case-study

How a Leading Healthcare Network Reduced Cancellations and Increased Revenue with a Patient Relationship Management Solution

As much as clinicians and healthcare professionals wish to adopt patient relationship management solutions to help facilitate the focus on proactive, coordinated care, they are hampered by outdated technology environments and solutions. Clinicians understand that patients with chronic illnesses, such as heart disease or diabetes, can benefit from frequent educational communications and handy reminders. However, the absence of widely available, easy-to-use systems that automate tasks, such as scheduling follow-up calls, developing and distributing targeted communications, and adequately responding to questions, makes managing ongoing relationships hard.

A leading not-for-profit Ohio-based healthcare network with a bed capacity of more than 1200 and 500+ affiliated physicians aimed to reduce its high number of patient no-shows and increase patient footfall with comprehensive engagement. To facilitate email-based communications, automate follow-up activities such as appointment scheduling and information sharing, and assimilate the care coordination process across the organization, the network leveraged Innovaccer’s Patient Relationship Management solution based on the FHIR-enabled Data Activation Platform. It helped the organization save their care staff’s time and increase revenue with personalized outreach on a broad patient base, with comprehensive, data-driven, and fully coordinated care.

Meeting the challenges

To enable a comprehensive, data-driven patient relationship solution and create a unified view of every patient, the network had to address some key issues:

  • Healthcare data was stored in numerous disparate sources and distributed across various contracts. The lack of a common standard for storing and sharing patient data resulted in data silos and operational inefficiency.
  • The care staff used phone calls, emails, SMS, and chats to communicate with the patients. However, the biggest challenge was to store communication history in one place and get quick access to this information.
  • The network found it complex to determine who, when, and how often to engage patients and the medium by which this engagement should occur for maximum conversion.
  • In the absence of a robust care management solution, patient follow-ups were disorganized, and there were not sufficient channels for bulk outreach.
  • Without a centralized repository of patient data, it was challenging to assess patient risk-score and stratify them based on needs.
  • As the care coordination staff was decentralized and their workflows were complicated, the network recorded a few conflicting appointments, reduced process efficiency, and increased care costs.

Enabling end-to-end healthcare data integration for smooth care delivery

With Innovaccer’s proprietary FHIR Healthcare Data Platform, the network collected data from various sources, including EHRs, claims, pharmacies, hospitals, clinics, and labs. It leveraged rich analytics on patient data, prepared custom insights, and created useful dashboards for a comprehensive view of their population’s health. The FHIR Healthcare Data Platform enabled real-time decision support, automated workflows for care teams, and point-of-care alerts for providers, translating comprehensively into a smooth and more efficient platform for care delivery in a complex environment.

Patient segmentation based on customized filters

With custom patient lists (by payer, age, attribution, etc.) at their fingertips, care managers could leverage automated marketing campaigns with best practices (best subject line for a breast cancer screening outreach, the best time of the week to outreach to women in age 65+, etc.) to run impactful campaigns.

Execution of machine-learning (ML) algorithms to proactively identify high-risk patients

The next step involved the execution of machine-learning algorithms to identify high-risk patients proactively. These ML algorithms estimate the cost of care for patients from past EMR and claim data on customizable dashboards. With multiple modeling inputs, such as the predicted cost of care, social vulnerability, the presence of multiple chronic conditions, and other factors, advanced program-driven analytics helped in patient stratification based on patient needs or predefined risk thresholds. With accurate patient stratification in place, care managers could automate the appointment scheduling process for high-risk or high-cost or urgent care patients.

Omnichannel outreach to accelerate patient acquisition

Care managers leveraged programmatic, omnichannel outreach with intelligent routing algorithms to connect inbound calls to the contact center. They were provided with end-to-end campaign impact analytics - from the click-through rates, scheduling rates, call response rates, rep performance, number and category of grievances, call volume by reason, and revenue per campaign to analyze the outcome of their relationship-building exercise daily. The solution also enabled auto logging of call notes to record all patient interactions and maintain continuity across patient interactions.

Apart from delivering critical information about the physicians to the networks’ relationship managers, care managers leveraged in-workflow referral management to strengthen their referral network and build revenue.

Integrated worklists for all care management activities and strong patient relationships

Innovaccer’s solution provided the network with an automated strategy to assign patients to the right care managers. It empowered the care managers with integrated worklists to manage a wide range of care services such as transitional care management, chronic condition management, remote patient monitoring, discharge planning, etc.

To standardize care delivery across the network, care protocols were embedded in the care managers’ workflows. The network was provided with insights on past interactions with patients through a longitudinal patient view. With integration to a wide range of RPM devices for fitness or personal health, more robust engagement with patients could be built. The solution also raised smart alerts on steep variance in a patient's physiological parameters, so that the right care intervention could be made at the right time.

Patient engagement application to track the patient health journey

Innovaccer’s solution empowered the network’s patients with access to all their health information at their fingertips, with or without the need for an app. The solution enabled the patients to set their communication preferences and streamlined their ability to seek care to book and consult physicians virtually.

Care managers could track patient health effectively with a wide range of personal health device integrations. They could share care plans with the patients to engage them on a better health path and educate them on their healthcare journey or procedures. A few providers also leveraged gamification to provide gentle nudges and aid habit formation in their patients and noted a higher patient adherence level and satisfaction.

Results

The health network adopted an advanced, data-driven approach to drive quality and financial success across multiple specialties and contracts. With Innovaccer’s FHIR Healthcare Data Platform, the network was able to achieve the following outcomes:

  • With seamless patient engagement and thorough follow-ups, the hospital recorded a 15% no-show rate in outpatient visits and claimed an increase in revenue by $45,000,000.
  • Due to the reduction in cancellations, the hospital noted an 11% decrease in customer service teams’ man-hours required.
  • With end-to-end comprehensive care and patient relationship management, the network recorded a 35% improvement in the number of care protocols finished in time and a 2x increase in the completion rate of health assessments.
  • With deep data insights on its ROI and advanced analytics on clinical data and key metrics, the network recorded a 20% reduction in avoidable ED admits.
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