Given Medicare’s addition of several orthopedic procedures to its fee schedule, an increasingly graying population and a post-COVID effect that has predisposed...
- Special Editions
Crucial Communication With Patient Apps
By: Jared Bilski | Editor-in-Chief
Define your needs, customize your messaging and streamline the information-distribution process.
I loved the text messages you sent out! They were so helpful — it felt like you knew exactly what I wasn’t sure about.
Craig J. Della Valle, MD, chief of adult reconstruction at Midwest Orthopaedics at Rush in Chicago, hears some variation of the above message a lot from satisfied patients. That sentiment — and the reduction in phone calls from patients asking the same questions over and over of busy surgical professionals — makes all the effort Dr. Della Valle and his team put into customizing the text messaging platform they use well worth it.
“The text messaging allows us to communicate with patients and preemptively answer their common frequently asked questions — and it’s decreased the number of phone calls our staff fields,” says Dr. Della Valle. “But it’s definitely required some effort from surgeons and staff.”
Logistical game changer
Communication app platforms that automatically push out crucial reminders, updates, instructions, FAQs and more at every phase of the perioperative journey are often critical for any high-volume facility — especially those in the GI space. Take the Sansum Clinic, for instance. The Santa Barbara, Calif., facility does more than 800 colonoscopies each month. Without the ability to send automated — but customized — messages to those colonoscopy patients leading up to their procedures, who knows how many hours front-desk staff would spend reminding patients of upcoming appointments and prep protocols, or answering questions about medication interactions or other concerns? Instead, the Clinic leans heavily on a text messaging platform that reaches patients at four critical points leading up to their procedures. “It’s an efficient way to get direct messaging out,” says Adelina Gonzales, RN, the RN manager ambulatory surgery center/gastroenterology department for Sansum Clinic.
Dr. Della Valle and Ms. Gonzales shared how they use text messaging at their respective facilities and offer insight into how you can get the most out of whatever patient communication app platform you use:
• Define your purpose. While both Dr. Della Valle and Ms. Gonzales rely on text messages to communicate with patients, they do so in different phases of the perioperative journey. Ms. Gonzales’ facility focuses on pre-procedure reminders, pushing the first text message out as soon as patients schedule an appointment. Point of contact number two takes place three weeks prior to the procedure and covers instructions and details on the bowel prep prescription, including the pharmacy that is mailing the cost-free prescription and its contact info.
During the height of pandemic, surgical facilities were still performing critical elective procedures (except for during the shutdown) — and that meant ensuring the patients who came in for surgery tested negative for COVID-19.
Against this backdrop, Sansum Clinic in Santa Barbara, Calif., tapped into yet another use for its text messaging. Adelina Gonzales, RN, the RN manager ambulatory surgery center/gastroenterology department at Sansum, says it had patients use its messaging platform to send a picture of a negative COVID-19 test before coming in. It’s yet another example of the many ways technology can make life easier for providers and patients alike.
The final two text messages that patients receive are reminders that occur five days and three days before the patient’s colonoscopy, respectively.
The Clinic arrived at this timeline through trial and error, says Ms. Gonzales. “Originally we were sending out messages seven, five, three and one day before the procedure, but it was too much,” she says. “Then we spaced it out and changed the timing.” While Ms. Gonzales says around 75% of patients love the convenience of the text messages they receive, there is a small segment of mostly older patients who aren’t fans. In these cases, patients opt for phone calls and direct mail instructions on bowel prep.
On the other side of the spectrum, Dr. Della Valle’s patients receive their messages postoperatively.
“Patients will get texts with instructions like, ‘Post-op Day: Keep leg elevated with three, four or five pillows,’ or simple nudges on the importance of taking it easy even if there’s no pain,” he says. “The idea of the post-text is to reassure and remind.”
• Customization is king. Platforms that push text messages, videos or automated phone calls to patients are meant to make busy staffers’ lives easier in the long run, but virtually all these platforms require some legwork on the back end in terms of customization. This is paramount to the success of your automated communication efforts, stresses Dr. Della Valle.
“This crucial early part of the process does require some effort on the part of the surgeon,” he says.
“Surgeon champions are key. You need their input because if the template doesn’t work for the surgeon, it’s not going to work for your practice.” For Dr. Della Valle’s patients, that process entailed determining what post-op information to push out, what exercises they should be doing and help with processes like changing bandages. “You need to map out what info you want patients to receive and when you want them to receive it,” he says. Without a clear picture of all the messaging your platform is pushing out, patients wind up receiving information that’s not consistent with your own practices and ultimately wind up doing more harm than good. A few examples Dr. Della Valle cites include sending out two-week post-op appointment reminders when your center doesn’t require such a visit or, for hip replacements, pushing texts on posterior hip precautions when such instructions aren’t a part of the recovery plan.
Ms. Gonzales is also a big proponent of tailored information. “Our text messaging platform is customizable. That’s the beauty of it,” she says, adding that her IT team was able to create custom templates and phrases that allowed her to push out universal standard messaging quickly without any typing. “It takes around five minutes to send out messages for the four doctors we have here,” says Ms. Gonzales, adding that all she needs to add is the language and phone number. That’s another benefit facilities will want to look for in a prospective communication platform — text messaging in multiple languages. “One feature that patients really appreciate is the ability to receive messages in their own language — whether it’s Spanish or Russian,” says Ms. Gonzales.
Sometimes, however, a question is beyond the scope of an automated message. In these cases, Ms. Gonzales simply looks at the patient’s messages and responds to the clinical front desk. For instance, a patient may question whether they can continue taking their blood pressure medication or voice concerns over how they’re feeling during the prep process. “There are situations that warrant more direct communication,” says Ms. Gonzales, who like many ASC leaders comes from a clinical background. “If a patient says they’re feeling nauseous, I’m able to respond and say, ‘OK, slow it down’ or ‘try drinking through a straw.’”
You need to map out what info you want patients to receive and when you want them to receive it.
Craig J. Della Valle, MD
• Education is everything. Like most major initiatives, launching a patient communication app platform hinges on total team buy-in and involvement. “A really big thing is making sure staff has a full understanding of the app or system,” says Dr. Della Valle. “Sit the whole team down and make sure they really get it — in the long run, this will save time and increase patient satisfaction.”
For most surgical facilities, improvements in those two areas — time management and patient satisfaction — are prime reasons to invest in communication app platforms in the first place. OSM
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