Group Management Association (MGMA) and published in Modern Healthcare . One interesting fact is that all but one of the 10 largest medical practices are located on the east or west coast. Overall, six of the top 20 medical groups are located in the Midwest, one in Texas, and the rest in coastal cities.
There are 51, 280 physicians practicing in the nation’s 20 largest medical groups. This represents about 6.4% of the 800,000 physicians licensed in the United States – P. Kirk
