No Digital Front Door: Failing the Modern Healthcare Consumer
After Telehealthās prime time moment during the Covid-19 health crisis, much attention this year has been focused back on the ādigital front doorā ā the set of digital technologies through which interactions of the Modern Healthcare Consumer with their healthcare providers are enabled.
But according to a recent survey of over 1,000 adult patients in December 2022, only 17% of patients felt that the āexperience accessing healthcare is getting betterā. Which in the context of a mostly ad hoc rollout of telehealth and telemedicine offerings is shockingly low. 21% of patients even thought it was getting worse and given the state of access in the last 2 years prior, even 62% indicating āthe sameā are not laurels to rest on.
On the provider side, and this may provide an insight into the dismal patient experience, things are worse: 47% of providers felt that access was getting worse over the course of 2022.
Digging Further Into the Data
Before we throw the telehealth baby out with the end of the public health emergency, letās take a deeper look at the key root causes of āfrustration with accessā.
On the patient side the top three pain points were time to appointment (78%), fitting an appointment into oneās personal schedule (49%) and the process to schedule appointments (40%).
On the provider side the top pain points were staffing shortages (87%), the continuing confusion caused by the pandemic (64%) and the challenge of cost estimates (63%).
Whatās revealing is that 76% of patients declared theyād want to schedule appointments online and 56% want more digital options for managing healthcare. Thus the majority of patients are ready for more digital access, despite the reluctant attitude by many providers.
Yet only 46% of the respondents on the provider said that the expect organizations to invest more into digital front door technology.
Another aspect of the survey also focused on the Modern Healthcare Consumersā desire for more price transparency, which, as providers pointed out, is not trivial to determine.
The Digital Front Door, widened.
While the term ādigital front doorā was historically focused on the online patient portal provided by EMR vendors, allowing patients to see physician notes and lab results and communicating securely with their care team, healthcareās digital front door in 2023 encompasses many other technologies involved in the delivery of care.
Here are just a few of the tasks that the Modern Healthcare Consumer expects to accomplish digitally, that should be part of a healthcare providerās vision for their digital front door:
Schedule appointments online and search for provider
Communicate with the care care team on non-clinical aspects.
Receive accurate cost estimates
Receive care through video visits.
Communicate with providers through secure messaging
Access clinical notes, lab or test results, immunization records,
Manage prescriptions
Complete and sign forms or questionnaires
Receive vetted education related to diagnoses or procedures
Managing bills and payment options
Telehealth to Increase Access
While telehealth is not a panacea for these challenges, it can certainly help organizations to significantly alleviate some of the challenges outlined in the report. Telehealth appointments can be set up and started literally in minutes, whereas an in-person appointment requires the patient to be on the premises and staff available to room the patient.
Assuming that actual provider work load is not at 100%, telehealth offers a great opportunity to convert (1) cancellations into telehealth visits, (2) no-shows into tele-late-shows and (3) schedule holes into telehealth visits with patients who otherwise would have to wait weeks to get in.
Especially for the latter scenario, technology can greatly help to automate the process, e.g., through automated text messages: āan appointment is now available at 3 PM, first come first serve, click hereā.
A note on the cancellations: Iām making the assumption that patients in many cases could still carve out the 10-15 minutes for a tele visit from home, from work, or from the parking lot, if they donāt have to leave work early, donāt have to hire a babysitter, or donāt have to arrange for transportation.
For health centers or health systems with multiple clinic locations, telehealth can also be used for āload balancingā: if one clinicās provider capacity is limited, other providers at other clinics can conduct āsite-to-siteā visits vs. having to cancel a patient due to a provider that is unavailable.
Finally, patients desire to access care outside of their working hours is a convenience that many Modern Healthcare Consumers are yearning for. When providers are set up to conduct telehealth visits from home, the flexibilities for after-hour or weekend care are endless, without having to ākeep the doors open and the lights onā in the brick-and-mortar infrastructure.
Telehealth Optimization Guidance
For telehealth to work well in a spontaneous, ad hoc environment, multiple aspects of the telehealth experience must be optimized.
In our experience, patient satisfaction with their video visits can be directly attributed with the physicianās willingness to consider telehealth as a viable alternative care delivery modality.
The recipe for great telehealth experiences is deceptively simple and technology is only a small part of it.
Here are the five elements that need to be optimized before you can go full-scale of utilizing telehealth at a momentās notice as outline in the 3 scenarios above:
Defined Workflows – telehealth is a series of 7 processes and if in a digitally connected environment those are not properly defined, everyoneās experience will suffer.
Adequate Technology – you donāt need fancy bells and whistles, but the basic features and appropriate user experience are a must.
Proper Training – delivering ācare at a distanceā is fairly new and not taught in medical school; but training is also needed for front office staff and nurses.
Responsive Support – with more moving parts, more things can go wrong process-wise and technology-wise; well-skilled support has to be on speed dial to be able to solve problems in real time.
Committed Leadership – change starts at the top, and if the leadership team does not fully buy into the ādigital (r)evolution of healthcareā, neither will the providers and the patients will suffer.
A Reusable Approach
Accelerating the adoption of digital health innovation should be on every healthcare leaderās mind and the 5-ingredients recipe above is universally applicable to any expansion of the digital front door, not just telehealth.
The biggest challenge is knowing which of the multiple facets of the digital front door to pay attention to in light of limited resources including staff, money, and time.
Reach out to Christian to explore in conversation how even in these trying times, your organization can implement innovations successfully and sustainably.
To receive articles like these in your Inbox every week, you can subscribe to Christianās Telehealth Tuesday Newsletter.
Christian Milaster and his team optimize Telehealth Services for health systems and physician practices. Christian is the Founder and President of Ingenium Digital Health Advisors where he and his expert consortium partner with healthcare leaders to enable the delivery of extraordinary care.
Contact Christian by phone or text at 657-464-3648, via email, or video chat.
Christian Milaster optimizes Telehealth Services for health systems and physician practices as the interim Telehealth Program Director. He serves as a Digital Health & Telehealth Advisor to startups and established Health IT firms.
Christian is a Master Builder of Digital Health and Telehealth Programs and the Founder and President of Ingenium Digital Health Advisors, a boutique consultancy focused on enabling the effective delivery of extraordinary care through workflow optimization and the judicious use of technology.
Born, raised, and educated as an Engineer in Germany, Christian started his career at IBM Global Services before joining the Mayo Clinic in Minnesota, where he worked for 12 years in various roles before launching Ingenium in 2012.