As we learn to equilibrate with COVID-19, we are collectively learning how to modulate our acceptance of risk in order to re-emerge and engage with the world around us. It has at times over the course of the pandemic been a necessary choice, oftentimes in the name of risk, to forgo routine healthcare. Our avoidance of more routine prevention and health maintenance activities to minimize exposure and taxation of health systems has unfortunately increased other health risks, particularly risks stemming from delays in diagnosis and timely management of health conditions – both of which have led to crowded emergency departments with urgent complications, increased complexity of chronic conditions, and bottlenecks to accessing care.
With health systems straining under the pressures caused both directly by COVID patient care and those stemming from patients who have delayed the care of non-COVID conditions and general health maintenance, strategic interventions are needed now to minimize the current acuity of the situation and achieve long term stability. These strategies should begin by rethinking patient access with an emphasis on four key actions:
1. Send proactive outbound invitations to re-access care:
Given the ebbs and flows of perceived risks to re-entering the pursuit of screening, health maintenance, and chronic disease management, patients are well-served by being invited back and doing so in a targeted fashion aligned with health system capacity. There is a tremendous need to attend to these delayed care activities, with research demonstrating over 50% of patients have delayed care since the onset of the pandemic, and we must be creative in how to get patient re-engagement.
Digital outreach with targeted campaigns, personalized to the needs of a given patient population, is a reasonable place to start. EHRs and CRMs can help in identifying those overdue for visits, testing, imaging, and immunizations to receive proactive calls and/or emails. If those emails allow patients to schedule their appointments easily from within the message via online scheduling, or by one-tap calls from a mobile device, health systems can truly streamline the patient’s access journey and foster action.
2. Make re-engaging easy and convenient:
The streamlining of appointment booking is an increasingly important consideration when it comes to rethinking friction-free access opportunities. Online scheduling is the preferred scheduling method for 40% of all consumers and this trend is only growing further. This should be reflected in not only the email campaign outreach strategies as above but also as an integral part of a health system’s digital consumer experience.
In fact, we see in our customer base that 40% or more of online scheduled appointments are made by new patients, demonstrating the value of these investments in attracting patients to your system by capitalizing on the growing preference to book this way. Furthermore, our customers commonly see one-third or more of their online appointments scheduled outside of normal business hours, which speaks again to the need for convenient booking experiences, while highlighting an avenue to increase efficiency in a health system by offloading call volumes.
3. Offer varied care delivery options:
The pandemic has ushered in virtual care as not just a viable alternative to in-person appointments, but often a preferred option. In a 2021 survey of 1,000 healthcare consumers, more than 70% of those who obtained virtual care during the pandemic said it was their first time having a virtual visit and over 40% expressed a preference to receive routine and/or mental healthcare virtually or through a hybrid virtual/in-person approach moving forward. If we are to close healthcare gaps, accounting for these preferences in care delivery options will prove critical. Likewise, convenient care settings for in-person care, such as urgent care clinics, should be included in the options presented to patients where appropriate, as they also have an important role in facilitating flexibility and removing barriers to access.
4. Help patients navigate those options:
It is not enough though to present these myriad options to patients without also providing guidance. Patients, particularly those who have not been regularly engaging with their providers, can feel overwhelmed and confused trying to determine what is appropriate for their particular clinical needs. Providing patient education about the types of conditions best suited to different delivery modalities and contexts, and doing so at an appropriate medical literacy level and with different language support, is necessary to have these investments in online access reach their potential by not sacrificing appointment accuracy.
Consistent accessibility of information, both on digital properties and via call centers, plays a crucial role in strategic access investments. Organizations should also consider the value of surfacing community resources, (e.g., diaper banks, food insecurity help, prescription assistance programs, housing assistance) as part of these educational efforts, as they have tremendous importance in the preservation of wellbeing, speaking to the social determinants of health that impact patients and strain our healthcare infrastructure.
We are unfortunately in a game of catch-up with healthcare and the stakes could not be higher. As demonstrated by a recent EASD report, looking at diabetes care alone we are seeing how much the landscape has shifted – and not in our favor – with millions of diagnostic tests missing or delayed, resulting in hundreds of thousands of missed pre-diabetes diagnoses and tens of thousands of new diabetes diagnoses in the UK during just six months of lockdown.
There is then of course the additional impact of the lack of monitoring testing in known diabetics, causing worsening diabetic control as evidenced by the rise in HbA1c values, and increased risk of hyperglycemia, heart disease, and stroke, as well as the poorer outcomes in those patients who also contracted COVID. We are sure to see similar advanced disease presentations stemming from missed cancer and heart disease screenings and follow-up, with some of those effects appreciable even now, and others manifesting in the years to come. The toll on our patient communities, care providers, and health systems should not be understated. We are in a position though to respond and start turning the tide by strategically investing in the ways in which people can obtain care and making our access channels as frictionless and convenient as possible.
About Erin Jospe, MD, Chief Medical Officer & SVP, Account Management at Kyruus
Dr. Erin Jospe is the Chief Medical Officer and Senior Vice President of Account Management at Kyruus, where she oversees the company’s clinical and customer engagement strategies. She is regularly engaged as a speaker and author on patient access with an emphasis on change management and clinical engagement. Dr. Jospe is board certified in internal medicine and remains clinically active with 20 years of experience with some of Boston’s highest regarded health systems.