Keck Medicine of USC, a health system based in Los Angeles, had experienced a few years of dramatic growth in both patient volume and geographic footprint, with numerous ambulatory locations and partnerships with hospitals in Los Angeles, Orange, Kern and Tulare Counties.

THE PROBLEM

To help optimize availability for a large patient population, many of whom require complex, specialized care, Keck needed to minimize appointment no-shows and late cancellations. At the time, its IT required staff to manually enter appointment details.

This process did not integrate with the electronic health record and provided limited visibility into what was going on during patients’ real-time care journeys. On top of that, staff was looking for stronger levels of customer support.

Further, Keck needed a solution that would be adaptable and scalable – something that would be capable of taking on expanded features and additional use-cases (beyond appointment reminders) over time, particularly as Keck’s 10-year-old health system continues its dramatic growth trajectory.

PROPOSAL

Patient-engagement IT vendor Lumeon proposed a multi-layered solution. First, it offered an automation platform that would integrate with Keck’s EHR, and automate the patient journey, beginning with text message appointment reminders.

Automation would alleviate the manual work staff was doing in scheduling appointments, following up with reminders and rescheduling no-shows, enabling staff to focus on other, higher-value tasks.

“Over time, as we identified other processes that could improve with automation, Lumeon consolidated these services into a single technology platform,” said Laurie Johnson, chief ambulatory officer at Keck Medicine of USC.

"If you can automate engagement and the handling of manual tasks to reduce the burden on your staff while delivering the high caliber of experience that patients expect, everyone wins."

Laurie Johnson, Keck Medicine of USC

“For instance, to support physical distancing and reduce the risk of COVID-19 exposure at our facilities, we used Lumeon’s automation platform to create a virtual check-in process, which keeps patients waiting outside of the facility until their physician is ready to see them for their appointment.”

MARKETPLACE

There are a variety of patient engagement and relationship management tools on the health IT market today. Some of the vendors of these tools include Luma Health, Lumeon, Nimblr, RevenueWell, Salesforce, Solutionreach, Weave, WebPT and WELL.

MEETING THE CHALLENGE

Lumeon’s platform automates appointment reminder activities and processes. Patients receive three reminders for each appointment – via voice, e-mail or text – and in their preferred language, without manual intervention from staff. The system also is programmed to avoid calling patients during inconvenient hours.

“Care teams only need to engage with the system to follow up with a patient due to noncompliance, a no-show for an appointment or if the patient has requested help from their care team,” Johnson explained. “Staff also have access to a centralized, self-service library of pathways so they can make changes as and when needed.”

Because the technology is integrated with Keck’s Cerner EHR, all reminders are in sync with the latest patient information. For example, if a patient cancels an appointment, the reminder automatically is canceled. Or, if a patient has multiple appointments on the same day, then the system only sends one reminder to cover all of them.

“This level of automation improves efficiency and lowers the burden on our staff, reducing the likelihood of errors as a result,” Johnson said. “It also cuts costs by ensuring more patients come to their appointments, or cancel or reschedule with sufficient notice so the system can then fill those empty slots.”

The virtual check-in solution, deployed recently during the COVID-19 pandemic, sends patients automated text message reminders ahead of their upcoming appointments that include instructions to remain in their car and simply text “READY” upon arrival.

“After texting ‘READY,’ the patient is registered as having checked in and is asked to continue to wait in their car or near the clinic until further notice,” Johnson explained. “When the care team is ready to receive them, a text message is sent to notify the patient to come in, along with directions to the appropriate location. Upon arrival, they can be escorted directly to their exam room.”

RESULTS

With the appointment reminders solution, Keck was able to reduce its no-show rate from 7% to 5%. Managing approximately 100,000 appointment reminders per month, this reduction resulted in immense revenue savings.

“The patients, staff and physicians at Keck Medicine also noted a significant change during the initial adoption of Lumeon’s automation platform,” Johnson noted. “They witnessed huge benefits to their patients, experiencing care in a more efficient and convenient manner.”

With regard to the virtual check-in solution, Keck currently is in the pilot phase. During the first 10 days that the system was live, 67% of eligible patients used the system to check in virtually for their appointments, avoiding congestion in the outpatient facility during COVID-19.

“Once we fully deploy the virtual check-in solution across the health system, we can safely manage check-ins for more than 80,000 patients per month,” Johnson said.

“Keck Medicine of USC has an enduring commitment to the healthcare needs of our community. Patient safety is always our highest priority, and during times like this, it’s even more important to create an environment where our patients feel safe and at ease during their visit and continue to seek the care they need.”

ADVICE FOR OTHERS

“Patient engagement is incredibly important, but it’s not the sole consideration,” Johnson advised. “Think about how it impacts your care team. If you can automate engagement and the handling of manual tasks to reduce the burden on your staff while delivering the high caliber of experience that patients expect, everyone wins.”

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.